|
HC VEDOLIZUMAB CMPT
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$107.33
|
| Rate for Payer: BCN Commercial |
$101.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Medicare |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.64
|
| Rate for Payer: UHC Exchange |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$32.64
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.86 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$106.58
|
| Rate for Payer: BCN Commercial |
$100.90
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
IP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$161.77 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: BCBS Trust/PPO |
$203.16
|
| Rate for Payer: BCN Commercial |
$192.33
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: Nomi Health Commercial |
$204.08
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health HMO/PPO |
$216.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.01
|
| Rate for Payer: UHC Core |
$207.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.66
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
OP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: Aetna Medicare |
$64.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.78
|
| Rate for Payer: BCBS Complete |
$29.28
|
| Rate for Payer: BCBS MAPPO |
$62.22
|
| Rate for Payer: BCBS Trust/PPO |
$204.60
|
| Rate for Payer: BCN Commercial |
$193.50
|
| Rate for Payer: BCN Medicare Advantage |
$62.22
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.22
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.66
|
| Rate for Payer: Mclaren Medicaid |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.33
|
| Rate for Payer: Meridian Medicaid |
$29.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: Nomi Health Commercial |
$204.08
|
| Rate for Payer: PACE Senior Care Partners |
$59.11
|
| Rate for Payer: PACE SWMI |
$62.22
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: PHP Medicare Advantage |
$62.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health HMO/PPO |
$216.53
|
| Rate for Payer: Priority Health Medicare |
$62.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.75
|
| Rate for Payer: Railroad Medicare Medicare |
$62.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.01
|
| Rate for Payer: UHC Core |
$207.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.22
|
| Rate for Payer: UHC Exchange |
$62.22
|
| Rate for Payer: UHC Medicare Advantage |
$62.22
|
| Rate for Payer: UHCCP Medicaid |
$27.89
|
| Rate for Payer: VA VA |
$62.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.66
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
IP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$663.82 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: BCBS Trust/PPO |
$833.65
|
| Rate for Payer: BCN Commercial |
$789.23
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: Nomi Health Commercial |
$837.43
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health HMO/PPO |
$888.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.71
|
| Rate for Payer: UHC Core |
$852.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.95
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
OP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$242.55 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: Aetna Medicare |
$265.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$319.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$319.14
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$255.31
|
| Rate for Payer: BCBS Trust/PPO |
$839.58
|
| Rate for Payer: BCN Commercial |
$794.03
|
| Rate for Payer: BCN Medicare Advantage |
$255.31
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.31
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.95
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.08
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: Nomi Health Commercial |
$837.43
|
| Rate for Payer: PACE Senior Care Partners |
$242.55
|
| Rate for Payer: PACE SWMI |
$255.31
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: PHP Medicare Advantage |
$255.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health HMO/PPO |
$888.50
|
| Rate for Payer: Priority Health Medicare |
$257.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.24
|
| Rate for Payer: Railroad Medicare Medicare |
$255.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.71
|
| Rate for Payer: UHC Core |
$852.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.31
|
| Rate for Payer: UHC Exchange |
$255.31
|
| Rate for Payer: UHC Medicare Advantage |
$255.31
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$255.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.95
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
OP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$383.62 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: Aetna Medicare |
$634.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$763.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$763.11
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$610.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.54
|
| Rate for Payer: BCN Commercial |
$1,898.62
|
| Rate for Payer: BCN Medicare Advantage |
$610.49
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.49
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.47
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.01
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$702.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: Nomi Health Commercial |
$2,002.41
|
| Rate for Payer: PACE Senior Care Partners |
$579.97
|
| Rate for Payer: PACE SWMI |
$610.49
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: PHP Medicare Advantage |
$610.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.51
|
| Rate for Payer: Priority Health Medicare |
$616.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.11
|
| Rate for Payer: Railroad Medicare Medicare |
$610.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,148.92
|
| Rate for Payer: UHC Core |
$2,039.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.49
|
| Rate for Payer: UHC Exchange |
$610.49
|
| Rate for Payer: UHC Medicare Advantage |
$610.49
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$610.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.47
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
IP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,587.27 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,993.37
|
| Rate for Payer: BCN Commercial |
$1,887.15
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: Nomi Health Commercial |
$2,002.41
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,148.92
|
| Rate for Payer: UHC Core |
$2,039.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.47
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
IP
|
$1,072.90
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$697.38 |
| Max. Negotiated Rate |
$965.61 |
| Rate for Payer: Aetna Commercial |
$911.97
|
| Rate for Payer: BCBS Trust/PPO |
$875.81
|
| Rate for Payer: BCN Commercial |
$829.14
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cofinity Commercial |
$922.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.32
|
| Rate for Payer: Healthscope Commercial |
$965.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.97
|
| Rate for Payer: Nomi Health Commercial |
$879.78
|
| Rate for Payer: PHP Commercial |
$911.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.38
|
| Rate for Payer: Priority Health HMO/PPO |
$933.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.15
|
