|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.01
|
| Rate for Payer: BCN Commercial |
$85.01
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$16.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: Aetna Medicare |
$4.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.18
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$4.14
|
| Rate for Payer: BCBS Trust/PPO |
$12.88
|
| Rate for Payer: BCN Commercial |
$12.88
|
| Rate for Payer: BCN Medicare Advantage |
$4.14
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.14
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.08
|
| Rate for Payer: PACE Senior Care Partners |
$3.93
|
| Rate for Payer: PACE SWMI |
$4.14
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: PHP Medicare Advantage |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.41
|
| Rate for Payer: Priority Health Medicare |
$4.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.10
|
| Rate for Payer: Railroad Medicare Medicare |
$4.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.57
|
| Rate for Payer: UHC Core |
$13.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.14
|
| Rate for Payer: UHC Medicare Advantage |
$4.26
|
| Rate for Payer: VA VA |
$4.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$16.56
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$14.90 |
| Rate for Payer: Aetna Commercial |
$14.08
|
| Rate for Payer: BCBS Trust/PPO |
$12.80
|
| Rate for Payer: BCN Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cofinity Commercial |
$14.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$14.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.08
|
| Rate for Payer: PHP Commercial |
$14.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.57
|
| Rate for Payer: UHC Core |
$13.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.42
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$22.69
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$41.24
|
| Rate for Payer: BCN Commercial |
$41.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Mclaren Medicaid |
$21.61
|
| Rate for Payer: Meridian Medicaid |
$22.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Medicare |
$13.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.66
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.35 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.99
|
| Rate for Payer: BCN Commercial |
$40.99
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.61 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: Aetna Medicare |
$25.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.94
|
| Rate for Payer: BCBS Complete |
$22.69
|
| Rate for Payer: BCBS MAPPO |
$24.75
|
| Rate for Payer: BCBS Trust/PPO |
$76.97
|
| Rate for Payer: BCN Commercial |
$76.97
|
| Rate for Payer: BCN Medicare Advantage |
$24.75
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.75
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.25
|
| Rate for Payer: Mclaren Medicaid |
$21.61
|
| Rate for Payer: Meridian Medicaid |
$22.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PACE Senior Care Partners |
$23.51
|
| Rate for Payer: PACE SWMI |
$24.75
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: PHP Medicare Advantage |
$24.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.13
|
| Rate for Payer: Priority Health Medicare |
$24.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.38
|
| Rate for Payer: Railroad Medicare Medicare |
$24.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.12
|
| Rate for Payer: UHC Core |
$82.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.75
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: VA VA |
$24.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.25
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.38 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.51
|
| Rate for Payer: BCN Commercial |
$76.51
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.20
|
| Rate for Payer: Healthscope Commercial |
$89.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.15
|
| Rate for Payer: PHP Commercial |
$84.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.12
|
| Rate for Payer: UHC Core |
$82.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.25
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$426.86
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$101.38 |
| Max. Negotiated Rate |
$384.17 |
| Rate for Payer: Aetna Commercial |
$362.83
|
| Rate for Payer: Aetna Medicare |
$110.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.39
|
| Rate for Payer: BCBS Complete |
$170.74
|
| Rate for Payer: BCBS MAPPO |
$106.72
|
| Rate for Payer: BCBS Trust/PPO |
$331.88
|
| Rate for Payer: BCN Commercial |
$331.88
|
| Rate for Payer: BCN Medicare Advantage |
$106.72
|
| Rate for Payer: Cash Price |
$341.49
|
| Rate for Payer: Cofinity Commercial |
$367.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.72
|
| Rate for Payer: Healthscope Commercial |
$384.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.83
|
| Rate for Payer: PACE Senior Care Partners |
$101.38
|
| Rate for Payer: PACE SWMI |
$106.72
|
| Rate for Payer: PHP Commercial |
$362.83
|
| Rate for Payer: PHP Medicare Advantage |
$106.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.37
|
| Rate for Payer: Priority Health Medicare |
$106.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.34
|
| Rate for Payer: Railroad Medicare Medicare |
$106.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.64
|
| Rate for Payer: UHC Core |
$356.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.72
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: VA VA |
$106.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.14
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$426.86
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$260.34 |
| Max. Negotiated Rate |
$384.17 |
| Rate for Payer: Aetna Commercial |
$362.83
|
| Rate for Payer: BCBS Trust/PPO |
$329.88
|
| Rate for Payer: BCN Commercial |
$329.88
|
| Rate for Payer: Cash Price |
$341.49
|
| Rate for Payer: Cofinity Commercial |
$367.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.49
|
| Rate for Payer: Healthscope Commercial |
$384.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.83
|
| Rate for Payer: PHP Commercial |
$362.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.64
|
| Rate for Payer: UHC Core |
$356.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.14
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.87 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$135.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.22 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: Aetna Medicare |
$35.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.39
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$33.92
|
| Rate for Payer: BCBS Trust/PPO |
$105.48
|
| Rate for Payer: BCN Commercial |
$105.48
|
| Rate for Payer: BCN Medicare Advantage |
$33.92
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.92
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.74
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.31
|
| Rate for Payer: PACE Senior Care Partners |
$32.22
|
| Rate for Payer: PACE SWMI |
$33.92
