|
HC VENT CPS Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,279.47 |
| Max. Negotiated Rate |
$7,310.03 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: BCBS Trust/PPO |
$6,630.20
|
| Rate for Payer: BCN Commercial |
$6,276.88
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO |
$7,066.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,441.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,147.59
|
| Rate for Payer: UHC Core |
$6,782.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.69
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,929.04 |
| Max. Negotiated Rate |
$7,310.03 |
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$2,111.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,538.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,538.21
|
| Rate for Payer: BCBS Complete |
$2,462.14
|
| Rate for Payer: BCBS MAPPO |
$2,030.57
|
| Rate for Payer: BCBS Trust/PPO |
$6,677.31
|
| Rate for Payer: BCN Commercial |
$6,315.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,030.57
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,030.57
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.69
|
| Rate for Payer: Mclaren Medicaid |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,132.09
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,335.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$6,660.25
|
| Rate for Payer: PACE Senior Care Partners |
$1,929.04
|
| Rate for Payer: PACE SWMI |
$2,030.57
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,030.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,344.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO |
$7,066.37
|
| Rate for Payer: Priority Health Medicare |
$2,050.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,441.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,030.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,147.59
|
| Rate for Payer: UHC Core |
$6,782.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,030.57
|
| Rate for Payer: UHC Exchange |
$2,030.57
|
| Rate for Payer: UHC Medicare Advantage |
$2,030.57
|
| Rate for Payer: UHCCP Medicaid |
$2,344.74
|
| Rate for Payer: VA VA |
$2,030.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.69
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$557.92 |
| Max. Negotiated Rate |
$772.51 |
| Rate for Payer: Aetna Commercial |
$729.59
|
| Rate for Payer: BCBS Trust/PPO |
$700.66
|
| Rate for Payer: BCN Commercial |
$663.33
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$738.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Healthscope Commercial |
$772.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: Nomi Health Commercial |
$703.84
|
| Rate for Payer: PHP Commercial |
$729.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: Priority Health HMO/PPO |
$746.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$575.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.34
|
| Rate for Payer: UHC Core |
$716.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$203.86 |
| Max. Negotiated Rate |
$772.51 |
| Rate for Payer: Aetna Commercial |
$729.59
|
| Rate for Payer: Aetna Medicare |
$223.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.23
|
| Rate for Payer: BCBS Complete |
$343.34
|
| Rate for Payer: BCBS MAPPO |
$214.59
|
| Rate for Payer: BCBS Trust/PPO |
$705.64
|
| Rate for Payer: BCN Commercial |
$667.36
|
| Rate for Payer: BCN Medicare Advantage |
$214.59
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$738.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.59
|
| Rate for Payer: Healthscope Commercial |
$772.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: Nomi Health Commercial |
$703.84
|
| Rate for Payer: PACE Senior Care Partners |
$203.86
|
| Rate for Payer: PACE SWMI |
$214.59
|
| Rate for Payer: PHP Commercial |
$729.59
|
| Rate for Payer: PHP Medicare Advantage |
$214.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: Priority Health HMO/PPO |
$746.76
|
| Rate for Payer: Priority Health Medicare |
$216.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$575.09
|
| Rate for Payer: Railroad Medicare Medicare |
$214.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.34
|
| Rate for Payer: UHC Core |
$716.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.59
|
| Rate for Payer: UHC Exchange |
$214.59
|
| Rate for Payer: UHC Medicare Advantage |
$214.59
|
| Rate for Payer: VA VA |
$214.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,211.96 |
| Max. Negotiated Rate |
$4,592.67 |
| Rate for Payer: Aetna Commercial |
$4,337.52
|
| Rate for Payer: Aetna Medicare |
$1,326.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,594.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,594.68
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$1,275.74
|
| Rate for Payer: BCBS Trust/PPO |
$4,195.15
|
| Rate for Payer: BCN Commercial |
$3,967.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.74
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$4,388.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.74
|
| Rate for Payer: Healthscope Commercial |
$4,592.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,827.23
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,339.53
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,467.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: Nomi Health Commercial |
$4,184.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,211.96
|
| Rate for Payer: PACE SWMI |
$1,275.74
|
| Rate for Payer: PHP Commercial |
$4,337.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,439.58
|
| Rate for Payer: Priority Health Medicare |
$1,288.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,418.99
|
| Rate for Payer: Railroad Medicare Medicare |
$1,275.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,490.61
|
| Rate for Payer: UHC Core |
$4,260.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.74
|
| Rate for Payer: UHC Exchange |
$1,275.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.74
