|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,650.64
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$291.01 |
| Max. Negotiated Rate |
$1,485.58 |
| Rate for Payer: Aetna Commercial |
$1,403.04
|
| Rate for Payer: Aetna Medicare |
$429.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$515.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$515.83
|
| Rate for Payer: BCBS Complete |
$305.53
|
| Rate for Payer: BCBS MAPPO |
$412.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,356.99
|
| Rate for Payer: BCN Commercial |
$1,356.99
|
| Rate for Payer: BCN Medicare Advantage |
$412.66
|
| Rate for Payer: Cash Price |
$1,320.51
|
| Rate for Payer: Cofinity Commercial |
$1,419.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.66
|
| Rate for Payer: Healthscope Commercial |
$1,485.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,237.98
|
| Rate for Payer: Mclaren Medicaid |
$291.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.29
|
| Rate for Payer: Meridian Medicaid |
$305.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$474.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$453.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.04
|
| Rate for Payer: Nomi Health Commercial |
$1,353.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.98
|
| Rate for Payer: PACE Senior Care Partners |
$392.03
|
| Rate for Payer: PACE SWMI |
$412.66
|
| Rate for Payer: PHP Commercial |
$1,403.04
|
| Rate for Payer: PHP Medicare Advantage |
$412.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$291.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,436.06
|
| Rate for Payer: Priority Health Medicare |
$416.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.85
|
| Rate for Payer: Railroad Medicare Medicare |
$412.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.56
|
| Rate for Payer: UHC Core |
$1,378.28
|
| Rate for Payer: UHC Exchange |
$412.66
|
| Rate for Payer: UHC Medicaid |
$291.01
|
| Rate for Payer: UHC Medicare Advantage |
$412.66
|
| Rate for Payer: UHCCP Medicaid |
$291.01
|
| Rate for Payer: VA VA |
$412.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,237.98
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
IP
|
$1,650.64
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,148.85 |
| Max. Negotiated Rate |
$1,485.58 |
| Rate for Payer: Aetna Commercial |
$1,403.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.26
|
| Rate for Payer: BCN Commercial |
$1,363.26
|
| Rate for Payer: Cash Price |
$1,320.51
|
| Rate for Payer: Cofinity Commercial |
$1,419.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,320.51
|
| Rate for Payer: Healthscope Commercial |
$1,485.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,237.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,403.04
|
| Rate for Payer: Nomi Health Commercial |
$1,353.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,237.98
|
| Rate for Payer: PHP Commercial |
$1,403.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,436.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,148.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.56
|
| Rate for Payer: UHC Core |
$1,378.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,237.98
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
IP
|
$733.73
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$510.68 |
| Max. Negotiated Rate |
$660.36 |
| Rate for Payer: Aetna Commercial |
$623.67
|
| Rate for Payer: BCBS Trust/PPO |
$605.99
|
| Rate for Payer: BCN Commercial |
$605.99
|
| Rate for Payer: Cash Price |
$586.98
|
| Rate for Payer: Cofinity Commercial |
$631.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.98
|
| Rate for Payer: Healthscope Commercial |
$660.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.67
|
| Rate for Payer: Nomi Health Commercial |
$601.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.30
|
| Rate for Payer: PHP Commercial |
$623.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$638.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$510.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$645.68
|
| Rate for Payer: UHC Core |
$612.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.30
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
OP
|
$733.73
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$660.36 |
| Rate for Payer: Aetna Commercial |
$623.67
|
| Rate for Payer: Aetna Medicare |
$190.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.29
|
| Rate for Payer: BCBS Complete |
$135.81
|
| Rate for Payer: BCBS MAPPO |
$183.43
|
| Rate for Payer: BCBS Trust/PPO |
$603.20
|
| Rate for Payer: BCN Commercial |
$603.20
|
| Rate for Payer: BCN Medicare Advantage |
$183.43
|
| Rate for Payer: Cash Price |
$586.98
|
| Rate for Payer: Cofinity Commercial |
$631.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.43
|
| Rate for Payer: Healthscope Commercial |
$660.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$550.30
|
| Rate for Payer: Mclaren Medicaid |
$129.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.60
|
| Rate for Payer: Meridian Medicaid |
$135.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$210.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.67
|
| Rate for Payer: Nomi Health Commercial |
$601.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$550.30
|
| Rate for Payer: PACE Senior Care Partners |
$174.26
|
