|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,789.77 |
| Max. Negotiated Rate |
$3,862.76 |
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,503.52
|
| Rate for Payer: BCN Commercial |
$3,316.82
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO |
$3,734.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,776.92
|
| Rate for Payer: UHC Core |
$3,583.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,019.34 |
| Max. Negotiated Rate |
$3,862.76 |
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: Aetna Medicare |
$1,115.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,341.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,341.23
|
| Rate for Payer: BCBS Complete |
$1,215.03
|
| Rate for Payer: BCBS MAPPO |
$1,072.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,528.41
|
| Rate for Payer: BCN Commercial |
$3,336.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.99
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.99
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Mclaren Medicaid |
$1,157.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,126.64
|
| Rate for Payer: Meridian Medicaid |
$1,215.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,233.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,019.34
|
| Rate for Payer: PACE SWMI |
$1,072.99
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO |
$3,734.00
|
| Rate for Payer: Priority Health Medicare |
$1,083.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,072.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,776.92
|
| Rate for Payer: UHC Core |
$3,583.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.99
|
| Rate for Payer: UHC Exchange |
$1,072.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.99
|
| Rate for Payer: UHCCP Medicaid |
$1,157.10
|
| Rate for Payer: VA VA |
$1,072.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,380.83 |
| Max. Negotiated Rate |
$5,232.60 |
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: Aetna Medicare |
$1,511.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,816.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,816.88
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$1,453.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,779.69
|
| Rate for Payer: BCN Commercial |
$4,520.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,453.50
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,453.50
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,526.17
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,671.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,380.83
|
| Rate for Payer: PACE SWMI |
$1,453.50
|
| Rate for Payer: PHP Commercial |
$4,941.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,453.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: Priority Health HMO/PPO |
$5,058.18
|
| Rate for Payer: Priority Health Medicare |
$1,468.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,895.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,453.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,116.32
|
| Rate for Payer: UHC Core |
$4,854.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,453.50
|
| Rate for Payer: UHC Exchange |
$1,453.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,453.50
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$1,453.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,779.10 |
| Max. Negotiated Rate |
$5,232.60 |
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: BCBS Trust/PPO |
$4,745.97
|
| Rate for Payer: BCN Commercial |
$4,493.06
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| Rate for Payer: PHP Commercial |
$4,941.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: Priority Health HMO/PPO |
$5,058.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,895.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,116.32
|
| Rate for Payer: UHC Core |
$4,854.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,175.58 |
| Max. Negotiated Rate |
$4,396.96 |
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,988.04
|
| Rate for Payer: BCN Commercial |
$3,775.52
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,250.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,273.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,299.25
|
| Rate for Payer: UHC Core |
$4,079.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,160.31 |
| Max. Negotiated Rate |
$4,396.96 |
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: Aetna Medicare |
$1,270.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,526.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,526.72
|
| Rate for Payer: BCBS Complete |
$2,762.96
|
| Rate for Payer: BCBS MAPPO |
$1,221.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,016.38
|
| Rate for Payer: BCN Commercial |
$3,798.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,221.38
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,221.38
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Mclaren Medicaid |
$2,631.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,282.45
|
| Rate for Payer: Meridian Medicaid |
$2,762.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,404.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,160.31
|
| Rate for Payer: PACE SWMI |
$1,221.38
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,221.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,631.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,250.39
|
| Rate for Payer: Priority Health Medicare |
$1,233.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,273.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,221.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,299.25
|
| Rate for Payer: UHC Core |
$4,079.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,221.38
|
| Rate for Payer: UHC Exchange |
$1,221.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,221.38
|
| Rate for Payer: UHCCP Medicaid |
$2,631.21
|
| Rate for Payer: VA VA |
