|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,059.78 |
| Max. Negotiated Rate |
$4,236.61 |
| Rate for Payer: Aetna Commercial |
$4,001.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,842.61
|
| Rate for Payer: BCN Commercial |
$3,637.84
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cofinity Commercial |
$4,048.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.88
|
| Rate for Payer: Healthscope Commercial |
$4,236.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,530.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,001.25
|
| Rate for Payer: Nomi Health Commercial |
$3,860.03
|
| Rate for Payer: PHP Commercial |
$4,001.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,059.78
|
| Rate for Payer: Priority Health HMO/PPO |
$4,095.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,153.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,142.47
|
| Rate for Payer: UHC Core |
$3,930.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.51
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$894.77 |
| Max. Negotiated Rate |
$3,390.70 |
| Rate for Payer: Aetna Commercial |
$3,202.33
|
| Rate for Payer: Aetna Medicare |
$979.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,177.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,177.33
|
| Rate for Payer: BCBS Complete |
$2,082.02
|
| Rate for Payer: BCBS MAPPO |
$941.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.22
|
| Rate for Payer: BCN Commercial |
$2,929.19
|
| Rate for Payer: BCN Medicare Advantage |
$941.86
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$3,240.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.86
|
| Rate for Payer: Healthscope Commercial |
$3,390.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.59
|
| Rate for Payer: Mclaren Medicaid |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$988.96
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,083.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: Nomi Health Commercial |
$3,089.31
|
| Rate for Payer: PACE Senior Care Partners |
$894.77
|
| Rate for Payer: PACE SWMI |
$941.86
|
| Rate for Payer: PHP Commercial |
$3,202.33
|
| Rate for Payer: PHP Medicare Advantage |
$941.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,982.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health HMO/PPO |
$3,277.68
|
| Rate for Payer: Priority Health Medicare |
$951.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,524.19
|
| Rate for Payer: Railroad Medicare Medicare |
$941.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.36
|
| Rate for Payer: UHC Core |
$3,145.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$941.86
|
| Rate for Payer: UHC Exchange |
$941.86
|
| Rate for Payer: UHC Medicare Advantage |
$941.86
|
| Rate for Payer: UHCCP Medicaid |
$1,982.75
|
| Rate for Payer: VA VA |
$941.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.59
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,448.84 |
| Max. Negotiated Rate |
$3,390.70 |
| Rate for Payer: Aetna Commercial |
$3,202.33
|
| Rate for Payer: BCBS Trust/PPO |
$3,075.37
|
| Rate for Payer: BCN Commercial |
$2,911.49
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$3,240.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Healthscope Commercial |
$3,390.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: Nomi Health Commercial |
$3,089.31
|
| Rate for Payer: PHP Commercial |
$3,202.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health HMO/PPO |
$3,277.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,524.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.36
|
| Rate for Payer: UHC Core |
$3,145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.59
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,781.62 |
| Max. Negotiated Rate |
$3,851.47 |
| Rate for Payer: Aetna Commercial |
$3,637.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,493.28
|
| Rate for Payer: BCN Commercial |
$3,307.13
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$3,680.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Healthscope Commercial |
$3,851.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,209.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: Nomi Health Commercial |
$3,509.12
|
| Rate for Payer: PHP Commercial |
$3,637.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: Priority Health HMO/PPO |
$3,723.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,867.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,765.88
|
| Rate for Payer: UHC Core |
$3,573.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,209.56
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,016.36 |
| Max. Negotiated Rate |
$3,851.47 |
| Rate for Payer: Aetna Commercial |
$3,637.50
|
| Rate for Payer: Aetna Medicare |
$1,112.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,337.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,337.32
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$1,069.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,518.10
|
| Rate for Payer: BCN Commercial |
$3,327.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.85
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$3,680.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.85
|
| Rate for Payer: Healthscope Commercial |
$3,851.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,209.56
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.35
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,230.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: Nomi Health Commercial |
$3,509.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,016.36
|
| Rate for Payer: PACE SWMI |
$1,069.85
|
| Rate for Payer: PHP Commercial |
$3,637.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: Priority Health HMO/PPO |
