|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,000.05 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.70
|
| Rate for Payer: BCN Commercial |
$1,186.70
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$156.02 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$230.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.56
|
| Rate for Payer: BCBS Complete |
$163.81
|
| Rate for Payer: BCBS MAPPO |
$221.25
|
| Rate for Payer: BCBS Trust/PPO |
$727.54
|
| Rate for Payer: BCN Commercial |
$727.54
|
| Rate for Payer: BCN Medicare Advantage |
$221.25
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.25
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Mclaren Medicaid |
$156.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.31
|
| Rate for Payer: Meridian Medicaid |
$163.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Senior Care Partners |
$210.18
|
| Rate for Payer: PACE SWMI |
$221.25
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$221.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Medicare |
$223.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: Railroad Medicare Medicare |
$221.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: UHC Exchange |
$221.25
|
| Rate for Payer: UHC Medicaid |
$156.02
|
| Rate for Payer: UHC Medicare Advantage |
$221.25
|
| Rate for Payer: UHCCP Medicaid |
$156.02
|
| Rate for Payer: VA VA |
$221.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$615.95 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: BCBS Trust/PPO |
$730.90
|
| Rate for Payer: BCN Commercial |
$730.90
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$615.95 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: BCBS Trust/PPO |
$730.90
|
| Rate for Payer: BCN Commercial |
$730.90
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$156.02 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$230.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.56
|
| Rate for Payer: BCBS Complete |
$163.81
|
| Rate for Payer: BCBS MAPPO |
$221.25
|
| Rate for Payer: BCBS Trust/PPO |
$727.54
|
| Rate for Payer: BCN Commercial |
$727.54
|
| Rate for Payer: BCN Medicare Advantage |
$221.25
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.25
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Mclaren Medicaid |
$156.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.31
|
| Rate for Payer: Meridian Medicaid |
$163.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Senior Care Partners |
$210.18
|
| Rate for Payer: PACE SWMI |
$221.25
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$221.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Medicare |
$223.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: Railroad Medicare Medicare |
$221.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: UHC Exchange |
$221.25
|
| Rate for Payer: UHC Medicaid |
$156.02
|
| Rate for Payer: UHC Medicare Advantage |
$221.25
|
| Rate for Payer: UHCCP Medicaid |
$156.02
|
| Rate for Payer: VA VA |
$221.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$425.40 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna Medicare |
$627.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$754.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$754.05
|
| Rate for Payer: BCBS Complete |
$446.64
|
| Rate for Payer: BCBS MAPPO |
$603.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.69
|
| Rate for Payer: BCN Commercial |
$1,983.69
|
| Rate for Payer: BCN Medicare Advantage |
$603.24
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.24
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Mclaren Medicaid |
$425.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.40
|
| Rate for Payer: Meridian Medicaid |
$446.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$663.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: PACE Senior Care Partners |
$573.08
|
| Rate for Payer: PACE SWMI |
$603.24
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: PHP Medicare Advantage |
$603.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$425.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,099.28
|
| Rate for Payer: Priority Health Medicare |
$609.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,679.42
|
| Rate for Payer: Railroad Medicare Medicare |
$603.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,123.40
|
| Rate for Payer: UHC Core |
$2,014.82
|
| Rate for Payer: UHC Exchange |
$603.24
|
| Rate for Payer: UHC Medicaid |
$425.40
|
| Rate for Payer: UHC Medicare Advantage |
$603.24
|
| Rate for Payer: UHCCP Medicaid |
$425.40
|
| Rate for Payer: VA VA |
$603.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,679.42 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,992.86
|
| Rate for Payer: BCN Commercial |
$1,992.86
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,809.72
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,099.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,679.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,123.40
|
| Rate for Payer: UHC Core |
$2,014.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$519.81 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna Medicare |
$766.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$921.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$921.39
|
| Rate for Payer: BCBS Complete |
$545.76
|
| Rate for Payer: BCBS MAPPO |
$737.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,423.93
|
| Rate for Payer: BCN Commercial |
$2,423.93
|
| Rate for Payer: BCN Medicare Advantage |
$737.12
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.12
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Mclaren Medicaid |
$519.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.97
|
| Rate for Payer: Meridian Medicaid |
$545.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$847.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: PACE Senior Care Partners |
$700.26
|
| Rate for Payer: PACE SWMI |
$737.12
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: PHP Medicare Advantage |
$737.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,565.16
|
| Rate for Payer: Priority Health Medicare |
$744.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,052.13
|
| Rate for Payer: Railroad Medicare Medicare |
