|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,671.92 |
| Max. Negotiated Rate |
$2,314.97 |
| Rate for Payer: Aetna Commercial |
$2,186.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,099.68
|
| Rate for Payer: BCN Commercial |
$1,987.79
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$2,212.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Healthscope Commercial |
$2,314.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$2,109.20
|
| Rate for Payer: PHP Commercial |
$2,186.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health HMO/PPO |
$2,237.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,723.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,263.53
|
| Rate for Payer: UHC Core |
$2,147.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.14
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,314.25 |
| Max. Negotiated Rate |
$3,204.35 |
| Rate for Payer: Aetna Commercial |
$3,026.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,906.35
|
| Rate for Payer: BCN Commercial |
$2,751.47
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,061.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Healthscope Commercial |
$3,204.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: PHP Commercial |
$3,026.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health HMO/PPO |
$3,097.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,385.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,133.14
|
| Rate for Payer: UHC Core |
$2,972.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.29
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$735.57 |
| Max. Negotiated Rate |
$3,204.35 |
| Rate for Payer: Aetna Commercial |
$3,026.33
|
| Rate for Payer: Aetna Medicare |
$925.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,112.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,112.62
|
| Rate for Payer: BCBS Complete |
$772.40
|
| Rate for Payer: BCBS MAPPO |
$890.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,927.00
|
| Rate for Payer: BCN Commercial |
$2,768.20
|
| Rate for Payer: BCN Medicare Advantage |
$890.10
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$3,061.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.10
|
| Rate for Payer: Healthscope Commercial |
$3,204.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.29
|
| Rate for Payer: Mclaren Medicaid |
$735.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$934.60
|
| Rate for Payer: Meridian Medicaid |
$772.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,023.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,919.52
|
| Rate for Payer: PACE Senior Care Partners |
$845.59
|
| Rate for Payer: PACE SWMI |
$890.10
|
| Rate for Payer: PHP Commercial |
$3,026.33
|
| Rate for Payer: PHP Medicare Advantage |
$890.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health HMO/PPO |
$3,097.54
|
| Rate for Payer: Priority Health Medicare |
$899.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,385.46
|
| Rate for Payer: Railroad Medicare Medicare |
$890.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,133.14
|
| Rate for Payer: UHC Core |
$2,972.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$890.10
|
| Rate for Payer: UHC Exchange |
$890.10
|
| Rate for Payer: UHC Medicare Advantage |
$890.10
|
| Rate for Payer: UHCCP Medicaid |
$735.57
|
| Rate for Payer: VA VA |
$890.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.29
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,558.54 |
| Max. Negotiated Rate |
$3,542.60 |
| Rate for Payer: Aetna Commercial |
$3,345.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,213.14
|
| Rate for Payer: BCN Commercial |
$3,041.91
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,385.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Healthscope Commercial |
$3,542.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: PHP Commercial |
$3,345.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3,424.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,637.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,463.87
|
| Rate for Payer: UHC Core |
$3,286.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.16
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$735.57 |
| Max. Negotiated Rate |
$3,542.60 |
| Rate for Payer: Aetna Commercial |
$3,345.79
|
| Rate for Payer: Aetna Medicare |
$1,023.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,230.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,230.07
|
| Rate for Payer: BCBS Complete |
$772.40
|
| Rate for Payer: BCBS MAPPO |
$984.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,235.97
|
| Rate for Payer: BCN Commercial |
$3,060.41
|
| Rate for Payer: BCN Medicare Advantage |
$984.05
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$3,385.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.05
|
| Rate for Payer: Healthscope Commercial |
$3,542.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.16
|
| Rate for Payer: Mclaren Medicaid |
$735.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,033.26
|
| Rate for Payer: Meridian Medicaid |
$772.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$3,227.70
|
| Rate for Payer: PACE Senior Care Partners |
$934.85
|
| Rate for Payer: PACE SWMI |
$984.05
|
| Rate for Payer: PHP Commercial |
$3,345.79
|
| Rate for Payer: PHP Medicare Advantage |
$984.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health HMO/PPO |
$3,424.51
|
| Rate for Payer: Priority Health Medicare |
$993.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,637.27
|
| Rate for Payer: Railroad Medicare Medicare |
$984.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,463.87
|
| Rate for Payer: UHC Core |
$3,286.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.05
|
| Rate for Payer: UHC Exchange |
$984.05
|
| Rate for Payer: UHC Medicare Advantage |
$984.05
|
| Rate for Payer: UHCCP Medicaid |
$735.57
|
| Rate for Payer: VA VA |
$984.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.16