| Rate for Payer: UHC Core |
$895.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.67
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
OP
|
$1,072.90
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$965.61 |
| Rate for Payer: Aetna Commercial |
$911.97
|
| Rate for Payer: Aetna Medicare |
$278.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.28
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$268.23
|
| Rate for Payer: BCBS Trust/PPO |
$882.03
|
| Rate for Payer: BCN Commercial |
$834.18
|
| Rate for Payer: BCN Medicare Advantage |
$268.23
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cofinity Commercial |
$922.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.23
|
| Rate for Payer: Healthscope Commercial |
$965.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.67
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.64
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.97
|
| Rate for Payer: Nomi Health Commercial |
$879.78
|
| Rate for Payer: PACE Senior Care Partners |
$254.81
|
| Rate for Payer: PACE SWMI |
$268.23
|
| Rate for Payer: PHP Commercial |
$911.97
|
| Rate for Payer: PHP Medicare Advantage |
$268.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.38
|
| Rate for Payer: Priority Health HMO/PPO |
$933.42
|
| Rate for Payer: Priority Health Medicare |
$270.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.84
|
| Rate for Payer: Railroad Medicare Medicare |
$268.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.15
|
| Rate for Payer: UHC Core |
$895.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.23
|
| Rate for Payer: UHC Exchange |
$268.23
|
| Rate for Payer: UHC Medicare Advantage |
$268.23
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$268.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.67
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,273.65 |
| Max. Negotiated Rate |
$1,763.51 |
| Rate for Payer: Aetna Commercial |
$1,665.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.51
|
| Rate for Payer: BCN Commercial |
$1,514.27
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,685.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Healthscope Commercial |
$1,763.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: PHP Commercial |
$1,665.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.32
|
| Rate for Payer: UHC Core |
$1,636.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.60
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$1,763.51 |
| Rate for Payer: Aetna Commercial |
$1,665.54
|
| Rate for Payer: Aetna Medicare |
$509.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.33
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$489.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.87
|
| Rate for Payer: BCN Commercial |
$1,523.48
|
| Rate for Payer: BCN Medicare Advantage |
$489.87
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,685.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.87
|
| Rate for Payer: Healthscope Commercial |
$1,763.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.60
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.36
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: PACE Senior Care Partners |
$465.37
|
| Rate for Payer: PACE SWMI |
$489.87
|
| Rate for Payer: PHP Commercial |
$1,665.54
|
| Rate for Payer: PHP Medicare Advantage |
$489.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.73
|
| Rate for Payer: Priority Health Medicare |
$494.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.84
|
| Rate for Payer: Railroad Medicare Medicare |
$489.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.32
|
| Rate for Payer: UHC Core |
$1,636.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.87
|
| Rate for Payer: UHC Exchange |
$489.87
|
| Rate for Payer: UHC Medicare Advantage |
$489.87
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$489.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.60
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
OP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$735.57 |
| Max. Negotiated Rate |
$4,096.96 |
| Rate for Payer: Aetna Commercial |
$3,869.35
|
| Rate for Payer: Aetna Medicare |
$1,183.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,422.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,422.56
|
| Rate for Payer: BCBS Complete |
$772.40
|
| Rate for Payer: BCBS MAPPO |
$1,138.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,742.35
|
| Rate for Payer: BCN Commercial |
$3,539.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.05
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$3,914.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.05
|
| Rate for Payer: Healthscope Commercial |
$4,096.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,414.14
|
| Rate for Payer: Mclaren Medicaid |
$735.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,194.95
|
| Rate for Payer: Meridian Medicaid |
$772.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,308.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: PACE Senior Care Partners |
$1,081.14
|
| Rate for Payer: PACE SWMI |
$1,138.05
|
| Rate for Payer: PHP Commercial |
$3,869.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$735.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3,960.40
|
| Rate for Payer: Priority Health Medicare |
$1,149.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,005.92
|
| Rate for Payer: UHC Core |
$3,801.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.05
|
| Rate for Payer: UHC Exchange |
$1,138.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,138.05
|
| Rate for Payer: UHCCP Medicaid |
$735.57
|
| Rate for Payer: VA VA |
$1,138.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,414.14
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
IP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,958.92 |
| Max. Negotiated Rate |
$4,096.96 |
| Rate for Payer: Aetna Commercial |
$3,869.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,715.94
|
| Rate for Payer: BCN Commercial |
$3,517.92
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$3,914.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Healthscope Commercial |
$4,096.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,414.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: PHP Commercial |
$3,869.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3,960.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,005.92
|
| Rate for Payer: UHC Core |
$3,801.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,414.14
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
OP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$383.62 |
| Max. Negotiated Rate |
$2,179.61 |
| Rate for Payer: Aetna Commercial |
$2,058.52
|
| Rate for Payer: Aetna Medicare |
$629.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$756.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$756.81
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$605.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.95
|
| Rate for Payer: BCN Commercial |
$1,882.94
|
| Rate for Payer: BCN Medicare Advantage |
$605.45
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,082.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.45
|
| Rate for Payer: Healthscope Commercial |
$2,179.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,816.34
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.72
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: PACE Senior Care Partners |
$575.18
|
| Rate for Payer: PACE SWMI |
$605.45
|
| Rate for Payer: PHP Commercial |
$2,058.52
|