$3,723.09
|
| Rate for Payer: Priority Health Medicare |
$1,080.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,867.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,069.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,765.88
|
| Rate for Payer: UHC Core |
$3,573.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.85
|
| Rate for Payer: UHC Exchange |
$1,069.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.85
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$1,069.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,209.56
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$626.67 |
| Rate for Payer: Aetna Commercial |
$591.86
|
| Rate for Payer: BCBS Trust/PPO |
$568.39
|
| Rate for Payer: BCN Commercial |
$538.10
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$598.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Healthscope Commercial |
$626.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: Nomi Health Commercial |
$570.97
|
| Rate for Payer: PHP Commercial |
$591.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health HMO/PPO |
$605.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$466.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.74
|
| Rate for Payer: UHC Core |
$581.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.23
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
OP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.66 |
| Max. Negotiated Rate |
$626.67 |
| Rate for Payer: Aetna Commercial |
$591.86
|
| Rate for Payer: Aetna Medicare |
$181.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.59
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$174.07
|
| Rate for Payer: BCBS Trust/PPO |
$572.43
|
| Rate for Payer: BCN Commercial |
$541.37
|
| Rate for Payer: BCN Medicare Advantage |
$174.07
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$598.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.07
|
| Rate for Payer: Healthscope Commercial |
$626.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.23
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.78
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: Nomi Health Commercial |
$570.97
|
| Rate for Payer: PACE Senior Care Partners |
$165.37
|
| Rate for Payer: PACE SWMI |
$174.07
|
| Rate for Payer: PHP Commercial |
$591.86
|
| Rate for Payer: PHP Medicare Advantage |
$174.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health HMO/PPO |
$605.78
|
| Rate for Payer: Priority Health Medicare |
$175.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$466.52
|
| Rate for Payer: Railroad Medicare Medicare |
$174.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.74
|
| Rate for Payer: UHC Core |
$581.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.07
|
| Rate for Payer: UHC Exchange |
$174.07
|
| Rate for Payer: UHC Medicare Advantage |
$174.07
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$174.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.23
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
OP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$260.39 |
| Max. Negotiated Rate |
$986.74 |
| Rate for Payer: Aetna Commercial |
$931.92
|
| Rate for Payer: Aetna Medicare |
$285.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.62
|
| Rate for Payer: BCBS Complete |
$438.55
|
| Rate for Payer: BCBS MAPPO |
$274.10
|
| Rate for Payer: BCBS Trust/PPO |
$901.33
|
| Rate for Payer: BCN Commercial |
$852.44
|
| Rate for Payer: BCN Medicare Advantage |
$274.10
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$942.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.10
|
| Rate for Payer: Healthscope Commercial |
$986.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: Nomi Health Commercial |
$899.03
|
| Rate for Payer: PACE Senior Care Partners |
$260.39
|
| Rate for Payer: PACE SWMI |
$274.10
|
| Rate for Payer: PHP Commercial |
$931.92
|
| Rate for Payer: PHP Medicare Advantage |
$274.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: Priority Health HMO/PPO |
$953.85
|
| Rate for Payer: Priority Health Medicare |
$276.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.57
|
| Rate for Payer: Railroad Medicare Medicare |
$274.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.81
|
| Rate for Payer: UHC Core |
$915.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.10
|
| Rate for Payer: UHC Exchange |
$274.10
|
| Rate for Payer: UHC Medicare Advantage |
$274.10
|
| Rate for Payer: VA VA |
$274.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.28
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
IP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$712.65 |
| Max. Negotiated Rate |
$986.74 |
| Rate for Payer: Aetna Commercial |
$931.92
|
| Rate for Payer: BCBS Trust/PPO |
$894.97
|
| Rate for Payer: BCN Commercial |
$847.28
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$942.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Healthscope Commercial |
$986.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: Nomi Health Commercial |
$899.03
|
| Rate for Payer: PHP Commercial |
$931.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: Priority Health HMO/PPO |
$953.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.81
|
| Rate for Payer: UHC Core |
$915.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.28
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
OP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,487.43 |
| Max. Negotiated Rate |
$5,636.58 |
| Rate for Payer: Aetna Commercial |
$5,323.44
|
| Rate for Payer: Aetna Medicare |
$1,628.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,957.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,957.15
|
| Rate for Payer: BCBS Complete |
