|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$16,230.24 |
| Max. Negotiated Rate |
$22,472.64 |
| Rate for Payer: Aetna Commercial |
$21,224.16
|
| Rate for Payer: BCBS Trust/PPO |
$20,382.68
|
| Rate for Payer: BCN Commercial |
$19,296.51
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cofinity Commercial |
$21,473.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,975.68
|
| Rate for Payer: Healthscope Commercial |
$22,472.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,727.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: Nomi Health Commercial |
$20,475.07
|
| Rate for Payer: PHP Commercial |
$21,224.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,230.24
|
| Rate for Payer: Priority Health HMO/PPO |
$21,723.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,729.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,973.25
|
| Rate for Payer: UHC Core |
$20,849.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,727.20
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
OP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,265.07 |
| Max. Negotiated Rate |
$38,899.21 |
| Rate for Payer: Aetna Commercial |
$36,738.14
|
| Rate for Payer: Aetna Medicare |
$11,237.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,506.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,506.67
|
| Rate for Payer: BCBS Complete |
$17,288.54
|
| Rate for Payer: BCBS MAPPO |
$10,805.34
|
| Rate for Payer: BCBS Trust/PPO |
$35,532.26
|
| Rate for Payer: BCN Commercial |
$33,604.59
|
| Rate for Payer: BCN Medicare Advantage |
$10,805.34
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$37,170.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,805.34
|
| Rate for Payer: Healthscope Commercial |
$38,899.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32,416.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,345.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,426.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: Nomi Health Commercial |
$35,441.50
|
| Rate for Payer: PACE Senior Care Partners |
$10,265.07
|
| Rate for Payer: PACE SWMI |
$10,805.34
|
| Rate for Payer: PHP Commercial |
$36,738.14
|
| Rate for Payer: PHP Medicare Advantage |
$10,805.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: Priority Health HMO/PPO |
$37,602.57
|
| Rate for Payer: Priority Health Medicare |
$10,913.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28,958.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10,805.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,034.78
|
| Rate for Payer: UHC Core |
$36,089.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,805.34
|
| Rate for Payer: UHC Exchange |
$10,805.34
|
| Rate for Payer: UHC Medicare Advantage |
$10,805.34
|
| Rate for Payer: VA VA |
$10,805.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32,416.00
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
IP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$28,093.87 |
| Max. Negotiated Rate |
$38,899.21 |
| Rate for Payer: Aetna Commercial |
$36,738.14
|
| Rate for Payer: BCBS Trust/PPO |
$35,281.58
|
| Rate for Payer: BCN Commercial |
$33,401.45
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$37,170.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Healthscope Commercial |
$38,899.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32,416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: Nomi Health Commercial |
$35,441.50
|
| Rate for Payer: PHP Commercial |
$36,738.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: Priority Health HMO/PPO |
$37,602.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28,958.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38,034.78
|
| Rate for Payer: UHC Core |
$36,089.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32,416.00
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$3,891.10
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$924.14 |
| Max. Negotiated Rate |
$3,501.99 |
| Rate for Payer: Aetna Commercial |
$3,307.44
|
| Rate for Payer: Aetna Medicare |
$1,011.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,215.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,215.97
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$972.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,198.87
|
| Rate for Payer: BCN Commercial |
$3,025.33
|
| Rate for Payer: BCN Medicare Advantage |
$972.78
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cofinity Commercial |
$3,346.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.78
|
| Rate for Payer: Healthscope Commercial |
$3,501.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.32
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.41
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,118.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.44
|
| Rate for Payer: Nomi Health Commercial |
$3,190.70
|
| Rate for Payer: PACE Senior Care Partners |
$924.14
|
| Rate for Payer: PACE SWMI |
$972.78
|
| Rate for Payer: PHP Commercial |
$3,307.44
|
| Rate for Payer: PHP Medicare Advantage |
$972.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: Priority Health HMO/PPO |
$3,385.26
|
| Rate for Payer: Priority Health Medicare |
$982.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,607.04
|
| Rate for Payer: Railroad Medicare Medicare |
$972.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,424.17
|
| Rate for Payer: UHC Core |
$3,249.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$972.78
|
| Rate for Payer: UHC Exchange |
$972.78
|
| Rate for Payer: UHC Medicare Advantage |
$972.78
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$972.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.32
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$3,891.10
