|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$636.72
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$443.16 |
| Max. Negotiated Rate |
$573.05 |
| Rate for Payer: Aetna Commercial |
$541.21
|
| Rate for Payer: BCBS Trust/PPO |
$525.87
|
| Rate for Payer: BCN Commercial |
$525.87
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Commercial |
$547.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Healthscope Commercial |
$573.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Nomi Health Commercial |
$522.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: PHP Commercial |
$541.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$553.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$443.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.31
|
| Rate for Payer: UHC Core |
$531.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.54
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$636.72
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$112.25 |
| Max. Negotiated Rate |
$573.05 |
| Rate for Payer: Aetna Commercial |
$541.21
|
| Rate for Payer: Aetna Medicare |
$165.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.97
|
| Rate for Payer: BCBS Complete |
$117.86
|
| Rate for Payer: BCBS MAPPO |
$159.18
|
| Rate for Payer: BCBS Trust/PPO |
$523.45
|
| Rate for Payer: BCN Commercial |
$523.45
|
| Rate for Payer: BCN Medicare Advantage |
$159.18
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Commercial |
$547.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.18
|
| Rate for Payer: Healthscope Commercial |
$573.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.54
|
| Rate for Payer: Mclaren Medicaid |
$112.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.14
|
| Rate for Payer: Meridian Medicaid |
$117.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Nomi Health Commercial |
$522.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: PACE Senior Care Partners |
$151.22
|
| Rate for Payer: PACE SWMI |
$159.18
|
| Rate for Payer: PHP Commercial |
$541.21
|
| Rate for Payer: PHP Medicare Advantage |
$159.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$553.95
|
| Rate for Payer: Priority Health Medicare |
$160.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$443.16
|
| Rate for Payer: Railroad Medicare Medicare |
$159.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$560.31
|
| Rate for Payer: UHC Core |
$531.66
|
| Rate for Payer: UHC Exchange |
$159.18
|
| Rate for Payer: UHC Medicaid |
$112.25
|
| Rate for Payer: UHC Medicare Advantage |
$159.18
|
| Rate for Payer: UHCCP Medicaid |
$112.25
|
| Rate for Payer: VA VA |
$159.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.54
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$19.23
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$17.31 |
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.01
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$4.81
|
| Rate for Payer: BCBS Trust/PPO |
$15.81
|
| Rate for Payer: BCN Commercial |
$15.81
|
| Rate for Payer: BCN Medicare Advantage |
$4.81
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$16.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.81
|
| Rate for Payer: Healthscope Commercial |
$17.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.42
|
| Rate for Payer: Mclaren Medicaid |
$3.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.05
|
| Rate for Payer: Meridian Medicaid |
$3.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Nomi Health Commercial |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: PACE Senior Care Partners |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.81
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.73
|
| Rate for Payer: Priority Health Medicare |
$4.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: Railroad Medicare Medicare |
$4.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.92
|
| Rate for Payer: UHC Core |
$16.06
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHC Medicare Advantage |
$4.81
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: VA VA |
$4.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.42
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$19.23
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$17.31 |
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: BCBS Trust/PPO |
$15.88
|
| Rate for Payer: BCN Commercial |
$15.88
|
| Rate for Payer: Cash Price |
$15.38
|
| Rate for Payer: Cofinity Commercial |
$16.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.38
|
| Rate for Payer: Healthscope Commercial |
$17.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.35
|
| Rate for Payer: Nomi Health Commercial |
$15.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.42
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.92
|
| Rate for Payer: UHC Core |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.42
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$281.22
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.73 |
| Max. Negotiated Rate |
$253.10 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: BCBS Trust/PPO |
$232.26
|
| Rate for Payer: BCN Commercial |
$232.26
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.47
|
| Rate for Payer: UHC Core |
$234.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.91
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$281.22
