|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
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 AND ATHERECT
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
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 REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$13,009.31
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,456.05 |
| Max. Negotiated Rate |
$11,708.38 |
| Rate for Payer: Aetna Commercial |
$11,057.91
|
| Rate for Payer: BCBS Trust/PPO |
$10,619.50
|
| Rate for Payer: BCN Commercial |
$10,053.59
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cofinity Commercial |
$11,188.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,407.45
|
| Rate for Payer: Healthscope Commercial |
$11,708.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,756.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,057.91
|
| Rate for Payer: Nomi Health Commercial |
$10,667.63
|
| Rate for Payer: PHP Commercial |
$11,057.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,456.05
|
| Rate for Payer: Priority Health HMO/PPO |
$11,318.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,716.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,448.19
|
| Rate for Payer: UHC Core |
$10,862.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,756.98
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$13,009.31
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,089.71 |
| Max. Negotiated Rate |
$11,708.38 |
| Rate for Payer: Aetna Commercial |
$11,057.91
|
| Rate for Payer: Aetna Medicare |
$3,382.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,065.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,065.41
|
| Rate for Payer: BCBS Complete |
$8,435.67
|
| Rate for Payer: BCBS MAPPO |
$3,252.33
|
| Rate for Payer: BCBS Trust/PPO |
$10,694.95
|
| Rate for Payer: BCN Commercial |
$10,114.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,252.33
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cofinity Commercial |
$11,188.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,407.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,252.33
|
| Rate for Payer: Healthscope Commercial |
$11,708.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,756.98
|
| Rate for Payer: Mclaren Medicaid |
$8,033.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,414.94
|
| Rate for Payer: Meridian Medicaid |
$8,435.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,740.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,057.91
|
| Rate for Payer: Nomi Health Commercial |
$10,667.63
|
| Rate for Payer: PACE Senior Care Partners |
$3,089.71
|
| Rate for Payer: PACE SWMI |
$3,252.33
|
| Rate for Payer: PHP Commercial |
$11,057.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,252.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,033.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,456.05
|
| Rate for Payer: Priority Health HMO/PPO |
$11,318.10
|
| Rate for Payer: Priority Health Medicare |
$3,284.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,716.24
|
| Rate for Payer: Railroad Medicare Medicare |
$3,252.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,448.19
|
| Rate for Payer: UHC Core |
$10,862.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,252.33
|
| Rate for Payer: UHC Exchange |
$3,252.33
|
| Rate for Payer: UHC Medicare Advantage |
$3,252.33
|
| Rate for Payer: UHCCP Medicaid |
$8,033.44
|
| Rate for Payer: VA VA |
$3,252.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,756.98
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
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 DES/CABG ADD.
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
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 DES/CABG INITIAL
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 DES/CABG INITIAL
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
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 REVAS MI/DES
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: BCBS Trust/PPO |
$24,222.36
|
| Rate for Payer: BCN Commercial |
$22,931.56
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO |
$25,815.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,881.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,112.55
|
| Rate for Payer: UHC Core |
$24,777.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,047.42 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$7,715.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,272.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,272.92
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS MAPPO |
$7,418.34
|
| Rate for Payer: BCBS Trust/PPO |
$24,394.46
|
| Rate for Payer: BCN Commercial |
$23,071.03
|
| Rate for Payer: BCN Medicare Advantage |
$7,418.34
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,418.34
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,789.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,531.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PACE Senior Care Partners |
$7,047.42
|
| Rate for Payer: PACE SWMI |
$7,418.34
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: PHP Medicare Advantage |
$7,418.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO |
$25,815.81
|
| Rate for Payer: Priority Health Medicare |
$7,492.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,881.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7,418.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,112.55
|
| Rate for Payer: UHC Core |
$24,777.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,418.34
|