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: PHP Medicare Advantage |
$33.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.02
|
| Rate for Payer: Priority Health Medicare |
$33.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.74
|
| Rate for Payer: Railroad Medicare Medicare |
$33.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.38
|
| Rate for Payer: UHC Core |
$113.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.92
|
| Rate for Payer: UHC Medicare Advantage |
$34.93
|
| Rate for Payer: VA VA |
$33.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.74
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$135.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.74 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: BCBS Trust/PPO |
$104.84
|
| Rate for Payer: BCN Commercial |
$104.84
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.31
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.38
|
| Rate for Payer: UHC Core |
$113.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.74
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,314.44
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$549.68 |
| Max. Negotiated Rate |
$2,083.00 |
| Rate for Payer: Aetna Commercial |
$1,967.27
|
| Rate for Payer: Aetna Medicare |
$601.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.26
|
| Rate for Payer: BCBS Complete |
$925.78
|
| Rate for Payer: BCBS MAPPO |
$578.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,799.48
|
| Rate for Payer: BCN Commercial |
$1,799.48
|
| Rate for Payer: BCN Medicare Advantage |
$578.61
|
| Rate for Payer: Cash Price |
$1,851.55
|
| Rate for Payer: Cofinity Commercial |
$1,990.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.61
|
| Rate for Payer: Healthscope Commercial |
$2,083.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,735.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,967.27
|
| Rate for Payer: PACE Senior Care Partners |
$549.68
|
| Rate for Payer: PACE SWMI |
$578.61
|
| Rate for Payer: PHP Commercial |
$1,967.27
|
| Rate for Payer: PHP Medicare Advantage |
$578.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,013.56
|
| Rate for Payer: Priority Health Medicare |
$578.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.58
|
| Rate for Payer: Railroad Medicare Medicare |
$578.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,036.71
|
| Rate for Payer: UHC Core |
$1,932.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.61
|
| Rate for Payer: UHC Medicare Advantage |
$595.97
|
| Rate for Payer: VA VA |
$578.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,735.83
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,314.44
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,411.58 |
| Max. Negotiated Rate |
$2,083.00 |
| Rate for Payer: Aetna Commercial |
$1,967.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,788.60
|
| Rate for Payer: BCN Commercial |
$1,788.60
|
| Rate for Payer: Cash Price |
$1,851.55
|
| Rate for Payer: Cofinity Commercial |
$1,990.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.55
|
| Rate for Payer: Healthscope Commercial |
$2,083.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,735.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,967.27
|
| Rate for Payer: PHP Commercial |
$1,967.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,620.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,013.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,036.71
|
| Rate for Payer: UHC Core |
$1,932.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,735.83
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$492.56
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.98 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$418.68
|
| Rate for Payer: Aetna Medicare |
$128.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.92
|
| Rate for Payer: BCBS Complete |
$197.02
|
| Rate for Payer: BCBS MAPPO |
$123.14
|
| Rate for Payer: BCBS Trust/PPO |
$382.97
|
| Rate for Payer: BCN Commercial |
$382.97
|
| Rate for Payer: BCN Medicare Advantage |
$123.14
|
| Rate for Payer: Cash Price |
$394.05
|
| Rate for Payer: Cofinity Commercial |
$423.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.14
|
| Rate for Payer: Healthscope Commercial |
$443.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$129.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$418.68
|
| Rate for Payer: PACE Senior Care Partners |
$116.98
|
| Rate for Payer: PACE SWMI |
$123.14
|
| Rate for Payer: PHP Commercial |
$418.68
|
| Rate for Payer: PHP Medicare Advantage |
$123.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.53
|
| Rate for Payer: Priority Health Medicare |
$123.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.41
|
| Rate for Payer: Railroad Medicare Medicare |
$123.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.45
|
| Rate for Payer: UHC Core |
$411.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.14
|
| Rate for Payer: UHC Medicare Advantage |
$126.83
|
| Rate for Payer: VA VA |
$123.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.42
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$492.56
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.41 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$418.68
|
| Rate for Payer: BCBS Trust/PPO |
$380.65
|
| Rate for Payer: BCN Commercial |
$380.65
|
| Rate for Payer: Cash Price |
$394.05
|
| Rate for Payer: Cofinity Commercial |
$423.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.05
|
| Rate for Payer: Healthscope Commercial |
$443.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$418.68
|
| Rate for Payer: PHP Commercial |
$418.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.45
|
| Rate for Payer: UHC Core |
$411.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.42
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$541.81
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.45 |
| Max. Negotiated Rate |
$487.63 |
| Rate for Payer: Aetna Commercial |
$460.54
|
| Rate for Payer: BCBS Trust/PPO |
$418.71
|
| Rate for Payer: BCN Commercial |
$418.71
|
| Rate for Payer: Cash Price |
$433.45
|
| Rate for Payer: Cofinity Commercial |
$465.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.45
|
| Rate for Payer: Healthscope Commercial |
$487.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.54
|
| Rate for Payer: PHP Commercial |
$460.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.79
|
| Rate for Payer: UHC Core |
$452.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.36
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$541.81
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.68 |
| Max. Negotiated Rate |
$487.63 |
| Rate for Payer: Aetna Commercial |
$460.54
|
| Rate for Payer: Aetna Medicare |
$140.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.32
|
| Rate for Payer: BCBS Complete |
$216.72
|
| Rate for Payer: BCBS MAPPO |
$135.45
|
| Rate for Payer: BCBS Trust/PPO |
$421.26
|
| Rate for Payer: BCN Commercial |
$421.26
|
| Rate for Payer: BCN Medicare Advantage |
$135.45
|
| Rate for Payer: Cash Price |
$433.45
|
| Rate for Payer: Cofinity Commercial |
$465.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.45
