|
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 LOWER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$171.23 |
| 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 |
$179.80
|
| 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 |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.78
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| 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 |
$171.23
|
| 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 |
$171.23
|
| 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
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$171.23 |
| 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 |
$179.80
|
| 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 |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.78
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| 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 |
$171.23
|
| 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 |
$171.23
|
| 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 |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| 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
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.75
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| Rate for Payer: VA VA |
$216.91
|
| 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 VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$573.08 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna Medicare |
$627.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$754.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$754.05
|
| Rate for Payer: BCBS Complete |
$965.18
|
| Rate for Payer: BCBS MAPPO |
$603.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.69
|
| Rate for Payer: BCN Commercial |
$1,876.08
|
| Rate for Payer: BCN Medicare Advantage |
$603.24
|
| 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: Health Alliance Plan Medicare Advantage |
$603.24
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: Nomi Health Commercial |
$1,978.63
|
| Rate for Payer: PACE Senior Care Partners |
$573.08
|
| Rate for Payer: PACE SWMI |
$603.24
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: PHP Medicare Advantage |
$603.24
|
| 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 Medicare |
$609.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,616.68
|
| Rate for Payer: Railroad Medicare Medicare |
$603.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,123.40
|
| Rate for Payer: UHC Core |
$2,014.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.24
|
| Rate for Payer: UHC Exchange |
$603.24
|
| Rate for Payer: UHC Medicare Advantage |
$603.24
|
| Rate for Payer: VA VA |
$603.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
|
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
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,916.50 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.83
|
| Rate for Payer: BCN Commercial |
$2,278.57
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,565.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,975.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,594.64
|
| Rate for Payer: UHC Core |
$2,461.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$700.26 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna Medicare |
$766.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$921.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$921.39
|
| Rate for Payer: BCBS Complete |
$1,179.38
|
| Rate for Payer: BCBS MAPPO |
$737.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,423.93
|
| Rate for Payer: BCN Commercial |
$2,292.43
|
| Rate for Payer: BCN Medicare Advantage |
$737.12
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.12
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$847.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: Nomi Health Commercial |
$2,417.74
|
| Rate for Payer: PACE Senior Care Partners |
$700.26
|
| Rate for Payer: PACE SWMI |
$737.12
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: PHP Medicare Advantage |
$737.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,565.16
|
| Rate for Payer: Priority Health Medicare |
$744.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,975.47
|
| Rate for Payer: Railroad Medicare Medicare |
$737.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,594.64
|
| Rate for Payer: UHC Core |
$2,461.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$737.12
|
| Rate for Payer: UHC Exchange |
$737.12
|
| Rate for Payer: UHC Medicare Advantage |
$737.12
|
| Rate for Payer: VA VA |
$737.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.25 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: BCBS Trust/PPO |
$333.11
|
| Rate for Payer: BCN Commercial |
$315.36
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO |
$355.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$340.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna Medicare |
$106.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.52
|
| Rate for Payer: BCBS Complete |
$163.23
|
| Rate for Payer: BCBS MAPPO |
$102.02
|
| Rate for Payer: BCBS Trust/PPO |
$335.47
|
| Rate for Payer: BCN Commercial |
$317.27
|
| Rate for Payer: BCN Medicare Advantage |
$102.02
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.02
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: Nomi Health Commercial |
$334.62
|
| Rate for Payer: PACE Senior Care Partners |
$96.92
|
| Rate for Payer: PACE SWMI |
$102.02
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: PHP Medicare Advantage |
$102.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health HMO/PPO |
$355.02
|
| Rate for Payer: Priority Health Medicare |
$103.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.41
|
| Rate for Payer: Railroad Medicare Medicare |
$102.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.10
|
| Rate for Payer: UHC Core |
$340.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.02
|
| Rate for Payer: UHC Exchange |
$102.02
|
| Rate for Payer: UHC Medicare Advantage |
