|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$799.77 |
| Max. Negotiated Rate |
$1,034.19 |
| Rate for Payer: Aetna Commercial |
$976.74
|
| Rate for Payer: BCBS Trust/PPO |
$949.04
|
| Rate for Payer: BCN Commercial |
$949.04
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$988.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,034.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Nomi Health Commercial |
$942.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: PHP Commercial |
$976.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$999.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,011.21
|
| Rate for Payer: UHC Core |
$959.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.83
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.59 |
| Max. Negotiated Rate |
$1,034.19 |
| Rate for Payer: Aetna Commercial |
$976.74
|
| Rate for Payer: Aetna Medicare |
$298.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.09
|
| Rate for Payer: BCBS Complete |
$212.70
|
| Rate for Payer: BCBS MAPPO |
$287.27
|
| Rate for Payer: BCBS Trust/PPO |
$944.68
|
| Rate for Payer: BCN Commercial |
$944.68
|
| Rate for Payer: BCN Medicare Advantage |
$287.27
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Commercial |
$988.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.27
|
| Rate for Payer: Healthscope Commercial |
$1,034.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.83
|
| Rate for Payer: Mclaren Medicaid |
$202.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.64
|
| Rate for Payer: Meridian Medicaid |
$212.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$330.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$316.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Nomi Health Commercial |
$942.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: PACE Senior Care Partners |
$272.91
|
| Rate for Payer: PACE SWMI |
$287.27
|
| Rate for Payer: PHP Commercial |
$976.74
|
| Rate for Payer: PHP Medicare Advantage |
$287.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$999.72
|
| Rate for Payer: Priority Health Medicare |
$290.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.77
|
| Rate for Payer: Railroad Medicare Medicare |
$287.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,011.21
|
| Rate for Payer: UHC Core |
$959.50
|
| Rate for Payer: UHC Exchange |
$287.27
|
| Rate for Payer: UHC Medicaid |
$202.59
|
| Rate for Payer: UHC Medicare Advantage |
$287.27
|
| Rate for Payer: UHCCP Medicaid |
$202.59
|
| Rate for Payer: VA VA |
$287.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.83
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.56 |
| Max. Negotiated Rate |
$896.21 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.18
|
| Rate for Payer: BCBS Complete |
$184.32
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$818.64
|
| Rate for Payer: BCN Commercial |
$818.64
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Commercial |
$856.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$896.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.84
|
| Rate for Payer: Mclaren Medicaid |
$175.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.39
|
| Rate for Payer: Meridian Medicaid |
$184.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Nomi Health Commercial |
$816.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: PACE Senior Care Partners |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$846.42
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$866.34
|
| Rate for Payer: Priority Health Medicare |
$251.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.07
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.30
|
| Rate for Payer: UHC Core |
$831.48
|
| Rate for Payer: UHC Exchange |
$248.95
|
| Rate for Payer: UHC Medicaid |
$175.56
|
| Rate for Payer: UHC Medicare Advantage |
$248.95
|
| Rate for Payer: UHCCP Medicaid |
$175.56
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.84
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$693.07 |
| Max. Negotiated Rate |
$896.21 |
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: BCBS Trust/PPO |
$822.42
|
| Rate for Payer: BCN Commercial |
$822.42
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Commercial |
$856.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Healthscope Commercial |
$896.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Nomi Health Commercial |
$816.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: PHP Commercial |
$846.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$866.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$693.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.30
|
| Rate for Payer: UHC Core |
$831.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.84
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$872.49 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.33
|
| Rate for Payer: BCN Commercial |
$1,035.33
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,090.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.15
|
| Rate for Payer: UHC Core |
$1,046.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.01 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna Medicare |
$325.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$391.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$391.74