$737.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,594.64
|
| Rate for Payer: UHC Core |
$2,461.96
|
| Rate for Payer: UHC Exchange |
$737.12
|
| Rate for Payer: UHC Medicaid |
$519.81
|
| Rate for Payer: UHC Medicare Advantage |
$737.12
|
| Rate for Payer: UHCCP Medicaid |
$519.81
|
| Rate for Payer: VA VA |
$737.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,052.13 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.13
|
| Rate for Payer: BCN Commercial |
$2,435.13
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,211.34
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,565.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,052.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,594.64
|
| Rate for Payer: UHC Core |
$2,461.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$289.70 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: BCBS Trust/PPO |
$343.76
|
| Rate for Payer: BCN Commercial |
$343.76
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.28
|
| Rate for Payer: UHC Core |
$347.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.17
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$416.23
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$73.38 |
| Max. Negotiated Rate |
$374.61 |
| Rate for Payer: Aetna Commercial |
$353.80
|
| Rate for Payer: Aetna Medicare |
$108.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.07
|
| Rate for Payer: BCBS Complete |
$77.04
|
| Rate for Payer: BCBS MAPPO |
$104.06
|
| Rate for Payer: BCBS Trust/PPO |
$342.18
|
| Rate for Payer: BCN Commercial |
$342.18
|
| Rate for Payer: BCN Medicare Advantage |
$104.06
|
| Rate for Payer: Cash Price |
$332.98
|
| Rate for Payer: Cofinity Commercial |
$357.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.06
|
| Rate for Payer: Healthscope Commercial |
$374.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.17
|
| Rate for Payer: Mclaren Medicaid |
$73.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.26
|
| Rate for Payer: Meridian Medicaid |
$77.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.80
|
| Rate for Payer: Nomi Health Commercial |
$341.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.17
|
| Rate for Payer: PACE Senior Care Partners |
$98.85
|
| Rate for Payer: PACE SWMI |
$104.06
|
| Rate for Payer: PHP Commercial |
$353.80
|
| Rate for Payer: PHP Medicare Advantage |
$104.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.12
|
| Rate for Payer: Priority Health Medicare |
$105.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.70
|
| Rate for Payer: Railroad Medicare Medicare |
$104.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.28
|
| Rate for Payer: UHC Core |
$347.55
|
| Rate for Payer: UHC Exchange |
$104.06
|
| Rate for Payer: UHC Medicaid |
$73.38
|
| Rate for Payer: UHC Medicare Advantage |
$104.06
|
| Rate for Payer: UHCCP Medicaid |
$73.38
|
| Rate for Payer: VA VA |
$104.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.17
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,585.70 |
| Max. Negotiated Rate |
$8,094.87 |
| Rate for Payer: Aetna Commercial |
$7,645.15
|
| Rate for Payer: Aetna Medicare |
$2,338.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,810.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,810.72
|
| Rate for Payer: BCBS Complete |
$1,664.84
|
| Rate for Payer: BCBS MAPPO |
$2,248.57
|
| Rate for Payer: BCBS Trust/PPO |
$7,394.21
|
| Rate for Payer: BCN Commercial |
$7,394.21
|
| Rate for Payer: BCN Medicare Advantage |
$2,248.57
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Commercial |
$7,735.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,248.57
|
| Rate for Payer: Healthscope Commercial |
$8,094.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,745.73
|
| Rate for Payer: Mclaren Medicaid |
$1,585.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,361.00
|
| Rate for Payer: Meridian Medicaid |
$1,664.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,585.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,473.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Nomi Health Commercial |
$7,375.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: PACE Senior Care Partners |
$2,136.15
|
| Rate for Payer: PACE SWMI |
$2,248.57
|
| Rate for Payer: PHP Commercial |
$7,645.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,248.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,585.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,825.04
|
| Rate for Payer: Priority Health Medicare |
$2,271.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,260.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,248.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,914.98
|
| Rate for Payer: UHC Core |
$7,510.24
|
| Rate for Payer: UHC Exchange |
$2,248.57
|
| Rate for Payer: UHC Medicaid |
$1,585.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,248.57
|
| Rate for Payer: UHCCP Medicaid |
$1,585.70
|
| Rate for Payer: VA VA |
$2,248.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,745.73
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,994.30
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$6,260.03 |
| Max. Negotiated Rate |
$8,094.87 |
| Rate for Payer: Aetna Commercial |
$7,645.15
|
| Rate for Payer: BCBS Trust/PPO |
$7,428.39
|
| Rate for Payer: BCN Commercial |
$7,428.39
|
| Rate for Payer: Cash Price |
$7,195.44
|
| Rate for Payer: Cofinity Commercial |
$7,735.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,195.44
|
| Rate for Payer: Healthscope Commercial |
$8,094.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,745.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,645.15
|
| Rate for Payer: Nomi Health Commercial |
$7,375.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,745.73
|
| Rate for Payer: PHP Commercial |
$7,645.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,825.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,260.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,914.98
|
| Rate for Payer: UHC Core |
$7,510.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,745.73
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,562.52 |
| Max. Negotiated Rate |
$4,606.71 |
| Rate for Payer: Aetna Commercial |
$4,350.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,227.43
|
| Rate for Payer: BCN Commercial |
$4,227.43