$1,221.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$174.52 |
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: BCBS Trust/PPO |
$158.29
|
| Rate for Payer: BCN Commercial |
$149.85
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO |
$168.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.64
|
| Rate for Payer: UHC Core |
$161.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$46.05 |
| Max. Negotiated Rate |
$174.52 |
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna Medicare |
$50.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.60
|
| Rate for Payer: BCBS Complete |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$159.41
|
| Rate for Payer: BCN Commercial |
$150.77
|
| Rate for Payer: BCN Medicare Advantage |
$48.48
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.48
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.90
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PACE Senior Care Partners |
$46.05
|
| Rate for Payer: PACE SWMI |
$48.48
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO |
$168.70
|
| Rate for Payer: Priority Health Medicare |
$48.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.92
|
| Rate for Payer: Railroad Medicare Medicare |
$48.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.64
|
| Rate for Payer: UHC Core |
$161.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.48
|
| Rate for Payer: UHC Exchange |
$48.48
|
| Rate for Payer: UHC Medicare Advantage |
$48.48
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$48.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,001.05 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: Aetna Medicare |
$1,095.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,317.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,317.17
|
| Rate for Payer: BCBS Complete |
$1,685.98
|
| Rate for Payer: BCBS MAPPO |
$1,053.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,465.12
|
| Rate for Payer: BCN Commercial |
$3,277.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.74
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.74
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,106.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,211.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: PACE Senior Care Partners |
$1,001.05
|
| Rate for Payer: PACE SWMI |
$1,053.74
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,667.02
|
| Rate for Payer: Priority Health Medicare |
$1,064.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,824.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,709.16
|
| Rate for Payer: UHC Core |
$3,519.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,053.74
|
| Rate for Payer: UHC Exchange |
$1,053.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,053.74
|
| Rate for Payer: VA VA |
$1,053.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
IP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,739.72 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,440.67
|
| Rate for Payer: BCN Commercial |
$3,257.32
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,667.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,824.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,709.16
|
| Rate for Payer: UHC Core |
$3,519.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,067.46 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,340.56
|
| Rate for Payer: BCN Commercial |
$1,269.12
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.03 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna Medicare |
$426.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$513.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$513.20
|
| Rate for Payer: BCBS Complete |
$1,179.37
|
| Rate for Payer: BCBS MAPPO |
$410.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,350.09
|
| Rate for Payer: BCN Commercial |
$1,276.84
|
| Rate for Payer: BCN Medicare Advantage |
$410.56
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.56
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Mclaren Medicaid |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.09
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$472.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PACE Senior Care Partners |
$390.03
|
| Rate for Payer: PACE SWMI |
$410.56
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: PHP Medicare Advantage |
$410.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,123.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Medicare |
$414.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: Railroad Medicare Medicare |
$410.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.56
|
| Rate for Payer: UHC Exchange |
$410.56
|
| Rate for Payer: UHC Medicare Advantage |
$410.56
|
| Rate for Payer: UHCCP Medicaid |
$1,123.14
|
| Rate for Payer: VA VA |
$410.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
IP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$43,395.61 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: BCBS Trust/PPO |
$54,498.20
|
| Rate for Payer: BCN Commercial |
$51,594.04
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: Nomi Health Commercial |
$54,745.23
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health HMO/PPO |
$58,083.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44,730.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,750.97
|
| Rate for Payer: UHC Core |
$55,746.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
OP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,856.09 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna Medicare |
$17,358.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,863.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,863.27
|
| Rate for Payer: BCBS Complete |
$26,704.99
|
| Rate for Payer: BCBS MAPPO |
$16,690.62
|
| Rate for Payer: BCBS Trust/PPO |
$54,885.43
|
| Rate for Payer: BCN Commercial |
$51,907.82
|
| Rate for Payer: BCN Medicare Advantage |
$16,690.62
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,690.62