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$1,275.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,827.23
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,316.93 |
| Max. Negotiated Rate |
$4,592.67 |
| Rate for Payer: Aetna Commercial |
$4,337.52
|
| Rate for Payer: BCBS Trust/PPO |
$4,165.55
|
| Rate for Payer: BCN Commercial |
$3,943.58
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$4,388.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Healthscope Commercial |
$4,592.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,827.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: Nomi Health Commercial |
$4,184.44
|
| Rate for Payer: PHP Commercial |
$4,337.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,439.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,418.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,490.61
|
| Rate for Payer: UHC Core |
$4,260.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,827.23
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,295.85 |
| Max. Negotiated Rate |
$4,910.58 |
| Rate for Payer: Aetna Commercial |
$4,637.77
|
| Rate for Payer: Aetna Medicare |
$1,418.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,705.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,705.06
|
| Rate for Payer: BCBS Complete |
$2,182.48
|
| Rate for Payer: BCBS MAPPO |
$1,364.05
|
| Rate for Payer: BCBS Trust/PPO |
$4,485.54
|
| Rate for Payer: BCN Commercial |
$4,242.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,364.05
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$4,692.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,364.05
|
| Rate for Payer: Healthscope Commercial |
$4,910.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,092.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,432.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,568.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: Nomi Health Commercial |
$4,474.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,295.85
|
| Rate for Payer: PACE SWMI |
$1,364.05
|
| Rate for Payer: PHP Commercial |
$4,637.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,364.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: Priority Health HMO/PPO |
$4,746.89
|
| Rate for Payer: Priority Health Medicare |
$1,377.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,655.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,364.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,801.46
|
| Rate for Payer: UHC Core |
$4,555.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,364.05
|
| Rate for Payer: UHC Exchange |
$1,364.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,364.05
|
| Rate for Payer: VA VA |
$1,364.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,092.15
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,546.53 |
| Max. Negotiated Rate |
$4,910.58 |
| Rate for Payer: Aetna Commercial |
$4,637.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,453.90
|
| Rate for Payer: BCN Commercial |
$4,216.55
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$4,692.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Healthscope Commercial |
$4,910.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,092.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: Nomi Health Commercial |
$4,474.08
|
| Rate for Payer: PHP Commercial |
$4,637.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: Priority Health HMO/PPO |
$4,746.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,655.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,801.46
|
| Rate for Payer: UHC Core |
$4,555.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,092.15
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,132.45 |
| Max. Negotiated Rate |
$4,291.39 |
| Rate for Payer: Aetna Commercial |
$4,052.98
|
| Rate for Payer: Aetna Medicare |
$1,239.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.07
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$1,192.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,919.95
|
| Rate for Payer: BCN Commercial |
$3,707.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.05
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$4,100.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.05
|
| Rate for Payer: Healthscope Commercial |
$4,291.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,576.16
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.66
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,370.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: Nomi Health Commercial |
$3,909.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,132.45
|
| Rate for Payer: PACE SWMI |
$1,192.05
|
| Rate for Payer: PHP Commercial |
$4,052.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: Priority Health HMO/PPO |
$4,148.34
|
| Rate for Payer: Priority Health Medicare |
$1,203.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,194.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,196.02
|
| Rate for Payer: UHC Core |
$3,981.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,192.05
|
| Rate for Payer: UHC Exchange |
$1,192.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,192.05
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$1,192.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,576.16
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,099.34 |
| Max. Negotiated Rate |
$4,291.39 |
| Rate for Payer: Aetna Commercial |
$4,052.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,892.29
|
| Rate for Payer: BCN Commercial |
$3,684.87
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$4,100.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Healthscope Commercial |
$4,291.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,576.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: Nomi Health Commercial |
$3,909.93
|
| Rate for Payer: PHP Commercial |
$4,052.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: Priority Health HMO/PPO |
