|
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 |
$4,021.03 |
| 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 |
$4,021.03
|
| 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 |
$3,829.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$4,021.03
|
| 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 |
$3,829.30
|
| 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 |
$3,829.30
|
| 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
|
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 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 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 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 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
|
|
|
HC SQ ICD
|
Facility
|
IP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36,671.86 |
| Max. Negotiated Rate |
$50,776.42 |
| Rate for Payer: Aetna Commercial |
$47,955.50
|
| Rate for Payer: BCBS Trust/PPO |
$46,054.21
|
| Rate for Payer: BCN Commercial |
$43,600.02
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$48,519.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Healthscope Commercial |
$50,776.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42,313.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: PHP Commercial |
$47,955.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49,083.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,800.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,648.05
|
| Rate for Payer: UHC Core |
$47,109.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42,313.68
|
|
|
HC SQ ICD
|
Facility
|
OP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,399.33 |
| Max. Negotiated Rate |
$50,776.42 |
| Rate for Payer: Aetna Commercial |
$47,955.50
|
| Rate for Payer: Aetna Medicare |
$14,668.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,630.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,630.70
|
| Rate for Payer: BCBS Complete |
$22,567.30
|
| Rate for Payer: BCBS MAPPO |
$14,104.56
|
| Rate for Payer: BCBS Trust/PPO |
$46,381.44
|
| Rate for Payer: BCN Commercial |
$43,865.18
|
| Rate for Payer: BCN Medicare Advantage |
$14,104.56
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$48,519.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,104.56
|
| Rate for Payer: Healthscope Commercial |
$50,776.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42,313.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,809.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,220.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: PACE Senior Care Partners |
$13,399.33
|
| Rate for Payer: PACE SWMI |
$14,104.56
|
| Rate for Payer: PHP Commercial |
$47,955.50
|
| Rate for Payer: PHP Medicare Advantage |
$14,104.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49,083.87
|
| Rate for Payer: Priority Health Medicare |
$14,245.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,800.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14,104.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,648.05
|
| Rate for Payer: UHC Core |
$47,109.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,104.56
|
| Rate for Payer: UHC Exchange |
$14,104.56
|
| Rate for Payer: UHC Medicare Advantage |
$14,104.56
|
| Rate for Payer: VA VA |
$14,104.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42,313.68
|
|
|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,482.34 |
| Max. Negotiated Rate |
$13,196.25 |
| Rate for Payer: Aetna Commercial |
$12,463.12
|
| Rate for Payer: Aetna Medicare |
$3,812.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,582.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,582.03
|
| Rate for Payer: BCBS Complete |
$5,865.00
|
| Rate for Payer: BCBS MAPPO |
$3,665.62
|
| Rate for Payer: BCBS Trust/PPO |
$12,054.04
|
| Rate for Payer: BCN Commercial |
$11,400.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,665.62
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$12,609.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,665.62
|
| Rate for Payer: Healthscope Commercial |
$13,196.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,996.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,848.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,215.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: PACE Senior Care Partners |
$3,482.34
|
| Rate for Payer: PACE SWMI |
$3,665.62
|
| Rate for Payer: PHP Commercial |
$12,463.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,665.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: Priority Health HMO/PPO |
$12,756.38
|
| Rate for Payer: Priority Health Medicare |
$3,702.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,823.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3,665.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,903.00
|
| Rate for Payer: UHC Core |
$12,243.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,665.62
|
| Rate for Payer: UHC Exchange |
$3,665.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,665.62
|
| Rate for Payer: VA VA |
$3,665.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,996.88
|
|
|
HC SQ ICD LEAD
|
Facility
|
IP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,530.62 |
| Max. Negotiated Rate |
$13,196.25 |
| Rate for Payer: Aetna Commercial |
$12,463.12
|
| Rate for Payer: BCBS Trust/PPO |
$11,969.00
|
| Rate for Payer: BCN Commercial |
$11,331.18
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$12,609.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Healthscope Commercial |
$13,196.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,996.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: PHP Commercial |
$12,463.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: Priority Health HMO/PPO |
$12,756.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,823.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,903.00
|
| Rate for Payer: UHC Core |
$12,243.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,996.88
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
OP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$50.41 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$209.53
|
| Rate for Payer: Aetna Medicare |
$64.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.03
|
| Rate for Payer: BCBS Complete |
$52.94
|
| Rate for Payer: BCBS MAPPO |
$61.63
|
| Rate for Payer: BCBS Trust/PPO |
$202.66
|
| Rate for Payer: BCN Commercial |
$191.66
|
| Rate for Payer: BCN Medicare Advantage |
$61.63
