|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna Medicare |
$10.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.97
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$10.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.13
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.38
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.38
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Mclaren Medicaid |
$4.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.90
|
| Rate for Payer: Meridian Medicaid |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE Senior Care Partners |
$9.86
|
| Rate for Payer: PACE SWMI |
$10.38
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: Railroad Medicare Medicare |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.38
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$10.38
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: VA VA |
$10.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$19,352.18
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,596.14 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: Aetna Medicare |
$5,031.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,047.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,047.56
|
| Rate for Payer: BCBS Complete |
$7,740.87
|
| Rate for Payer: BCBS MAPPO |
$4,838.04
|
| Rate for Payer: BCBS Trust/PPO |
$15,909.43
|
| Rate for Payer: BCN Commercial |
$15,046.32
|
| Rate for Payer: BCN Medicare Advantage |
$4,838.04
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,838.04
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,079.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,563.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,596.14
|
| Rate for Payer: PACE SWMI |
$4,838.04
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,838.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Medicare |
$4,886.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4,838.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,838.04
|
| Rate for Payer: UHC Exchange |
$4,838.04
|
| Rate for Payer: UHC Medicare Advantage |
$4,838.04
|
| Rate for Payer: VA VA |
$4,838.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$19,352.18
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.92 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: BCBS Trust/PPO |
$15,797.18
|
| Rate for Payer: BCN Commercial |
$14,955.36
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$19,352.18
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,596.14 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: Aetna Medicare |
$5,031.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,047.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,047.56
|
| Rate for Payer: BCBS Complete |
$7,740.87
|
| Rate for Payer: BCBS MAPPO |
$4,838.04
|
| Rate for Payer: BCBS Trust/PPO |
$15,909.43
|
| Rate for Payer: BCN Commercial |
$15,046.32
|
| Rate for Payer: BCN Medicare Advantage |
$4,838.04
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,838.04
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,079.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,563.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,596.14
|
| Rate for Payer: PACE SWMI |
$4,838.04
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,838.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Medicare |
$4,886.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4,838.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,838.04
|
| Rate for Payer: UHC Exchange |
$4,838.04
|
| Rate for Payer: UHC Medicare Advantage |
$4,838.04
|
| Rate for Payer: VA VA |
$4,838.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$19,352.18
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.92 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: BCBS Trust/PPO |
$15,797.18
|
| Rate for Payer: BCN Commercial |
$14,955.36
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,536.70 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna Commercial |
$16,236.62
|
| Rate for Payer: Aetna Medicare |
$4,966.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,969.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,969.34
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS MAPPO |
$4,775.48
|
| Rate for Payer: BCBS Trust/PPO |
$15,703.67
|
| Rate for Payer: BCN Commercial |
$14,851.73
|
| Rate for Payer: BCN Medicare Advantage |
$4,775.48
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,775.48
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,014.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,491.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.62
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: PACE Senior Care Partners |
$4,536.70
|
| Rate for Payer: PACE SWMI |
$4,775.48
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| Rate for Payer: PHP Medicare Advantage |
$4,775.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,618.65
|
| Rate for Payer: Priority Health Medicare |
$4,823.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,798.27
|
| Rate for Payer: Railroad Medicare Medicare |
$4,775.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,809.67
|
| Rate for Payer: UHC Core |
$15,950.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,775.48
|
| Rate for Payer: UHC Exchange |
$4,775.48
|
| Rate for Payer: UHC Medicare Advantage |
$4,775.48
|
| Rate for Payer: VA VA |
$4,775.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,416.24 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna Commercial |
$16,236.62
|
| Rate for Payer: BCBS Trust/PPO |
$15,592.88
|
| Rate for Payer: BCN Commercial |
$14,761.95
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.62
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,618.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,798.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,809.67
|
| Rate for Payer: UHC Core |
$15,950.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,925.17 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$7,581.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,112.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,112.06
