|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,199.35
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.85 |
| Max. Negotiated Rate |
$1,079.42 |
| Rate for Payer: Aetna Commercial |
$1,019.45
|
| Rate for Payer: Aetna Medicare |
$311.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.80
|
| Rate for Payer: BCBS Complete |
$479.74
|
| Rate for Payer: BCBS MAPPO |
$299.84
|
| Rate for Payer: BCBS Trust/PPO |
$932.49
|
| Rate for Payer: BCN Commercial |
$932.49
|
| Rate for Payer: BCN Medicare Advantage |
$299.84
|
| Rate for Payer: Cash Price |
$959.48
|
| Rate for Payer: Cofinity Commercial |
$1,031.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.84
|
| Rate for Payer: Healthscope Commercial |
$1,079.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$314.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,019.45
|
| Rate for Payer: PACE Senior Care Partners |
$284.85
|
| Rate for Payer: PACE SWMI |
$299.84
|
| Rate for Payer: PHP Commercial |
$1,019.45
|
| Rate for Payer: PHP Medicare Advantage |
$299.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$839.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.43
|
| Rate for Payer: Priority Health Medicare |
$299.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.48
|
| Rate for Payer: Railroad Medicare Medicare |
$299.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.43
|
| Rate for Payer: UHC Core |
$1,001.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.84
|
| Rate for Payer: UHC Medicare Advantage |
$308.83
|
| Rate for Payer: VA VA |
$299.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.51
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,199.35
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$731.48 |
| Max. Negotiated Rate |
$1,079.42 |
| Rate for Payer: Aetna Commercial |
$1,019.45
|
| Rate for Payer: BCBS Trust/PPO |
$926.86
|
| Rate for Payer: BCN Commercial |
$926.86
|
| Rate for Payer: Cash Price |
$959.48
|
| Rate for Payer: Cofinity Commercial |
$1,031.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.48
|
| Rate for Payer: Healthscope Commercial |
$1,079.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,019.45
|
| Rate for Payer: PHP Commercial |
$1,019.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$839.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,043.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.43
|
| Rate for Payer: UHC Core |
$1,001.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.51
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,552.09
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$946.62 |
| Max. Negotiated Rate |
$1,396.88 |
| Rate for Payer: Aetna Commercial |
$1,319.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,199.46
|
| Rate for Payer: BCN Commercial |
$1,199.46
|
| Rate for Payer: Cash Price |
$1,241.67
|
| Rate for Payer: Cofinity Commercial |
$1,334.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.67
|
| Rate for Payer: Healthscope Commercial |
$1,396.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,319.28
|
| Rate for Payer: PHP Commercial |
$1,319.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.84
|
| Rate for Payer: UHC Core |
$1,296.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.07
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,552.09
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.62 |
| Max. Negotiated Rate |
$1,396.88 |
| Rate for Payer: Aetna Commercial |
$1,319.28
|
| Rate for Payer: Aetna Medicare |
$403.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$485.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$485.03
|
| Rate for Payer: BCBS Complete |
$620.84
|
| Rate for Payer: BCBS MAPPO |
$388.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.75
|
| Rate for Payer: BCN Commercial |
$1,206.75
|
| Rate for Payer: BCN Medicare Advantage |
$388.02
|
| Rate for Payer: Cash Price |
$1,241.67
|
| Rate for Payer: Cofinity Commercial |
$1,334.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.02
|
| Rate for Payer: Healthscope Commercial |
$1,396.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$407.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$446.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,319.28
|
| Rate for Payer: PACE Senior Care Partners |
$368.62
|
| Rate for Payer: PACE SWMI |
$388.02
|
| Rate for Payer: PHP Commercial |
$1,319.28
|
| Rate for Payer: PHP Medicare Advantage |
$388.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,086.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,350.32
|
| Rate for Payer: Priority Health Medicare |
$388.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.62
|
| Rate for Payer: Railroad Medicare Medicare |
$388.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.84
|
| Rate for Payer: UHC Core |
$1,296.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.02
|
| Rate for Payer: UHC Medicare Advantage |
$399.66
|
| Rate for Payer: VA VA |
$388.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.07
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,175.42
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$516.66 |
| Max. Negotiated Rate |
$1,957.88 |
| Rate for Payer: Aetna Commercial |
$1,849.11
|
| Rate for Payer: Aetna Medicare |