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$477.67 |
| Max. Negotiated Rate |
$661.39 |
| Rate for Payer: Aetna Commercial |
$624.65
|
| Rate for Payer: BCBS Trust/PPO |
$599.88
|
| Rate for Payer: BCN Commercial |
$567.92
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$632.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$661.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: PHP Commercial |
$624.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health HMO/PPO |
$639.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.69
|
| Rate for Payer: UHC Core |
$613.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.16
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.53 |
| Max. Negotiated Rate |
$661.39 |
| Rate for Payer: Aetna Commercial |
$624.65
|
| Rate for Payer: Aetna Medicare |
$191.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.65
|
| Rate for Payer: BCBS Complete |
$293.95
|
| Rate for Payer: BCBS MAPPO |
$183.72
|
| Rate for Payer: BCBS Trust/PPO |
$604.14
|
| Rate for Payer: BCN Commercial |
$571.37
|
| Rate for Payer: BCN Medicare Advantage |
$183.72
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$632.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.72
|
| Rate for Payer: Healthscope Commercial |
$661.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: Nomi Health Commercial |
$602.60
|
| Rate for Payer: PACE Senior Care Partners |
$174.53
|
| Rate for Payer: PACE SWMI |
$183.72
|
| Rate for Payer: PHP Commercial |
$624.65
|
| Rate for Payer: PHP Medicare Advantage |
$183.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health HMO/PPO |
$639.35
|
| Rate for Payer: Priority Health Medicare |
$185.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.37
|
| Rate for Payer: Railroad Medicare Medicare |
$183.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.69
|
| Rate for Payer: UHC Core |
$613.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.72
|
| Rate for Payer: UHC Exchange |
$183.72
|
| Rate for Payer: UHC Medicare Advantage |
$183.72
|
| Rate for Payer: VA VA |
$183.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.16
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$2.05
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: Meridian Medicaid |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,228.58 |
| Max. Negotiated Rate |
$4,470.35 |
| Rate for Payer: Aetna Commercial |
$4,221.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,054.60
|
| Rate for Payer: BCN Commercial |
$3,838.54
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,470.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,725.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: Nomi Health Commercial |
$4,072.98
|
| Rate for Payer: PHP Commercial |
$4,221.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,321.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,327.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,371.00
|
| Rate for Payer: UHC Core |
$4,147.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,725.29
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,179.67 |
| Max. Negotiated Rate |
$4,470.35 |
| Rate for Payer: Aetna Commercial |
$4,221.99
|
| Rate for Payer: Aetna Medicare |
$1,291.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,552.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,552.20
|
| Rate for Payer: BCBS Complete |
$1,986.82
|
| Rate for Payer: BCBS MAPPO |
$1,241.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,083.41
|
| Rate for Payer: BCN Commercial |
$3,861.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,241.76
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,241.76
|
| Rate for Payer: Healthscope Commercial |
$4,470.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,725.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,303.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,428.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: Nomi Health Commercial |
$4,072.98
|
| Rate for Payer: PACE Senior Care Partners |
$1,179.67
|
| Rate for Payer: PACE SWMI |
$1,241.76
|
| Rate for Payer: PHP Commercial |
$4,221.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,241.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,321.33
|
| Rate for Payer: Priority Health Medicare |
$1,254.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,327.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,241.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,371.00
|
| Rate for Payer: UHC Core |
$4,147.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,241.76
|
| Rate for Payer: UHC Exchange |
$1,241.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,241.76
|
| Rate for Payer: VA VA |
$1,241.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,725.29
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,735.09 |
| Max. Negotiated Rate |
$5,171.67 |
| Rate for Payer: Aetna Commercial |
$4,884.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,690.70
|
| Rate for Payer: BCN Commercial |
$4,440.74
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$4,941.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Healthscope Commercial |
$5,171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,309.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: Nomi Health Commercial |
$4,711.97
|
| Rate for Payer: PHP Commercial |
$4,884.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: Priority Health HMO/PPO |
$4,999.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,850.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,056.74
|
| Rate for Payer: UHC Core |
$4,798.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,309.73
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,364.75 |
| Max. Negotiated Rate |
$5,171.67 |
| Rate for Payer: Aetna Commercial |
$4,884.35
|
| Rate for Payer: Aetna Medicare |
$1,494.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,795.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,795.72