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$7,289.65
|
| Rate for Payer: BCBS Trust/PPO |
$23,971.29
|
| Rate for Payer: BCN Commercial |
$22,670.81
|
| Rate for Payer: BCN Medicare Advantage |
$7,289.65
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,289.65
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,654.13
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,383.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PACE Senior Care Partners |
$6,925.17
|
| Rate for Payer: PACE SWMI |
$7,289.65
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$7,289.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO |
$25,367.98
|
| Rate for Payer: Priority Health Medicare |
$7,362.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,536.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,289.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,659.57
|
| Rate for Payer: UHC Core |
$24,347.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,289.65
|
| Rate for Payer: UHC Exchange |
$7,289.65
|
| Rate for Payer: UHC Medicare Advantage |
$7,289.65
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$7,289.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,953.09 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: BCBS Trust/PPO |
$23,802.17
|
| Rate for Payer: BCN Commercial |
$22,533.77
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO |
$25,367.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,536.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,659.57
|
| Rate for Payer: UHC Core |
$24,347.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$31,416.00
|
|
|
Service Code
|
CPT C9764
|
| Hospital Charge Code |
48100124
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,420.40 |
| Max. Negotiated Rate |
$28,274.40 |
| Rate for Payer: Aetna Commercial |
$26,703.60
|
| Rate for Payer: BCBS Trust/PPO |
$25,644.88
|
| Rate for Payer: BCN Commercial |
$24,278.28
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cofinity Commercial |
$27,017.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,132.80
|
| Rate for Payer: Healthscope Commercial |
$28,274.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,562.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,703.60
|
| Rate for Payer: Nomi Health Commercial |
$25,761.12
|
| Rate for Payer: PHP Commercial |
$26,703.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,420.40
|
| Rate for Payer: Priority Health HMO/PPO |
$27,331.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,048.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,646.08
|
| Rate for Payer: UHC Core |
$26,232.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,562.00
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
OP
|
$31,416.00
|
|
|
Service Code
|
CPT C9764
|
| Hospital Charge Code |
48100124
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,461.30 |
| Max. Negotiated Rate |
$28,274.40 |
| Rate for Payer: Aetna Commercial |
$26,703.60
|
| Rate for Payer: Aetna Medicare |
$8,168.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,817.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,817.50
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$7,854.00
|
| Rate for Payer: BCBS Trust/PPO |
$25,827.09
|
| Rate for Payer: BCN Commercial |
$24,425.94
|
| Rate for Payer: BCN Medicare Advantage |
$7,854.00
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cofinity Commercial |
$27,017.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,132.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,854.00
|
| Rate for Payer: Healthscope Commercial |
$28,274.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,562.00
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,246.70
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,032.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,703.60
|
| Rate for Payer: Nomi Health Commercial |
$25,761.12
|
| Rate for Payer: PACE Senior Care Partners |
$7,461.30
|
| Rate for Payer: PACE SWMI |
$7,854.00
|
| Rate for Payer: PHP Commercial |
$26,703.60
|
| Rate for Payer: PHP Medicare Advantage |
$7,854.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,420.40
|
| Rate for Payer: Priority Health HMO/PPO |
$27,331.92
|
| Rate for Payer: Priority Health Medicare |
$7,932.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,048.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7,854.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,646.08
|
| Rate for Payer: UHC Core |
$26,232.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,854.00
|
| Rate for Payer: UHC Exchange |
$7,854.00
|
| Rate for Payer: UHC Medicare Advantage |
$7,854.00
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$7,854.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,562.00
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,887.21 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$13,013.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,641.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,641.06
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$12,512.85
|
| Rate for Payer: BCBS Trust/PPO |
$41,147.26
|
| Rate for Payer: BCN Commercial |
$38,914.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,512.85
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,512.85
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,138.49
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,389.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PACE Senior Care Partners |
$11,887.21
|
| Rate for Payer: PACE SWMI |
$12,512.85
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$12,512.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Medicare |
$12,637.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,512.85
|
| Rate for Payer: UHC Exchange |
$12,512.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,512.85
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$12,512.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$32,533.41 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: BCBS Trust/PPO |
$40,856.96