| Rate for Payer: PACE SWMI |
$183.43
|
| Rate for Payer: PHP Commercial |
$623.67
|
| Rate for Payer: PHP Medicare Advantage |
$183.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$638.35
|
| Rate for Payer: Priority Health Medicare |
$185.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$510.68
|
| Rate for Payer: Railroad Medicare Medicare |
$183.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$645.68
|
| Rate for Payer: UHC Core |
$612.66
|
| Rate for Payer: UHC Exchange |
$183.43
|
| Rate for Payer: UHC Medicaid |
$129.36
|
| Rate for Payer: UHC Medicare Advantage |
$183.43
|
| Rate for Payer: UHCCP Medicaid |
$129.36
|
| Rate for Payer: VA VA |
$183.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$550.30
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$638.76
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.61 |
| Max. Negotiated Rate |
$574.88 |
| Rate for Payer: Aetna Commercial |
$542.95
|
| Rate for Payer: Aetna Medicare |
$166.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$199.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$199.61
|
| Rate for Payer: BCBS Complete |
$118.23
|
| Rate for Payer: BCBS MAPPO |
$159.69
|
| Rate for Payer: BCBS Trust/PPO |
$525.12
|
| Rate for Payer: BCN Commercial |
$525.12
|
| Rate for Payer: BCN Medicare Advantage |
$159.69
|
| Rate for Payer: Cash Price |
$511.01
|
| Rate for Payer: Cofinity Commercial |
$549.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.69
|
| Rate for Payer: Healthscope Commercial |
$574.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.07
|
| Rate for Payer: Mclaren Medicaid |
$112.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.67
|
| Rate for Payer: Meridian Medicaid |
$118.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$175.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.95
|
| Rate for Payer: Nomi Health Commercial |
$523.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.07
|
| Rate for Payer: PACE Senior Care Partners |
$151.71
|
| Rate for Payer: PACE SWMI |
$159.69
|
| Rate for Payer: PHP Commercial |
$542.95
|
| Rate for Payer: PHP Medicare Advantage |
$159.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$555.72
|
| Rate for Payer: Priority Health Medicare |
$161.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.58
|
| Rate for Payer: Railroad Medicare Medicare |
$159.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.11
|
| Rate for Payer: UHC Core |
$533.36
|
| Rate for Payer: UHC Exchange |
$159.69
|
| Rate for Payer: UHC Medicaid |
$112.61
|
| Rate for Payer: UHC Medicare Advantage |
$159.69
|
| Rate for Payer: UHCCP Medicaid |
$112.61
|
| Rate for Payer: VA VA |
$159.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.07
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$638.76
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$444.58 |
| Max. Negotiated Rate |
$574.88 |
| Rate for Payer: Aetna Commercial |
$542.95
|
| Rate for Payer: BCBS Trust/PPO |
$527.55
|
| Rate for Payer: BCN Commercial |
$527.55
|
| Rate for Payer: Cash Price |
$511.01
|
| Rate for Payer: Cofinity Commercial |
$549.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.01
|
| Rate for Payer: Healthscope Commercial |
$574.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$479.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.95
|
| Rate for Payer: Nomi Health Commercial |
$523.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.07
|
| Rate for Payer: PHP Commercial |
$542.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$555.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$562.11
|
| Rate for Payer: UHC Core |
$533.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$479.07
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,220.39
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$849.39 |
| Max. Negotiated Rate |
$1,098.35 |
| Rate for Payer: Aetna Commercial |
$1,037.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.92
|
| Rate for Payer: BCN Commercial |
$1,007.92
|
| Rate for Payer: Cash Price |
$976.31
|
| Rate for Payer: Cofinity Commercial |
$1,049.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.31
|
| Rate for Payer: Healthscope Commercial |
$1,098.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$915.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.33
|
| Rate for Payer: Nomi Health Commercial |
$1,000.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.29
|
| Rate for Payer: PHP Commercial |
$1,037.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,061.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.94
|
| Rate for Payer: UHC Core |
$1,019.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$915.29
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,220.39
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$215.15 |
| Max. Negotiated Rate |
$1,098.35 |
| Rate for Payer: Aetna Commercial |
$1,037.33
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.37
|
| Rate for Payer: BCBS Complete |
$225.89
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.28
|
| Rate for Payer: BCN Commercial |
$1,003.28
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$976.31
|
| Rate for Payer: Cofinity Commercial |
$1,049.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$976.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$1,098.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$915.29