$2,505.15
|
| Rate for Payer: BCBS MAPPO |
$1,565.72
|
| Rate for Payer: BCBS Trust/PPO |
$5,148.71
|
| Rate for Payer: BCN Commercial |
$4,869.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.72
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$5,386.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.72
|
| Rate for Payer: Healthscope Commercial |
$5,636.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,644.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,800.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: Nomi Health Commercial |
$5,135.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,487.43
|
| Rate for Payer: PACE SWMI |
$1,565.72
|
| Rate for Payer: PHP Commercial |
$5,323.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: Priority Health HMO/PPO |
$5,448.70
|
| Rate for Payer: Priority Health Medicare |
$1,581.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,196.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,565.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,511.33
|
| Rate for Payer: UHC Core |
$5,229.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.72
|
| Rate for Payer: UHC Exchange |
$1,565.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.72
|
| Rate for Payer: VA VA |
$1,565.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.15
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
IP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,070.87 |
| Max. Negotiated Rate |
$5,636.58 |
| Rate for Payer: Aetna Commercial |
$5,323.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,112.38
|
| Rate for Payer: BCN Commercial |
$4,839.95
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$5,386.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Healthscope Commercial |
$5,636.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: Nomi Health Commercial |
$5,135.55
|
| Rate for Payer: PHP Commercial |
$5,323.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: Priority Health HMO/PPO |
$5,448.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,196.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,511.33
|
| Rate for Payer: UHC Core |
$5,229.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.15
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
IP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,589.14 |
| Max. Negotiated Rate |
$2,200.35 |
| Rate for Payer: Aetna Commercial |
$2,078.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,995.71
|
| Rate for Payer: BCN Commercial |
$1,889.36
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$2,102.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Healthscope Commercial |
$2,200.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,833.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: Nomi Health Commercial |
$2,004.76
|
| Rate for Payer: PHP Commercial |
$2,078.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: Priority Health HMO/PPO |
$2,127.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,638.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,151.45
|
| Rate for Payer: UHC Core |
$2,041.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,833.62
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
OP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$580.65 |
| Max. Negotiated Rate |
$2,200.35 |
| Rate for Payer: Aetna Commercial |
$2,078.11
|
| Rate for Payer: Aetna Medicare |
$635.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$764.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$764.01
|
| Rate for Payer: BCBS Complete |
$977.93
|
| Rate for Payer: BCBS MAPPO |
$611.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,009.89
|
| Rate for Payer: BCN Commercial |
$1,900.86
|
| Rate for Payer: BCN Medicare Advantage |
$611.21
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$2,102.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$611.21
|
| Rate for Payer: Healthscope Commercial |
$2,200.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,833.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$702.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: Nomi Health Commercial |
$2,004.76
|
| Rate for Payer: PACE Senior Care Partners |
$580.65
|
| Rate for Payer: PACE SWMI |
$611.21
|
| Rate for Payer: PHP Commercial |
$2,078.11
|
| Rate for Payer: PHP Medicare Advantage |
$611.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: Priority Health HMO/PPO |
$2,127.00
|
| Rate for Payer: Priority Health Medicare |
$617.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,638.04
|
| Rate for Payer: Railroad Medicare Medicare |
$611.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,151.45
|
| Rate for Payer: UHC Core |
$2,041.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$611.21
|
| Rate for Payer: UHC Exchange |
$611.21
|
| Rate for Payer: UHC Medicare Advantage |
$611.21
|
| Rate for Payer: VA VA |
$611.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,833.62
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.25 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$1,000.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,202.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,202.96
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$962.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.66
|
| Rate for Payer: BCN Commercial |
$2,992.97
|
| Rate for Payer: BCN Medicare Advantage |
$962.37
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.37
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,106.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Senior Care Partners |
$914.25
|
| Rate for Payer: PACE SWMI |
$962.37
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$962.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Medicare |
