|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$194.56 |
| Max. Negotiated Rate |
$269.39 |
| Rate for Payer: Aetna Commercial |
$254.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.33
|
| Rate for Payer: BCN Commercial |
$231.31
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$257.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$269.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: Nomi Health Commercial |
$245.44
|
| Rate for Payer: PHP Commercial |
$254.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health HMO/PPO |
$260.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.40
|
| Rate for Payer: UHC Core |
$249.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.49
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$861.90 |
| Max. Negotiated Rate |
$1,193.40 |
| Rate for Payer: Aetna Commercial |
$1,127.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,082.41
|
| Rate for Payer: BCN Commercial |
$1,024.73
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,140.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Healthscope Commercial |
$1,193.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: PHP Commercial |
$1,127.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,153.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,166.88
|
| Rate for Payer: UHC Core |
$1,107.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.50
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$1,193.40 |
| Rate for Payer: Aetna Commercial |
$1,127.10
|
| Rate for Payer: Aetna Medicare |
$344.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$414.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$414.38
|
| Rate for Payer: BCBS Complete |
$386.62
|
| Rate for Payer: BCBS MAPPO |
$331.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.10
|
| Rate for Payer: BCN Commercial |
$1,030.96
|
| Rate for Payer: BCN Medicare Advantage |
$331.50
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,140.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.50
|
| Rate for Payer: Healthscope Commercial |
$1,193.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.50
|
| Rate for Payer: Mclaren Medicaid |
$368.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.07
|
| Rate for Payer: Meridian Medicaid |
$386.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$381.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,087.32
|
| Rate for Payer: PACE Senior Care Partners |
$314.93
|
| Rate for Payer: PACE SWMI |
$331.50
|
| Rate for Payer: PHP Commercial |
$1,127.10
|
| Rate for Payer: PHP Medicare Advantage |
$331.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO |
$1,153.62
|
| Rate for Payer: Priority Health Medicare |
$334.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.42
|
| Rate for Payer: Railroad Medicare Medicare |
$331.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,166.88
|
| Rate for Payer: UHC Core |
$1,107.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$331.50
|
| Rate for Payer: UHC Exchange |
$331.50
|
| Rate for Payer: UHC Medicare Advantage |
$331.50
|
| Rate for Payer: UHCCP Medicaid |
$368.19
|
| Rate for Payer: VA VA |
$331.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.50
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,916.20 |
| Max. Negotiated Rate |
$7,261.38 |
| Rate for Payer: Aetna Commercial |
$6,857.97
|
| Rate for Payer: Aetna Medicare |
$2,097.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,521.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,521.31
|
| Rate for Payer: BCBS Complete |
$2,462.14
|
| Rate for Payer: BCBS MAPPO |
$2,017.05
|
| Rate for Payer: BCBS Trust/PPO |
$6,632.87
|
| Rate for Payer: BCN Commercial |
$6,273.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,017.05
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$6,938.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,017.05
|
| Rate for Payer: Healthscope Commercial |
$7,261.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,051.15
|
| Rate for Payer: Mclaren Medicaid |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,117.90
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,319.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: PACE Senior Care Partners |
$1,916.20
|
| Rate for Payer: PACE SWMI |
$2,017.05
|
| Rate for Payer: PHP Commercial |
$6,857.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,017.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,344.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health HMO/PPO |
$7,019.33
|
| Rate for Payer: Priority Health Medicare |
$2,037.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,405.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,017.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,100.02
|
| Rate for Payer: UHC Core |
$6,736.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,017.05
|
| Rate for Payer: UHC Exchange |
$2,017.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,017.05
|
| Rate for Payer: UHCCP Medicaid |
$2,344.74
|
| Rate for Payer: VA VA |
$2,017.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,051.15
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,244.33 |
| Max. Negotiated Rate |
$7,261.38 |
| Rate for Payer: Aetna Commercial |
$6,857.97
|
| Rate for Payer: BCBS Trust/PPO |
$6,586.07
|
| Rate for Payer: BCN Commercial |
$6,235.10
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$6,938.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Healthscope Commercial |
$7,261.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,051.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,615.92