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$212.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.63
|
| Rate for Payer: Healthscope Commercial |
$221.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.88
|
| Rate for Payer: Mclaren Medicaid |
$50.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.71
|
| Rate for Payer: Meridian Medicaid |
$52.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: PACE Senior Care Partners |
$58.55
|
| Rate for Payer: PACE SWMI |
$61.63
|
| Rate for Payer: PHP Commercial |
$209.53
|
| Rate for Payer: PHP Medicare Advantage |
$61.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: Priority Health HMO/PPO |
$214.46
|
| Rate for Payer: Priority Health Medicare |
$62.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.16
|
| Rate for Payer: Railroad Medicare Medicare |
$61.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.93
|
| Rate for Payer: UHC Core |
$205.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.63
|
| Rate for Payer: UHC Exchange |
$61.63
|
| Rate for Payer: UHC Medicare Advantage |
$61.63
|
| Rate for Payer: UHCCP Medicaid |
$50.41
|
| Rate for Payer: VA VA |
$61.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.88
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
IP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$160.23 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$209.53
|
| Rate for Payer: BCBS Trust/PPO |
$201.23
|
| Rate for Payer: BCN Commercial |
$190.50
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$212.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Healthscope Commercial |
$221.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: PHP Commercial |
$209.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: Priority Health HMO/PPO |
$214.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.93
|
| Rate for Payer: UHC Core |
$205.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.88
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$324.31 |
| Max. Negotiated Rate |
$449.05 |
| Rate for Payer: Aetna Commercial |
$424.10
|
| Rate for Payer: BCBS Trust/PPO |
$407.28
|
| Rate for Payer: BCN Commercial |
$385.58
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$429.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Healthscope Commercial |
$449.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: PHP Commercial |
$424.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: Priority Health HMO/PPO |
$434.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.07
|
| Rate for Payer: UHC Core |
$416.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.20
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$50.41 |
| Max. Negotiated Rate |
$449.05 |
| Rate for Payer: Aetna Commercial |
$424.10
|
| Rate for Payer: Aetna Medicare |
$129.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.92
|
| Rate for Payer: BCBS Complete |
$52.94
|
| Rate for Payer: BCBS MAPPO |
$124.74
|
| Rate for Payer: BCBS Trust/PPO |
$410.18
|
| Rate for Payer: BCN Commercial |
$387.93
|
| Rate for Payer: BCN Medicare Advantage |
$124.74
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$429.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.74
|
| Rate for Payer: Healthscope Commercial |
$449.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.20
|
| Rate for Payer: Mclaren Medicaid |
$50.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.97
|
| Rate for Payer: Meridian Medicaid |
$52.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: PACE Senior Care Partners |
$118.50
|
| Rate for Payer: PACE SWMI |
$124.74
|
| Rate for Payer: PHP Commercial |
$424.10
|
| Rate for Payer: PHP Medicare Advantage |
$124.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: Priority Health HMO/PPO |
$434.08
|
| Rate for Payer: Priority Health Medicare |
$125.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.29
|
| Rate for Payer: Railroad Medicare Medicare |
$124.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.07
|
| Rate for Payer: UHC Core |
$416.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.74
|
| Rate for Payer: UHC Exchange |
$124.74
|
| Rate for Payer: UHC Medicare Advantage |
$124.74
|
| Rate for Payer: UHCCP Medicaid |
$50.41
|
| Rate for Payer: VA VA |
$124.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.20
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$97.36 |
| Max. Negotiated Rate |
$134.81 |
| Rate for Payer: Aetna Commercial |
$127.32
|
| Rate for Payer: BCBS Trust/PPO |
$122.27
|
| Rate for Payer: BCN Commercial |
$115.76
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$128.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Healthscope Commercial |
$134.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PHP Commercial |
$127.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO |
$130.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.82
|
| Rate for Payer: UHC Core |
$125.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.34
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$134.81 |
| Rate for Payer: Aetna Commercial |
$127.32
|
| Rate for Payer: Aetna Medicare |
$38.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.81
|
| Rate for Payer: BCBS Complete |
$52.94
|
| Rate for Payer: BCBS MAPPO |
$37.45
|
| Rate for Payer: BCBS Trust/PPO |
$123.14
|
| Rate for Payer: BCN Commercial |
$116.46
|
| Rate for Payer: BCN Medicare Advantage |
$37.45
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$128.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.45
|
| Rate for Payer: Healthscope Commercial |
$134.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.34
|
| Rate for Payer: Mclaren Medicaid |
$50.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.32
|
| Rate for Payer: Meridian Medicaid |
$52.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PACE Senior Care Partners |
$35.58
|
| Rate for Payer: PACE SWMI |
$37.45
|
| Rate for Payer: PHP Commercial |
$127.32
|
| Rate for Payer: PHP Medicare Advantage |
$37.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO |
$130.32
|
| Rate for Payer: Priority Health Medicare |
$37.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.36
|
| Rate for Payer: Railroad Medicare Medicare |
$37.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.82
|
| Rate for Payer: UHC Core |
$125.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.45
|
| Rate for Payer: UHC Exchange |
$37.45
|
| Rate for Payer: UHC Medicare Advantage |
$37.45
|
| Rate for Payer: UHCCP Medicaid |
$50.41
|
| Rate for Payer: VA VA |
$37.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.34