| Rate for Payer: UHC Exchange |
$7,418.34
|
| Rate for Payer: UHC Medicare Advantage |
$7,418.34
|
| Rate for Payer: VA VA |
$7,418.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,047.42 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$7,715.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,272.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,272.92
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS MAPPO |
$7,418.34
|
| Rate for Payer: BCBS Trust/PPO |
$24,394.46
|
| Rate for Payer: BCN Commercial |
$23,071.03
|
| Rate for Payer: BCN Medicare Advantage |
$7,418.34
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,418.34
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,789.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,531.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PACE Senior Care Partners |
$7,047.42
|
| Rate for Payer: PACE SWMI |
$7,418.34
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: PHP Medicare Advantage |
$7,418.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO |
$25,815.81
|
| Rate for Payer: Priority Health Medicare |
$7,492.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,881.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7,418.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,112.55
|
| Rate for Payer: UHC Core |
$24,777.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,418.34
|
| Rate for Payer: UHC Exchange |
$7,418.34
|
| Rate for Payer: UHC Medicare Advantage |
$7,418.34
|
| Rate for Payer: VA VA |
$7,418.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,287.68 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: BCBS Trust/PPO |
$24,222.36
|
| Rate for Payer: BCN Commercial |
$22,931.56
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$24,332.15
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO |
$25,815.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,881.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,112.55
|
| Rate for Payer: UHC Core |
$24,777.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,805.76 |
| Max. Negotiated Rate |
$14,421.82 |
| Rate for Payer: Aetna Commercial |
$13,620.60
|
| Rate for Payer: Aetna Medicare |
$4,166.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,007.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,007.58
|
| Rate for Payer: BCBS Complete |
$4,881.81
|
| Rate for Payer: BCBS MAPPO |
$4,006.06
|
| Rate for Payer: BCBS Trust/PPO |
$13,173.53
|
| Rate for Payer: BCN Commercial |
$12,458.85
|
| Rate for Payer: BCN Medicare Advantage |
$4,006.06
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$13,780.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,006.06
|
| Rate for Payer: Healthscope Commercial |
$14,421.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$4,649.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,206.36
|
| Rate for Payer: Meridian Medicaid |
$4,881.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,606.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: Nomi Health Commercial |
$13,139.88
|
| Rate for Payer: PACE Senior Care Partners |
$3,805.76
|
| Rate for Payer: PACE SWMI |
$4,006.06
|
| Rate for Payer: PHP Commercial |
$13,620.60
|
| Rate for Payer: PHP Medicare Advantage |
$4,006.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,649.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health HMO/PPO |
$13,941.09
|
| Rate for Payer: Priority Health Medicare |
$4,046.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,736.24
|
| Rate for Payer: Railroad Medicare Medicare |
$4,006.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,101.33
|
| Rate for Payer: UHC Core |
$13,380.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,006.06
|
| Rate for Payer: UHC Exchange |
$4,006.06
|
| Rate for Payer: UHC Medicare Advantage |
$4,006.06
|
| Rate for Payer: UHCCP Medicaid |
$4,649.03
|
| Rate for Payer: VA VA |
$4,006.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,018.18
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,415.76 |
| Max. Negotiated Rate |
$14,421.82 |
| Rate for Payer: Aetna Commercial |
$13,620.60
|
| Rate for Payer: BCBS Trust/PPO |
$13,080.59
|
| Rate for Payer: BCN Commercial |
$12,383.53
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$13,780.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Healthscope Commercial |
$14,421.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: Nomi Health Commercial |
$13,139.88
|
| Rate for Payer: PHP Commercial |
$13,620.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health HMO/PPO |
$13,941.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,736.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,101.33
|
| Rate for Payer: UHC Core |
$13,380.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,018.18
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$738.86 |
| Max. Negotiated Rate |
$2,799.90 |
| Rate for Payer: Aetna Commercial |
$2,644.35
|
| Rate for Payer: Aetna Medicare |
$808.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$972.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$972.19
|
| Rate for Payer: BCBS Complete |
$1,244.40
|
| Rate for Payer: BCBS MAPPO |
$777.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,557.55
|
| Rate for Payer: BCN Commercial |
$2,418.80
|
| Rate for Payer: BCN Medicare Advantage |
$777.75
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,675.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.75
|
| Rate for Payer: Healthscope Commercial |