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.35
|
| Rate for Payer: Meridian Medicaid |
$225.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,037.33
|
| Rate for Payer: Nomi Health Commercial |
$1,000.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$915.29
|
| Rate for Payer: PACE Senior Care Partners |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$1,037.33
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,061.74
|
| Rate for Payer: Priority Health Medicare |
$308.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.39
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,073.94
|
| Rate for Payer: UHC Core |
$1,019.03
|
| Rate for Payer: UHC Exchange |
$305.10
|
| Rate for Payer: UHC Medicaid |
$215.15
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$215.15
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$915.29
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$644.68
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$448.70 |
| Max. Negotiated Rate |
$580.21 |
| Rate for Payer: Aetna Commercial |
$547.98
|
| Rate for Payer: BCBS Trust/PPO |
$532.44
|
| Rate for Payer: BCN Commercial |
$532.44
|
| Rate for Payer: Cash Price |
$515.74
|
| Rate for Payer: Cofinity Commercial |
$554.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.74
|
| Rate for Payer: Healthscope Commercial |
$580.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.98
|
| Rate for Payer: Nomi Health Commercial |
$528.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.51
|
| Rate for Payer: PHP Commercial |
$547.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$560.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.32
|
| Rate for Payer: UHC Core |
$538.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.51
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$644.68
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.66 |
| Max. Negotiated Rate |
$580.21 |
| Rate for Payer: Aetna Commercial |
$547.98
|
| Rate for Payer: Aetna Medicare |
$167.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.46
|
| Rate for Payer: BCBS Complete |
$119.33
|
| Rate for Payer: BCBS MAPPO |
$161.17
|
| Rate for Payer: BCBS Trust/PPO |
$529.99
|
| Rate for Payer: BCN Commercial |
$529.99
|
| Rate for Payer: BCN Medicare Advantage |
$161.17
|
| Rate for Payer: Cash Price |
$515.74
|
| Rate for Payer: Cofinity Commercial |
$554.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.17
|
| Rate for Payer: Healthscope Commercial |
$580.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.51
|
| Rate for Payer: Mclaren Medicaid |
$113.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.23
|
| Rate for Payer: Meridian Medicaid |
$119.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$177.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.98
|
| Rate for Payer: Nomi Health Commercial |
$528.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$483.51
|
| Rate for Payer: PACE Senior Care Partners |
$153.11
|
| Rate for Payer: PACE SWMI |
$161.17
|
| Rate for Payer: PHP Commercial |
$547.98
|
| Rate for Payer: PHP Medicare Advantage |
$161.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$560.87
|
| Rate for Payer: Priority Health Medicare |
$162.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.70
|
| Rate for Payer: Railroad Medicare Medicare |
$161.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.32
|
| Rate for Payer: UHC Core |
$538.31
|
| Rate for Payer: UHC Exchange |
$161.17
|
| Rate for Payer: UHC Medicaid |
$113.66
|
| Rate for Payer: UHC Medicare Advantage |
$161.17
|
| Rate for Payer: UHCCP Medicaid |
$113.66
|
| Rate for Payer: VA VA |
$161.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.51
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,231.49
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$569.71 |
| Max. Negotiated Rate |
$2,908.34 |
| Rate for Payer: Aetna Commercial |
$2,746.77
|
| Rate for Payer: Aetna Medicare |
$840.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,009.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,009.84
|
| Rate for Payer: BCBS Complete |
$598.15
|
| Rate for Payer: BCBS MAPPO |
$807.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,656.61
|
| Rate for Payer: BCN Commercial |
$2,656.61
|
| Rate for Payer: BCN Medicare Advantage |
$807.87
|
| Rate for Payer: Cash Price |
$2,585.19
|
| Rate for Payer: Cofinity Commercial |
$2,779.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,585.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$807.87
|
| Rate for Payer: Healthscope Commercial |
$2,908.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,423.62
|
| Rate for Payer: Mclaren Medicaid |
$569.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$848.27
|
| Rate for Payer: Meridian Medicaid |
$598.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$929.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$888.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,746.77
|
| Rate for Payer: Nomi Health Commercial |
$2,649.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,423.62
|
| Rate for Payer: PACE Senior Care Partners |
$767.48
|
| Rate for Payer: PACE SWMI |
$807.87
|
| Rate for Payer: PHP Commercial |
$2,746.77
|
| Rate for Payer: PHP Medicare Advantage |
$807.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,811.40
|
| Rate for Payer: Priority Health Medicare |
