|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
IP
|
$809.36
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$493.63 |
| Max. Negotiated Rate |
$728.42 |
| Rate for Payer: Aetna Commercial |
$687.96
|
| Rate for Payer: BCBS Trust/PPO |
$625.47
|
| Rate for Payer: BCN Commercial |
$625.47
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cofinity Commercial |
$696.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.49
|
| Rate for Payer: Healthscope Commercial |
$728.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.96
|
| Rate for Payer: PHP Commercial |
$687.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.24
|
| Rate for Payer: UHC Core |
$675.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.02
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$809.36
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$728.42 |
| Rate for Payer: Aetna Commercial |
$687.96
|
| Rate for Payer: Aetna Medicare |
$210.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$252.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$252.92
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$202.34
|
| Rate for Payer: BCBS Trust/PPO |
$629.28
|
| Rate for Payer: BCN Commercial |
$629.28
|
| Rate for Payer: BCN Medicare Advantage |
$202.34
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cofinity Commercial |
$696.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.34
|
| Rate for Payer: Healthscope Commercial |
$728.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.02
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.96
|
| Rate for Payer: PACE Senior Care Partners |
$192.22
|
| Rate for Payer: PACE SWMI |
$202.34
|
| Rate for Payer: PHP Commercial |
$687.96
|
| Rate for Payer: PHP Medicare Advantage |
$202.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.14
|
| Rate for Payer: Priority Health Medicare |
$202.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.63
|
| Rate for Payer: Railroad Medicare Medicare |
$202.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.24
|
| Rate for Payer: UHC Core |
$675.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.34
|
| Rate for Payer: UHC Medicare Advantage |
$208.41
|
| Rate for Payer: VA VA |
$202.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.02
|
|
|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$10.17
|
| Rate for Payer: BCN Commercial |
$10.17
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.58
|
| Rate for Payer: UHC Core |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna Medicare |
$3.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.11
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS MAPPO |
$3.29
|
| Rate for Payer: BCBS Trust/PPO |
$10.23
|
| Rate for Payer: BCN Commercial |
$10.23
|
| Rate for Payer: BCN Medicare Advantage |
$3.29
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.29
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: PACE Senior Care Partners |
$3.13
|
| Rate for Payer: PACE SWMI |
$3.29
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: PHP Medicare Advantage |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.45
|
| Rate for Payer: Priority Health Medicare |
$3.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.58
|
| Rate for Payer: UHC Core |
$10.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.29
|
| Rate for Payer: UHC Medicare Advantage |
$3.39
|
| Rate for Payer: VA VA |
$3.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$400.14 |
| Max. Negotiated Rate |
$590.46 |
| Rate for Payer: Aetna Commercial |
$557.66
|
| Rate for Payer: BCBS Trust/PPO |
$507.01
|
| Rate for Payer: BCN Commercial |
$507.01
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$564.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Healthscope Commercial |
$590.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: PHP Commercial |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.34
|
| Rate for Payer: UHC Core |
$547.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.05
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.82 |
| Max. Negotiated Rate |
$590.46 |
| Rate for Payer: Aetna Commercial |
$557.66
|
| Rate for Payer: Aetna Medicare |
$170.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.02
|
| Rate for Payer: BCBS Complete |
$262.43
|
| Rate for Payer: BCBS MAPPO |
$164.02
|
| Rate for Payer: BCBS Trust/PPO |
$510.09
|
| Rate for Payer: BCN Commercial |
$510.09
|
| Rate for Payer: BCN Medicare Advantage |
$164.02
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$564.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$590.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: PACE Senior Care Partners |
$155.82
|
| Rate for Payer: PACE SWMI |
$164.02
|
| Rate for Payer: PHP Commercial |
$557.66
|
| Rate for Payer: PHP Medicare Advantage |
$164.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$570.78
|
| Rate for Payer: Priority Health Medicare |
$164.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.14
|
| Rate for Payer: Railroad Medicare Medicare |
$164.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.34
|
| Rate for Payer: UHC Core |
$547.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.02
|
| Rate for Payer: UHC Medicare Advantage |
$168.94
|
| Rate for Payer: VA VA |
$164.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.05
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$381.41 |
| Max. Negotiated Rate |
$562.82 |
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: BCBS Trust/PPO |
$483.28
|
| Rate for Payer: BCN Commercial |
$483.28
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$537.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Healthscope Commercial |
$562.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: PHP Commercial |
$531.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.32
|
| Rate for Payer: UHC Core |
$522.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.02
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$148.52 |
| Max. Negotiated Rate |
$562.82 |
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: Aetna Medicare |
$162.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.42
|
| Rate for Payer: BCBS Complete |
$250.14
|
| Rate for Payer: BCBS MAPPO |
$156.34
|
| Rate for Payer: BCBS Trust/PPO |
$486.22
|
| Rate for Payer: BCN Commercial |
$486.22
|
| Rate for Payer: BCN Medicare Advantage |
$156.34
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$537.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.34
|
| Rate for Payer: Healthscope Commercial |
$562.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: PACE Senior Care Partners |
$148.52
|
| Rate for Payer: PACE SWMI |
$156.34
|
| Rate for Payer: PHP Commercial |
$531.56
|
| Rate for Payer: PHP Medicare Advantage |
$156.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$544.06
|
| Rate for Payer: Priority Health Medicare |