|
| Rate for Payer: PHP Commercial |
$6,857.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health HMO/PPO |
$7,019.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,405.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,100.02
|
| Rate for Payer: UHC Core |
$6,736.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,051.15
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$120.54 |
| Max. Negotiated Rate |
$456.79 |
| Rate for Payer: Aetna Commercial |
$431.41
|
| Rate for Payer: Aetna Medicare |
$131.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.61
|
| Rate for Payer: BCBS Complete |
$203.02
|
| Rate for Payer: BCBS MAPPO |
$126.89
|
| Rate for Payer: BCBS Trust/PPO |
$417.25
|
| Rate for Payer: BCN Commercial |
$394.61
|
| Rate for Payer: BCN Medicare Advantage |
$126.89
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$436.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.89
|
| Rate for Payer: Healthscope Commercial |
$456.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: PACE Senior Care Partners |
$120.54
|
| Rate for Payer: PACE SWMI |
$126.89
|
| Rate for Payer: PHP Commercial |
$431.41
|
| Rate for Payer: PHP Medicare Advantage |
$126.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health HMO/PPO |
$441.56
|
| Rate for Payer: Priority Health Medicare |
$128.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.05
|
| Rate for Payer: Railroad Medicare Medicare |
$126.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.64
|
| Rate for Payer: UHC Core |
$423.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.89
|
| Rate for Payer: UHC Exchange |
$126.89
|
| Rate for Payer: UHC Medicare Advantage |
$126.89
|
| Rate for Payer: VA VA |
$126.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.65
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$329.90 |
| Max. Negotiated Rate |
$456.79 |
| Rate for Payer: Aetna Commercial |
$431.41
|
| Rate for Payer: BCBS Trust/PPO |
$414.30
|
| Rate for Payer: BCN Commercial |
$392.23
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$436.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$456.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: Nomi Health Commercial |
$416.18
|
| Rate for Payer: PHP Commercial |
$431.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health HMO/PPO |
$441.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.64
|
| Rate for Payer: UHC Core |
$423.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.65
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$176.30 |
| Rate for Payer: Aetna Commercial |
$150.93
|
| Rate for Payer: Aetna Medicare |
$46.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.49
|
| Rate for Payer: BCBS Complete |
$176.30
|
| Rate for Payer: BCBS MAPPO |
$44.39
|
| Rate for Payer: BCBS Trust/PPO |
$145.97
|
| Rate for Payer: BCN Commercial |
$138.05
|
| Rate for Payer: BCN Medicare Advantage |
$44.39
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$152.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.39
|
| Rate for Payer: Healthscope Commercial |
$159.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.17
|
| Rate for Payer: Mclaren Medicaid |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.61
|
| Rate for Payer: Meridian Medicaid |
$176.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: PACE Senior Care Partners |
$42.17
|
| Rate for Payer: PACE SWMI |
$44.39
|
| Rate for Payer: PHP Commercial |
$150.93
|
| Rate for Payer: PHP Medicare Advantage |
$44.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health HMO/PPO |
$154.48
|
| Rate for Payer: Priority Health Medicare |
$44.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.97
|
| Rate for Payer: Railroad Medicare Medicare |
$44.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.25
|
| Rate for Payer: UHC Core |
$148.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.39
|
| Rate for Payer: UHC Exchange |
$44.39
|
| Rate for Payer: UHC Medicare Advantage |
$44.39
|
| Rate for Payer: UHCCP Medicaid |
$167.90
|
| Rate for Payer: VA VA |
$44.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.17
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.41 |
| Max. Negotiated Rate |
$159.80 |
| Rate for Payer: Aetna Commercial |
$150.93
|
| Rate for Payer: BCBS Trust/PPO |
$144.94
|
| Rate for Payer: BCN Commercial |
$137.22
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$152.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Healthscope Commercial |
$159.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$145.60
|
| Rate for Payer: PHP Commercial |
$150.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health HMO/PPO |
$154.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.25
|
| Rate for Payer: UHC Core |
$148.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.17
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$93.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$97.67
|
| Rate for Payer: BCN Commercial |
$92.47
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$97.84
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$93.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$93.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$97.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$93.17
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$97.67
|
| Rate for Payer: BCN Commercial |
$92.47
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$97.84