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,525.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,194.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: Nomi Health Commercial |
$54,745.23
|
| Rate for Payer: PACE Senior Care Partners |
$15,856.09
|
| Rate for Payer: PACE SWMI |
$16,690.62
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: PHP Medicare Advantage |
$16,690.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health HMO/PPO |
$58,083.35
|
| Rate for Payer: Priority Health Medicare |
$16,857.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44,730.85
|
| Rate for Payer: Railroad Medicare Medicare |
$16,690.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,750.97
|
| Rate for Payer: UHC Core |
$55,746.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,690.62
|
| Rate for Payer: UHC Exchange |
$16,690.62
|
| Rate for Payer: UHC Medicare Advantage |
$16,690.62
|
| Rate for Payer: VA VA |
$16,690.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
OP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,114.80 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna Medicare |
$16,546.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,887.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,887.90
|
| Rate for Payer: BCBS Complete |
$25,456.51
|
| Rate for Payer: BCBS MAPPO |
$15,910.32
|
| Rate for Payer: BCBS Trust/PPO |
$52,319.49
|
| Rate for Payer: BCN Commercial |
$49,481.09
|
| Rate for Payer: BCN Medicare Advantage |
$15,910.32
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,910.32
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,705.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,296.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: Nomi Health Commercial |
$52,185.84
|
| Rate for Payer: PACE Senior Care Partners |
$15,114.80
|
| Rate for Payer: PACE SWMI |
$15,910.32
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: PHP Medicare Advantage |
$15,910.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health HMO/PPO |
$55,367.90
|
| Rate for Payer: Priority Health Medicare |
$16,069.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42,639.65
|
| Rate for Payer: Railroad Medicare Medicare |
$15,910.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,004.32
|
| Rate for Payer: UHC Core |
$53,140.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,910.32
|
| Rate for Payer: UHC Exchange |
$15,910.32
|
| Rate for Payer: UHC Medicare Advantage |
$15,910.32
|
| Rate for Payer: VA VA |
$15,910.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
IP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$41,366.83 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: BCBS Trust/PPO |
$51,950.37
|
| Rate for Payer: BCN Commercial |
$49,181.97
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: Nomi Health Commercial |
$52,185.84
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health HMO/PPO |
$55,367.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42,639.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,004.32
|
| Rate for Payer: UHC Core |
$53,140.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
OP
|
$69,883.67
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,597.37 |
| Max. Negotiated Rate |
$62,895.30 |
| Rate for Payer: Aetna Commercial |
$59,401.12
|
| Rate for Payer: Aetna Medicare |
$18,169.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,838.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,838.65
|
| Rate for Payer: BCBS Complete |
$27,953.47
|
| Rate for Payer: BCBS MAPPO |
$17,470.92
|
| Rate for Payer: BCBS Trust/PPO |
$57,451.37
|
| Rate for Payer: BCN Commercial |
$54,334.55
|
| Rate for Payer: BCN Medicare Advantage |
$17,470.92
|
| Rate for Payer: Cash Price |
$55,906.94
|
| Rate for Payer: Cofinity Commercial |
$60,099.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55,906.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,470.92
|
| Rate for Payer: Healthscope Commercial |
$62,895.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52,412.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,344.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,091.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,401.12
|
| Rate for Payer: Nomi Health Commercial |
$57,304.61
|
| Rate for Payer: PACE Senior Care Partners |
$16,597.37
|
| Rate for Payer: PACE SWMI |
$17,470.92
|
| Rate for Payer: PHP Commercial |
$59,401.12
|
| Rate for Payer: PHP Medicare Advantage |
$17,470.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,424.39
|
| Rate for Payer: Priority Health HMO/PPO |
$60,798.79
|
| Rate for Payer: Priority Health Medicare |
$17,645.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46,822.06
|
| Rate for Payer: Railroad Medicare Medicare |
$17,470.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,497.63
|
| Rate for Payer: UHC Core |
$58,352.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,470.92
|
| Rate for Payer: UHC Exchange |
$17,470.92
|
| Rate for Payer: UHC Medicare Advantage |
$17,470.92
|
| Rate for Payer: VA VA |
$17,470.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52,412.75
|
|
|
HC REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPR
|
Facility
|
IP
|
$69,883.67
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
48100120
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$45,424.39 |
| Max. Negotiated Rate |
$62,895.30 |
| Rate for Payer: Aetna Commercial |
$59,401.12
|
| Rate for Payer: BCBS Trust/PPO |
$57,046.04
|
| Rate for Payer: BCN Commercial |
$54,006.10
|
| Rate for Payer: Cash Price |
$55,906.94
|
| Rate for Payer: Cofinity Commercial |
$60,099.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55,906.94
|
| Rate for Payer: Healthscope Commercial |
$62,895.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52,412.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59,401.12
|
| Rate for Payer: Nomi Health Commercial |
$57,304.61
|
| Rate for Payer: PHP Commercial |
