|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
IP
|
$12,063.19
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,395.98 |
| Max. Negotiated Rate |
$10,856.87 |
| Rate for Payer: Aetna Commercial |
$10,253.71
|
| Rate for Payer: BCBS Trust/PPO |
$9,962.99
|
| Rate for Payer: BCN Commercial |
$9,962.99
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cofinity Commercial |
$10,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,650.55
|
| Rate for Payer: Healthscope Commercial |
$10,856.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,047.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,253.71
|
| Rate for Payer: Nomi Health Commercial |
$9,891.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,047.39
|
| Rate for Payer: PHP Commercial |
$10,253.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,494.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,395.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,615.61
|
| Rate for Payer: UHC Core |
$10,072.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,047.39
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
OP
|
$12,063.19
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,126.74 |
| Max. Negotiated Rate |
$10,856.87 |
| Rate for Payer: Aetna Commercial |
$10,253.71
|
| Rate for Payer: Aetna Medicare |
$3,136.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,769.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,769.75
|
| Rate for Payer: BCBS Complete |
$2,232.90
|
| Rate for Payer: BCBS MAPPO |
$3,015.80
|
| Rate for Payer: BCBS Trust/PPO |
$9,917.15
|
| Rate for Payer: BCN Commercial |
$9,917.15
|
| Rate for Payer: BCN Medicare Advantage |
$3,015.80
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cofinity Commercial |
$10,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,650.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,015.80
|
| Rate for Payer: Healthscope Commercial |
$10,856.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,047.39
|
| Rate for Payer: Mclaren Medicaid |
$2,126.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,166.59
|
| Rate for Payer: Meridian Medicaid |
$2,232.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,468.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,317.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,253.71
|
| Rate for Payer: Nomi Health Commercial |
$9,891.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,047.39
|
| Rate for Payer: PACE Senior Care Partners |
$2,865.01
|
| Rate for Payer: PACE SWMI |
$3,015.80
|
| Rate for Payer: PHP Commercial |
$10,253.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,015.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,126.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,494.98
|
| Rate for Payer: Priority Health Medicare |
$3,045.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,395.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,015.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,615.61
|
| Rate for Payer: UHC Core |
$10,072.76
|
| Rate for Payer: UHC Exchange |
$3,015.80
|
| Rate for Payer: UHC Medicaid |
$2,126.74
|
| Rate for Payer: UHC Medicare Advantage |
$3,015.80
|
| Rate for Payer: UHCCP Medicaid |
$2,126.74
|
| Rate for Payer: VA VA |
$3,015.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,047.39
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
OP
|
$32,044.32
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$32,044.32
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
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 TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
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 REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$13,269.50
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,235.57 |
| Max. Negotiated Rate |
$11,942.55 |
| Rate for Payer: Aetna Commercial |
$11,279.08
|
| Rate for Payer: BCBS Trust/PPO |
$10,959.28
|
| Rate for Payer: BCN Commercial |
$10,959.28
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cofinity Commercial |
$11,411.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,615.60
|
| Rate for Payer: Healthscope Commercial |
$11,942.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,952.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,279.08
|
| Rate for Payer: Nomi Health Commercial |
$10,880.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,952.12
|
| Rate for Payer: PHP Commercial |
$11,279.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,544.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,235.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,677.16
|
| Rate for Payer: UHC Core |
$11,080.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,952.12
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$13,269.50
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,339.41 |
| Max. Negotiated Rate |
$11,942.55 |
| Rate for Payer: Aetna Commercial |
$11,279.08
|
| Rate for Payer: Aetna Medicare |
$3,450.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,146.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,146.72
|
| Rate for Payer: BCBS Complete |
$2,456.18
|
| Rate for Payer: BCBS MAPPO |
$3,317.38
|
| Rate for Payer: BCBS Trust/PPO |
$10,908.86
|
| Rate for Payer: BCN Commercial |
$10,908.86
|
| Rate for Payer: BCN Medicare Advantage |
$3,317.38
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cofinity Commercial |
$11,411.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,615.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,317.38
|
| Rate for Payer: Healthscope Commercial |
$11,942.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,952.12
|
| Rate for Payer: Mclaren Medicaid |
$2,339.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,483.24
|
| Rate for Payer: Meridian Medicaid |
$2,456.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,814.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,649.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,279.08
|
| Rate for Payer: Nomi Health Commercial |
$10,880.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,952.12
|
| Rate for Payer: PACE Senior Care Partners |
$3,151.51
|
| Rate for Payer: PACE SWMI |
$3,317.38
|
| Rate for Payer: PHP Commercial |
$11,279.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,317.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,339.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,544.47
|
| Rate for Payer: Priority Health Medicare |
$3,350.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,235.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,317.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,677.16
|
| Rate for Payer: UHC Core |
$11,080.03
|
| Rate for Payer: UHC Exchange |
$3,317.38
|
| Rate for Payer: UHC Medicaid |
$2,339.41
|
| Rate for Payer: UHC Medicare Advantage |
$3,317.38
|
| Rate for Payer: UHCCP Medicaid |
$2,339.41
|
| Rate for Payer: VA VA |
$3,317.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,952.12
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
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 DES/CABG ADD.
