|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
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 UPPER EXTREMITY
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
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 VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
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 VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
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 VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,041.15
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$183.55 |
| Max. Negotiated Rate |
$937.03 |
| Rate for Payer: Aetna Commercial |
$884.98
|
| Rate for Payer: Aetna Medicare |
$270.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.36
|
| Rate for Payer: BCBS Complete |
$192.72
|
| Rate for Payer: BCBS MAPPO |
$260.29
|
| Rate for Payer: BCBS Trust/PPO |
$855.93
|
| Rate for Payer: BCN Commercial |
$855.93
|
| Rate for Payer: BCN Medicare Advantage |
$260.29
|
| Rate for Payer: Cash Price |
$832.92
|
| Rate for Payer: Cofinity Commercial |
$895.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.29
|
| Rate for Payer: Healthscope Commercial |
$937.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.86
|
| Rate for Payer: Mclaren Medicaid |
$183.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.30
|
| Rate for Payer: Meridian Medicaid |
$192.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.98
|
| Rate for Payer: Nomi Health Commercial |
$853.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.86
|
| Rate for Payer: PACE Senior Care Partners |
$247.27
|
| Rate for Payer: PACE SWMI |
$260.29
|
| Rate for Payer: PHP Commercial |
$884.98
|
| Rate for Payer: PHP Medicare Advantage |
$260.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.80
|
| Rate for Payer: Priority Health Medicare |
$262.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.64
|
| Rate for Payer: Railroad Medicare Medicare |
$260.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.21
|
| Rate for Payer: UHC Core |
$869.36
|
| Rate for Payer: UHC Exchange |
$260.29
|
| Rate for Payer: UHC Medicaid |
$183.55
|
| Rate for Payer: UHC Medicare Advantage |
$260.29
|
| Rate for Payer: UHCCP Medicaid |
$183.55
|
| Rate for Payer: VA VA |
$260.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.86
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,041.15
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$724.64 |
| Max. Negotiated Rate |
$937.03 |
| Rate for Payer: Aetna Commercial |
$884.98
|
| Rate for Payer: BCBS Trust/PPO |
$859.89
|
| Rate for Payer: BCN Commercial |
$859.89
|
| Rate for Payer: Cash Price |
$832.92
|
| Rate for Payer: Cofinity Commercial |
$895.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.92
|
| Rate for Payer: Healthscope Commercial |
$937.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.98
|
| Rate for Payer: Nomi Health Commercial |
$853.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.86
|
| Rate for Payer: PHP Commercial |
$884.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.21
|
| Rate for Payer: UHC Core |
$869.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.86
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.78
|
| Rate for Payer: BCN Commercial |
$25.78
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.78
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicaid |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.50
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$8,284.71
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,460.59 |
| Max. Negotiated Rate |
$7,456.24 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: Aetna Medicare |
$2,154.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,588.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,588.97
|
| Rate for Payer: BCBS Complete |
$1,533.50
|
| Rate for Payer: BCBS MAPPO |
$2,071.18
|
| Rate for Payer: BCBS Trust/PPO |
$6,810.86
|
| Rate for Payer: BCN Commercial |
$6,810.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,071.18
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,071.18
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,213.53
|
| Rate for Payer: Mclaren Medicaid |
$1,460.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,174.74
|
| Rate for Payer: Meridian Medicaid |
$1,533.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,381.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,278.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,967.62
|
| Rate for Payer: PACE SWMI |
$2,071.18
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,071.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,460.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,207.70
|
| Rate for Payer: Priority Health Medicare |
$2,091.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,766.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,071.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,290.54
|
| Rate for Payer: UHC Core |
$6,917.73
|
| Rate for Payer: UHC Exchange |
$2,071.18
|
| Rate for Payer: UHC Medicaid |
$1,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,071.18
|
| Rate for Payer: UHCCP Medicaid |
$1,460.59
|
| Rate for Payer: VA VA |
$2,071.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,213.53
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$8,284.71
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,766.16 |
| Max. Negotiated Rate |
$7,456.24 |
| Rate for Payer: Aetna Commercial |
$7,042.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,842.34