$2,799.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,333.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$816.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$894.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: Nomi Health Commercial |
$2,551.02
|
| Rate for Payer: PACE Senior Care Partners |
$738.86
|
| Rate for Payer: PACE SWMI |
$777.75
|
| Rate for Payer: PHP Commercial |
$2,644.35
|
| Rate for Payer: PHP Medicare Advantage |
$777.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,706.57
|
| Rate for Payer: Priority Health Medicare |
$785.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,084.37
|
| Rate for Payer: Railroad Medicare Medicare |
$777.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,737.68
|
| Rate for Payer: UHC Core |
$2,597.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.75
|
| Rate for Payer: UHC Exchange |
$777.75
|
| Rate for Payer: UHC Medicare Advantage |
$777.75
|
| Rate for Payer: VA VA |
$777.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,333.25
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,022.15 |
| Max. Negotiated Rate |
$2,799.90 |
| Rate for Payer: Aetna Commercial |
$2,644.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.51
|
| Rate for Payer: BCN Commercial |
$2,404.18
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,675.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Healthscope Commercial |
$2,799.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,333.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: Nomi Health Commercial |
$2,551.02
|
| Rate for Payer: PHP Commercial |
$2,644.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health HMO/PPO |
$2,706.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,084.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,737.68
|
| Rate for Payer: UHC Core |
$2,597.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,333.25
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,794.90 |
| Max. Negotiated Rate |
$6,801.71 |
| Rate for Payer: Aetna Commercial |
$6,423.84
|
| Rate for Payer: Aetna Medicare |
$1,964.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,361.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,361.71
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$1,889.36
|
| Rate for Payer: BCBS Trust/PPO |
$6,212.99
|
| Rate for Payer: BCN Commercial |
$5,875.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,889.36
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$6,499.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,889.36
|
| Rate for Payer: Healthscope Commercial |
$6,801.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,668.10
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,983.83
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,172.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: Nomi Health Commercial |
$6,197.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,794.90
|
| Rate for Payer: PACE SWMI |
$1,889.36
|
| Rate for Payer: PHP Commercial |
$6,423.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,889.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health HMO/PPO |
$6,574.99
|
| Rate for Payer: Priority Health Medicare |
$1,908.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,063.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,889.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,650.56
|
| Rate for Payer: UHC Core |
$6,310.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,889.36
|
| Rate for Payer: UHC Exchange |
$1,889.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,889.36
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$1,889.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,668.10
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,912.35 |
| Max. Negotiated Rate |
$6,801.71 |
| Rate for Payer: Aetna Commercial |
$6,423.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,169.15
|
| Rate for Payer: BCN Commercial |
$5,840.41
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$6,499.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Healthscope Commercial |
$6,801.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,668.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: Nomi Health Commercial |
$6,197.12
|
| Rate for Payer: PHP Commercial |
$6,423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health HMO/PPO |
$6,574.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,063.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,650.56
|
| Rate for Payer: UHC Core |
$6,310.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,668.10
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,825.82 |
| Max. Negotiated Rate |
$5,297.28 |
| Rate for Payer: Aetna Commercial |
$5,002.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,804.64
|
| Rate for Payer: BCN Commercial |
$4,548.60
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$5,061.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Healthscope Commercial |
$5,297.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,414.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: Nomi Health Commercial |
$4,826.41
|
| Rate for Payer: PHP Commercial |
$5,002.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health HMO/PPO |
$5,120.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,943.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,179.57
|
| Rate for Payer: UHC Core |
$4,914.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,414.40
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,397.89 |
| Max. Negotiated Rate |
$5,297.28 |
| Rate for Payer: Aetna Commercial |
$5,002.99
|
| Rate for Payer: Aetna Medicare |