$971.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.37
|
| Rate for Payer: UHC Exchange |
$962.37
|
| Rate for Payer: UHC Medicare Advantage |
$962.37
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$962.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.33
|
| Rate for Payer: BCN Commercial |
$2,974.88
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.33
|
| Rate for Payer: BCN Commercial |
$2,974.88
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.25 |
| Max. Negotiated Rate |
$4,104.01 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$1,000.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,202.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,202.96
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$962.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.66
|
| Rate for Payer: BCN Commercial |
$2,992.97
|
| Rate for Payer: BCN Medicare Advantage |
$962.37
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.37
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,106.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Senior Care Partners |
$914.25
|
| Rate for Payer: PACE SWMI |
$962.37
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$962.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Medicare |
$971.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.37
|
| Rate for Payer: UHC Exchange |
$962.37
|
| Rate for Payer: UHC Medicare Advantage |
$962.37
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$962.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$269.44 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: BCBS Trust/PPO |
$338.38
|
| Rate for Payer: BCN Commercial |
$320.35
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO |
$360.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.79
|
| Rate for Payer: UHC Core |
$346.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$98.45 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna Medicare |
$107.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.54
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: BCBS MAPPO |
$103.63
|
| Rate for Payer: BCBS Trust/PPO |
$340.79
|
| Rate for Payer: BCN Commercial |
$322.30
|
| Rate for Payer: BCN Medicare Advantage |
$103.63
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: Nomi Health Commercial |
$339.91
|
| Rate for Payer: PACE Senior Care Partners |
$98.45
|
| Rate for Payer: PACE SWMI |
$103.63
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: PHP Medicare Advantage |
$103.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health HMO/PPO |
$360.64
|
| Rate for Payer: Priority Health Medicare |
$104.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.74
|
| Rate for Payer: Railroad Medicare Medicare |
$103.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.79
|
| Rate for Payer: UHC Core |
$346.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.63
|
| Rate for Payer: UHC Exchange |
$103.63
|
| Rate for Payer: UHC Medicare Advantage |
$103.63
|
| Rate for Payer: VA VA |
$103.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
IP
|
$1,024.11
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$665.67 |
| Max. Negotiated Rate |
$921.70 |
| Rate for Payer: Aetna Commercial |
$870.49
|
| Rate for Payer: BCBS Trust/PPO |
$835.98
|
| Rate for Payer: BCN Commercial |
$791.43
|
| Rate for Payer: Cash Price |
$819.29
|
| Rate for Payer: Cofinity Commercial |
$880.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.29
|
| Rate for Payer: Healthscope Commercial |
$921.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.49
|
| Rate for Payer: Nomi Health Commercial |
$839.77
|
| Rate for Payer: PHP Commercial |
$870.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.67
|
| Rate for Payer: Priority Health HMO/PPO |
$890.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$901.22
|
| Rate for Payer: UHC Core |
$855.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.08
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
OP
|
$1,024.11
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$243.23 |
| Max. Negotiated Rate |
$921.70 |
| Rate for Payer: Aetna Commercial |
$870.49
|
| Rate for Payer: Aetna Medicare |
$266.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$320.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$320.03
|
| Rate for Payer: BCBS Complete |
$409.64
|
| Rate for Payer: BCBS MAPPO |
$256.03
|
| Rate for Payer: BCBS Trust/PPO |
$841.92
|
| Rate for Payer: BCN Commercial |
$796.25
|
| Rate for Payer: BCN Medicare Advantage |
$256.03
|
| Rate for Payer: Cash Price |
$819.29
|
| Rate for Payer: Cofinity Commercial |
$880.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$256.03
|
| Rate for Payer: Healthscope Commercial |
$921.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$294.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.49
|
| Rate for Payer: Nomi Health Commercial |
$839.77
|
| Rate for Payer: PACE Senior Care Partners |
$243.23
|
| Rate for Payer: PACE SWMI |
$256.03
|
| Rate for Payer: PHP Commercial |
$870.49
|
| Rate for Payer: PHP Medicare Advantage |
$256.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.67
|
| Rate for Payer: Priority Health HMO/PPO |
$890.98
|
| Rate for Payer: Priority Health Medicare |
$258.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.15
|
| Rate for Payer: Railroad Medicare Medicare |
$256.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$901.22
|
| Rate for Payer: UHC Core |
$855.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$256.03
|
| Rate for Payer: UHC Exchange |
$256.03
|
| Rate for Payer: UHC Medicare Advantage |
$256.03
|
| Rate for Payer: VA VA |
$256.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.08
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