$102.02
|
| Rate for Payer: VA VA |
$102.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$37.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$37.73
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Exchange |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.48
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,094.26 |
| Max. Negotiated Rate |
$7,936.15 |
| Rate for Payer: Aetna Commercial |
$7,495.25
|
| Rate for Payer: Aetna Medicare |
$2,292.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,755.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,755.61
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$2,204.48
|
| Rate for Payer: BCBS Trust/PPO |
$7,249.23
|
| Rate for Payer: BCN Commercial |
$6,855.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,204.48
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$7,583.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,204.48
|
| Rate for Payer: Healthscope Commercial |
$7,936.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,613.46
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,314.71
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,535.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,495.25
|
| Rate for Payer: Nomi Health Commercial |
$7,230.71
|
| Rate for Payer: PACE Senior Care Partners |
$2,094.26
|
| Rate for Payer: PACE SWMI |
$2,204.48
|
| Rate for Payer: PHP Commercial |
$7,495.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,204.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| Rate for Payer: Priority Health HMO/PPO |
$7,671.61
|
| Rate for Payer: Priority Health Medicare |
$2,226.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,908.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,204.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,759.79
|
| Rate for Payer: UHC Core |
$7,362.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,204.48
|
| Rate for Payer: UHC Exchange |
$2,204.48
|
| Rate for Payer: UHC Medicare Advantage |
$2,204.48
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$2,204.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,613.46
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,731.66 |
| Max. Negotiated Rate |
$7,936.15 |
| Rate for Payer: Aetna Commercial |
$7,495.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,198.08
|
| Rate for Payer: BCN Commercial |
$6,814.50
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$7,583.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Healthscope Commercial |
$7,936.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,613.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,495.25
|
| Rate for Payer: Nomi Health Commercial |
$7,230.71
|
| Rate for Payer: PHP Commercial |
$7,495.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| Rate for Payer: Priority Health HMO/PPO |
$7,671.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,908.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,759.79
|
| Rate for Payer: UHC Core |
$7,362.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,613.46
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,018.21
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,191.82 |
| Max. Negotiated Rate |
$4,516.39 |
| Rate for Payer: Aetna Commercial |
$4,265.48
|
| Rate for Payer: Aetna Medicare |
$1,304.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,568.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,568.19
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,254.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,125.47
|
| Rate for Payer: BCN Commercial |
$3,901.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,254.55
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cofinity Commercial |
$4,315.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,254.55
|
| Rate for Payer: Healthscope Commercial |
$4,516.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,763.66
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,317.28
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,442.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,265.48
|
| Rate for Payer: Nomi Health Commercial |
$4,114.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,191.82
|
| Rate for Payer: PACE SWMI |
$1,254.55
|
| Rate for Payer: PHP Commercial |
$4,265.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,254.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.84
|
| Rate for Payer: Priority Health HMO/PPO |
$4,365.84
|
| Rate for Payer: Priority Health Medicare |
$1,267.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,362.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,254.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,416.02
|
| Rate for Payer: UHC Core |
$4,190.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,254.55
|
| Rate for Payer: UHC Exchange |
$1,254.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,254.55
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,254.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,763.66
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$5,018.21
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,261.84 |
| Max. Negotiated Rate |
$4,516.39 |
| Rate for Payer: Aetna Commercial |
$4,265.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,096.36
|
| Rate for Payer: BCN Commercial |
$3,878.07
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cofinity Commercial |
$4,315.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,014.57
|
| Rate for Payer: Healthscope Commercial |
$4,516.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,763.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,265.48
|
| Rate for Payer: Nomi Health Commercial |
$4,114.93
|
| Rate for Payer: PHP Commercial |
$4,265.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.84
|
| Rate for Payer: Priority Health HMO/PPO |
$4,365.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,362.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,416.02
|
| Rate for Payer: UHC Core |
$4,190.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,763.66