$565.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$679.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$679.82
|
| Rate for Payer: BCBS Complete |
$870.17
|
| Rate for Payer: BCBS MAPPO |
$543.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.39
|
| Rate for Payer: BCN Commercial |
$1,691.39
|
| Rate for Payer: BCN Medicare Advantage |
$543.86
|
| Rate for Payer: Cash Price |
$1,740.34
|
| Rate for Payer: Cofinity Commercial |
$1,870.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.86
|
| Rate for Payer: Healthscope Commercial |
$1,957.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$571.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$625.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.11
|
| Rate for Payer: PACE Senior Care Partners |
$516.66
|
| Rate for Payer: PACE SWMI |
$543.86
|
| Rate for Payer: PHP Commercial |
$1,849.11
|
| Rate for Payer: PHP Medicare Advantage |
$543.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.62
|
| Rate for Payer: Priority Health Medicare |
$543.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,326.79
|
| Rate for Payer: Railroad Medicare Medicare |
$543.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.37
|
| Rate for Payer: UHC Core |
$1,816.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.86
|
| Rate for Payer: UHC Medicare Advantage |
$560.17
|
| Rate for Payer: VA VA |
$543.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.56
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,175.42
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,326.79 |
| Max. Negotiated Rate |
$1,957.88 |
| Rate for Payer: Aetna Commercial |
$1,849.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.16
|
| Rate for Payer: BCN Commercial |
$1,681.16
|
| Rate for Payer: Cash Price |
$1,740.34
|
| Rate for Payer: Cofinity Commercial |
$1,870.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.34
|
| Rate for Payer: Healthscope Commercial |
$1,957.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.11
|
| Rate for Payer: PHP Commercial |
$1,849.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,326.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.37
|
| Rate for Payer: UHC Core |
$1,816.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.56
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$112.22 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: BCBS Trust/PPO |
$142.20
|
| Rate for Payer: BCN Commercial |
$142.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna Medicare |
$47.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.50
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$46.00
|
| Rate for Payer: BCBS Trust/PPO |
$143.06
|
| Rate for Payer: BCN Commercial |
$143.06
|
| Rate for Payer: BCN Medicare Advantage |
$46.00
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
| Rate for Payer: PACE Senior Care Partners |
$43.70
|
| Rate for Payer: PACE SWMI |
$46.00
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: PHP Medicare Advantage |
$46.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.08
|
| Rate for Payer: Priority Health Medicare |
$46.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.22
|
| Rate for Payer: Railroad Medicare Medicare |
$46.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.00
|
| Rate for Payer: UHC Medicare Advantage |
$47.38
|
| Rate for Payer: VA VA |
$46.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$155.52 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$197.06
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.87 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: Aetna Medicare |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.69
|
| Rate for Payer: BCBS Complete |
$39.76
|
| Rate for Payer: BCBS MAPPO |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$198.26
|
| Rate for Payer: BCN Commercial |
$198.26
|
| Rate for Payer: BCN Medicare Advantage |
$63.75
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.75
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Mclaren Medicaid |
$37.87
|
| Rate for Payer: Meridian Medicaid |
$39.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: PHP Medicare Advantage |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Medicare |
$63.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: Railroad Medicare Medicare |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.75
|
| Rate for Payer: UHC Medicare Advantage |
$65.66
|
| Rate for Payer: VA VA |
$63.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.87 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: Aetna Medicare |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.69
|
| Rate for Payer: BCBS Complete |
$39.76
|
| Rate for Payer: BCBS MAPPO |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$198.26
|
| Rate for Payer: BCN Commercial |
$198.26
|
| Rate for Payer: BCN Medicare Advantage |
$63.75
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.75
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Mclaren Medicaid |
$37.87
|
| Rate for Payer: Meridian Medicaid |
$39.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: PHP Medicare Advantage |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Medicare |