$59,401.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45,424.39
|
| Rate for Payer: Priority Health HMO/PPO |
$60,798.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46,822.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,497.63
|
| Rate for Payer: UHC Core |
$58,352.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52,412.75
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
OP
|
$60,520.07
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,373.52 |
| Max. Negotiated Rate |
$54,468.06 |
| Rate for Payer: Aetna Commercial |
$51,442.06
|
| Rate for Payer: Aetna Medicare |
$15,735.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,912.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,912.52
|
| Rate for Payer: BCBS Complete |
$24,208.03
|
| Rate for Payer: BCBS MAPPO |
$15,130.02
|
| Rate for Payer: BCBS Trust/PPO |
$49,753.55
|
| Rate for Payer: BCN Commercial |
$47,054.35
|
| Rate for Payer: BCN Medicare Advantage |
$15,130.02
|
| Rate for Payer: Cash Price |
$48,416.06
|
| Rate for Payer: Cofinity Commercial |
$52,047.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,416.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,130.02
|
| Rate for Payer: Healthscope Commercial |
$54,468.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,390.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,886.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,399.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,442.06
|
| Rate for Payer: Nomi Health Commercial |
$49,626.46
|
| Rate for Payer: PACE Senior Care Partners |
$14,373.52
|
| Rate for Payer: PACE SWMI |
$15,130.02
|
| Rate for Payer: PHP Commercial |
$51,442.06
|
| Rate for Payer: PHP Medicare Advantage |
$15,130.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39,338.05
|
| Rate for Payer: Priority Health HMO/PPO |
$52,652.46
|
| Rate for Payer: Priority Health Medicare |
$15,281.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40,548.45
|
| Rate for Payer: Railroad Medicare Medicare |
$15,130.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,257.66
|
| Rate for Payer: UHC Core |
$50,534.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,130.02
|
| Rate for Payer: UHC Exchange |
$15,130.02
|
| Rate for Payer: UHC Medicare Advantage |
$15,130.02
|
| Rate for Payer: VA VA |
$15,130.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,390.05
|
|
|
HC REPLACE AORTIC VALVE PERC FEMORAL ARTERY APPR
|
Facility
|
IP
|
$60,520.07
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
48100117
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$39,338.05 |
| Max. Negotiated Rate |
$54,468.06 |
| Rate for Payer: Aetna Commercial |
$51,442.06
|
| Rate for Payer: BCBS Trust/PPO |
$49,402.53
|
| Rate for Payer: BCN Commercial |
$46,769.91
|
| Rate for Payer: Cash Price |
$48,416.06
|
| Rate for Payer: Cofinity Commercial |
$52,047.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48,416.06
|
| Rate for Payer: Healthscope Commercial |
$54,468.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,390.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51,442.06
|
| Rate for Payer: Nomi Health Commercial |
$49,626.46
|
| Rate for Payer: PHP Commercial |
$51,442.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39,338.05
|
| Rate for Payer: Priority Health HMO/PPO |
$52,652.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40,548.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53,257.66
|
| Rate for Payer: UHC Core |
$50,534.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,390.05
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
OP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,152.41 |
| Max. Negotiated Rate |
$19,524.93 |
| Rate for Payer: Aetna Commercial |
$18,440.21
|
| Rate for Payer: Aetna Medicare |
$5,640.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,779.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,779.49
|
| Rate for Payer: BCBS Complete |
$17,041.15
|
| Rate for Payer: BCBS MAPPO |
$5,423.59
|
| Rate for Payer: BCBS Trust/PPO |
$17,834.94
|
| Rate for Payer: BCN Commercial |
$16,867.37
|
| Rate for Payer: BCN Medicare Advantage |
$5,423.59
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$18,657.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,423.59
|
| Rate for Payer: Healthscope Commercial |
$19,524.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,270.78
|
| Rate for Payer: Mclaren Medicaid |
$16,228.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,694.77
|
| Rate for Payer: Meridian Medicaid |
$17,041.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,237.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: Nomi Health Commercial |
$17,789.38
|
| Rate for Payer: PACE Senior Care Partners |
$5,152.41
|
| Rate for Payer: PACE SWMI |
$5,423.59
|
| Rate for Payer: PHP Commercial |
$18,440.21
|
| Rate for Payer: PHP Medicare Advantage |
$5,423.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,228.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: Priority Health HMO/PPO |
$18,874.10
|
| Rate for Payer: Priority Health Medicare |
$5,477.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,535.23
|
| Rate for Payer: Railroad Medicare Medicare |
$5,423.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,091.05
|
| Rate for Payer: UHC Core |
$18,114.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,423.59
|
| Rate for Payer: UHC Exchange |
$5,423.59
|
| Rate for Payer: UHC Medicare Advantage |
$5,423.59
|
| Rate for Payer: UHCCP Medicaid |
$16,228.60
|
| Rate for Payer: VA VA |
$5,423.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,270.78
|
|
|
HC REPLACE DUAL CHAMBER ICD
|
Facility
|
IP
|
$21,694.37
|
|
|
Service Code
|
CPT 33263
|
| Hospital Charge Code |
36100358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,101.34 |
| Max. Negotiated Rate |
$19,524.93 |
| Rate for Payer: Aetna Commercial |
$18,440.21
|
| Rate for Payer: BCBS Trust/PPO |
$17,709.11
|
| Rate for Payer: BCN Commercial |