|
| Rate for Payer: BCBS Complete |
$2,298.52
|
| Rate for Payer: BCBS MAPPO |
$1,436.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,724.03
|
| Rate for Payer: BCN Commercial |
$4,467.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,436.58
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$4,941.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,436.58
|
| Rate for Payer: Healthscope Commercial |
$5,171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,309.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,508.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,652.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: Nomi Health Commercial |
$4,711.97
|
| Rate for Payer: PACE Senior Care Partners |
$1,364.75
|
| Rate for Payer: PACE SWMI |
$1,436.58
|
| Rate for Payer: PHP Commercial |
$4,884.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,436.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: Priority Health HMO/PPO |
$4,999.28
|
| Rate for Payer: Priority Health Medicare |
$1,450.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,850.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,436.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,056.74
|
| Rate for Payer: UHC Core |
$4,798.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,436.58
|
| Rate for Payer: UHC Exchange |
$1,436.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,436.58
|
| Rate for Payer: VA VA |
$1,436.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,309.73
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,205.60 |
| Max. Negotiated Rate |
$8,592.37 |
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: BCBS Trust/PPO |
$7,793.28
|
| Rate for Payer: BCN Commercial |
$7,377.98
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,210.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Healthscope Commercial |
$8,592.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,160.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$7,828.61
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health HMO/PPO |
$8,305.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,396.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,401.43
|
| Rate for Payer: UHC Core |
$7,971.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.43 |
| Max. Negotiated Rate |
$8,592.37 |
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: Aetna Medicare |
$2,482.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,983.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,983.46
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$2,386.77
|
| Rate for Payer: BCBS Trust/PPO |
$7,848.65
|
| Rate for Payer: BCN Commercial |
$7,422.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,386.77
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,210.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,386.77
|
| Rate for Payer: Healthscope Commercial |
$8,592.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,160.31
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,506.11
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,744.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$7,828.61
|
| Rate for Payer: PACE Senior Care Partners |
$2,267.43
|
| Rate for Payer: PACE SWMI |
$2,386.77
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,386.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health HMO/PPO |
$8,305.96
|
| Rate for Payer: Priority Health Medicare |
$2,410.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,396.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,386.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,401.43
|
| Rate for Payer: UHC Core |
$7,971.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,386.77
|
| Rate for Payer: UHC Exchange |
$2,386.77
|
| Rate for Payer: UHC Medicare Advantage |
$2,386.77
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$2,386.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,128.05 |
| Max. Negotiated Rate |
$9,869.61 |
| Rate for Payer: Aetna Commercial |
$9,321.30
|
| Rate for Payer: BCBS Trust/PPO |
$8,951.73
|
| Rate for Payer: BCN Commercial |
$8,474.70
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$9,430.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Healthscope Commercial |
$9,869.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,224.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: Nomi Health Commercial |
$8,992.31
|
| Rate for Payer: PHP Commercial |
$9,321.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health HMO/PPO |
$9,540.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,347.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,650.28
|
| Rate for Payer: UHC Core |
$9,156.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,224.67
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,604.48 |
| Max. Negotiated Rate |
$9,869.61 |
| Rate for Payer: Aetna Commercial |
$9,321.30
|
| Rate for Payer: Aetna Medicare |
$2,851.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,426.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,426.95
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$2,741.56
|
| Rate for Payer: BCBS Trust/PPO |
$9,015.34
|
| Rate for Payer: BCN Commercial |
$8,526.24
|
| Rate for Payer: BCN Medicare Advantage |
$2,741.56
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$9,430.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,741.56
|
| Rate for Payer: Healthscope Commercial |
$9,869.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,224.67
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,878.64
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,152.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: Nomi Health Commercial |
$8,992.31
|
| Rate for Payer: PACE Senior Care Partners |
$2,604.48
|
| Rate for Payer: PACE SWMI |
$2,741.56
|
| Rate for Payer: PHP Commercial |
$9,321.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,741.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health HMO/PPO |