$4,148.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,194.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,196.02
|
| Rate for Payer: UHC Core |
$3,981.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,576.16
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$864.83 |
| Max. Negotiated Rate |
$3,277.26 |
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: Aetna Medicare |
$946.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,137.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,137.94
|
| Rate for Payer: BCBS Complete |
$1,456.56
|
| Rate for Payer: BCBS MAPPO |
$910.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,993.59
|
| Rate for Payer: BCN Commercial |
$2,831.19
|
| Rate for Payer: BCN Medicare Advantage |
$910.35
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.35
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$955.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,046.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Nomi Health Commercial |
$2,985.95
|
| Rate for Payer: PACE Senior Care Partners |
$864.83
|
| Rate for Payer: PACE SWMI |
$910.35
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: PHP Medicare Advantage |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: Priority Health HMO/PPO |
$3,168.02
|
| Rate for Payer: Priority Health Medicare |
$919.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.74
|
| Rate for Payer: Railroad Medicare Medicare |
$910.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,204.43
|
| Rate for Payer: UHC Core |
$3,040.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$910.35
|
| Rate for Payer: UHC Exchange |
$910.35
|
| Rate for Payer: UHC Medicare Advantage |
$910.35
|
| Rate for Payer: VA VA |
$910.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.05
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,366.91 |
| Max. Negotiated Rate |
$3,277.26 |
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,972.47
|
| Rate for Payer: BCN Commercial |
$2,814.07
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: Nomi Health Commercial |
$2,985.95
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: Priority Health HMO/PPO |
$3,168.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,204.43
|
| Rate for Payer: UHC Core |
$3,040.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.05
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,544.41 |
| Max. Negotiated Rate |
$10,446.11 |
| Rate for Payer: Aetna Commercial |
$9,865.77
|
| Rate for Payer: BCBS Trust/PPO |
$9,474.62
|
| Rate for Payer: BCN Commercial |
$8,969.73
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$9,981.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Healthscope Commercial |
$10,446.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,705.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: Nomi Health Commercial |
$9,517.57
|
| Rate for Payer: PHP Commercial |
$9,865.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: Priority Health HMO/PPO |
$10,097.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,776.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,213.98
|
| Rate for Payer: UHC Core |
$9,691.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,705.09
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,756.61 |
| Max. Negotiated Rate |
$10,446.11 |
| Rate for Payer: Aetna Commercial |
$9,865.77
|
| Rate for Payer: Aetna Medicare |
$3,017.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,627.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,627.12
|
| Rate for Payer: BCBS Complete |
$4,642.72
|
| Rate for Payer: BCBS MAPPO |
$2,901.70
|
| Rate for Payer: BCBS Trust/PPO |
$9,541.94
|
| Rate for Payer: BCN Commercial |
$9,024.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,901.70
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$9,981.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,901.70
|
| Rate for Payer: Healthscope Commercial |
$10,446.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,705.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,046.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,336.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: Nomi Health Commercial |
$9,517.57
|
| Rate for Payer: PACE Senior Care Partners |
$2,756.61
|
| Rate for Payer: PACE SWMI |
$2,901.70
|
| Rate for Payer: PHP Commercial |
$9,865.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,901.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: Priority Health HMO/PPO |
$10,097.91
|
| Rate for Payer: Priority Health Medicare |
$2,930.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,776.55
|
| Rate for Payer: Railroad Medicare Medicare |
$2,901.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,213.98
|
| Rate for Payer: UHC Core |
$9,691.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,901.70
|
| Rate for Payer: UHC Exchange |
$2,901.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,901.70
|
| Rate for Payer: VA VA |
$2,901.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,705.09
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$11,266.87
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,675.88 |
| Max. Negotiated Rate |
$10,140.18 |
| Rate for Payer: Aetna Commercial |
$9,576.84
|
| Rate for Payer: Aetna Medicare |
$2,929.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,520.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,520.90
|
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$2,816.72
|
| Rate for Payer: BCBS Trust/PPO |
$9,262.49
|
| Rate for Payer: BCN Commercial |
$8,759.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,816.72
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cofinity Commercial |
$9,689.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,013.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,816.72
|
| Rate for Payer: Healthscope Commercial |
$10,140.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,450.15
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,957.55
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,239.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,576.84