$63.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: Railroad Medicare Medicare |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.75
|
| Rate for Payer: UHC Medicare Advantage |
$65.66
|
| Rate for Payer: VA VA |
$63.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$155.52 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$197.06
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
IP
|
$3,037.66
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,852.67 |
| Max. Negotiated Rate |
$2,733.89 |
| Rate for Payer: Aetna Commercial |
$2,582.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,347.50
|
| Rate for Payer: BCN Commercial |
$2,347.50
|
| Rate for Payer: Cash Price |
$2,430.13
|
| Rate for Payer: Cofinity Commercial |
$2,612.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.13
|
| Rate for Payer: Healthscope Commercial |
$2,733.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,278.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,582.01
|
| Rate for Payer: PHP Commercial |
$2,582.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,642.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,673.14
|
| Rate for Payer: UHC Core |
$2,536.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,278.24
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
OP
|
$3,037.66
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$721.44 |
| Max. Negotiated Rate |
$2,733.89 |
| Rate for Payer: Aetna Commercial |
$2,582.01
|
| Rate for Payer: Aetna Medicare |
$789.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$949.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$949.27
|
| Rate for Payer: BCBS Complete |
$1,215.06
|
| Rate for Payer: BCBS MAPPO |
$759.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,361.78
|
| Rate for Payer: BCN Commercial |
$2,361.78
|
| Rate for Payer: BCN Medicare Advantage |
$759.42
|
| Rate for Payer: Cash Price |
$2,430.13
|
| Rate for Payer: Cofinity Commercial |
$2,612.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,430.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.42
|
| Rate for Payer: Healthscope Commercial |
$2,733.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,278.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$797.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,582.01
|
| Rate for Payer: PACE Senior Care Partners |
$721.44
|
| Rate for Payer: PACE SWMI |
$759.42
|
| Rate for Payer: PHP Commercial |
$2,582.01
|
| Rate for Payer: PHP Medicare Advantage |
$759.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,126.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,642.76
|
| Rate for Payer: Priority Health Medicare |
$759.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,852.67
|
| Rate for Payer: Railroad Medicare Medicare |
$759.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,673.14
|
| Rate for Payer: UHC Core |
$2,536.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.42
|
| Rate for Payer: UHC Medicare Advantage |
$782.20
|
| Rate for Payer: VA VA |
$759.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,278.24
|
|
|
HC ZINC LEVEL
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.41 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$38.10
|
| Rate for Payer: BCN Commercial |
$38.10
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.75
|
| Rate for Payer: Mclaren Medicaid |
$8.41
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.65
|
| Rate for Payer: PACE Senior Care Partners |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.63
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.89
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.12
|
| Rate for Payer: UHC Core |
$40.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Medicare Advantage |
$12.62
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.75
|
|
|
HC ZINC LEVEL
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.89 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: BCBS Trust/PPO |
$37.87
|
| Rate for Payer: BCN Commercial |
$37.87
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.65
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.12
|
| Rate for Payer: UHC Core |
$40.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.75
|
|
|
HC ZINC URINE
|
Facility
|
IP
|
$68.60
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.84 |
| Max. Negotiated Rate |
$61.74 |
| Rate for Payer: Aetna Commercial |
$58.31
|
| Rate for Payer: BCBS Trust/PPO |
$53.01
|
| Rate for Payer: BCN Commercial |
$53.01
|
| Rate for Payer: Cash Price |
$54.88
|
| Rate for Payer: Cofinity Commercial |
$59.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.88
|
| Rate for Payer: Healthscope Commercial |
$61.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.31
|
| Rate for Payer: PHP Commercial |
$58.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.37
|
| Rate for Payer: UHC Core |
$57.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.45
|
|
|
HC ZINC URINE
|
Facility
|
OP
|
$68.60
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.41 |
| Max. Negotiated Rate |
$61.74 |
| Rate for Payer: Aetna Commercial |
$58.31
|
| Rate for Payer: Aetna Medicare |
$17.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.44
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$17.15