$815.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.12
|
| Rate for Payer: Railroad Medicare Medicare |
$807.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,843.71
|
| Rate for Payer: UHC Core |
$2,698.29
|
| Rate for Payer: UHC Exchange |
$807.87
|
| Rate for Payer: UHC Medicaid |
$569.71
|
| Rate for Payer: UHC Medicare Advantage |
$807.87
|
| Rate for Payer: UHCCP Medicaid |
$569.71
|
| Rate for Payer: VA VA |
$807.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,423.62
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
IP
|
$3,231.49
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,249.12 |
| Max. Negotiated Rate |
$2,908.34 |
| Rate for Payer: Aetna Commercial |
$2,746.77
|
| Rate for Payer: BCBS Trust/PPO |
$2,668.89
|
| Rate for Payer: BCN Commercial |
$2,668.89
|
| Rate for Payer: Cash Price |
$2,585.19
|
| Rate for Payer: Cofinity Commercial |
$2,779.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,585.19
|
| Rate for Payer: Healthscope Commercial |
$2,908.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,423.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,746.77
|
| Rate for Payer: Nomi Health Commercial |
$2,649.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,423.62
|
| Rate for Payer: PHP Commercial |
$2,746.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,811.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,843.71
|
| Rate for Payer: UHC Core |
$2,698.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,423.62
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,377.86
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,438.99 |
| Max. Negotiated Rate |
$5,740.07 |
| Rate for Payer: Aetna Commercial |
$5,421.18
|
| Rate for Payer: BCBS Trust/PPO |
$5,267.47
|
| Rate for Payer: BCN Commercial |
$5,267.47
|
| Rate for Payer: Cash Price |
$5,102.29
|
| Rate for Payer: Cofinity Commercial |
$5,484.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,102.29
|
| Rate for Payer: Healthscope Commercial |
$5,740.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,783.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,421.18
|
| Rate for Payer: Nomi Health Commercial |
$5,229.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,783.40
|
| Rate for Payer: PHP Commercial |
$5,421.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,548.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,438.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,612.52
|
| Rate for Payer: UHC Core |
$5,325.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,783.40
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,377.86
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,124.42 |
| Max. Negotiated Rate |
$5,740.07 |
| Rate for Payer: Aetna Commercial |
$5,421.18
|
| Rate for Payer: Aetna Medicare |
$1,658.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,993.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,993.08
|
| Rate for Payer: BCBS Complete |
$1,180.54
|
| Rate for Payer: BCBS MAPPO |
$1,594.46
|
| Rate for Payer: BCBS Trust/PPO |
$5,243.24
|
| Rate for Payer: BCN Commercial |
$5,243.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,594.46
|
| Rate for Payer: Cash Price |
$5,102.29
|
| Rate for Payer: Cofinity Commercial |
$5,484.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,102.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,594.46
|
| Rate for Payer: Healthscope Commercial |
$5,740.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,783.40
|
| Rate for Payer: Mclaren Medicaid |
$1,124.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,674.19
|
| Rate for Payer: Meridian Medicaid |
$1,180.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,833.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,753.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,421.18
|
| Rate for Payer: Nomi Health Commercial |
$5,229.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,783.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,514.74
|
| Rate for Payer: PACE SWMI |
$1,594.46
|
| Rate for Payer: PHP Commercial |
$5,421.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,594.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,124.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,548.74
|
| Rate for Payer: Priority Health Medicare |
$1,610.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,438.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,594.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,612.52
|
| Rate for Payer: UHC Core |
$5,325.51
|
| Rate for Payer: UHC Exchange |
$1,594.46
|
| Rate for Payer: UHC Medicaid |
$1,124.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,594.46
|
| Rate for Payer: UHCCP Medicaid |
$1,124.42
|
| Rate for Payer: VA VA |
$1,594.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,783.40
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,767.42
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,622.12 |
| Max. Negotiated Rate |
$3,390.68 |
| Rate for Payer: Aetna Commercial |
$3,202.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,111.51
|
| Rate for Payer: BCN Commercial |
$3,111.51
|
| Rate for Payer: Cash Price |
$3,013.94
|
| Rate for Payer: Cofinity Commercial |
$3,239.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.94
|
| Rate for Payer: Healthscope Commercial |
$3,390.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.31