$1,530.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,839.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,839.33
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$1,471.47
|
| Rate for Payer: BCBS Trust/PPO |
$4,838.77
|
| Rate for Payer: BCN Commercial |
$4,576.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,471.47
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$5,061.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,471.47
|
| Rate for Payer: Healthscope Commercial |
$5,297.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,414.40
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,545.04
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,692.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: Nomi Health Commercial |
$4,826.41
|
| Rate for Payer: PACE Senior Care Partners |
$1,397.89
|
| Rate for Payer: PACE SWMI |
$1,471.47
|
| Rate for Payer: PHP Commercial |
$5,002.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,471.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health HMO/PPO |
$5,120.71
|
| Rate for Payer: Priority Health Medicare |
$1,486.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,943.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,471.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,179.57
|
| Rate for Payer: UHC Core |
$4,914.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,471.47
|
| Rate for Payer: UHC Exchange |
$1,471.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$1,471.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,414.40
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.31
|
| Rate for Payer: BCN Commercial |
$2,073.59
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.42
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.26 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$697.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$838.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$838.51
|
| Rate for Payer: BCBS Complete |
$1,452.56
|
| Rate for Payer: BCBS MAPPO |
$670.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.88
|
| Rate for Payer: BCN Commercial |
$2,086.20
|
| Rate for Payer: BCN Medicare Advantage |
$670.80
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.80
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.42
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.35
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$771.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PACE Senior Care Partners |
$637.26
|
| Rate for Payer: PACE SWMI |
$670.80
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$670.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Medicare |
$677.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: Railroad Medicare Medicare |
$670.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.80
|
| Rate for Payer: UHC Exchange |
$670.80
|
| Rate for Payer: UHC Medicare Advantage |
$670.80
|
| Rate for Payer: UHCCP Medicaid |
$1,383.30
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.42
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,162.54 |
| Max. Negotiated Rate |
$1,609.67 |
| Rate for Payer: Aetna Commercial |
$1,520.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,459.97
|
| Rate for Payer: BCN Commercial |
$1,382.17
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,538.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Healthscope Commercial |
$1,609.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.59
|
| Rate for Payer: PHP Commercial |
$1,520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,573.90
|
| Rate for Payer: UHC Core |
$1,493.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.39
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$424.77 |
| Max. Negotiated Rate |
$1,609.67 |
| Rate for Payer: Aetna Commercial |
$1,520.24
|
| Rate for Payer: Aetna Medicare |
$465.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$558.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$558.91
|
| Rate for Payer: BCBS Complete |
$715.41
|
| Rate for Payer: BCBS MAPPO |
$447.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,470.34
|
| Rate for Payer: BCN Commercial |
$1,390.57
|
| Rate for Payer: BCN Medicare Advantage |
$447.13
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,538.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.13
|
| Rate for Payer: Healthscope Commercial |
$1,609.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: Nomi Health Commercial |
$1,466.59
|
| Rate for Payer: PACE Senior Care Partners |
$424.77
|
| Rate for Payer: PACE SWMI |
$447.13
|
| Rate for Payer: PHP Commercial |
$1,520.24
|
| Rate for Payer: PHP Medicare Advantage |
$447.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,556.01
|
| Rate for Payer: Priority Health Medicare |
$451.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.31
|
| Rate for Payer: Railroad Medicare Medicare |
$447.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,573.90
|
| Rate for Payer: UHC Core |
$1,493.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$447.13
|
| Rate for Payer: UHC Exchange |
$447.13
|
| Rate for Payer: UHC Medicare Advantage |
$447.13
|
| Rate for Payer: VA VA |
$447.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.39
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.10 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$4.30
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$4.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$4.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$4.10
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