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Commercial |
$4,401.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Healthscope Commercial |
$4,606.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,838.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Nomi Health Commercial |
$4,197.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: PHP Commercial |
$4,350.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,453.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,562.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,504.34
|
| Rate for Payer: UHC Core |
$4,274.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,838.93
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,118.57
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$902.40 |
| Max. Negotiated Rate |
$4,606.71 |
| Rate for Payer: Aetna Commercial |
$4,350.78
|
| Rate for Payer: Aetna Medicare |
$1,330.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,599.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,599.55
|
| Rate for Payer: BCBS Complete |
$947.45
|
| Rate for Payer: BCBS MAPPO |
$1,279.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,207.98
|
| Rate for Payer: BCN Commercial |
$4,207.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,279.64
|
| Rate for Payer: Cash Price |
$4,094.86
|
| Rate for Payer: Cofinity Commercial |
$4,401.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,094.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,279.64
|
| Rate for Payer: Healthscope Commercial |
$4,606.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,838.93
|
| Rate for Payer: Mclaren Medicaid |
$902.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,343.62
|
| Rate for Payer: Meridian Medicaid |
$947.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,471.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,407.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,350.78
|
| Rate for Payer: Nomi Health Commercial |
$4,197.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,838.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,215.66
|
| Rate for Payer: PACE SWMI |
$1,279.64
|
| Rate for Payer: PHP Commercial |
$4,350.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,279.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$902.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,453.16
|
| Rate for Payer: Priority Health Medicare |
$1,292.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,562.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,279.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,504.34
|
| Rate for Payer: UHC Core |
$4,274.01
|
| Rate for Payer: UHC Exchange |
$1,279.64
|
| Rate for Payer: UHC Medicaid |
$902.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,279.64
|
| Rate for Payer: UHCCP Medicaid |
$902.40
|
| Rate for Payer: VA VA |
$1,279.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,838.93
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,733.88 |
| Max. Negotiated Rate |
$2,242.09 |
| Rate for Payer: Aetna Commercial |
$2,117.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.49
|
| Rate for Payer: BCN Commercial |
$2,057.49
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Commercial |
$2,142.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Healthscope Commercial |
$2,242.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,868.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Nomi Health Commercial |
$2,042.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: PHP Commercial |
$2,117.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,167.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,192.26
|
| Rate for Payer: UHC Core |
$2,080.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,868.41
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,491.21
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$439.20 |
| Max. Negotiated Rate |
$2,242.09 |
| Rate for Payer: Aetna Commercial |
$2,117.53
|
| Rate for Payer: Aetna Medicare |
$647.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$778.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$778.50
|
| Rate for Payer: BCBS Complete |
$461.12
|
| Rate for Payer: BCBS MAPPO |
$622.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,048.02
|
| Rate for Payer: BCN Commercial |
$2,048.02
|
| Rate for Payer: BCN Medicare Advantage |
$622.80
|
| Rate for Payer: Cash Price |
$1,992.97
|
| Rate for Payer: Cofinity Commercial |
$2,142.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.80
|
| Rate for Payer: Healthscope Commercial |
$2,242.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,868.41
|
| Rate for Payer: Mclaren Medicaid |
$439.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.94
|
| Rate for Payer: Meridian Medicaid |
$461.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.53
|
| Rate for Payer: Nomi Health Commercial |
$2,042.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.41
|
| Rate for Payer: PACE Senior Care Partners |
$591.66
|
| Rate for Payer: PACE SWMI |
$622.80
|
| Rate for Payer: PHP Commercial |
$2,117.53
|
| Rate for Payer: PHP Medicare Advantage |
$622.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,167.35
|
| Rate for Payer: Priority Health Medicare |
$629.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.88
|
| Rate for Payer: Railroad Medicare Medicare |
$622.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,192.26
|
| Rate for Payer: UHC Core |
$2,080.16
|
| Rate for Payer: UHC Exchange |
$622.80
|
| Rate for Payer: UHC Medicaid |
$439.20
|
| Rate for Payer: UHC Medicare Advantage |
$622.80
|
| Rate for Payer: UHCCP Medicaid |
$439.20
|
| Rate for Payer: VA VA |
$622.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,868.41
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$322.99 |
| Max. Negotiated Rate |
$1,648.82 |
| Rate for Payer: Aetna Commercial |
$1,557.22
|
| Rate for Payer: Aetna Medicare |
$476.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$572.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$572.51
|
| Rate for Payer: BCBS Complete |
$339.11
|
| Rate for Payer: BCBS MAPPO |
$458.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,506.10
|
| Rate for Payer: BCN Commercial |
$1,506.10
|
| Rate for Payer: BCN Medicare Advantage |
$458.00