|
| Rate for Payer: BCN Commercial |
$6,842.34
|
| Rate for Payer: Cash Price |
$6,627.77
|
| Rate for Payer: Cofinity Commercial |
$7,124.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,627.77
|
| Rate for Payer: Healthscope Commercial |
$7,456.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,213.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,042.00
|
| Rate for Payer: Nomi Health Commercial |
$6,793.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,213.53
|
| Rate for Payer: PHP Commercial |
$7,042.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,207.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,766.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,290.54
|
| Rate for Payer: UHC Core |
$6,917.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,213.53
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$875.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$609.35 |
| Max. Negotiated Rate |
$787.96 |
| Rate for Payer: Aetna Commercial |
$744.18
|
| Rate for Payer: BCBS Trust/PPO |
$723.08
|
| Rate for Payer: BCN Commercial |
$723.08
|
| Rate for Payer: Cash Price |
$700.41
|
| Rate for Payer: Cofinity Commercial |
$752.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.41
|
| Rate for Payer: Healthscope Commercial |
$787.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$744.18
|
| Rate for Payer: Nomi Health Commercial |
$717.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$656.63
|
| Rate for Payer: PHP Commercial |
$744.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$761.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.45
|
| Rate for Payer: UHC Core |
$731.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.63
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$875.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$154.35 |
| Max. Negotiated Rate |
$787.96 |
| Rate for Payer: Aetna Commercial |
$744.18
|
| Rate for Payer: Aetna Medicare |
$227.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.60
|
| Rate for Payer: BCBS Complete |
$162.06
|
| Rate for Payer: BCBS MAPPO |
$218.88
|
| Rate for Payer: BCBS Trust/PPO |
$719.76
|
| Rate for Payer: BCN Commercial |
$719.76
|
| Rate for Payer: BCN Medicare Advantage |
$218.88
|
| Rate for Payer: Cash Price |
$700.41
|
| Rate for Payer: Cofinity Commercial |
$752.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.88
|
| Rate for Payer: Healthscope Commercial |
$787.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.63
|
| Rate for Payer: Mclaren Medicaid |
$154.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.82
|
| Rate for Payer: Meridian Medicaid |
$162.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$744.18
|
| Rate for Payer: Nomi Health Commercial |
$717.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$656.63
|
| Rate for Payer: PACE Senior Care Partners |
$207.93
|
| Rate for Payer: PACE SWMI |
$218.88
|
| Rate for Payer: PHP Commercial |
$744.18
|
| Rate for Payer: PHP Medicare Advantage |
$218.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$761.69
|
| Rate for Payer: Priority Health Medicare |
$221.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.35
|
| Rate for Payer: Railroad Medicare Medicare |
$218.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.45
|
| Rate for Payer: UHC Core |
$731.05
|
| Rate for Payer: UHC Exchange |
$218.88
|
| Rate for Payer: UHC Medicaid |
$154.35
|
| Rate for Payer: UHC Medicare Advantage |
$218.88
|
| Rate for Payer: UHCCP Medicaid |
$154.35
|
| Rate for Payer: VA VA |
$218.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.63
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,358.12
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$944.64 |
| Max. Negotiated Rate |
$4,822.31 |
| Rate for Payer: Aetna Commercial |
$4,554.40
|
| Rate for Payer: Aetna Medicare |
$1,393.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,674.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,674.41
|
| Rate for Payer: BCBS Complete |
$991.79
|
| Rate for Payer: BCBS MAPPO |
$1,339.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,404.91
|
| Rate for Payer: BCN Commercial |
$4,404.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,339.53
|
| Rate for Payer: Cash Price |
$4,286.50
|
| Rate for Payer: Cofinity Commercial |
$4,607.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,286.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,339.53
|
| Rate for Payer: Healthscope Commercial |
$4,822.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,018.59
|
| Rate for Payer: Mclaren Medicaid |
$944.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,406.51
|
| Rate for Payer: Meridian Medicaid |
$991.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,540.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,473.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,554.40
|
| Rate for Payer: Nomi Health Commercial |
$4,393.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,018.59
|
| Rate for Payer: PACE Senior Care Partners |
$1,272.55
|
| Rate for Payer: PACE SWMI |
$1,339.53
|
| Rate for Payer: PHP Commercial |
$4,554.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,339.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,661.56
|
| Rate for Payer: Priority Health Medicare |
$1,352.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,729.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,339.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,715.15
|
| Rate for Payer: UHC Core |