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,529.22 |
| Max. Negotiated Rate |
$3,501.99 |
| Rate for Payer: Aetna Commercial |
$3,307.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,176.30
|
| Rate for Payer: BCN Commercial |
$3,007.04
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cofinity Commercial |
$3,346.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.88
|
| Rate for Payer: Healthscope Commercial |
$3,501.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.44
|
| Rate for Payer: Nomi Health Commercial |
$3,190.70
|
| Rate for Payer: PHP Commercial |
$3,307.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: Priority Health HMO/PPO |
$3,385.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,607.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,424.17
|
| Rate for Payer: UHC Core |
$3,249.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.32
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
IP
|
$16,004.00
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,402.60 |
| Max. Negotiated Rate |
$14,403.60 |
| Rate for Payer: Aetna Commercial |
$13,603.40
|
| Rate for Payer: BCBS Trust/PPO |
$13,064.07
|
| Rate for Payer: BCN Commercial |
$12,367.89
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cofinity Commercial |
$13,763.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,803.20
|
| Rate for Payer: Healthscope Commercial |
$14,403.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,003.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,603.40
|
| Rate for Payer: Nomi Health Commercial |
$13,123.28
|
| Rate for Payer: PHP Commercial |
$13,603.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,402.60
|
| Rate for Payer: Priority Health HMO/PPO |
$13,923.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,722.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,083.52
|
| Rate for Payer: UHC Core |
$13,363.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
OP
|
$16,004.00
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,800.95 |
| Max. Negotiated Rate |
$14,403.60 |
| Rate for Payer: Aetna Commercial |
$13,603.40
|
| Rate for Payer: Aetna Medicare |
$4,161.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,001.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,001.25
|
| Rate for Payer: BCBS Complete |
$4,241.07
|
| Rate for Payer: BCBS MAPPO |
$4,001.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,156.89
|
| Rate for Payer: BCN Commercial |
$12,443.11
|
| Rate for Payer: BCN Medicare Advantage |
$4,001.00
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cofinity Commercial |
$13,763.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,803.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,001.00
|
| Rate for Payer: Healthscope Commercial |
$14,403.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,003.00
|
| Rate for Payer: Mclaren Medicaid |
$4,038.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,201.05
|
| Rate for Payer: Meridian Medicaid |
$4,241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,601.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,603.40
|
| Rate for Payer: Nomi Health Commercial |
$13,123.28
|
| Rate for Payer: PACE Senior Care Partners |
$3,800.95
|
| Rate for Payer: PACE SWMI |
$4,001.00
|
| Rate for Payer: PHP Commercial |
$13,603.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,001.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,038.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,402.60
|
| Rate for Payer: Priority Health HMO/PPO |
$13,923.48
|
| Rate for Payer: Priority Health Medicare |
$4,041.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,722.68
|
| Rate for Payer: Railroad Medicare Medicare |
$4,001.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,083.52
|
| Rate for Payer: UHC Core |
$13,363.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,001.00
|
| Rate for Payer: UHC Exchange |
$4,001.00
|
| Rate for Payer: UHC Medicare Advantage |
$4,001.00
|
| Rate for Payer: UHCCP Medicaid |
$4,038.85
|
| Rate for Payer: VA VA |
$4,001.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
OP
|
$563.36
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$133.80 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna Medicare |
$146.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.05
|
| Rate for Payer: BCBS Complete |
$225.34
|
| Rate for Payer: BCBS MAPPO |
$140.84
|
| Rate for Payer: BCBS Trust/PPO |
$463.14
|
| Rate for Payer: BCN Commercial |
$438.01
|
| Rate for Payer: BCN Medicare Advantage |
$140.84
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.84
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: Nomi Health Commercial |
$461.96
|
| Rate for Payer: PACE Senior Care Partners |
$133.80
|
| Rate for Payer: PACE SWMI |
$140.84
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: PHP Medicare Advantage |
$140.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.18
|
| Rate for Payer: Priority Health HMO/PPO |
$490.12
|
| Rate for Payer: Priority Health Medicare |
$142.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.45
|
| Rate for Payer: Railroad Medicare Medicare |
$140.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.76
|
| Rate for Payer: UHC Core |
$470.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.84
|
| Rate for Payer: UHC Exchange |
$140.84
|
| Rate for Payer: UHC Medicare Advantage |
$140.84
|
| Rate for Payer: VA VA |
$140.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
IP
|
$563.36
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$366.18 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: BCBS Trust/PPO |
$459.87
|
| Rate for Payer: BCN Commercial |
$435.36
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: Nomi Health Commercial |