|
| Rate for Payer: Nomi Health Commercial |
$3,089.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,825.57
|
| Rate for Payer: PHP Commercial |
$3,202.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,277.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,622.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.33
|
| Rate for Payer: UHC Core |
$3,145.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.57
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,767.42
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$664.20 |
| Max. Negotiated Rate |
$3,390.68 |
| Rate for Payer: Aetna Commercial |
$3,202.31
|
| Rate for Payer: Aetna Medicare |
$979.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,177.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,177.32
|
| Rate for Payer: BCBS Complete |
$697.35
|
| Rate for Payer: BCBS MAPPO |
$941.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.20
|
| Rate for Payer: BCN Commercial |
$3,097.20
|
| Rate for Payer: BCN Medicare Advantage |
$941.86
|
| Rate for Payer: Cash Price |
$3,013.94
|
| Rate for Payer: Cofinity Commercial |
$3,239.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.86
|
| Rate for Payer: Healthscope Commercial |
$3,390.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.57
|
| Rate for Payer: Mclaren Medicaid |
$664.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$988.95
|
| Rate for Payer: Meridian Medicaid |
$697.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,083.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.31
|
| Rate for Payer: Nomi Health Commercial |
$3,089.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,825.57
|
| Rate for Payer: PACE Senior Care Partners |
$894.76
|
| Rate for Payer: PACE SWMI |
$941.86
|
| Rate for Payer: PHP Commercial |
$3,202.31
|
| Rate for Payer: PHP Medicare Advantage |
$941.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,277.66
|
| Rate for Payer: Priority Health Medicare |
$951.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,622.12
|
| Rate for Payer: Railroad Medicare Medicare |
$941.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.33
|
| Rate for Payer: UHC Core |
$3,145.80
|
| Rate for Payer: UHC Exchange |
$941.86
|
| Rate for Payer: UHC Medicaid |
$664.20
|
| Rate for Payer: UHC Medicare Advantage |
$941.86
|
| Rate for Payer: UHCCP Medicaid |
$664.20
|
| Rate for Payer: VA VA |
$941.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.57
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$5,021.39
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,494.89 |
| Max. Negotiated Rate |
$4,519.25 |
| Rate for Payer: Aetna Commercial |
$4,268.18
|
| Rate for Payer: BCBS Trust/PPO |
$4,147.17
|
| Rate for Payer: BCN Commercial |
$4,147.17
|
| Rate for Payer: Cash Price |
$4,017.11
|
| Rate for Payer: Cofinity Commercial |
$4,318.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,017.11
|
| Rate for Payer: Healthscope Commercial |
$4,519.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,766.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,268.18
|
| Rate for Payer: Nomi Health Commercial |
$4,117.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,766.04
|
| Rate for Payer: PHP Commercial |
$4,268.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,368.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,494.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,418.82
|
| Rate for Payer: UHC Core |
$4,192.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,766.04
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$5,021.39
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$885.27 |
| Max. Negotiated Rate |
$4,519.25 |
| Rate for Payer: Aetna Commercial |
$4,268.18
|
| Rate for Payer: Aetna Medicare |
$1,305.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,569.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,569.18
|
| Rate for Payer: BCBS Complete |
$929.46
|
| Rate for Payer: BCBS MAPPO |
$1,255.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,128.08
|
| Rate for Payer: BCN Commercial |
$4,128.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,255.35
|
| Rate for Payer: Cash Price |
$4,017.11
|
| Rate for Payer: Cofinity Commercial |
$4,318.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,017.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,255.35
|
| Rate for Payer: Healthscope Commercial |
$4,519.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,766.04
|
| Rate for Payer: Mclaren Medicaid |
$885.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,318.11
|
| Rate for Payer: Meridian Medicaid |
$929.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,443.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,380.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,268.18
|
| Rate for Payer: Nomi Health Commercial |
$4,117.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,766.04
|
| Rate for Payer: PACE Senior Care Partners |
$1,192.58
|
| Rate for Payer: PACE SWMI |
$1,255.35
|
| Rate for Payer: PHP Commercial |
$4,268.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,255.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$885.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,368.61
|
| Rate for Payer: Priority Health Medicare |