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
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 DES/CABG INITIAL
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 DES/CABG INITIAL
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 REVAS MI/DES
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$21,065.71 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: BCBS Trust/PPO |
$24,997.37
|
| Rate for Payer: BCN Commercial |
$24,997.37
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,332.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,065.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,634.80
|
| Rate for Payer: UHC Core |
$25,272.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,336.04 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: Aetna Medicare |
$7,869.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,458.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,458.38
|
| Rate for Payer: BCBS Complete |
$5,602.39
|
| Rate for Payer: BCBS MAPPO |
$7,566.70
|
| Rate for Payer: BCBS Trust/PPO |
$24,882.35
|
| Rate for Payer: BCN Commercial |
$24,882.35
|
| Rate for Payer: BCN Medicare Advantage |
$7,566.70
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,566.70
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: Mclaren Medicaid |
$5,336.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,945.04
|
| Rate for Payer: Meridian Medicaid |
$5,602.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,701.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,323.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PACE Senior Care Partners |
$7,188.37
|
| Rate for Payer: PACE SWMI |
$7,566.70
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: PHP Medicare Advantage |
$7,566.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,336.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,332.13
|
| Rate for Payer: Priority Health Medicare |
$7,642.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,065.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7,566.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,634.80
|
| Rate for Payer: UHC Core |
$25,272.79
|
| Rate for Payer: UHC Exchange |
$7,566.70
|
| Rate for Payer: UHC Medicaid |
$5,336.04
|
| Rate for Payer: UHC Medicare Advantage |
$7,566.70
|
| Rate for Payer: UHCCP Medicaid |
$5,336.04
|
| Rate for Payer: VA VA |
$7,566.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$21,065.71 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: BCBS Trust/PPO |
$24,997.37
|
| Rate for Payer: BCN Commercial |
$24,997.37
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,332.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,065.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,634.80
|
| Rate for Payer: UHC Core |
$25,272.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,336.04 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: Aetna Medicare |
$7,869.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,458.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,458.38
|
| Rate for Payer: BCBS Complete |
$5,602.39
|
| Rate for Payer: BCBS MAPPO |
$7,566.70
|
| Rate for Payer: BCBS Trust/PPO |
$24,882.35
|
| Rate for Payer: BCN Commercial |
$24,882.35
|
| Rate for Payer: BCN Medicare Advantage |
$7,566.70
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,566.70
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: Mclaren Medicaid |
$5,336.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,945.04
|
| Rate for Payer: Meridian Medicaid |
$5,602.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,701.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,323.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Nomi Health Commercial |
$24,818.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PACE Senior Care Partners |
$7,188.37
|
| Rate for Payer: PACE SWMI |
$7,566.70
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: PHP Medicare Advantage |
$7,566.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,336.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,332.13
|
| Rate for Payer: Priority Health Medicare |
$7,642.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,065.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7,566.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,634.80
|
| Rate for Payer: UHC Core |
$25,272.79
|
| Rate for Payer: UHC Exchange |
$7,566.70
|
| Rate for Payer: UHC Medicaid |
$5,336.04
|
| Rate for Payer: UHC Medicare Advantage |
$7,566.70
|
| Rate for Payer: UHCCP Medicaid |
$5,336.04
|
| Rate for Payer: VA VA |
$7,566.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,375.93 |
| Max. Negotiated Rate |
$14,710.25 |
| Rate for Payer: Aetna Commercial |
$13,893.01
|
| Rate for Payer: BCBS Trust/PPO |
$13,499.10
|
| Rate for Payer: BCN Commercial |
$13,499.10
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Commercial |
$14,056.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Healthscope Commercial |
$14,710.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,258.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Nomi Health Commercial |
$13,402.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: PHP Commercial |
$13,893.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14,219.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,375.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,383.35
|
| Rate for Payer: UHC Core |
$13,647.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,258.54
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,881.57 |
| Max. Negotiated Rate |
$14,710.25 |
| Rate for Payer: Aetna Commercial |
$13,893.01
|
| Rate for Payer: Aetna Medicare |
$4,249.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,107.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,107.73
|
| Rate for Payer: BCBS Complete |
$3,025.41
|
| Rate for Payer: BCBS MAPPO |
$4,086.18
|
| Rate for Payer: BCBS Trust/PPO |
$13,436.99
|
| Rate for Payer: BCN Commercial |
$13,436.99
|
| Rate for Payer: BCN Medicare Advantage |
$4,086.18
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Commercial |
$14,056.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,086.18
|
| Rate for Payer: Healthscope Commercial |
$14,710.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,258.54
|
| Rate for Payer: Mclaren Medicaid |