$461.96
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.18
|
| Rate for Payer: Priority Health HMO/PPO |
$490.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.76
|
| Rate for Payer: UHC Core |
$470.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,456.44 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Aetna Medicare |
$420.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$505.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$505.71
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$404.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,330.38
|
| Rate for Payer: BCN Commercial |
$1,258.20
|
| Rate for Payer: BCN Medicare Advantage |
$404.57
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cofinity Commercial |
$1,391.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.57
|
| Rate for Payer: Healthscope Commercial |
$1,456.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.70
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.53
|
| Rate for Payer: Nomi Health Commercial |
$1,326.98
|
| Rate for Payer: PACE Senior Care Partners |
$384.34
|
| Rate for Payer: PACE SWMI |
$404.57
|
| Rate for Payer: PHP Commercial |
$1,375.53
|
| Rate for Payer: PHP Medicare Advantage |
$404.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.88
|
| Rate for Payer: Priority Health HMO/PPO |
$1,407.89
|
| Rate for Payer: Priority Health Medicare |
$408.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,084.24
|
| Rate for Payer: Railroad Medicare Medicare |
$404.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,424.08
|
| Rate for Payer: UHC Core |
$1,351.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.57
|
| Rate for Payer: UHC Exchange |
$404.57
|
| Rate for Payer: UHC Medicare Advantage |
$404.57
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$404.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.70
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
IP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,051.88 |
| Max. Negotiated Rate |
$1,456.44 |
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.99
|
| Rate for Payer: BCN Commercial |
$1,250.60
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cofinity Commercial |
$1,391.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.62
|
| Rate for Payer: Healthscope Commercial |
$1,456.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.53
|
| Rate for Payer: Nomi Health Commercial |
$1,326.98
|
| Rate for Payer: PHP Commercial |
$1,375.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.88
|
| Rate for Payer: Priority Health HMO/PPO |
$1,407.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,084.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,424.08
|
| Rate for Payer: UHC Core |
$1,351.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.70
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
OP
|
$611.44
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$550.30 |
| Rate for Payer: Aetna Commercial |
$519.72
|
| Rate for Payer: Aetna Medicare |
$158.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.08
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$152.86
|
| Rate for Payer: BCBS Trust/PPO |
$502.66
|
| Rate for Payer: BCN Commercial |
$475.39
|
| Rate for Payer: BCN Medicare Advantage |
$152.86
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$525.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.86
|
| Rate for Payer: Healthscope Commercial |
$550.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$458.58
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.50
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$519.72
|
| Rate for Payer: Nomi Health Commercial |
$501.38
|
| Rate for Payer: PACE Senior Care Partners |
$145.22
|
| Rate for Payer: PACE SWMI |
$152.86
|
| Rate for Payer: PHP Commercial |
$519.72
|
| Rate for Payer: PHP Medicare Advantage |
$152.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.44
|
| Rate for Payer: Priority Health HMO/PPO |
$531.95
|
| Rate for Payer: Priority Health Medicare |
$154.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.66
|
| Rate for Payer: Railroad Medicare Medicare |
$152.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.07
|
| Rate for Payer: UHC Core |
$510.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.86
|
| Rate for Payer: UHC Exchange |
$152.86
|
| Rate for Payer: UHC Medicare Advantage |
$152.86
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$152.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$458.58
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
IP
|
$611.44
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$397.44 |
| Max. Negotiated Rate |
$550.30 |
| Rate for Payer: Aetna Commercial |
$519.72
|
| Rate for Payer: BCBS Trust/PPO |
$499.12
|
| Rate for Payer: BCN Commercial |
$472.52
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$525.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.15
|
| Rate for Payer: Healthscope Commercial |
$550.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$458.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$519.72
|
| Rate for Payer: Nomi Health Commercial |
$501.38
|
| Rate for Payer: PHP Commercial |
$519.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.44
|
| Rate for Payer: Priority Health HMO/PPO |
$531.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.07
|
| Rate for Payer: UHC Core |
$510.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$458.58
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$103.94 |
| Max. Negotiated Rate |
$394.69 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$394.69
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$375.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$394.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$375.87