$1,267.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,494.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,255.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,418.82
|
| Rate for Payer: UHC Core |
$4,192.86
|
| Rate for Payer: UHC Exchange |
$1,255.35
|
| Rate for Payer: UHC Medicaid |
$885.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,255.35
|
| Rate for Payer: UHCCP Medicaid |
$885.27
|
| Rate for Payer: VA VA |
$1,255.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,766.04
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$922.48
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.63 |
| Max. Negotiated Rate |
$830.23 |
| Rate for Payer: Aetna Commercial |
$784.11
|
| Rate for Payer: Aetna Medicare |
$239.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.27
|
| Rate for Payer: BCBS Complete |
$170.75
|
| Rate for Payer: BCBS MAPPO |
$230.62
|
| Rate for Payer: BCBS Trust/PPO |
$758.37
|
| Rate for Payer: BCN Commercial |
$758.37
|
| Rate for Payer: BCN Medicare Advantage |
$230.62
|
| Rate for Payer: Cash Price |
$737.98
|
| Rate for Payer: Cofinity Commercial |
$793.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.62
|
| Rate for Payer: Healthscope Commercial |
$830.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.86
|
| Rate for Payer: Mclaren Medicaid |
$162.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.15
|
| Rate for Payer: Meridian Medicaid |
$170.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$253.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.11
|
| Rate for Payer: Nomi Health Commercial |
$756.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$691.86
|
| Rate for Payer: PACE Senior Care Partners |
$219.09
|
| Rate for Payer: PACE SWMI |
$230.62
|
| Rate for Payer: PHP Commercial |
$784.11
|
| Rate for Payer: PHP Medicare Advantage |
$230.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$802.56
|
| Rate for Payer: Priority Health Medicare |
$232.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$642.05
|
| Rate for Payer: Railroad Medicare Medicare |
$230.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.78
|
| Rate for Payer: UHC Core |
$770.27
|
| Rate for Payer: UHC Exchange |
$230.62
|
| Rate for Payer: UHC Medicaid |
$162.63
|
| Rate for Payer: UHC Medicare Advantage |
$230.62
|
| Rate for Payer: UHCCP Medicaid |
$162.63
|
| Rate for Payer: VA VA |
$230.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.86
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$922.48
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$642.05 |
| Max. Negotiated Rate |
$830.23 |
| Rate for Payer: Aetna Commercial |
$784.11
|
| Rate for Payer: BCBS Trust/PPO |
$761.88
|
| Rate for Payer: BCN Commercial |
$761.88
|
| Rate for Payer: Cash Price |
$737.98
|
| Rate for Payer: Cofinity Commercial |
$793.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.98
|
| Rate for Payer: Healthscope Commercial |
$830.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$784.11
|
| Rate for Payer: Nomi Health Commercial |
$756.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$691.86
|
| Rate for Payer: PHP Commercial |
$784.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$802.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$642.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.78
|
| Rate for Payer: UHC Core |
$770.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.86
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,686.83
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.39 |
| Max. Negotiated Rate |
$1,518.15 |
| Rate for Payer: Aetna Commercial |
$1,433.81
|
| Rate for Payer: Aetna Medicare |
$438.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$527.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$527.13
|
| Rate for Payer: BCBS Complete |
$312.23
|
| Rate for Payer: BCBS MAPPO |
$421.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.74
|
| Rate for Payer: BCN Commercial |
$1,386.74
|
| Rate for Payer: BCN Medicare Advantage |
$421.71
|
| Rate for Payer: Cash Price |
$1,349.46
|
| Rate for Payer: Cofinity Commercial |
$1,450.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.71
|
| Rate for Payer: Healthscope Commercial |
$1,518.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.12
|
| Rate for Payer: Mclaren Medicaid |
$297.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$442.79
|
| Rate for Payer: Meridian Medicaid |
$312.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$463.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.81
|
| Rate for Payer: Nomi Health Commercial |
$1,383.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,265.12
|
| Rate for Payer: PACE Senior Care Partners |
$400.62
|
| Rate for Payer: PACE SWMI |
$421.71
|
| Rate for Payer: PHP Commercial |
$1,433.81
|
| Rate for Payer: PHP Medicare Advantage |
$421.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,467.54
|
| Rate for Payer: Priority Health Medicare |
$425.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.03
|
| Rate for Payer: Railroad Medicare Medicare |
$421.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,484.41
|
| Rate for Payer: UHC Core |
$1,408.50
|
| Rate for Payer: UHC Exchange |
$421.71
|
| Rate for Payer: UHC Medicaid |
$297.39
|
| Rate for Payer: UHC Medicare Advantage |
$421.71
|
| Rate for Payer: UHCCP Medicaid |
$297.39
|
| Rate for Payer: VA VA |
$421.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.12
|
|