|
| Rate for Payer: BCBS Trust/PPO |
$53.34
|
| Rate for Payer: BCN Commercial |
$53.34
|
| Rate for Payer: BCN Medicare Advantage |
$17.15
|
| Rate for Payer: Cash Price |
$54.88
|
| Rate for Payer: Cash Price |
$54.88
|
| Rate for Payer: Cofinity Commercial |
$59.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.15
|
| Rate for Payer: Healthscope Commercial |
$61.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.45
|
| Rate for Payer: Mclaren Medicaid |
$8.41
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.29
|
| Rate for Payer: PACE SWMI |
$17.15
|
| Rate for Payer: PHP Commercial |
$58.31
|
| Rate for Payer: PHP Medicare Advantage |
$17.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.68
|
| Rate for Payer: Priority Health Medicare |
$17.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.37
|
| Rate for Payer: UHC Core |
$57.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.15
|
| Rate for Payer: UHC Medicare Advantage |
$17.66
|
| Rate for Payer: VA VA |
$17.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.45
|
|
|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$857.70
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$203.70 |
| Max. Negotiated Rate |
$771.93 |
| Rate for Payer: Aetna Commercial |
$729.04
|
| Rate for Payer: Aetna Medicare |
$223.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.03
|
| Rate for Payer: BCBS Complete |
$343.08
|
| Rate for Payer: BCBS MAPPO |
$214.42
|
| Rate for Payer: BCBS Trust/PPO |
$666.86
|
| Rate for Payer: BCN Commercial |
$666.86
|
| Rate for Payer: BCN Medicare Advantage |
$214.42
|
| Rate for Payer: Cash Price |
$686.16
|
| Rate for Payer: Cofinity Commercial |
$737.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.42
|
| Rate for Payer: Healthscope Commercial |
$771.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.04
|
| Rate for Payer: PACE Senior Care Partners |
$203.70
|
| Rate for Payer: PACE SWMI |
$214.42
|
| Rate for Payer: PHP Commercial |
$729.04
|
| Rate for Payer: PHP Medicare Advantage |
$214.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$746.20
|
| Rate for Payer: Priority Health Medicare |
$214.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$523.11
|
| Rate for Payer: Railroad Medicare Medicare |
$214.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.78
|
| Rate for Payer: UHC Core |
$716.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.42
|
| Rate for Payer: UHC Medicare Advantage |
$220.86
|
| Rate for Payer: VA VA |
$214.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.28
|
|
|
HC Z INFUSION WIRE
|
Facility
|
IP
|
$857.70
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$523.11 |
| Max. Negotiated Rate |
$771.93 |
| Rate for Payer: Aetna Commercial |
$729.04
|
| Rate for Payer: BCBS Trust/PPO |
$662.83
|
| Rate for Payer: BCN Commercial |
$662.83
|
| Rate for Payer: Cash Price |
$686.16
|
| Rate for Payer: Cofinity Commercial |
$737.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.16
|
| Rate for Payer: Healthscope Commercial |
$771.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$729.04
|
| Rate for Payer: PHP Commercial |
$729.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$746.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$523.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.78
|
| Rate for Payer: UHC Core |
$716.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.28
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
OP
|
$12,880.85
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,059.20 |
| Max. Negotiated Rate |
$11,592.76 |
| Rate for Payer: Aetna Commercial |
$10,948.72
|
| Rate for Payer: Aetna Medicare |
$3,349.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,025.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,025.27
|
| Rate for Payer: BCBS Complete |
$5,152.34
|
| Rate for Payer: BCBS MAPPO |
$3,220.21
|
| Rate for Payer: BCBS Trust/PPO |
$10,014.86
|
| Rate for Payer: BCN Commercial |
$10,014.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,220.21
|
| Rate for Payer: Cash Price |
$10,304.68
|
| Rate for Payer: Cofinity Commercial |
$11,077.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,304.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,220.21
|
| Rate for Payer: Healthscope Commercial |
$11,592.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,660.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,381.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,703.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,948.72
|
| Rate for Payer: PACE Senior Care Partners |
$3,059.20
|
| Rate for Payer: PACE SWMI |
$3,220.21
|
| Rate for Payer: PHP Commercial |
$10,948.72
|
| Rate for Payer: PHP Medicare Advantage |
$3,220.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,016.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,206.34
|
| Rate for Payer: Priority Health Medicare |
$3,220.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,856.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,220.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,335.15
|
| Rate for Payer: UHC Core |
$10,755.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,220.21
|
| Rate for Payer: UHC Medicare Advantage |
$3,316.82
|