$4,474.03
|
| Rate for Payer: UHC Exchange |
$1,339.53
|
| Rate for Payer: UHC Medicaid |
$944.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,339.53
|
| Rate for Payer: UHCCP Medicaid |
$944.64
|
| Rate for Payer: VA VA |
$1,339.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,018.59
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,358.12
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,729.25 |
| Max. Negotiated Rate |
$4,822.31 |
| Rate for Payer: Aetna Commercial |
$4,554.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,425.27
|
| Rate for Payer: BCN Commercial |
$4,425.27
|
| Rate for Payer: Cash Price |
$4,286.50
|
| Rate for Payer: Cofinity Commercial |
$4,607.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,286.50
|
| Rate for Payer: Healthscope Commercial |
$4,822.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,018.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,554.40
|
| Rate for Payer: Nomi Health Commercial |
$4,393.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,018.59
|
| Rate for Payer: PHP Commercial |
$4,554.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,661.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,729.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,715.15
|
| Rate for Payer: UHC Core |
$4,474.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,018.59
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,729.01
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,010.02 |
| Max. Negotiated Rate |
$5,156.11 |
| Rate for Payer: Aetna Commercial |
$4,869.66
|
| Rate for Payer: Aetna Medicare |
$1,489.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,790.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,790.32
|
| Rate for Payer: BCBS Complete |
$1,060.44
|
| Rate for Payer: BCBS MAPPO |
$1,432.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,709.82
|
| Rate for Payer: BCN Commercial |
$4,709.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,432.25
|
| Rate for Payer: Cash Price |
$4,583.21
|
| Rate for Payer: Cofinity Commercial |
$4,926.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,583.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,432.25
|
| Rate for Payer: Healthscope Commercial |
$5,156.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,296.76
|
| Rate for Payer: Mclaren Medicaid |
$1,010.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,503.87
|
| Rate for Payer: Meridian Medicaid |
$1,060.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,647.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,575.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,869.66
|
| Rate for Payer: Nomi Health Commercial |
$4,697.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,360.64
|
| Rate for Payer: PACE SWMI |
$1,432.25
|
| Rate for Payer: PHP Commercial |
$4,869.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,432.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,010.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,984.24
|
| Rate for Payer: Priority Health Medicare |
$1,446.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,987.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,432.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,041.53
|
| Rate for Payer: UHC Core |
$4,783.72
|
| Rate for Payer: UHC Exchange |
$1,432.25
|
| Rate for Payer: UHC Medicaid |
$1,010.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,432.25
|
| Rate for Payer: UHCCP Medicaid |
$1,010.02
|
| Rate for Payer: VA VA |
$1,432.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,296.76
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,729.01
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,987.39 |
| Max. Negotiated Rate |
$5,156.11 |
| Rate for Payer: Aetna Commercial |
$4,869.66
|
| Rate for Payer: BCBS Trust/PPO |
$4,731.59
|
| Rate for Payer: BCN Commercial |
$4,731.59
|
| Rate for Payer: Cash Price |
$4,583.21
|
| Rate for Payer: Cofinity Commercial |
$4,926.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,583.21
|
| Rate for Payer: Healthscope Commercial |
$5,156.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,296.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,869.66
|
| Rate for Payer: Nomi Health Commercial |
$4,697.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,296.76
|
| Rate for Payer: PHP Commercial |
$4,869.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,984.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,987.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,041.53
|
| Rate for Payer: UHC Core |
$4,783.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,296.76
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$5,006.62
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,484.61 |
| Max. Negotiated Rate |
$4,505.96 |
| Rate for Payer: Aetna Commercial |
$4,255.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,134.97
|
| Rate for Payer: BCN Commercial |
$4,134.97
|
| Rate for Payer: Cash Price |
$4,005.30
|
| Rate for Payer: Cofinity Commercial |
$4,305.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.30
|
| Rate for Payer: Healthscope Commercial |
$4,505.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,754.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.63
|
| Rate for Payer: Nomi Health Commercial |
$4,105.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,754.97
|
| Rate for Payer: PHP Commercial |
$4,255.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,355.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,484.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,405.83