$16,765.41
|
| Rate for Payer: Cash Price |
$17,355.50
|
| Rate for Payer: Cofinity Commercial |
$18,657.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,355.50
|
| Rate for Payer: Healthscope Commercial |
$19,524.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,270.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,440.21
|
| Rate for Payer: Nomi Health Commercial |
$17,789.38
|
| Rate for Payer: PHP Commercial |
$18,440.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,101.34
|
| Rate for Payer: Priority Health HMO/PPO |
$18,874.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,535.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,091.05
|
| Rate for Payer: UHC Core |
$18,114.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,270.78
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
IP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,678.70 |
| Max. Negotiated Rate |
$14,785.89 |
| Rate for Payer: Aetna Commercial |
$13,964.45
|
| Rate for Payer: BCBS Trust/PPO |
$13,410.80
|
| Rate for Payer: BCN Commercial |
$12,696.15
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$14,128.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Healthscope Commercial |
$14,785.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,321.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: Nomi Health Commercial |
$13,471.59
|
| Rate for Payer: PHP Commercial |
$13,964.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: Priority Health HMO/PPO |
$14,293.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,007.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,457.32
|
| Rate for Payer: UHC Core |
$13,718.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,321.58
|
|
|
HC REPLACE DUAL CHAMBER PPM
|
Facility
|
OP
|
$16,428.77
|
|
|
Service Code
|
CPT 33228
|
| Hospital Charge Code |
36100355
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,901.83 |
| Max. Negotiated Rate |
$14,785.89 |
| Rate for Payer: Aetna Commercial |
$13,964.45
|
| Rate for Payer: Aetna Medicare |
$4,271.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,133.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,133.99
|
| Rate for Payer: BCBS Complete |
$7,945.28
|
| Rate for Payer: BCBS MAPPO |
$4,107.19
|
| Rate for Payer: BCBS Trust/PPO |
$13,506.09
|
| Rate for Payer: BCN Commercial |
$12,773.37
|
| Rate for Payer: BCN Medicare Advantage |
$4,107.19
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cash Price |
$13,143.02
|
| Rate for Payer: Cofinity Commercial |
$14,128.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,143.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,107.19
|
| Rate for Payer: Healthscope Commercial |
$14,785.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,321.58
|
| Rate for Payer: Mclaren Medicaid |
$7,566.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,312.55
|
| Rate for Payer: Meridian Medicaid |
$7,945.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,723.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,964.45
|
| Rate for Payer: Nomi Health Commercial |
$13,471.59
|
| Rate for Payer: PACE Senior Care Partners |
$3,901.83
|
| Rate for Payer: PACE SWMI |
$4,107.19
|
| Rate for Payer: PHP Commercial |
$13,964.45
|
| Rate for Payer: PHP Medicare Advantage |
$4,107.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,566.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,678.70
|
| Rate for Payer: Priority Health HMO/PPO |
$14,293.03
|
| Rate for Payer: Priority Health Medicare |
$4,148.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,007.28
|
| Rate for Payer: Railroad Medicare Medicare |
$4,107.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,457.32
|
| Rate for Payer: UHC Core |
$13,718.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,107.19
|
| Rate for Payer: UHC Exchange |
$4,107.19
|
| Rate for Payer: UHC Medicare Advantage |
$4,107.19
|
| Rate for Payer: UHCCP Medicaid |
$7,566.43
|
| Rate for Payer: VA VA |
$4,107.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,321.58
|
|
|
HC REPLACEMENT CATH CVAD
|
Facility
|
OP
|
$3,052.33
|
|
|
Service Code
|
CPT 36578
|
| Hospital Charge Code |
36100133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.93 |
| Max. Negotiated Rate |
$2,747.10 |
| Rate for Payer: Aetna Commercial |
$2,594.48
|
| Rate for Payer: Aetna Medicare |
$793.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$953.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$953.85
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$763.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.32
|
| Rate for Payer: BCN Commercial |
$2,373.19
|
| Rate for Payer: BCN Medicare Advantage |
$763.08
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cash Price |
$2,441.86
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,441.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.08
|
| Rate for Payer: Healthscope Commercial |
$2,747.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.25
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.24
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.48
|
| Rate for Payer: Nomi Health Commercial |
$2,502.91
|
| Rate for Payer: PACE Senior Care Partners |
$724.93
|
| Rate for Payer: PACE SWMI |
$763.08
|
| Rate for Payer: PHP Commercial |
$2,594.48
|
| Rate for Payer: PHP Medicare Advantage |
$763.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.01
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.53
|
| Rate for Payer: Priority Health Medicare |
$770.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.06
|
| Rate for Payer: Railroad Medicare Medicare |
$763.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.05
|
| Rate for Payer: UHC Core |
$2,548.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.08
|
| Rate for Payer: UHC Exchange |
$763.08
|
| Rate for Payer: UHC Medicare Advantage |
$763.08
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$763.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.25
|
|