OP
|
$1,277.63
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$303.44 |
| Max. Negotiated Rate |
$1,149.87 |
| Rate for Payer: Aetna Commercial |
$1,085.99
|
| Rate for Payer: Aetna Medicare |
$332.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.26
|
| Rate for Payer: BCBS Complete |
$511.05
|
| Rate for Payer: BCBS MAPPO |
$319.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.34
|
| Rate for Payer: BCN Commercial |
$993.36
|
| Rate for Payer: BCN Medicare Advantage |
$319.41
|
| Rate for Payer: Cash Price |
$1,022.10
|
| Rate for Payer: Cofinity Commercial |
$1,098.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,022.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.41
|
| Rate for Payer: Healthscope Commercial |
$1,149.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$958.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$335.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.99
|
| Rate for Payer: Nomi Health Commercial |
$1,047.66
|
| Rate for Payer: PACE Senior Care Partners |
$303.44
|
| Rate for Payer: PACE SWMI |
$319.41
|
| Rate for Payer: PHP Commercial |
$1,085.99
|
| Rate for Payer: PHP Medicare Advantage |
$319.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,111.54
|
| Rate for Payer: Priority Health Medicare |
$322.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$856.01
|
| Rate for Payer: Railroad Medicare Medicare |
$319.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,124.31
|
| Rate for Payer: UHC Core |
$1,066.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.41
|
| Rate for Payer: UHC Exchange |
$319.41
|
| Rate for Payer: UHC Medicare Advantage |
$319.41
|
| Rate for Payer: VA VA |
$319.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$958.22
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
IP
|
$1,277.63
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$830.46 |
| Max. Negotiated Rate |
$1,149.87 |
| Rate for Payer: Aetna Commercial |
$1,085.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,042.93
|
| Rate for Payer: BCN Commercial |
$987.35
|
| Rate for Payer: Cash Price |
$1,022.10
|
| Rate for Payer: Cofinity Commercial |
$1,098.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,022.10
|
| Rate for Payer: Healthscope Commercial |
$1,149.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$958.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.99
|
| Rate for Payer: Nomi Health Commercial |
$1,047.66
|
| Rate for Payer: PHP Commercial |
$1,085.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$830.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,111.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$856.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,124.31
|
| Rate for Payer: UHC Core |
$1,066.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$958.22
|
|
|
HC SP Z TRUE FILL
|
Facility
|
IP
|
$6,757.01
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,392.06 |
| Max. Negotiated Rate |
$6,081.31 |
| Rate for Payer: Aetna Commercial |
$5,743.46
|
| Rate for Payer: BCBS Trust/PPO |
$5,515.75
|
| Rate for Payer: BCN Commercial |
$5,221.82
|
| Rate for Payer: Cash Price |
$5,405.61
|
| Rate for Payer: Cofinity Commercial |
$5,811.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.61
|
| Rate for Payer: Healthscope Commercial |
$6,081.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,067.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.46
|
| Rate for Payer: Nomi Health Commercial |
$5,540.75
|
| Rate for Payer: PHP Commercial |
$5,743.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,392.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5,878.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,527.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,946.17
|
| Rate for Payer: UHC Core |
$5,642.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,067.76
|
|
|
HC SP Z TRUE FILL
|
Facility
|
OP
|
$6,757.01
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,604.79 |
| Max. Negotiated Rate |
$6,081.31 |
| Rate for Payer: Aetna Commercial |
$5,743.46
|
| Rate for Payer: Aetna Medicare |
$1,756.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,111.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,111.57
|
| Rate for Payer: BCBS Complete |
$2,702.80
|
| Rate for Payer: BCBS MAPPO |
$1,689.25
|
| Rate for Payer: BCBS Trust/PPO |
$5,554.94
|
| Rate for Payer: BCN Commercial |
$5,253.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.25
|
| Rate for Payer: Cash Price |
$5,405.61
|
| Rate for Payer: Cofinity Commercial |
$5,811.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,405.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.25
|
| Rate for Payer: Healthscope Commercial |
$6,081.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,067.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,773.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,942.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,743.46
|
| Rate for Payer: Nomi Health Commercial |
$5,540.75
|
| Rate for Payer: PACE Senior Care Partners |
$1,604.79
|
| Rate for Payer: PACE SWMI |
$1,689.25
|
| Rate for Payer: PHP Commercial |
$5,743.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,392.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5,878.60
|
| Rate for Payer: Priority Health Medicare |
$1,706.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,527.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,946.17
|
| Rate for Payer: UHC Core |
$5,642.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,689.25
|
| Rate for Payer: UHC Exchange |
$1,689.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,689.25
|
| Rate for Payer: VA VA |
$1,689.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,067.76
|
|