|
| Rate for Payer: UHC Core |
$4,180.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,754.97
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$5,006.62
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$882.67 |
| Max. Negotiated Rate |
$4,505.96 |
| Rate for Payer: Aetna Commercial |
$4,255.63
|
| Rate for Payer: Aetna Medicare |
$1,301.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,564.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,564.57
|
| Rate for Payer: BCBS Complete |
$926.73
|
| Rate for Payer: BCBS MAPPO |
$1,251.65
|
| Rate for Payer: BCBS Trust/PPO |
$4,115.94
|
| Rate for Payer: BCN Commercial |
$4,115.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,251.65
|
| Rate for Payer: Cash Price |
$4,005.30
|
| Rate for Payer: Cofinity Commercial |
$4,305.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,005.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,251.65
|
| Rate for Payer: Healthscope Commercial |
$4,505.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,754.97
|
| Rate for Payer: Mclaren Medicaid |
$882.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,314.24
|
| Rate for Payer: Meridian Medicaid |
$926.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,439.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,376.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,255.63
|
| Rate for Payer: Nomi Health Commercial |
$4,105.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,754.97
|
| Rate for Payer: PACE Senior Care Partners |
$1,189.07
|
| Rate for Payer: PACE SWMI |
$1,251.65
|
| Rate for Payer: PHP Commercial |
$4,255.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,251.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$882.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,355.76
|
| Rate for Payer: Priority Health Medicare |
$1,264.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,484.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,251.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,405.83
|
| Rate for Payer: UHC Core |
$4,180.53
|
| Rate for Payer: UHC Exchange |
$1,251.65
|
| Rate for Payer: UHC Medicaid |
$882.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,251.65
|
| Rate for Payer: UHCCP Medicaid |
$882.67
|
| Rate for Payer: VA VA |
$1,251.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,754.97
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,714.23
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,585.10 |
| Max. Negotiated Rate |
$3,342.81 |
| Rate for Payer: Aetna Commercial |
$3,157.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,067.58
|
| Rate for Payer: BCN Commercial |
$3,067.58
|
| Rate for Payer: Cash Price |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,194.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,971.38
|
| Rate for Payer: Healthscope Commercial |
$3,342.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,785.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,157.10
|
| Rate for Payer: Nomi Health Commercial |
$3,045.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,785.67
|
| Rate for Payer: PHP Commercial |
$3,157.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,231.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,585.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,268.52
|
| Rate for Payer: UHC Core |
$3,101.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,785.67
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,714.23
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$654.82 |
| Max. Negotiated Rate |
$3,342.81 |
| Rate for Payer: Aetna Commercial |
$3,157.10
|
| Rate for Payer: Aetna Medicare |
$965.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,160.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,160.70
|
| Rate for Payer: BCBS Complete |
$687.50
|
| Rate for Payer: BCBS MAPPO |
$928.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,053.47
|
| Rate for Payer: BCN Commercial |
$3,053.47
|
| Rate for Payer: BCN Medicare Advantage |
$928.56
|
| Rate for Payer: Cash Price |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,194.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,971.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$928.56
|
| Rate for Payer: Healthscope Commercial |
$3,342.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,785.67
|
| Rate for Payer: Mclaren Medicaid |
$654.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$974.99
|
| Rate for Payer: Meridian Medicaid |
$687.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,067.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,021.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,157.10
|
| Rate for Payer: Nomi Health Commercial |
$3,045.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,785.67
|
| Rate for Payer: PACE Senior Care Partners |
$882.13
|
| Rate for Payer: PACE SWMI |
$928.56
|
| Rate for Payer: PHP Commercial |
$3,157.10
|
| Rate for Payer: PHP Medicare Advantage |
$928.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$654.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,231.38
|
| Rate for Payer: Priority Health Medicare |
$937.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,585.10
|
| Rate for Payer: Railroad Medicare Medicare |
$928.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,268.52
|
| Rate for Payer: UHC Core |
$3,101.38
|
| Rate for Payer: UHC Exchange |
$928.56
|
| Rate for Payer: UHC Medicaid |