$156.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.41
|
| Rate for Payer: Railroad Medicare Medicare |
$156.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.32
|
| Rate for Payer: UHC Core |
$522.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.34
|
| Rate for Payer: UHC Medicare Advantage |
$161.03
|
| Rate for Payer: VA VA |
$156.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.02
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.71 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: BCBS Complete |
$9.61
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$18.68
|
| Rate for Payer: BCN Commercial |
$18.68
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$20.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$21.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: PACE Senior Care Partners |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$20.43
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.91
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.15
|
| Rate for Payer: UHC Core |
$20.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.19
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.02
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: BCBS Trust/PPO |
$18.57
|
| Rate for Payer: BCN Commercial |
$18.57
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$20.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$21.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: PHP Commercial |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.15
|
| Rate for Payer: UHC Core |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.02
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,104.48
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$673.62 |
| Max. Negotiated Rate |
$994.03 |
| Rate for Payer: Aetna Commercial |
$938.81
|
| Rate for Payer: BCBS Trust/PPO |
$853.54
|
| Rate for Payer: BCN Commercial |
$853.54
|
| Rate for Payer: Cash Price |
$883.58
|
| Rate for Payer: Cofinity Commercial |
$949.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.58
|
| Rate for Payer: Healthscope Commercial |
$994.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$828.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$938.81
|
| Rate for Payer: PHP Commercial |
$938.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$971.94
|
| Rate for Payer: UHC Core |
$922.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$828.36
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,104.48
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$262.31 |
| Max. Negotiated Rate |
$994.03 |
| Rate for Payer: Aetna Commercial |
$938.81
|
| Rate for Payer: Aetna Medicare |
$287.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$345.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$345.15
|
| Rate for Payer: BCBS Complete |
$441.79
|
| Rate for Payer: BCBS MAPPO |
$276.12
|
| Rate for Payer: BCBS Trust/PPO |
$858.73
|
| Rate for Payer: BCN Commercial |
$858.73
|
| Rate for Payer: BCN Medicare Advantage |
$276.12
|
| Rate for Payer: Cash Price |
$883.58
|
| Rate for Payer: Cofinity Commercial |
$949.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$276.12
|
| Rate for Payer: Healthscope Commercial |
$994.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$828.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$289.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$317.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$938.81
|
| Rate for Payer: PACE Senior Care Partners |
$262.31
|
| Rate for Payer: PACE SWMI |
$276.12
|
| Rate for Payer: PHP Commercial |
$938.81
|
| Rate for Payer: PHP Medicare Advantage |
$276.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$960.90
|
| Rate for Payer: Priority Health Medicare |
$276.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.62
|
| Rate for Payer: Railroad Medicare Medicare |
$276.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$971.94
|
| Rate for Payer: UHC Core |
$922.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$276.12
|
| Rate for Payer: UHC Medicare Advantage |
$284.40
|
| Rate for Payer: VA VA |
$276.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$828.36
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$227.32 |
| Max. Negotiated Rate |
$861.41 |
| Rate for Payer: Aetna Commercial |
$813.55
|
| Rate for Payer: Aetna Medicare |
$248.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$299.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$299.10
|
| Rate for Payer: BCBS Complete |
$382.85
|
| Rate for Payer: BCBS MAPPO |
$239.28
|
| Rate for Payer: BCBS Trust/PPO |
$744.16
|
| Rate for Payer: BCN Commercial |
$744.16
|
| Rate for Payer: BCN Medicare Advantage |
$239.28
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.28
|
| Rate for Payer: Healthscope Commercial |
$861.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: PACE Senior Care Partners |
$227.32
|
| Rate for Payer: PACE SWMI |
$239.28
|
| Rate for Payer: PHP Commercial |
$813.55
|
| Rate for Payer: PHP Medicare Advantage |
$239.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.69
|
| Rate for Payer: Priority Health Medicare |
$239.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.75
|
| Rate for Payer: Railroad Medicare Medicare |
$239.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$842.27
|
| Rate for Payer: UHC Core |
$799.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.28
|
| Rate for Payer: UHC Medicare Advantage |
$246.46
|
| Rate for Payer: VA VA |
$239.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.84
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$583.75 |
| Max. Negotiated Rate |
$861.41 |
| Rate for Payer: Aetna Commercial |
$813.55
|
| Rate for Payer: BCBS Trust/PPO |
$739.66
|
| Rate for Payer: BCN Commercial |
$739.66
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Healthscope Commercial |
$861.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: PHP Commercial |
$813.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$842.27
|
| Rate for Payer: UHC Core |
$799.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.84
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$286.16 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna Medicare |
$313.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.53
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: BCBS MAPPO |
$301.22
|
| Rate for Payer: BCBS Trust/PPO |
$936.81
|
| Rate for Payer: BCN Commercial |
$936.81
|
| Rate for Payer: BCN Medicare Advantage |
$301.22
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.22
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PACE Senior Care Partners |
$286.16
|
| Rate for Payer: PACE SWMI |
$301.22
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: PHP Medicare Advantage |
$301.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.26
|
