|
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 COMPL
|
Facility
|
OP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.80
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$404.57
|
| 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 |
$76.88 |
| 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 |
$191.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.07
|
| Rate for Payer: BCBS Complete |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.50
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| 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
|
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 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 |
$402.83 |
| 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 |
$402.83
|
| 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 |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| 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 |
$383.62
|
| 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 |
$383.62
|
| Rate for Payer: VA VA |
$109.41
|
| 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 |
$772.40 |
| 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 |
$772.40
|
| 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 |
$735.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.39
|
| Rate for Payer: Meridian Medicaid |
$772.40
|
| 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 |
$735.57
|
| 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 |
$735.57
|
| 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
|
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 |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| 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 |
$13.01
|
| 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 |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| 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 |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
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 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 |
$331.91
|
| 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 |
$897.35
|
| Rate for Payer: Mclaren Medicaid |
$316.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.07
|
| Rate for Payer: Meridian Medicaid |
$331.91
|
| 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 |
$316.08
|
| 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 |
$316.08
|
| Rate for Payer: VA VA |
$299.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.35
|
|
|
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 |
$897.35
|
| 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 |
$897.35
|
|
|
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 |
$331.91
|
| 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 |
$316.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.91
|
| Rate for Payer: Meridian Medicaid |
$331.91
|
| 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 |
$316.08
|
| 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 |
$316.08
|
| 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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.63
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| 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
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,064.32 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: BCBS Trust/PPO |
$5,104.16
|
| Rate for Payer: BCN Commercial |
$4,832.16
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: Nomi Health Commercial |
$5,127.30
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health HMO/PPO |
$5,439.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,189.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,502.46
|
| Rate for Payer: UHC Core |
$5,221.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,485.04 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna Medicare |
$1,625.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,954.00
|
| Rate for Payer: BCBS Complete |
$3,859.48
|
| Rate for Payer: BCBS MAPPO |
$1,563.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,140.43
|
| Rate for Payer: BCN Commercial |
$4,861.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,563.20
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,563.20
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Mclaren Medicaid |
$3,675.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,641.36
|
| Rate for Payer: Meridian Medicaid |
$3,859.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,797.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: Nomi Health Commercial |
$5,127.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,485.04
|
| Rate for Payer: PACE SWMI |
$1,563.20
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,563.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,675.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health HMO/PPO |
$5,439.94
|
| Rate for Payer: Priority Health Medicare |
$1,578.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,189.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,563.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,502.46
|
| Rate for Payer: UHC Core |
$5,221.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,563.20
|
| Rate for Payer: UHC Exchange |
$1,563.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,563.20
|
| Rate for Payer: UHCCP Medicaid |
$3,675.46
|
| Rate for Payer: VA VA |
$1,563.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,400.81 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.04
|
| Rate for Payer: BCN Commercial |
$2,854.38
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: Nomi Health Commercial |
$3,028.71
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.32
|
| Rate for Payer: UHC Core |
$3,084.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$877.22 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna Medicare |
$960.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,154.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,154.23
|
| Rate for Payer: BCBS Complete |
$1,477.42
|
| Rate for Payer: BCBS MAPPO |
$923.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,036.47
|
| Rate for Payer: BCN Commercial |
$2,871.74
|
| Rate for Payer: BCN Medicare Advantage |
$923.39
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.39
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: Nomi Health Commercial |
$3,028.71
|
| Rate for Payer: PACE Senior Care Partners |
$877.22
|
| Rate for Payer: PACE SWMI |
$923.39
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: PHP Medicare Advantage |
$923.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.39
|
| Rate for Payer: Priority Health Medicare |
$932.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.68
|
| Rate for Payer: Railroad Medicare Medicare |
$923.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.32
|
| Rate for Payer: UHC Core |
$3,084.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.39
|
| Rate for Payer: UHC Exchange |
$923.39
|
| Rate for Payer: UHC Medicare Advantage |
$923.39
|
| Rate for Payer: VA VA |
$923.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,169.20 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: Aetna Medicare |
$1,279.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,538.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,538.42
|
| Rate for Payer: BCBS Complete |
$1,969.17
|
| Rate for Payer: BCBS MAPPO |
$1,230.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,047.14
|
| Rate for Payer: BCN Commercial |
$3,827.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,230.73
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,230.73
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,292.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,415.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: PACE Senior Care Partners |
$1,169.20
|
| Rate for Payer: PACE SWMI |
$1,230.73
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,230.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,282.95
|
| Rate for Payer: Priority Health Medicare |
$1,243.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,230.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,332.18
|
| Rate for Payer: UHC Core |
$4,110.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,230.73
|
| Rate for Payer: UHC Exchange |
$1,230.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,230.73
|
| Rate for Payer: VA VA |
$1,230.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,199.90 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: BCBS Trust/PPO |
$4,018.59
|
| Rate for Payer: BCN Commercial |
$3,804.44
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,282.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,332.18
|
| Rate for Payer: UHC Core |
$4,110.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.79 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: Aetna Medicare |
$235.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$282.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$282.62
|
| Rate for Payer: BCBS Complete |
$361.76
|
| Rate for Payer: BCBS MAPPO |
$226.10
|
| Rate for Payer: BCBS Trust/PPO |
$743.50
|
| Rate for Payer: BCN Commercial |
$703.16
|
| Rate for Payer: BCN Medicare Advantage |
$226.10
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.10
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: PACE Senior Care Partners |
$214.79
|
| Rate for Payer: PACE SWMI |
$226.10
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: PHP Medicare Advantage |
$226.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health HMO/PPO |
$786.82
|
| Rate for Payer: Priority Health Medicare |
$228.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.94
|
| Rate for Payer: Railroad Medicare Medicare |
$226.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.86
|
| Rate for Payer: UHC Core |
$755.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.10
|
| Rate for Payer: UHC Exchange |
$226.10
|
| Rate for Payer: UHC Medicare Advantage |
$226.10
|
| Rate for Payer: VA VA |
$226.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$587.85 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: BCBS Trust/PPO |
$738.25
|
| Rate for Payer: BCN Commercial |
$698.91
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health HMO/PPO |
$786.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.86
|
| Rate for Payer: UHC Core |
$755.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$381.54 |
| Max. Negotiated Rate |
$1,445.85 |
| Rate for Payer: Aetna Commercial |
$1,365.53
|
| Rate for Payer: Aetna Medicare |
$417.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$502.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$502.03
|
| Rate for Payer: BCBS Complete |
$642.60
|
| Rate for Payer: BCBS MAPPO |
$401.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.70
|
| Rate for Payer: BCN Commercial |
$1,249.05
|
| Rate for Payer: BCN Medicare Advantage |
$401.62
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.62
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.53
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: PACE Senior Care Partners |
$381.54
|
| Rate for Payer: PACE SWMI |
$401.62
|
| Rate for Payer: PHP Commercial |
$1,365.53
|
| Rate for Payer: PHP Medicare Advantage |
$401.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,397.65
|
| Rate for Payer: Priority Health Medicare |
$405.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.36
|
| Rate for Payer: Railroad Medicare Medicare |
$401.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.72
|
| Rate for Payer: UHC Core |
$1,341.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.62
|
| Rate for Payer: UHC Exchange |
$401.62
|
| Rate for Payer: UHC Medicare Advantage |
$401.62
|
| Rate for Payer: VA VA |
$401.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