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$93.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$93.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$97.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$93.17
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$77.77 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$97.67
|
| Rate for Payer: BCN Commercial |
$92.47
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,930.28 |
| Max. Negotiated Rate |
$22,472.64 |
| Rate for Payer: Aetna Commercial |
$21,224.16
|
| Rate for Payer: Aetna Medicare |
$6,492.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,803.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,803.00
|
| Rate for Payer: BCBS Complete |
$14,478.82
|
| Rate for Payer: BCBS MAPPO |
$6,242.40
|
| Rate for Payer: BCBS Trust/PPO |
$20,527.51
|
| Rate for Payer: BCN Commercial |
$19,413.86
|
| Rate for Payer: BCN Medicare Advantage |
$6,242.40
|
| Rate for Payer: Cash Price |
$19,975.68
|
| 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: Health Alliance Plan Medicare Advantage |
$6,242.40
|
| Rate for Payer: Healthscope Commercial |
$22,472.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,727.20
|
| Rate for Payer: Mclaren Medicaid |
$13,788.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,554.52
|
| Rate for Payer: Meridian Medicaid |
$14,478.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,178.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: Nomi Health Commercial |
$20,475.07
|
| Rate for Payer: PACE Senior Care Partners |
$5,930.28
|
| Rate for Payer: PACE SWMI |
$6,242.40
|
| Rate for Payer: PHP Commercial |
$21,224.16
|
| Rate for Payer: PHP Medicare Advantage |
$6,242.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,788.45
|
| 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 Medicare |
$6,304.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,729.63
|
| Rate for Payer: Railroad Medicare Medicare |
$6,242.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,973.25
|
| Rate for Payer: UHC Core |
$20,849.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,242.40
|
| Rate for Payer: UHC Exchange |
$6,242.40
|
| Rate for Payer: UHC Medicare Advantage |
$6,242.40
|
| Rate for Payer: UHCCP Medicaid |
$13,788.45
|
| Rate for Payer: VA VA |
$6,242.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,727.20
|
|
|
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 |
$10,805.33
|
| Rate for Payer: BCBS Trust/PPO |
$35,532.26
|
| Rate for Payer: BCN Commercial |
$33,604.59
|
| Rate for Payer: BCN Medicare Advantage |
$10,805.33
|
| 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 |
$10,805.33
|
| Rate for Payer: Healthscope Commercial |
$38,899.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32,416.01
|
| 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 |
$10,805.33
|
| Rate for Payer: PHP Commercial |
$36,738.14
|
| Rate for Payer: PHP Medicare Advantage |
$10,805.33
|
| 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 |
$10,805.33
|
| 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 |
$10,805.33
|
| Rate for Payer: UHC Exchange |
$10,805.33
|
| Rate for Payer: UHC Medicare Advantage |
$10,805.33
|
| Rate for Payer: VA VA |
$10,805.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32,416.01
|
|
|
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 |
$32,416.01
|
| 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 |
$32,416.01
|
|
|
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 |
$3,307.43
|
| 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 |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$972.77
|
| Rate for Payer: BCBS Trust/PPO |
$3,198.87
|
| Rate for Payer: BCN Commercial |
$3,025.33
|
| Rate for Payer: BCN Medicare Advantage |
$972.77
|
| 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 |
$972.77
|
| Rate for Payer: Healthscope Commercial |
$3,501.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.32
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.41
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,118.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.43
|
| Rate for Payer: Nomi Health Commercial |
$3,190.70
|
| Rate for Payer: PACE Senior Care Partners |
$924.14
|
| Rate for Payer: PACE SWMI |
$972.77
|
| Rate for Payer: PHP Commercial |
$3,307.43
|
| Rate for Payer: PHP Medicare Advantage |
$972.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| 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 |
$972.77
|
| 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 |
$972.77
|
| Rate for Payer: UHC Exchange |
$972.77
|
| Rate for Payer: UHC Medicare Advantage |
$972.77
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$972.77
|
| 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 |
$3,307.43
|
| 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 |
$3,307.43
|
| Rate for Payer: Nomi Health Commercial |
$3,190.70
|
| Rate for Payer: PHP Commercial |
$3,307.43
|
| 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
|
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 |
$4,328.59
|
| 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 |
$4,122.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,201.05
|
| Rate for Payer: Meridian Medicaid |
$4,328.59
|
| 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 |
$4,122.20
|
| 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 |
$4,122.20
|
| Rate for Payer: VA VA |
$4,001.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
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 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 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
|
|