| Rate for Payer: PHP Medicare Advantage |
$605.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,106.96
|
| Rate for Payer: Priority Health Medicare |
$611.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.60
|
| Rate for Payer: Railroad Medicare Medicare |
$605.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,131.18
|
| Rate for Payer: UHC Core |
$2,022.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.45
|
| Rate for Payer: UHC Exchange |
$605.45
|
| Rate for Payer: UHC Medicare Advantage |
$605.45
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$605.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,816.34
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
IP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,574.16 |
| Max. Negotiated Rate |
$2,179.61 |
| Rate for Payer: Aetna Commercial |
$2,058.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.91
|
| Rate for Payer: BCN Commercial |
$1,871.56
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,082.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Healthscope Commercial |
$2,179.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,816.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: PHP Commercial |
$2,058.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,106.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,131.18
|
| Rate for Payer: UHC Core |
$2,022.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,816.34
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna Medicare |
$366.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.22
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$352.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.08
|
| Rate for Payer: BCN Commercial |
$1,095.26
|
| Rate for Payer: BCN Medicare Advantage |
$352.17
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.17
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.78
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PACE Senior Care Partners |
$334.56
|
| Rate for Payer: PACE SWMI |
$352.17
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: PHP Medicare Advantage |
$352.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,225.56
|
| Rate for Payer: Priority Health Medicare |
$355.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$943.82
|
| Rate for Payer: Railroad Medicare Medicare |
$352.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.65
|
| Rate for Payer: UHC Core |
$1,176.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.17
|
| Rate for Payer: UHC Exchange |
$352.17
|
| Rate for Payer: UHC Medicare Advantage |
$352.17
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$352.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$915.65 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.91
|
| Rate for Payer: BCN Commercial |
$1,088.64
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,225.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$943.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.65
|
| Rate for Payer: UHC Core |
$1,176.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna Medicare |
$366.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.22
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$352.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.08
|
| Rate for Payer: BCN Commercial |
$1,095.26
|
| Rate for Payer: BCN Medicare Advantage |
$352.17
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.17
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.78
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PACE Senior Care Partners |
$334.56
|
| Rate for Payer: PACE SWMI |
$352.17
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: PHP Medicare Advantage |
$352.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,225.56
|
| Rate for Payer: Priority Health Medicare |
$355.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$943.82
|
| Rate for Payer: Railroad Medicare Medicare |
$352.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.65
|
| Rate for Payer: UHC Core |
$1,176.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.17
|
| Rate for Payer: UHC Exchange |
$352.17
|
| Rate for Payer: UHC Medicare Advantage |
$352.17
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$352.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$915.65 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.91
|
| Rate for Payer: BCN Commercial |
$1,088.64
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: Nomi Health Commercial |
$1,155.13
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,225.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$943.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.65
|
| Rate for Payer: UHC Core |
$1,176.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna Medicare |
$225.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.13
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$216.91
|
| Rate for Payer: BCBS Trust/PPO |
$713.28
|
| Rate for Payer: BCN Commercial |
$674.58
|
| Rate for Payer: BCN Medicare Advantage |
$216.91
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.91
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Senior Care Partners |
$206.06
|
| Rate for Payer: PACE SWMI |
$216.91
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: PHP Medicare Advantage |
$216.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Medicare |
$219.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: Railroad Medicare Medicare |
$216.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.91
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicare Advantage |
$216.91
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$216.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: BCBS Trust/PPO |
$708.25
|
| Rate for Payer: BCN Commercial |
$670.50
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$563.96 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: BCBS Trust/PPO |
$708.25
|
| Rate for Payer: BCN Commercial |
$670.50
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna Medicare |
$225.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.13
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$216.91
|
| Rate for Payer: BCBS Trust/PPO |
$713.28
|
| Rate for Payer: BCN Commercial |
$674.58
|
| Rate for Payer: BCN Medicare Advantage |
$216.91
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.91
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: Nomi Health Commercial |
$711.46
|
| Rate for Payer: PACE Senior Care Partners |
$206.06
|
| Rate for Payer: PACE SWMI |
$216.91
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: PHP Medicare Advantage |
$216.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health HMO/PPO |
$754.84
|
| Rate for Payer: Priority Health Medicare |
$219.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$581.31
|
| Rate for Payer: Railroad Medicare Medicare |
$216.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.51
|
| Rate for Payer: UHC Core |
$724.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.91
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicare Advantage |
$216.91
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$216.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,568.42 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.70
|
| Rate for Payer: BCN Commercial |
$1,864.74
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.42
|
| Rate for Payer: Priority Health HMO/PPO |
$2,099.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,616.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,123.40
|
| Rate for Payer: UHC Core |
$2,014.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