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,442.36
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$580.06 |
| Max. Negotiated Rate |
$2,341.27 |
| Rate for Payer: Aetna Commercial |
$2,076.01
|
| Rate for Payer: Aetna Medicare |
$635.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$763.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$763.24
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$610.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.86
|
| Rate for Payer: BCN Commercial |
$1,898.93
|
| Rate for Payer: BCN Medicare Advantage |
$610.59
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cofinity Commercial |
$2,100.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.59
|
| Rate for Payer: Healthscope Commercial |
$2,198.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.77
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.12
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$702.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,076.01
|
| Rate for Payer: Nomi Health Commercial |
$2,002.74
|
| Rate for Payer: PACE Senior Care Partners |
$580.06
|
| Rate for Payer: PACE SWMI |
$610.59
|
| Rate for Payer: PHP Commercial |
$2,076.01
|
| Rate for Payer: PHP Medicare Advantage |
$610.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.53
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.85
|
| Rate for Payer: Priority Health Medicare |
$616.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.38
|
| Rate for Payer: Railroad Medicare Medicare |
$610.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,149.28
|
| Rate for Payer: UHC Core |
$2,039.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.59
|
| Rate for Payer: UHC Exchange |
$610.59
|
| Rate for Payer: UHC Medicare Advantage |
$610.59
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$610.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.77
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,442.36
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,587.53 |
| Max. Negotiated Rate |
$2,198.12 |
| Rate for Payer: Aetna Commercial |
$2,076.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,993.70
|
| Rate for Payer: BCN Commercial |
$1,887.46
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cofinity Commercial |
$2,100.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.89
|
| Rate for Payer: Healthscope Commercial |
$2,198.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,076.01
|
| Rate for Payer: Nomi Health Commercial |
$2,002.74
|
| Rate for Payer: PHP Commercial |
$2,076.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.53
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,149.28
|
| Rate for Payer: UHC Core |
$2,039.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.77
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,796.10
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,167.46 |
| Max. Negotiated Rate |
$1,616.49 |
| Rate for Payer: Aetna Commercial |
$1,526.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.16
|
| Rate for Payer: BCN Commercial |
$1,388.03
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cofinity Commercial |
$1,544.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.88
|
| Rate for Payer: Healthscope Commercial |
$1,616.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,347.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.68
|
| Rate for Payer: Nomi Health Commercial |
$1,472.80
|
| Rate for Payer: PHP Commercial |
$1,526.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,562.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,203.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,580.57
|
| Rate for Payer: UHC Core |
$1,499.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.08
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,796.10
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,616.49 |
| Rate for Payer: Aetna Commercial |
$1,526.68
|
| Rate for Payer: Aetna Medicare |
$466.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$561.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$561.28
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$449.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.57
|
| Rate for Payer: BCN Commercial |
$1,396.47
|
| Rate for Payer: BCN Medicare Advantage |
$449.02
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cofinity Commercial |
$1,544.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.02
|
| Rate for Payer: Healthscope Commercial |
$1,616.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,347.08
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$471.48
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.68
|
| Rate for Payer: Nomi Health Commercial |
$1,472.80
|
| Rate for Payer: PACE Senior Care Partners |
$426.57
|
| Rate for Payer: PACE SWMI |
$449.02
|
| Rate for Payer: PHP Commercial |
$1,526.68
|
| Rate for Payer: PHP Medicare Advantage |
$449.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,562.61
|
| Rate for Payer: Priority Health Medicare |
$453.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,203.39
|
| Rate for Payer: Railroad Medicare Medicare |
$449.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,580.57
|
| Rate for Payer: UHC Core |
$1,499.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.02
|
| Rate for Payer: UHC Exchange |
$449.02
|
| Rate for Payer: UHC Medicare Advantage |
$449.02
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$449.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.08
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,018.94 |
| Max. Negotiated Rate |
$4,180.08 |
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,791.33
|
| Rate for Payer: BCN Commercial |
$3,589.29
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,483.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO |
$4,040.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,087.19
|
| Rate for Payer: UHC Core |
$3,878.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,483.40
|
|