| Rate for Payer: Priority Health Medicare |
$301.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.87
|
| Rate for Payer: Railroad Medicare Medicare |
$301.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.31
|
| Rate for Payer: UHC Core |
$1,006.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.22
|
| Rate for Payer: UHC Medicare Advantage |
$310.26
|
| Rate for Payer: VA VA |
$301.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$734.87 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: BCBS Trust/PPO |
$931.15
|
| Rate for Payer: BCN Commercial |
$931.15
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.31
|
| Rate for Payer: UHC Core |
$1,006.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.81 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: BCBS Trust/PPO |
$806.90
|
| Rate for Payer: BCN Commercial |
$806.90
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.83
|
| Rate for Payer: UHC Core |
$871.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$247.98 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna Medicare |
$271.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.29
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: BCBS MAPPO |
$261.03
|
| Rate for Payer: BCBS Trust/PPO |
$811.81
|
| Rate for Payer: BCN Commercial |
$811.81
|
| Rate for Payer: BCN Medicare Advantage |
$261.03
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.03
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$274.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PACE Senior Care Partners |
$247.98
|
| Rate for Payer: PACE SWMI |
$261.03
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: PHP Medicare Advantage |
$261.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.39
|
| Rate for Payer: Priority Health Medicare |
$261.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.81
|
| Rate for Payer: Railroad Medicare Medicare |
$261.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.83
|
| Rate for Payer: UHC Core |
$871.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.03
|
| Rate for Payer: UHC Medicare Advantage |
$268.86
|
| Rate for Payer: VA VA |
$261.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$734.87 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: BCBS Trust/PPO |
$931.15
|
| Rate for Payer: BCN Commercial |
$931.15
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.31
|
| Rate for Payer: UHC Core |
$1,006.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$286.16 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna Medicare |
$313.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.53
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: BCBS MAPPO |
$301.22
|
| Rate for Payer: BCBS Trust/PPO |
$936.81
|
| Rate for Payer: BCN Commercial |
$936.81
|
| Rate for Payer: BCN Medicare Advantage |
$301.22
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.22
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PACE Senior Care Partners |
$286.16
|
| Rate for Payer: PACE SWMI |
$301.22
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: PHP Medicare Advantage |
$301.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.26
|
| Rate for Payer: Priority Health Medicare |
$301.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.87
|
| Rate for Payer: Railroad Medicare Medicare |
$301.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.31
|
| Rate for Payer: UHC Core |
$1,006.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.22
|
| Rate for Payer: UHC Medicare Advantage |
$310.26
|
| Rate for Payer: VA VA |
$301.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.81 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: BCBS Trust/PPO |
$806.90
|
| Rate for Payer: BCN Commercial |
$806.90
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.83
|
| Rate for Payer: UHC Core |
$871.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$247.98 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna Medicare |
$271.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.29
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: BCBS MAPPO |
$261.03
|
| Rate for Payer: BCBS Trust/PPO |
$811.81
|
| Rate for Payer: BCN Commercial |
$811.81
|
| Rate for Payer: BCN Medicare Advantage |
$261.03
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.03
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$274.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PACE Senior Care Partners |
$247.98
|
| Rate for Payer: PACE SWMI |
$261.03
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: PHP Medicare Advantage |
$261.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$908.39
|
| Rate for Payer: Priority Health Medicare |
$261.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.81
|
| Rate for Payer: Railroad Medicare Medicare |
$261.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.83
|
| Rate for Payer: UHC Core |
$871.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.03
|
| Rate for Payer: UHC Medicare Advantage |
$268.86
|
| Rate for Payer: VA VA |
$261.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Aetna Commercial |
$61.70
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.68
|
| Rate for Payer: BCBS Complete |
$29.04
|
| Rate for Payer: BCBS MAPPO |
$18.15
|
| Rate for Payer: BCBS Trust/PPO |
$56.44
|
| Rate for Payer: BCN Commercial |
$56.44
|
| Rate for Payer: BCN Medicare Advantage |
$18.15
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$62.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.15
|
| Rate for Payer: Healthscope Commercial |
$65.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: PACE Senior Care Partners |
$17.24
|
| Rate for Payer: PACE SWMI |
$18.15
|
| Rate for Payer: PHP Commercial |
$61.70
|
| Rate for Payer: PHP Medicare Advantage |
$18.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.15
|
| Rate for Payer: Priority Health Medicare |
$18.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.27
|
| Rate for Payer: Railroad Medicare Medicare |
$18.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.88
|
| Rate for Payer: UHC Core |
$60.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.69
|
| Rate for Payer: VA VA |
$18.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.44
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Aetna Commercial |
$61.70
|
| Rate for Payer: BCBS Trust/PPO |
$56.10
|
| Rate for Payer: BCN Commercial |
$56.10
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$62.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Healthscope Commercial |
$65.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: PHP Commercial |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.88
|
| Rate for Payer: UHC Core |
$60.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.44
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$37.05
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