$9,540.62
|
| Rate for Payer: Priority Health Medicare |
$2,768.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,347.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,741.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,650.28
|
| Rate for Payer: UHC Core |
$9,156.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,741.56
|
| Rate for Payer: UHC Exchange |
$2,741.56
|
| Rate for Payer: UHC Medicare Advantage |
$2,741.56
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$2,741.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,224.67
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,064.10 |
| Max. Negotiated Rate |
$11,611.31 |
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$3,354.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.71
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$3,225.36
|
| Rate for Payer: BCBS Trust/PPO |
$10,606.29
|
| Rate for Payer: BCN Commercial |
$10,030.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.36
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.36
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.63
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: PACE Senior Care Partners |
$3,064.10
|
| Rate for Payer: PACE SWMI |
$3,225.36
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11,224.27
|
| Rate for Payer: Priority Health Medicare |
$3,257.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,643.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,353.28
|
| Rate for Payer: UHC Core |
$10,772.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,225.36
|
| Rate for Payer: UHC Exchange |
$3,225.36
|
| Rate for Payer: UHC Medicare Advantage |
$3,225.36
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$3,225.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,385.95 |
| Max. Negotiated Rate |
$11,611.31 |
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: BCBS Trust/PPO |
$10,531.46
|
| Rate for Payer: BCN Commercial |
$9,970.25
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11,224.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,643.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,353.28
|
| Rate for Payer: UHC Core |
$10,772.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$12,901.46
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,064.10 |
| Max. Negotiated Rate |
$11,611.31 |
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$3,354.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.71
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$3,225.36
|
| Rate for Payer: BCBS Trust/PPO |
$10,606.29
|
| Rate for Payer: BCN Commercial |
$10,030.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.36
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.36
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.63
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: PACE Senior Care Partners |
$3,064.10
|
| Rate for Payer: PACE SWMI |
$3,225.36
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11,224.27
|
| Rate for Payer: Priority Health Medicare |
$3,257.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,643.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,353.28
|
| Rate for Payer: UHC Core |
$10,772.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,225.36
|
| Rate for Payer: UHC Exchange |
$3,225.36
|
| Rate for Payer: UHC Medicare Advantage |
$3,225.36
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$3,225.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,385.95 |
| Max. Negotiated Rate |
$11,611.31 |
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: BCBS Trust/PPO |
$10,531.46
|
| Rate for Payer: BCN Commercial |
$9,970.25
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$10,579.20
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11,224.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,643.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,353.28
|
| Rate for Payer: UHC Core |
$10,772.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
IP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,096.11 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.54
|
| Rate for Payer: BCN Commercial |
$1,303.19
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: Nomi Health Commercial |
$1,382.78
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,467.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,129.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
OP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.50 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$438.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$526.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$526.98
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: BCBS MAPPO |
$421.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.32
|
| Rate for Payer: BCN Commercial |
$1,311.11
|
| Rate for Payer: BCN Medicare Advantage |
$421.58
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.58
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: Nomi Health Commercial |
$1,382.78
|
| Rate for Payer: PACE Senior Care Partners |
$400.50
|
| Rate for Payer: PACE SWMI |
$421.58
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: PHP Medicare Advantage |
$421.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,467.10
|
| Rate for Payer: Priority Health Medicare |
$425.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,129.83
|
| Rate for Payer: Railroad Medicare Medicare |
$421.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.58
|
| Rate for Payer: UHC Exchange |
$421.58
|
| Rate for Payer: UHC Medicare Advantage |
$421.58
|
| Rate for Payer: VA VA |
$421.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELENIUM LEVEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC SELENIUM LEVEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$19.38
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$19.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$18.46
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