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.58 |
| Max. Negotiated Rate |
$253.10 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: Aetna Medicare |
$73.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.88
|
| Rate for Payer: BCBS Complete |
$52.05
|
| Rate for Payer: BCBS MAPPO |
$70.31
|
| Rate for Payer: BCBS Trust/PPO |
$231.19
|
| Rate for Payer: BCN Commercial |
$231.19
|
| Rate for Payer: BCN Medicare Advantage |
$70.31
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.31
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.91
|
| Rate for Payer: Mclaren Medicaid |
$49.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.82
|
| Rate for Payer: Meridian Medicaid |
$52.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PACE Senior Care Partners |
$66.79
|
| Rate for Payer: PACE SWMI |
$70.31
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: PHP Medicare Advantage |
$70.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.66
|
| Rate for Payer: Priority Health Medicare |
$71.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.73
|
| Rate for Payer: Railroad Medicare Medicare |
$70.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.47
|
| Rate for Payer: UHC Core |
$234.82
|
| Rate for Payer: UHC Exchange |
$70.31
|
| Rate for Payer: UHC Medicaid |
$49.58
|
| Rate for Payer: UHC Medicare Advantage |
$70.31
|
| Rate for Payer: UHCCP Medicaid |
$49.58
|
| Rate for Payer: VA VA |
$70.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.91
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
IP
|
$42.34
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.47 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: BCBS Trust/PPO |
$34.97
|
| Rate for Payer: BCN Commercial |
$34.97
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.26
|
| Rate for Payer: UHC Core |
$35.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$42.34
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$11.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.23
|
| Rate for Payer: BCBS Complete |
$7.84
|
| Rate for Payer: BCBS MAPPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$34.81
|
| Rate for Payer: BCN Commercial |
$34.81
|
| Rate for Payer: BCN Medicare Advantage |
$10.59
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.59
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$7.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PACE Senior Care Partners |
$10.06
|
| Rate for Payer: PACE SWMI |
$10.59
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$10.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.84
|
| Rate for Payer: Priority Health Medicare |
$10.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.47
|
| Rate for Payer: Railroad Medicare Medicare |
$10.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.26
|
| Rate for Payer: UHC Core |
$35.35
|
| Rate for Payer: UHC Exchange |
$10.59
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.59
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$19,739.22
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,738.50 |
| Max. Negotiated Rate |
$17,765.30 |
| Rate for Payer: Aetna Commercial |
$16,778.34
|
| Rate for Payer: BCBS Trust/PPO |
$16,302.62
|
| Rate for Payer: BCN Commercial |
$16,302.62
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$16,975.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$17,765.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,804.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: PHP Commercial |
$16,778.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,173.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,738.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,370.51
|
| Rate for Payer: UHC Core |
$16,482.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,804.42
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$19,739.22
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,480.02 |
| Max. Negotiated Rate |
$17,765.30 |
| Rate for Payer: Aetna Commercial |
$16,778.34
|
| Rate for Payer: Aetna Medicare |
$5,132.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,168.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,168.51
|
| Rate for Payer: BCBS Complete |
$3,653.73
|
| Rate for Payer: BCBS MAPPO |
$4,934.81
|
| Rate for Payer: BCBS Trust/PPO |
$16,227.61
|
| Rate for Payer: BCN Commercial |
$16,227.61
|
| Rate for Payer: BCN Medicare Advantage |
$4,934.81
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$16,975.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,934.81
|
| Rate for Payer: Healthscope Commercial |
$17,765.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,804.42
|
| Rate for Payer: Mclaren Medicaid |
$3,480.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,181.55
|
| Rate for Payer: Meridian Medicaid |
$3,653.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,675.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,428.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: PACE Senior Care Partners |
$4,688.06
|
| Rate for Payer: PACE SWMI |
$4,934.81
|
| Rate for Payer: PHP Commercial |
$16,778.34
|
| Rate for Payer: PHP Medicare Advantage |
$4,934.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,480.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,173.12
|
| Rate for Payer: Priority Health Medicare |
$4,984.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,738.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4,934.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,370.51