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Commercial |
$1,575.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.00
|
| Rate for Payer: Healthscope Commercial |
$1,648.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,374.02
|
| Rate for Payer: Mclaren Medicaid |
$322.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$480.91
|
| Rate for Payer: Meridian Medicaid |
$339.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$526.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$503.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,557.22
|
| Rate for Payer: Nomi Health Commercial |
$1,502.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: PACE Senior Care Partners |
$435.10
|
| Rate for Payer: PACE SWMI |
$458.00
|
| Rate for Payer: PHP Commercial |
$1,557.22
|
| Rate for Payer: PHP Medicare Advantage |
$458.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,593.86
|
| Rate for Payer: Priority Health Medicare |
$462.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.09
|
| Rate for Payer: Railroad Medicare Medicare |
$458.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,612.18
|
| Rate for Payer: UHC Core |
$1,529.74
|
| Rate for Payer: UHC Exchange |
$458.00
|
| Rate for Payer: UHC Medicaid |
$322.99
|
| Rate for Payer: UHC Medicare Advantage |
$458.00
|
| Rate for Payer: UHCCP Medicaid |
$322.99
|
| Rate for Payer: VA VA |
$458.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,374.02
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,832.02
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,275.09 |
| Max. Negotiated Rate |
$1,648.82 |
| Rate for Payer: Aetna Commercial |
$1,557.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.07
|
| Rate for Payer: BCN Commercial |
$1,513.07
|
| Rate for Payer: Cash Price |
$1,465.62
|
| Rate for Payer: Cofinity Commercial |
$1,575.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,465.62
|
| Rate for Payer: Healthscope Commercial |
$1,648.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,374.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,557.22
|
| Rate for Payer: Nomi Health Commercial |
$1,502.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,374.02
|
| Rate for Payer: PHP Commercial |
$1,557.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,593.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,612.18
|
| Rate for Payer: UHC Core |
$1,529.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,374.02
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,297.24 |
| Max. Negotiated Rate |
$4,263.68 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,912.64
|
| Rate for Payer: BCN Commercial |
$3,912.64
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,553.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$3,884.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,121.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,297.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,168.93
|
| Rate for Payer: UHC Core |
$3,955.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,553.07
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,737.42
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$835.21 |
| Max. Negotiated Rate |
$4,263.68 |
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna Medicare |
$1,231.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,480.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,480.44
|
| Rate for Payer: BCBS Complete |
$876.90
|
| Rate for Payer: BCBS MAPPO |
$1,184.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,894.63
|
| Rate for Payer: BCN Commercial |
$3,894.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.36
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.36
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,553.07
|
| Rate for Payer: Mclaren Medicaid |
$835.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.57
|
| Rate for Payer: Meridian Medicaid |
$876.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,362.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,302.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$3,884.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,125.14
|
| Rate for Payer: PACE SWMI |
$1,184.36
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,121.56
|
| Rate for Payer: Priority Health Medicare |
$1,196.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,297.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,184.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,168.93
|
| Rate for Payer: UHC Core |
$3,955.75
|
| Rate for Payer: UHC Exchange |
$1,184.36
|
| Rate for Payer: UHC Medicaid |
$835.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.36
|
| Rate for Payer: UHCCP Medicaid |
$835.21
|
| Rate for Payer: VA VA |
$1,184.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,553.07
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$253.32 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna Medicare |
$373.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.02
|
| Rate for Payer: BCBS Complete |
$265.96
|
| Rate for Payer: BCBS MAPPO |
$359.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.24
|
| Rate for Payer: BCN Commercial |
$1,181.24
|
| Rate for Payer: BCN Medicare Advantage |
$359.21
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.21
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Mclaren Medicaid |
$253.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.18
|
| Rate for Payer: Meridian Medicaid |
$265.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Senior Care Partners |
$341.25
|
| Rate for Payer: PACE SWMI |
$359.21
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: PHP Medicare Advantage |
$359.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Medicare |
$362.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: Railroad Medicare Medicare |
$359.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: UHC Exchange |
$359.21
|
| Rate for Payer: UHC Medicaid |
$253.32
|
| Rate for Payer: UHC Medicare Advantage |
$359.21
|
| Rate for Payer: UHCCP Medicaid |
$253.32
|
| Rate for Payer: VA VA |
$359.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,000.05 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.70
|
| Rate for Payer: BCN Commercial |
$1,186.70
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