|
| Rate for Payer: BCN Commercial |
$38,679.72
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,887.21 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$13,013.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,641.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,641.06
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$12,512.85
|
| Rate for Payer: BCBS Trust/PPO |
$41,147.26
|
| Rate for Payer: BCN Commercial |
$38,914.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,512.85
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,512.85
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,138.49
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,389.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PACE Senior Care Partners |
$11,887.21
|
| Rate for Payer: PACE SWMI |
$12,512.85
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$12,512.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Medicare |
$12,637.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,512.85
|
| Rate for Payer: UHC Exchange |
$12,512.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,512.85
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$12,512.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$32,533.41 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: BCBS Trust/PPO |
$40,856.96
|
| Rate for Payer: BCN Commercial |
$38,679.72
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$32,533.41 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: BCBS Trust/PPO |
$40,856.96
|
| Rate for Payer: BCN Commercial |
$38,679.72
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,887.21 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$13,013.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,641.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,641.06
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$12,512.85
|
| Rate for Payer: BCBS Trust/PPO |
$41,147.26
|
| Rate for Payer: BCN Commercial |
$38,914.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,512.85
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,512.85
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,138.49
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,389.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PACE Senior Care Partners |
$11,887.21
|
| Rate for Payer: PACE SWMI |
$12,512.85
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$12,512.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Medicare |
$12,637.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,512.85
|
| Rate for Payer: UHC Exchange |
$12,512.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,512.85
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$12,512.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
IP
|
$11,826.66
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,687.33 |
| Max. Negotiated Rate |
$10,643.99 |
| Rate for Payer: Aetna Commercial |
$10,052.66
|
| Rate for Payer: BCBS Trust/PPO |
$9,654.10
|
| Rate for Payer: BCN Commercial |
$9,139.64
|
| Rate for Payer: Cash Price |
$9,461.33
|
| Rate for Payer: Cofinity Commercial |
$10,170.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,461.33
|
| Rate for Payer: Healthscope Commercial |
$10,643.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,870.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,052.66
|
| Rate for Payer: Nomi Health Commercial |
$9,697.86
|
| Rate for Payer: PHP Commercial |
$10,052.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,687.33
|
| Rate for Payer: Priority Health HMO/PPO |
$10,289.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,923.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,407.46
|
| Rate for Payer: UHC Core |
$9,875.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,870.00
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
OP
|
$11,826.66
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,808.83 |
| Max. Negotiated Rate |
$13,357.09 |
| Rate for Payer: Aetna Commercial |
$10,052.66
|
| Rate for Payer: Aetna Medicare |
$3,074.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,695.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,695.83
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$2,956.66
|
| Rate for Payer: BCBS Trust/PPO |
$9,722.70
|
| Rate for Payer: BCN Commercial |
$9,195.23
|
| Rate for Payer: BCN Medicare Advantage |
$2,956.66
|
| Rate for Payer: Cash Price |
$9,461.33
|
| Rate for Payer: Cash Price |
$9,461.33
|
| Rate for Payer: Cofinity Commercial |
$10,170.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,461.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,956.66
|
| Rate for Payer: Healthscope Commercial |
$10,643.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,870.00
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,104.50
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,400.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,052.66
|
| Rate for Payer: Nomi Health Commercial |
$9,697.86
|
| Rate for Payer: PACE Senior Care Partners |
$2,808.83
|
| Rate for Payer: PACE SWMI |
$2,956.66
|
| Rate for Payer: PHP Commercial |
$10,052.66
|
| Rate for Payer: PHP Medicare Advantage |
$2,956.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,687.33
|
| Rate for Payer: Priority Health HMO/PPO |
$10,289.19
|
| Rate for Payer: Priority Health Medicare |
$2,986.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,923.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,956.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,407.46
|
| Rate for Payer: UHC Core |
$9,875.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,956.66
|
| Rate for Payer: UHC Exchange |
$2,956.66
|
| Rate for Payer: UHC Medicare Advantage |
$2,956.66
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$2,956.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,870.00
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
OP
|
$31,416.00
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,461.30 |
| Max. Negotiated Rate |
$28,274.40 |
| Rate for Payer: Aetna Commercial |
$26,703.60
|
| Rate for Payer: Aetna Medicare |