|
| Rate for Payer: UHC Core |
$16,482.25
|
| Rate for Payer: UHC Exchange |
$4,934.81
|
| Rate for Payer: UHC Medicaid |
$3,480.02
|
| Rate for Payer: UHC Medicare Advantage |
$4,934.81
|
| Rate for Payer: UHCCP Medicaid |
$3,480.02
|
| Rate for Payer: VA VA |
$4,934.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,804.42
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$19,739.22
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,480.02 |
| Max. Negotiated Rate |
$17,765.30 |
| Rate for Payer: Aetna Commercial |
$16,778.34
|
| Rate for Payer: Aetna Medicare |
$5,132.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,168.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,168.51
|
| Rate for Payer: BCBS Complete |
$3,653.73
|
| Rate for Payer: BCBS MAPPO |
$4,934.81
|
| Rate for Payer: BCBS Trust/PPO |
$16,227.61
|
| Rate for Payer: BCN Commercial |
$16,227.61
|
| Rate for Payer: BCN Medicare Advantage |
$4,934.81
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$16,975.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,934.81
|
| Rate for Payer: Healthscope Commercial |
$17,765.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,804.42
|
| Rate for Payer: Mclaren Medicaid |
$3,480.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,181.55
|
| Rate for Payer: Meridian Medicaid |
$3,653.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,675.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,428.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: PACE Senior Care Partners |
$4,688.06
|
| Rate for Payer: PACE SWMI |
$4,934.81
|
| Rate for Payer: PHP Commercial |
$16,778.34
|
| Rate for Payer: PHP Medicare Advantage |
$4,934.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,480.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,173.12
|
| Rate for Payer: Priority Health Medicare |
$4,984.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,738.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4,934.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,370.51
|
| Rate for Payer: UHC Core |
$16,482.25
|
| Rate for Payer: UHC Exchange |
$4,934.81
|
| Rate for Payer: UHC Medicaid |
$3,480.02
|
| Rate for Payer: UHC Medicare Advantage |
$4,934.81
|
| Rate for Payer: UHCCP Medicaid |
$3,480.02
|
| Rate for Payer: VA VA |
$4,934.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,804.42
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$19,739.22
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,738.50 |
| Max. Negotiated Rate |
$17,765.30 |
| Rate for Payer: Aetna Commercial |
$16,778.34
|
| Rate for Payer: BCBS Trust/PPO |
$16,302.62
|
| Rate for Payer: BCN Commercial |
$16,302.62
|
| Rate for Payer: Cash Price |
$15,791.38
|
| Rate for Payer: Cofinity Commercial |
$16,975.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,791.38
|
| Rate for Payer: Healthscope Commercial |
$17,765.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,804.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,778.34
|
| Rate for Payer: Nomi Health Commercial |
$16,186.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,804.42
|
| Rate for Payer: PHP Commercial |
$16,778.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,173.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,738.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,370.51
|
| Rate for Payer: UHC Core |
$16,482.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,804.42
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,560.82 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: BCBS Trust/PPO |
$16,091.79
|
| Rate for Payer: BCN Commercial |
$16,091.79
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,435.02 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$5,065.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,088.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,088.73
|
| Rate for Payer: BCBS Complete |
$3,606.48
|
| Rate for Payer: BCBS MAPPO |
$4,870.98
|
| Rate for Payer: BCBS Trust/PPO |
$16,017.75
|
| Rate for Payer: BCN Commercial |
$16,017.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,870.98
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,870.98
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Mclaren Medicaid |
$3,435.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,114.53
|
| Rate for Payer: Meridian Medicaid |
$3,606.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,601.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,358.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Nomi Health Commercial |
$15,976.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PACE Senior Care Partners |
$4,627.44
|
| Rate for Payer: PACE SWMI |
$4,870.98
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,870.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,435.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,951.03
|
| Rate for Payer: Priority Health Medicare |
$4,919.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,560.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4,870.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,145.87
|
| Rate for Payer: UHC Core |
$16,269.09
|
| Rate for Payer: UHC Exchange |
$4,870.98
|
| Rate for Payer: UHC Medicaid |
$3,435.02
|
| Rate for Payer: UHC Medicare Advantage |
$4,870.98
|
| Rate for Payer: UHCCP Medicaid |