|
| Rate for Payer: Healthscope Commercial |
$487.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$142.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.54
|
| Rate for Payer: PACE Senior Care Partners |
$128.68
|
| Rate for Payer: PACE SWMI |
$135.45
|
| Rate for Payer: PHP Commercial |
$460.54
|
| Rate for Payer: PHP Medicare Advantage |
$135.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.37
|
| Rate for Payer: Priority Health Medicare |
$135.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.45
|
| Rate for Payer: Railroad Medicare Medicare |
$135.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.79
|
| Rate for Payer: UHC Core |
$452.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.45
|
| Rate for Payer: UHC Medicare Advantage |
$139.52
|
| Rate for Payer: VA VA |
$135.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.36
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,381.71
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,515.66 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna Medicare |
$1,659.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,994.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,994.28
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$1,595.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,961.78
|
| Rate for Payer: BCN Commercial |
$4,961.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,595.43
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,105.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,595.43
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.28
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,675.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,834.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,515.66
|
| Rate for Payer: PACE SWMI |
$1,595.43
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,595.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,552.09
|
| Rate for Payer: Priority Health Medicare |
$1,595.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,892.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,595.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,615.90
|
| Rate for Payer: UHC Core |
$5,328.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,595.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,643.29
|
| Rate for Payer: VA VA |
$1,595.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.28
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,381.71
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,892.20 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: BCBS Trust/PPO |
$4,931.79
|
| Rate for Payer: BCN Commercial |
$4,931.79
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,105.37
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,552.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,892.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,615.90
|
| Rate for Payer: UHC Core |
$5,328.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.28
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,381.71
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,892.20 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: BCBS Trust/PPO |
$4,931.79
|
| Rate for Payer: BCN Commercial |
$4,931.79
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,105.37
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,552.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,892.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,615.90
|
| Rate for Payer: UHC Core |
$5,328.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.28
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,381.71
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,515.66 |
| Max. Negotiated Rate |
$5,743.54 |
| Rate for Payer: Aetna Commercial |
$5,424.45
|
| Rate for Payer: Aetna Medicare |
$1,659.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,994.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,994.28
|
| Rate for Payer: BCBS Complete |
$3,936.90
|
| Rate for Payer: BCBS MAPPO |
$1,595.43
|
| Rate for Payer: BCBS Trust/PPO |
$4,961.78
|
| Rate for Payer: BCN Commercial |
$4,961.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,595.43
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cash Price |
$5,105.37
|
| Rate for Payer: Cofinity Commercial |
$5,488.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,105.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,595.43
|
| Rate for Payer: Healthscope Commercial |
$5,743.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.28
|
| Rate for Payer: Mclaren Medicaid |
$3,749.43
|
| Rate for Payer: Meridian Medicaid |
$3,936.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,675.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,834.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,424.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,515.66
|
| Rate for Payer: PACE SWMI |
$1,595.43
|
| Rate for Payer: PHP Commercial |
$5,424.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,595.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,749.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,552.09
|
| Rate for Payer: Priority Health Medicare |
$1,595.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,892.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,595.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,615.90
|
| Rate for Payer: UHC Core |
$5,328.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,595.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,643.29
|
| Rate for Payer: VA VA |
$1,595.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.28
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$991.53
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna Medicare |
$257.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.85
|
| Rate for Payer: BCBS Complete |
$396.61
|
| Rate for Payer: BCBS MAPPO |
$247.88
|
| Rate for Payer: BCBS Trust/PPO |
$770.91
|
| Rate for Payer: BCN Commercial |
$770.91
|
| Rate for Payer: BCN Medicare Advantage |
$247.88
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.88
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PACE Senior Care Partners |
$235.49
|
| Rate for Payer: PACE SWMI |
$247.88
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: PHP Medicare Advantage |
$247.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.63
|
| Rate for Payer: Priority Health Medicare |
$247.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.73
|
| Rate for Payer: Railroad Medicare Medicare |
$247.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.55
|
| Rate for Payer: UHC Core |
$827.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.88
|
| Rate for Payer: UHC Medicare Advantage |
$255.32
|
| Rate for Payer: VA VA |
$247.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$991.53
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.73 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: BCBS Trust/PPO |
$766.25
|
| Rate for Payer: BCN Commercial |
$766.25
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.22
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.55
|
| Rate for Payer: UHC Core |
$827.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