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$626.24
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$148.73 |
| Max. Negotiated Rate |
$756.79 |
| Rate for Payer: Aetna Commercial |
$532.30
|
| Rate for Payer: Aetna Medicare |
$162.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.70
|
| Rate for Payer: BCBS Complete |
$756.79
|
| Rate for Payer: BCBS MAPPO |
$156.56
|
| Rate for Payer: BCBS Trust/PPO |
$514.83
|
| Rate for Payer: BCN Commercial |
$486.90
|
| Rate for Payer: BCN Medicare Advantage |
$156.56
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cofinity Commercial |
$538.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.56
|
| Rate for Payer: Healthscope Commercial |
$563.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.68
|
| Rate for Payer: Mclaren Medicaid |
$720.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.39
|
| Rate for Payer: Meridian Medicaid |
$756.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.30
|
| Rate for Payer: Nomi Health Commercial |
$513.52
|
| Rate for Payer: PACE Senior Care Partners |
$148.73
|
| Rate for Payer: PACE SWMI |
$156.56
|
| Rate for Payer: PHP Commercial |
$532.30
|
| Rate for Payer: PHP Medicare Advantage |
$156.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.06
|
| Rate for Payer: Priority Health HMO/PPO |
$544.83
|
| Rate for Payer: Priority Health Medicare |
$158.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$419.58
|
| Rate for Payer: Railroad Medicare Medicare |
$156.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$551.09
|
| Rate for Payer: UHC Core |
$522.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.56
|
| Rate for Payer: UHC Exchange |
$156.56
|
| Rate for Payer: UHC Medicare Advantage |
$156.56
|
| Rate for Payer: UHCCP Medicaid |
$720.70
|
| Rate for Payer: VA VA |
$156.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.68
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$626.24
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$407.06 |
| Max. Negotiated Rate |
$563.62 |
| Rate for Payer: Aetna Commercial |
$532.30
|
| Rate for Payer: BCBS Trust/PPO |
$511.20
|
| Rate for Payer: BCN Commercial |
$483.96
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cofinity Commercial |
$538.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.99
|
| Rate for Payer: Healthscope Commercial |
$563.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.30
|
| Rate for Payer: Nomi Health Commercial |
$513.52
|
| Rate for Payer: PHP Commercial |
$532.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.06
|
| Rate for Payer: Priority Health HMO/PPO |
$544.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$419.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$551.09
|
| Rate for Payer: UHC Core |
$522.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.68
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,196.46
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$284.16 |
| Max. Negotiated Rate |
$1,076.81 |
| Rate for Payer: Aetna Commercial |
$1,016.99
|
| Rate for Payer: Aetna Medicare |
$311.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$373.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$373.89
|
| Rate for Payer: BCBS Complete |
$325.20
|
| Rate for Payer: BCBS MAPPO |
$299.12
|
| Rate for Payer: BCBS Trust/PPO |
$983.61
|
| Rate for Payer: BCN Commercial |
$930.25
|
| Rate for Payer: BCN Medicare Advantage |
$299.12
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cofinity Commercial |
$1,028.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.12
|
| Rate for Payer: Healthscope Commercial |
$1,076.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.34
|
| Rate for Payer: Mclaren Medicaid |
$309.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.07
|
| Rate for Payer: Meridian Medicaid |
$325.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.99
|
| Rate for Payer: Nomi Health Commercial |
$981.10
|
| Rate for Payer: PACE Senior Care Partners |
$284.16
|
| Rate for Payer: PACE SWMI |
$299.12
|
| Rate for Payer: PHP Commercial |
$1,016.99
|
| Rate for Payer: PHP Medicare Advantage |
$299.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,040.92
|
| Rate for Payer: Priority Health Medicare |
$302.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.63
|
| Rate for Payer: Railroad Medicare Medicare |
$299.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,052.88
|
| Rate for Payer: UHC Core |
$999.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.12
|
| Rate for Payer: UHC Exchange |
$299.12
|
| Rate for Payer: UHC Medicare Advantage |
$299.12
|
| Rate for Payer: UHCCP Medicaid |
$309.69
|
| Rate for Payer: VA VA |
$299.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.34
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,196.46
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$777.70 |
| Max. Negotiated Rate |
$1,076.81 |
| Rate for Payer: Aetna Commercial |
$1,016.99
|
| Rate for Payer: BCBS Trust/PPO |
$976.67
|
| Rate for Payer: BCN Commercial |
$924.62
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cofinity Commercial |
$1,028.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.17
|
| Rate for Payer: Healthscope Commercial |
$1,076.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.99
|
| Rate for Payer: Nomi Health Commercial |
$981.10
|
| Rate for Payer: PHP Commercial |
$1,016.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health HMO/PPO |
$1,040.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,052.88
|
| Rate for Payer: UHC Core |
$999.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.34
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$632.04
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$410.83 |