$3,435.02
|
| Rate for Payer: VA VA |
$4,870.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,243.47 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$7,732.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,294.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,294.30
|
| Rate for Payer: BCBS Complete |
$5,505.20
|
| Rate for Payer: BCBS MAPPO |
$7,435.44
|
| Rate for Payer: BCBS Trust/PPO |
$24,450.71
|
| Rate for Payer: BCN Commercial |
$24,450.71
|
| Rate for Payer: BCN Medicare Advantage |
$7,435.44
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,435.44
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$5,243.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,807.21
|
| Rate for Payer: Meridian Medicaid |
$5,505.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,550.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,178.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Senior Care Partners |
$7,063.67
|
| Rate for Payer: PACE SWMI |
$7,435.44
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$7,435.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,243.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Medicare |
$7,509.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: Railroad Medicare Medicare |
$7,435.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: UHC Exchange |
$7,435.44
|
| Rate for Payer: UHC Medicaid |
$5,243.47
|
| Rate for Payer: UHC Medicare Advantage |
$7,435.44
|
| Rate for Payer: UHCCP Medicaid |
$5,243.47
|
| Rate for Payer: VA VA |
$7,435.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,700.27 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: BCBS Trust/PPO |
$24,563.73
|
| Rate for Payer: BCN Commercial |
$24,563.73
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$24,388.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,875.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,700.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,172.76
|
| Rate for Payer: UHC Core |
$24,834.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$32,044.32
|
|
|
Service Code
|
CPT C9764
|
| Hospital Charge Code |
48100124
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,302.85 |
| Max. Negotiated Rate |
$28,839.89 |
| Rate for Payer: Aetna Commercial |
$27,237.67
|
| Rate for Payer: BCBS Trust/PPO |
$26,465.40
|
| Rate for Payer: BCN Commercial |
$26,465.40
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cofinity Commercial |
$27,558.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,635.46
|
| Rate for Payer: Healthscope Commercial |
$28,839.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24,033.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,237.67
|
| Rate for Payer: Nomi Health Commercial |
$26,276.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24,033.24
|
| Rate for Payer: PHP Commercial |
$27,237.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27,878.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22,302.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,199.00
|
| Rate for Payer: UHC Core |
$26,757.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24,033.24
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
OP
|
$32,044.32
|
|
|
Service Code
|
CPT C9764
|
| Hospital Charge Code |
48100124
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,649.41 |
| Max. Negotiated Rate |
$28,839.89 |
| Rate for Payer: Aetna Commercial |
$27,237.67
|
| Rate for Payer: Aetna Medicare |
$8,331.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,013.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,013.85
|
| Rate for Payer: BCBS Complete |
$5,931.40
|
| Rate for Payer: BCBS MAPPO |
$8,011.08
|
| Rate for Payer: BCBS Trust/PPO |
$26,343.64
|
| Rate for Payer: BCN Commercial |
$26,343.64
|
| Rate for Payer: BCN Medicare Advantage |
$8,011.08
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cofinity Commercial |
$27,558.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,635.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,011.08
|
| Rate for Payer: Healthscope Commercial |
$28,839.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24,033.24
|
| Rate for Payer: Mclaren Medicaid |
$5,649.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,411.63
|
| Rate for Payer: Meridian Medicaid |
$5,931.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,212.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,812.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,237.67
|
| Rate for Payer: Nomi Health Commercial |
$26,276.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24,033.24
|
| Rate for Payer: PACE Senior Care Partners |
$7,610.53
|
| Rate for Payer: PACE SWMI |
$8,011.08
|
| Rate for Payer: PHP Commercial |
$27,237.67
|
| Rate for Payer: PHP Medicare Advantage |
$8,011.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,649.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27,878.56
|
| Rate for Payer: Priority Health Medicare |
$8,091.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22,302.85
|
| Rate for Payer: Railroad Medicare Medicare |
$8,011.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,199.00
|
| Rate for Payer: UHC Core |
$26,757.01
|
| Rate for Payer: UHC Exchange |
$8,011.08
|
| Rate for Payer: UHC Medicaid |
$5,649.41
|
| Rate for Payer: UHC Medicare Advantage |
$8,011.08
|
| Rate for Payer: UHCCP Medicaid |
$5,649.41
|
| Rate for Payer: VA VA |