$654.82
|
| Rate for Payer: UHC Medicare Advantage |
$928.56
|
| Rate for Payer: UHCCP Medicaid |
$654.82
|
| Rate for Payer: VA VA |
$928.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,785.67
|
|
|
HC VERSAPAP SUPPLY
|
Facility
|
IP
|
$61.20
|
|
| Hospital Charge Code |
27000711
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$50.55
|
| Rate for Payer: BCN Commercial |
$50.55
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.90
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC VERSAPAP SUPPLY
|
Facility
|
OP
|
$61.20
|
|
| Hospital Charge Code |
27000711
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.79 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$11.33
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$50.31
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$10.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$11.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.90
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.60
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicaid |
$10.79
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$10.79
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,838.93
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,087.20 |
| Max. Negotiated Rate |
$10,655.04 |
| Rate for Payer: Aetna Commercial |
$10,063.09
|
| Rate for Payer: Aetna Medicare |
$3,078.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,699.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,699.67
|
| Rate for Payer: BCBS Complete |
$2,191.39
|
| Rate for Payer: BCBS MAPPO |
$2,959.73
|
| Rate for Payer: BCBS Trust/PPO |
$9,732.78
|
| Rate for Payer: BCN Commercial |
$9,732.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,959.73
|
| Rate for Payer: Cash Price |
$9,471.14
|
| Rate for Payer: Cofinity Commercial |
$10,181.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,471.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,959.73
|
| Rate for Payer: Healthscope Commercial |
$10,655.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,879.20
|
| Rate for Payer: Mclaren Medicaid |
$2,087.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,107.72
|
| Rate for Payer: Meridian Medicaid |
$2,191.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,403.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,255.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,063.09
|
| Rate for Payer: Nomi Health Commercial |
$9,707.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,879.20
|
| Rate for Payer: PACE Senior Care Partners |
$2,811.75
|
| Rate for Payer: PACE SWMI |
$2,959.73
|
| Rate for Payer: PHP Commercial |
$10,063.09
|
| Rate for Payer: PHP Medicare Advantage |
$2,959.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,087.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,299.87
|
| Rate for Payer: Priority Health Medicare |
$2,989.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,239.90
|
| Rate for Payer: Railroad Medicare Medicare |
$2,959.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,418.26
|
| Rate for Payer: UHC Core |
$9,885.51
|
| Rate for Payer: UHC Exchange |
$2,959.73
|
| Rate for Payer: UHC Medicaid |
$2,087.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,959.73
|
| Rate for Payer: UHCCP Medicaid |
$2,087.20
|
| Rate for Payer: VA VA |
$2,959.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,879.20
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,838.93
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,239.90 |
| Max. Negotiated Rate |
$10,655.04 |
| Rate for Payer: Aetna Commercial |
$10,063.09
|
| Rate for Payer: BCBS Trust/PPO |
$9,777.77
|
| Rate for Payer: BCN Commercial |
$9,777.77
|
| Rate for Payer: Cash Price |
$9,471.14
|
| Rate for Payer: Cofinity Commercial |
$10,181.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,471.14
|
| Rate for Payer: Healthscope Commercial |
$10,655.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,879.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,063.09
|
| Rate for Payer: Nomi Health Commercial |
$9,707.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,879.20
|
| Rate for Payer: PHP Commercial |
$10,063.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,299.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,239.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,418.26
|
| Rate for Payer: UHC Core |
$9,885.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,879.20
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$11,830.21
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,233.83 |
| Max. Negotiated Rate |
$10,647.19 |
| Rate for Payer: Aetna Commercial |
$10,055.68
|
| Rate for Payer: BCBS Trust/PPO |
$9,770.57
|
| Rate for Payer: BCN Commercial |
$9,770.57
|
| Rate for Payer: Cash Price |
$9,464.17
|
| Rate for Payer: Cofinity Commercial |
$10,173.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,464.17
|
| Rate for Payer: Healthscope Commercial |
$10,647.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,872.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,055.68
|
| Rate for Payer: Nomi Health Commercial |
$9,700.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,872.66
|
| Rate for Payer: PHP Commercial |
$10,055.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,292.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,233.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,410.58
|
| Rate for Payer: UHC Core |
$9,878.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,872.66
|
|