|
| Rate for Payer: Nomi Health Commercial |
$9,238.83
|
| Rate for Payer: PACE Senior Care Partners |
$2,675.88
|
| Rate for Payer: PACE SWMI |
$2,816.72
|
| Rate for Payer: PHP Commercial |
$9,576.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,816.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,323.47
|
| Rate for Payer: Priority Health HMO/PPO |
$9,802.18
|
| Rate for Payer: Priority Health Medicare |
$2,844.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,548.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,816.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,914.85
|
| Rate for Payer: UHC Core |
$9,407.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,816.72
|
| Rate for Payer: UHC Exchange |
$2,816.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,816.72
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
| Rate for Payer: VA VA |
$2,816.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,450.15
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$11,266.87
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,323.47 |
| Max. Negotiated Rate |
$10,140.18 |
| Rate for Payer: Aetna Commercial |
$9,576.84
|
| Rate for Payer: BCBS Trust/PPO |
$9,197.15
|
| Rate for Payer: BCN Commercial |
$8,707.04
|
| Rate for Payer: Cash Price |
$9,013.50
|
| Rate for Payer: Cofinity Commercial |
$9,689.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,013.50
|
| Rate for Payer: Healthscope Commercial |
$10,140.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,450.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,576.84
|
| Rate for Payer: Nomi Health Commercial |
$9,238.83
|
| Rate for Payer: PHP Commercial |
$9,576.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,323.47
|
| Rate for Payer: Priority Health HMO/PPO |
$9,802.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,548.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,914.85
|
| Rate for Payer: UHC Core |
$9,407.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,450.15
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$11,123.75
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,641.89 |
| Max. Negotiated Rate |
$10,011.38 |
| Rate for Payer: Aetna Commercial |
$9,455.19
|
| Rate for Payer: Aetna Medicare |
$2,892.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,476.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,476.17
|
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$2,780.94
|
| Rate for Payer: BCBS Trust/PPO |
$9,144.83
|
| Rate for Payer: BCN Commercial |
$8,648.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,780.94
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cofinity Commercial |
$9,566.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,899.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,780.94
|
| Rate for Payer: Healthscope Commercial |
$10,011.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,342.81
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,919.98
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,198.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,455.19
|
| Rate for Payer: Nomi Health Commercial |
$9,121.48
|
| Rate for Payer: PACE Senior Care Partners |
$2,641.89
|
| Rate for Payer: PACE SWMI |
$2,780.94
|
| Rate for Payer: PHP Commercial |
$9,455.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,780.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,230.44
|
| Rate for Payer: Priority Health HMO/PPO |
$9,677.66
|
| Rate for Payer: Priority Health Medicare |
$2,808.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,452.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,780.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,788.90
|
| Rate for Payer: UHC Core |
$9,288.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,780.94
|
| Rate for Payer: UHC Exchange |
$2,780.94
|
| Rate for Payer: UHC Medicare Advantage |
$2,780.94
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
| Rate for Payer: VA VA |
$2,780.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,342.81
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$11,123.75
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,230.44 |
| Max. Negotiated Rate |
$10,011.38 |
| Rate for Payer: Aetna Commercial |
$9,455.19
|
| Rate for Payer: BCBS Trust/PPO |
$9,080.32
|
| Rate for Payer: BCN Commercial |
$8,596.43
|
| Rate for Payer: Cash Price |
$8,899.00
|
| Rate for Payer: Cofinity Commercial |
$9,566.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,899.00
|
| Rate for Payer: Healthscope Commercial |
$10,011.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,342.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,455.19
|
| Rate for Payer: Nomi Health Commercial |
$9,121.48
|
| Rate for Payer: PHP Commercial |
$9,455.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,230.44
|
| Rate for Payer: Priority Health HMO/PPO |
$9,677.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,452.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,788.90
|
| Rate for Payer: UHC Core |
$9,288.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,342.81
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
OP
|
$1,251.02
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$297.12 |
| Max. Negotiated Rate |
$1,125.92 |
| Rate for Payer: Aetna Commercial |
$1,063.37
|
| Rate for Payer: Aetna Medicare |
$325.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$390.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$390.94
|
| Rate for Payer: BCBS Complete |
$500.41
|
| Rate for Payer: BCBS MAPPO |
$312.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.46
|
| Rate for Payer: BCN Commercial |
$972.67
|
| Rate for Payer: BCN Medicare Advantage |
$312.75
|
| Rate for Payer: Cash Price |
$1,000.82
|
| Rate for Payer: Cofinity Commercial |
$1,075.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.75
|
| Rate for Payer: Healthscope Commercial |