$8,011.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24,033.24
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,000.54 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$13,273.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,953.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,953.88
|
| Rate for Payer: BCBS Complete |
$9,449.80
|
| Rate for Payer: BCBS MAPPO |
$12,763.11
|
| Rate for Payer: BCBS Trust/PPO |
$41,970.20
|
| Rate for Payer: BCN Commercial |
$41,970.20
|
| Rate for Payer: BCN Medicare Advantage |
$12,763.11
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,763.11
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$9,000.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,401.26
|
| Rate for Payer: Meridian Medicaid |
$9,449.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,677.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,039.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Senior Care Partners |
$12,124.95
|
| Rate for Payer: PACE SWMI |
$12,763.11
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$12,763.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,000.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Medicare |
$12,890.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12,763.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: UHC Exchange |
$12,763.11
|
| Rate for Payer: UHC Medicaid |
$9,000.54
|
| Rate for Payer: UHC Medicare Advantage |
$12,763.11
|
| Rate for Payer: UHCCP Medicaid |
$9,000.54
|
| Rate for Payer: VA VA |
$12,763.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,532.49 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: BCBS Trust/PPO |
$42,164.20
|
| Rate for Payer: BCN Commercial |
$42,164.20
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,532.49 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: BCBS Trust/PPO |
$42,164.20
|
| Rate for Payer: BCN Commercial |
$42,164.20
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,000.54 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$13,273.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,953.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,953.88
|
| Rate for Payer: BCBS Complete |
$9,449.80
|
| Rate for Payer: BCBS MAPPO |
$12,763.11
|
| Rate for Payer: BCBS Trust/PPO |
$41,970.20
|
| Rate for Payer: BCN Commercial |
$41,970.20
|
| Rate for Payer: BCN Medicare Advantage |
$12,763.11
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,763.11
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$9,000.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,401.26
|
| Rate for Payer: Meridian Medicaid |
$9,449.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,677.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,039.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Senior Care Partners |
$12,124.95
|
| Rate for Payer: PACE SWMI |
$12,763.11
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$12,763.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,000.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Medicare |
$12,890.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12,763.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: UHC Exchange |
$12,763.11
|
| Rate for Payer: UHC Medicaid |
$9,000.54
|
| Rate for Payer: UHC Medicare Advantage |
$12,763.11
|
| Rate for Payer: UHCCP Medicaid |
$9,000.54
|
| Rate for Payer: VA VA |
$12,763.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,000.54 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$13,273.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,953.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,953.88
|
| Rate for Payer: BCBS Complete |
$9,449.80
|
| Rate for Payer: BCBS MAPPO |
$12,763.11
|
| Rate for Payer: BCBS Trust/PPO |
$41,970.20
|
| Rate for Payer: BCN Commercial |
$41,970.20
|
| Rate for Payer: BCN Medicare Advantage |
$12,763.11
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,763.11
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$9,000.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,401.26
|
| Rate for Payer: Meridian Medicaid |
$9,449.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,677.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,039.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Senior Care Partners |
$12,124.95
|
| Rate for Payer: PACE SWMI |
$12,763.11
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$12,763.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,000.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Medicare |
$12,890.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12,763.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: UHC Exchange |
$12,763.11
|
| Rate for Payer: UHC Medicaid |
$9,000.54
|
| Rate for Payer: UHC Medicare Advantage |
$12,763.11
|
| Rate for Payer: UHCCP Medicaid |
$9,000.54
|
| Rate for Payer: VA VA |
$12,763.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,532.49 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: BCBS Trust/PPO |
$42,164.20
|
| Rate for Payer: BCN Commercial |
$42,164.20
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$41,862.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44,415.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,532.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,926.14
|
| Rate for Payer: UHC Core |
$42,628.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