| Max. Negotiated Rate |
$568.84 |
| Rate for Payer: Aetna Commercial |
$537.23
|
| Rate for Payer: BCBS Trust/PPO |
$515.93
|
| Rate for Payer: BCN Commercial |
$488.44
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cofinity Commercial |
$543.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.63
|
| Rate for Payer: Healthscope Commercial |
$568.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.23
|
| Rate for Payer: Nomi Health Commercial |
$518.27
|
| Rate for Payer: PHP Commercial |
$537.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.83
|
| Rate for Payer: Priority Health HMO/PPO |
$549.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.20
|
| Rate for Payer: UHC Core |
$527.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.03
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$632.04
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$150.11 |
| Max. Negotiated Rate |
$568.84 |
| Rate for Payer: Aetna Commercial |
$537.23
|
| Rate for Payer: Aetna Medicare |
$164.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$197.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$197.51
|
| Rate for Payer: BCBS Complete |
$325.20
|
| Rate for Payer: BCBS MAPPO |
$158.01
|
| Rate for Payer: BCBS Trust/PPO |
$519.60
|
| Rate for Payer: BCN Commercial |
$491.41
|
| Rate for Payer: BCN Medicare Advantage |
$158.01
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cofinity Commercial |
$543.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.01
|
| Rate for Payer: Healthscope Commercial |
$568.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.03
|
| Rate for Payer: Mclaren Medicaid |
$309.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.91
|
| Rate for Payer: Meridian Medicaid |
$325.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.23
|
| Rate for Payer: Nomi Health Commercial |
$518.27
|
| Rate for Payer: PACE Senior Care Partners |
$150.11
|
| Rate for Payer: PACE SWMI |
$158.01
|
| Rate for Payer: PHP Commercial |
$537.23
|
| Rate for Payer: PHP Medicare Advantage |
$158.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.83
|
| Rate for Payer: Priority Health HMO/PPO |
$549.87
|
| Rate for Payer: Priority Health Medicare |
$159.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.47
|
| Rate for Payer: Railroad Medicare Medicare |
$158.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$556.20
|
| Rate for Payer: UHC Core |
$527.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.01
|
| Rate for Payer: UHC Exchange |
$158.01
|
| Rate for Payer: UHC Medicare Advantage |
$158.01
|
| Rate for Payer: UHCCP Medicaid |
$309.69
|
| Rate for Payer: VA VA |
$158.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.03
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,168.13
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$752.43 |
| Max. Negotiated Rate |
$2,851.32 |
| Rate for Payer: Aetna Commercial |
$2,692.91
|
| Rate for Payer: Aetna Medicare |
$823.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$990.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$990.04
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$792.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,604.52
|
| Rate for Payer: BCN Commercial |
$2,463.22
|
| Rate for Payer: BCN Medicare Advantage |
$792.03
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cofinity Commercial |
$2,724.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,534.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$792.03
|
| Rate for Payer: Healthscope Commercial |
$2,851.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,376.10
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.63
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$910.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.91
|
| Rate for Payer: Nomi Health Commercial |
$2,597.87
|
| Rate for Payer: PACE Senior Care Partners |
$752.43
|
| Rate for Payer: PACE SWMI |
$792.03
|
| Rate for Payer: PHP Commercial |
$2,692.91
|
| Rate for Payer: PHP Medicare Advantage |
$792.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.28
|
| Rate for Payer: Priority Health HMO/PPO |
$2,756.27
|
| Rate for Payer: Priority Health Medicare |
$799.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,122.65
|
| Rate for Payer: Railroad Medicare Medicare |
$792.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.95
|
| Rate for Payer: UHC Core |
$2,645.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$792.03
|
| Rate for Payer: UHC Exchange |
$792.03
|
| Rate for Payer: UHC Medicare Advantage |
$792.03
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$792.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,376.10
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
IP
|
$3,168.13
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,059.28 |
| Max. Negotiated Rate |
$2,851.32 |
| Rate for Payer: Aetna Commercial |
$2,692.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,586.14
|
| Rate for Payer: BCN Commercial |
$2,448.33
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cofinity Commercial |
$2,724.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,534.50
|
| Rate for Payer: Healthscope Commercial |
$2,851.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,376.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.91
|
| Rate for Payer: Nomi Health Commercial |
$2,597.87
|
| Rate for Payer: PHP Commercial |
$2,692.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.28
|
| Rate for Payer: Priority Health HMO/PPO |
$2,756.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,122.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.95
|
| Rate for Payer: UHC Core |
$2,645.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,376.10
|
|