$1,125.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$328.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$359.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.37
|
| Rate for Payer: Nomi Health Commercial |
$1,025.84
|
| Rate for Payer: PACE Senior Care Partners |
$297.12
|
| Rate for Payer: PACE SWMI |
$312.75
|
| Rate for Payer: PHP Commercial |
$1,063.37
|
| Rate for Payer: PHP Medicare Advantage |
$312.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,088.39
|
| Rate for Payer: Priority Health Medicare |
$315.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$838.18
|
| Rate for Payer: Railroad Medicare Medicare |
$312.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.90
|
| Rate for Payer: UHC Core |
$1,044.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.75
|
| Rate for Payer: UHC Exchange |
$312.75
|
| Rate for Payer: UHC Medicare Advantage |
$312.75
|
| Rate for Payer: VA VA |
$312.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.26
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
IP
|
$1,251.02
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$813.16 |
| Max. Negotiated Rate |
$1,125.92 |
| Rate for Payer: Aetna Commercial |
$1,063.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.21
|
| Rate for Payer: BCN Commercial |
$966.79
|
| Rate for Payer: Cash Price |
$1,000.82
|
| Rate for Payer: Cofinity Commercial |
$1,075.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.82
|
| Rate for Payer: Healthscope Commercial |
$1,125.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.37
|
| Rate for Payer: Nomi Health Commercial |
$1,025.84
|
| Rate for Payer: PHP Commercial |
$1,063.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$813.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,088.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$838.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,100.90
|
| Rate for Payer: UHC Core |
$1,044.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.26
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$6,262.84
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,487.42 |
| Max. Negotiated Rate |
$5,636.56 |
| Rate for Payer: Aetna Commercial |
$5,323.41
|
| Rate for Payer: Aetna Medicare |
$1,628.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,957.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,957.14
|
| Rate for Payer: BCBS Complete |
$5,423.52
|
| Rate for Payer: BCBS MAPPO |
$1,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$5,148.68
|
| Rate for Payer: BCN Commercial |
$4,869.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,565.71
|
| Rate for Payer: Cash Price |
$5,010.27
|
| Rate for Payer: Cash Price |
$5,010.27
|
| Rate for Payer: Cofinity Commercial |
$5,386.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,565.71
|
| Rate for Payer: Healthscope Commercial |
$5,636.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.13
|
| Rate for Payer: Mclaren Medicaid |
$5,164.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,644.00
|
| Rate for Payer: Meridian Medicaid |
$5,423.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,800.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.41
|
| Rate for Payer: Nomi Health Commercial |
$5,135.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,487.42
|
| Rate for Payer: PACE SWMI |
$1,565.71
|
| Rate for Payer: PHP Commercial |
$5,323.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,164.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.85
|
| Rate for Payer: Priority Health HMO/PPO |
$5,448.67
|
| Rate for Payer: Priority Health Medicare |
$1,581.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,196.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,511.30
|
| Rate for Payer: UHC Core |
$5,229.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,565.71
|
| Rate for Payer: UHC Exchange |
$1,565.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,565.71
|
| Rate for Payer: UHCCP Medicaid |
$5,164.92
|
| Rate for Payer: VA VA |
$1,565.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.13
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$6,262.84
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,070.85 |
| Max. Negotiated Rate |
$5,636.56 |
| Rate for Payer: Aetna Commercial |
$5,323.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,112.36
|
| Rate for Payer: BCN Commercial |
$4,839.92
|
| Rate for Payer: Cash Price |
$5,010.27
|
| Rate for Payer: Cofinity Commercial |
$5,386.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.27
|
| Rate for Payer: Healthscope Commercial |
$5,636.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.41
|
| Rate for Payer: Nomi Health Commercial |
$5,135.53
|
| Rate for Payer: PHP Commercial |
$5,323.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.85
|
| Rate for Payer: Priority Health HMO/PPO |
$5,448.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,196.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,511.30
|
| Rate for Payer: UHC Core |
$5,229.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.13
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$5,010.27
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,256.68 |
| Max. Negotiated Rate |
$4,509.24 |
| Rate for Payer: Aetna Commercial |
$4,258.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,089.88
|
| Rate for Payer: BCN Commercial |
$3,871.94
|
| Rate for Payer: Cash Price |
$4,008.22
|
| Rate for Payer: Cofinity Commercial |
$4,308.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,008.22
|
| Rate for Payer: Healthscope Commercial |
$4,509.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,757.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,258.73
|
| Rate for Payer: Nomi Health Commercial |
$4,108.42
|
| Rate for Payer: PHP Commercial |
$4,258.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,256.68
|
| Rate for Payer: Priority Health HMO/PPO |
$4,358.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,409.04
|
| Rate for Payer: UHC Core |
$4,183.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,757.70
|
|