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$216.40 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: BCBS Trust/PPO |
$271.77
|
| Rate for Payer: BCN Commercial |
$257.29
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO |
$289.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.98
|
| Rate for Payer: UHC Core |
$278.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: Aetna Medicare |
$86.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.04
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$273.70
|
| Rate for Payer: BCN Commercial |
$258.85
|
| Rate for Payer: BCN Medicare Advantage |
$83.23
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.39
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PACE Senior Care Partners |
$79.07
|
| Rate for Payer: PACE SWMI |
$83.23
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: PHP Medicare Advantage |
$83.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO |
$289.65
|
| Rate for Payer: Priority Health Medicare |
$84.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.06
|
| Rate for Payer: Railroad Medicare Medicare |
$83.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.98
|
| Rate for Payer: UHC Core |
$278.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.23
|
| Rate for Payer: UHC Exchange |
$83.23
|
| Rate for Payer: UHC Medicare Advantage |
$83.23
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$83.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$736.59 |
| Max. Negotiated Rate |
$5,686.35 |
| Rate for Payer: Aetna Commercial |
$2,636.22
|
| Rate for Payer: Aetna Medicare |
$806.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.20
|
| Rate for Payer: BCBS Complete |
$5,686.35
|
| Rate for Payer: BCBS MAPPO |
$775.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.69
|
| Rate for Payer: BCN Commercial |
$2,411.36
|
| Rate for Payer: BCN Medicare Advantage |
$775.36
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,667.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.36
|
| Rate for Payer: Healthscope Commercial |
$2,791.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.07
|
| Rate for Payer: Mclaren Medicaid |
$5,415.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.13
|
| Rate for Payer: Meridian Medicaid |
$5,686.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PACE Senior Care Partners |
$736.59
|
| Rate for Payer: PACE SWMI |
$775.36
|
| Rate for Payer: PHP Commercial |
$2,636.22
|
| Rate for Payer: PHP Medicare Advantage |
$775.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,415.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO |
$2,698.24
|
| Rate for Payer: Priority Health Medicare |
$783.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,077.96
|
| Rate for Payer: Railroad Medicare Medicare |
$775.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.26
|
| Rate for Payer: UHC Core |
$2,589.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.36
|
| Rate for Payer: UHC Exchange |
$775.36
|
| Rate for Payer: UHC Medicare Advantage |
$775.36
|
| Rate for Payer: UHCCP Medicaid |
$5,415.21
|
| Rate for Payer: VA VA |
$775.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.07
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$2,791.29 |
| Rate for Payer: Aetna Commercial |
$2,636.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,531.70
|
| Rate for Payer: BCN Commercial |
$2,396.79
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,667.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Healthscope Commercial |
$2,791.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PHP Commercial |
$2,636.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO |
$2,698.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,077.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.26
|
| Rate for Payer: UHC Core |
$2,589.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.07
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,243.86 |
| Max. Negotiated Rate |
$4,775.44 |
| Rate for Payer: Aetna Commercial |
$4,510.13
|
| Rate for Payer: Aetna Medicare |
$1,379.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,658.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,658.14
|
| Rate for Payer: BCBS Complete |
$1,306.14
|
| Rate for Payer: BCBS MAPPO |
$1,326.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,362.10
|
| Rate for Payer: BCN Commercial |
$4,125.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,326.51
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,563.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,326.51
|
| Rate for Payer: Healthscope Commercial |
$4,775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.53
|
| Rate for Payer: Mclaren Medicaid |
$1,243.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,392.84
|
| Rate for Payer: Meridian Medicaid |
$1,306.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,525.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PACE Senior Care Partners |
$1,260.18
|
| Rate for Payer: PACE SWMI |
$1,326.51
|
| Rate for Payer: PHP Commercial |
$4,510.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,326.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,243.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,616.25
|
| Rate for Payer: Priority Health Medicare |
$1,339.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,555.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,326.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,669.32
|
| Rate for Payer: UHC Core |
$4,430.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,326.51
|
| Rate for Payer: UHC Exchange |
$1,326.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,326.51
|
| Rate for Payer: UHCCP Medicaid |
$1,243.86
|
| Rate for Payer: VA VA |
$1,326.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.53
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,448.93 |
| Max. Negotiated Rate |
$4,775.44 |
| Rate for Payer: Aetna Commercial |
$4,510.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,331.32
|
| Rate for Payer: BCN Commercial |
$4,100.51
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,563.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Commercial |
$4,775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PHP Commercial |
$4,510.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,616.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,555.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,669.32
|
| Rate for Payer: UHC Core |
$4,430.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.53
|
|