$2,881.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,290.49
|
| Rate for Payer: Meridian Medicaid |
$3,025.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,699.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,494.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Nomi Health Commercial |
$13,402.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: PACE Senior Care Partners |
$3,881.87
|
| Rate for Payer: PACE SWMI |
$4,086.18
|
| Rate for Payer: PHP Commercial |
$13,893.01
|
| Rate for Payer: PHP Medicare Advantage |
$4,086.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,881.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14,219.91
|
| Rate for Payer: Priority Health Medicare |
$4,127.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,375.93
|
| Rate for Payer: Railroad Medicare Medicare |
$4,086.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,383.35
|
| Rate for Payer: UHC Core |
$13,647.84
|
| Rate for Payer: UHC Exchange |
$4,086.18
|
| Rate for Payer: UHC Medicaid |
$2,881.57
|
| Rate for Payer: UHC Medicare Advantage |
$4,086.18
|
| Rate for Payer: UHCCP Medicaid |
$2,881.57
|
| Rate for Payer: VA VA |
$4,086.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,258.54
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$559.44 |
| Max. Negotiated Rate |
$2,855.90 |
| Rate for Payer: Aetna Commercial |
$2,697.24
|
| Rate for Payer: Aetna Medicare |
$825.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$991.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$991.63
|
| Rate for Payer: BCBS Complete |
$587.36
|
| Rate for Payer: BCBS MAPPO |
$793.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,608.70
|
| Rate for Payer: BCN Commercial |
$2,608.70
|
| Rate for Payer: BCN Medicare Advantage |
$793.30
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Commercial |
$2,728.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$793.30
|
| Rate for Payer: Healthscope Commercial |
$2,855.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.91
|
| Rate for Payer: Mclaren Medicaid |
$559.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$832.97
|
| Rate for Payer: Meridian Medicaid |
$587.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$912.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$872.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Nomi Health Commercial |
$2,602.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: PACE Senior Care Partners |
$753.64
|
| Rate for Payer: PACE SWMI |
$793.30
|
| Rate for Payer: PHP Commercial |
$2,697.24
|
| Rate for Payer: PHP Medicare Advantage |
$793.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,760.70
|
| Rate for Payer: Priority Health Medicare |
$801.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,208.56
|
| Rate for Payer: Railroad Medicare Medicare |
$793.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,792.43
|
| Rate for Payer: UHC Core |
$2,649.64
|
| Rate for Payer: UHC Exchange |
$793.30
|
| Rate for Payer: UHC Medicaid |
$559.44
|
| Rate for Payer: UHC Medicare Advantage |
$793.30
|
| Rate for Payer: UHCCP Medicaid |
$559.44
|
| Rate for Payer: VA VA |
$793.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.91
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,208.56 |
| Max. Negotiated Rate |
$2,855.90 |
| Rate for Payer: Aetna Commercial |
$2,697.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,620.76
|
| Rate for Payer: BCN Commercial |
$2,620.76
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Commercial |
$2,728.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Healthscope Commercial |
$2,855.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Nomi Health Commercial |
$2,602.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: PHP Commercial |
$2,697.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,760.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,208.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,792.43
|
| Rate for Payer: UHC Core |
$2,649.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.91
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,935.33
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,399.00 |
| Max. Negotiated Rate |
$7,141.80 |
| Rate for Payer: Aetna Commercial |
$6,745.03
|
| Rate for Payer: Aetna Medicare |
$2,063.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,479.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,479.79
|
| Rate for Payer: BCBS Complete |
$1,468.83
|
| Rate for Payer: BCBS MAPPO |
$1,983.83
|
| Rate for Payer: BCBS Trust/PPO |
$6,523.63
|
| Rate for Payer: BCN Commercial |
$6,523.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,983.83
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cofinity Commercial |
$6,824.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,348.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,983.83
|
| Rate for Payer: Healthscope Commercial |
$7,141.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,951.50
|
| Rate for Payer: Mclaren Medicaid |
$1,399.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,083.02
|
| Rate for Payer: Meridian Medicaid |
$1,468.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,281.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,182.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,745.03
|
| Rate for Payer: Nomi Health Commercial |
$6,506.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,951.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,884.64
|
| Rate for Payer: PACE SWMI |
$1,983.83
|
| Rate for Payer: PHP Commercial |
$6,745.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,983.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,399.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,903.74
|
| Rate for Payer: Priority Health Medicare |
$2,003.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,522.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,983.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,983.09
|
| Rate for Payer: UHC Core |
$6,626.00
|
| Rate for Payer: UHC Exchange |
$1,983.83
|
| Rate for Payer: UHC Medicaid |
$1,399.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,983.83
|
| Rate for Payer: UHCCP Medicaid |
$1,399.00
|
| Rate for Payer: VA VA |
$1,983.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,951.50
|
|