| Rate for Payer: VA VA |
$3,220.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,660.64
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
IP
|
$12,880.85
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,856.03 |
| Max. Negotiated Rate |
$11,592.76 |
| Rate for Payer: Aetna Commercial |
$10,948.72
|
| Rate for Payer: BCBS Trust/PPO |
$9,954.32
|
| Rate for Payer: BCN Commercial |
$9,954.32
|
| Rate for Payer: Cash Price |
$10,304.68
|
| Rate for Payer: Cofinity Commercial |
$11,077.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,304.68
|
| Rate for Payer: Healthscope Commercial |
$11,592.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,660.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,948.72
|
| Rate for Payer: PHP Commercial |
$10,948.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,016.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,206.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,856.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,335.15
|
| Rate for Payer: UHC Core |
$10,755.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,660.64
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
IP
|
$322.79
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$196.87 |
| Max. Negotiated Rate |
$290.51 |
| Rate for Payer: Aetna Commercial |
$274.37
|
| Rate for Payer: BCBS Trust/PPO |
$249.45
|
| Rate for Payer: BCN Commercial |
$249.45
|
| Rate for Payer: Cash Price |
$258.23
|
| Rate for Payer: Cofinity Commercial |
$277.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.23
|
| Rate for Payer: Healthscope Commercial |
$290.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.37
|
| Rate for Payer: PHP Commercial |
$274.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.06
|
| Rate for Payer: UHC Core |
$269.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.09
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
OP
|
$322.79
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.66 |
| Max. Negotiated Rate |
$290.51 |
| Rate for Payer: Aetna Commercial |
$274.37
|
| Rate for Payer: Aetna Medicare |
$83.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.87
|
| Rate for Payer: BCBS Complete |
$129.12
|
| Rate for Payer: BCBS MAPPO |
$80.70
|
| Rate for Payer: BCBS Trust/PPO |
$250.97
|
| Rate for Payer: BCN Commercial |
$250.97
|
| Rate for Payer: BCN Medicare Advantage |
$80.70
|
| Rate for Payer: Cash Price |
$258.23
|
| Rate for Payer: Cofinity Commercial |
$277.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.70
|
| Rate for Payer: Healthscope Commercial |
$290.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.37
|
| Rate for Payer: PACE Senior Care Partners |
$76.66
|
| Rate for Payer: PACE SWMI |
$80.70
|
| Rate for Payer: PHP Commercial |
$274.37
|
| Rate for Payer: PHP Medicare Advantage |
$80.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.83
|
| Rate for Payer: Priority Health Medicare |
$80.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.87
|
| Rate for Payer: Railroad Medicare Medicare |
$80.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.06
|
| Rate for Payer: UHC Core |
$269.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.70
|
| Rate for Payer: UHC Medicare Advantage |
$83.12
|
| Rate for Payer: VA VA |
$80.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.09
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
OP
|
$3,701.46
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$879.10 |
| Max. Negotiated Rate |
$3,331.31 |
| Rate for Payer: Aetna Commercial |
$3,146.24
|
| Rate for Payer: Aetna Medicare |
$962.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,156.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,156.71
|
| Rate for Payer: BCBS Complete |
$1,480.58
|
| Rate for Payer: BCBS MAPPO |
$925.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,877.89
|
| Rate for Payer: BCN Commercial |
$2,877.89
|
| Rate for Payer: BCN Medicare Advantage |
$925.36
|
| Rate for Payer: Cash Price |
$2,961.17
|
| Rate for Payer: Cofinity Commercial |
$3,183.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,961.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$925.36
|
| Rate for Payer: Healthscope Commercial |
$3,331.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,776.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$971.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,064.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,146.24
|
| Rate for Payer: PACE Senior Care Partners |
$879.10
|
| Rate for Payer: PACE SWMI |
$925.36
|
| Rate for Payer: PHP Commercial |
$3,146.24
|
| Rate for Payer: PHP Medicare Advantage |
$925.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,591.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,220.27
|
| Rate for Payer: Priority Health Medicare |
$925.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,257.52
|
| Rate for Payer: Railroad Medicare Medicare |
$925.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,257.28
|
| Rate for Payer: UHC Core |
$3,090.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$925.36
|
| Rate for Payer: UHC Medicare Advantage |
$953.13
|
| Rate for Payer: VA VA |
$925.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,776.10
|
|