$8,168.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,817.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,817.50
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$7,854.00
|
| Rate for Payer: BCBS Trust/PPO |
$25,827.09
|
| Rate for Payer: BCN Commercial |
$24,425.94
|
| Rate for Payer: BCN Medicare Advantage |
$7,854.00
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cofinity Commercial |
$27,017.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,132.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,854.00
|
| Rate for Payer: Healthscope Commercial |
$28,274.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,562.00
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,246.70
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,032.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,703.60
|
| Rate for Payer: Nomi Health Commercial |
$25,761.12
|
| Rate for Payer: PACE Senior Care Partners |
$7,461.30
|
| Rate for Payer: PACE SWMI |
$7,854.00
|
| Rate for Payer: PHP Commercial |
$26,703.60
|
| Rate for Payer: PHP Medicare Advantage |
$7,854.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,420.40
|
| Rate for Payer: Priority Health HMO/PPO |
$27,331.92
|
| Rate for Payer: Priority Health Medicare |
$7,932.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,048.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7,854.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,646.08
|
| Rate for Payer: UHC Core |
$26,232.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,854.00
|
| Rate for Payer: UHC Exchange |
$7,854.00
|
| Rate for Payer: UHC Medicare Advantage |
$7,854.00
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$7,854.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,562.00
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$31,416.00
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,420.40 |
| Max. Negotiated Rate |
$28,274.40 |
| Rate for Payer: Aetna Commercial |
$26,703.60
|
| Rate for Payer: BCBS Trust/PPO |
$25,644.88
|
| Rate for Payer: BCN Commercial |
$24,278.28
|
| Rate for Payer: Cash Price |
$25,132.80
|
| Rate for Payer: Cofinity Commercial |
$27,017.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,132.80
|
| Rate for Payer: Healthscope Commercial |
$28,274.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,562.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,703.60
|
| Rate for Payer: Nomi Health Commercial |
$25,761.12
|
| Rate for Payer: PHP Commercial |
$26,703.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,420.40
|
| Rate for Payer: Priority Health HMO/PPO |
$27,331.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,048.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,646.08
|
| Rate for Payer: UHC Core |
$26,232.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,562.00
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,887.21 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$13,013.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,641.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,641.06
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$12,512.85
|
| Rate for Payer: BCBS Trust/PPO |
$41,147.26
|
| Rate for Payer: BCN Commercial |
$38,914.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,512.85
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,512.85
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,138.49
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,389.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PACE Senior Care Partners |
$11,887.21
|
| Rate for Payer: PACE SWMI |
$12,512.85
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$12,512.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Medicare |
$12,637.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,512.85
|
| Rate for Payer: UHC Exchange |
$12,512.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,512.85
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$12,512.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$32,533.41 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: BCBS Trust/PPO |
$40,856.96
|
| Rate for Payer: BCN Commercial |
$38,679.72
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,887.21 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$13,013.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,641.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,641.06
|
| Rate for Payer: BCBS Complete |
$13,357.09
|
| Rate for Payer: BCBS MAPPO |
$12,512.85
|
| Rate for Payer: BCBS Trust/PPO |
$41,147.26
|
| Rate for Payer: BCN Commercial |
$38,914.96
|
| Rate for Payer: BCN Medicare Advantage |
$12,512.85
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,512.85
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$12,720.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,138.49
|
| Rate for Payer: Meridian Medicaid |
$13,357.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,389.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PACE Senior Care Partners |
$11,887.21
|
| Rate for Payer: PACE SWMI |
$12,512.85
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$12,512.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,720.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Medicare |
$12,637.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12,512.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,512.85
|
| Rate for Payer: UHC Exchange |
$12,512.85
|
| Rate for Payer: UHC Medicare Advantage |
$12,512.85
|
| Rate for Payer: UHCCP Medicaid |
$12,720.20
|
| Rate for Payer: VA VA |
$12,512.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$32,533.41 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: BCBS Trust/PPO |
$40,856.96
|
| Rate for Payer: BCN Commercial |
$38,679.72
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$41,042.15
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO |
$43,544.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33,534.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,045.23
|
| Rate for Payer: UHC Core |
$41,792.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