|
| Rate for Payer: BCBS Complete |
$232.04
|
| Rate for Payer: BCBS MAPPO |
$313.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.57
|
| Rate for Payer: BCN Commercial |
$1,030.57
|
| Rate for Payer: BCN Medicare Advantage |
$313.39
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.39
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Mclaren Medicaid |
$221.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.06
|
| Rate for Payer: Meridian Medicaid |
$232.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PACE Senior Care Partners |
$297.73
|
| Rate for Payer: PACE SWMI |
$313.39
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: PHP Medicare Advantage |
$313.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,090.61
|
| Rate for Payer: Priority Health Medicare |
$316.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.49
|
| Rate for Payer: Railroad Medicare Medicare |
$313.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.15
|
| Rate for Payer: UHC Core |
$1,046.74
|
| Rate for Payer: UHC Exchange |
$313.39
|
| Rate for Payer: UHC Medicaid |
$221.01
|
| Rate for Payer: UHC Medicare Advantage |
$313.39
|
| Rate for Payer: UHCCP Medicaid |
$221.01
|
| Rate for Payer: VA VA |
$313.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$191.52 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna Medicare |
$282.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.47
|
| Rate for Payer: BCBS Complete |
$201.08
|
| Rate for Payer: BCBS MAPPO |
$271.58
|
| Rate for Payer: BCBS Trust/PPO |
$893.06
|
| Rate for Payer: BCN Commercial |
$893.06
|
| Rate for Payer: BCN Medicare Advantage |
$271.58
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.58
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Mclaren Medicaid |
$191.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$201.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$298.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PACE Senior Care Partners |
$258.00
|
| Rate for Payer: PACE SWMI |
$271.58
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: PHP Medicare Advantage |
$271.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$945.09
|
| Rate for Payer: Priority Health Medicare |
$274.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.07
|
| Rate for Payer: Railroad Medicare Medicare |
$271.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.95
|
| Rate for Payer: UHC Core |
$907.07
|
| Rate for Payer: UHC Exchange |
$271.58
|
| Rate for Payer: UHC Medicaid |
$191.52
|
| Rate for Payer: UHC Medicare Advantage |
$271.58
|
| Rate for Payer: UHCCP Medicaid |
$191.52
|
| Rate for Payer: VA VA |
$271.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$756.07 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: BCBS Trust/PPO |
$897.18
|
| Rate for Payer: BCN Commercial |
$897.18
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$945.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.95
|
| Rate for Payer: UHC Core |
$907.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$872.49 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.33
|
| Rate for Payer: BCN Commercial |
$1,035.33
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,090.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.15
|
| Rate for Payer: UHC Core |
$1,046.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.01 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna Medicare |
$325.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$391.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$391.74
|
| Rate for Payer: BCBS Complete |
$232.04
|
| Rate for Payer: BCBS MAPPO |
$313.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.57
|
| Rate for Payer: BCN Commercial |
$1,030.57
|
| Rate for Payer: BCN Medicare Advantage |
$313.39
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.39
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Mclaren Medicaid |
$221.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.06
|
| Rate for Payer: Meridian Medicaid |
$232.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$344.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Nomi Health Commercial |
$1,027.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PACE Senior Care Partners |
$297.73
|
| Rate for Payer: PACE SWMI |
$313.39
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: PHP Medicare Advantage |
$313.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,090.61
|
| Rate for Payer: Priority Health Medicare |
$316.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$872.49
|
| Rate for Payer: Railroad Medicare Medicare |
$313.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.15
|
| Rate for Payer: UHC Core |
$1,046.74
|
| Rate for Payer: UHC Exchange |
$313.39
|
| Rate for Payer: UHC Medicaid |
$221.01
|
| Rate for Payer: UHC Medicare Advantage |
$313.39
|
| Rate for Payer: UHCCP Medicaid |
$221.01
|
| Rate for Payer: VA VA |
$313.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$191.52 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna Medicare |
$282.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.47
|
| Rate for Payer: BCBS Complete |
$201.08
|
| Rate for Payer: BCBS MAPPO |
$271.58
|
| Rate for Payer: BCBS Trust/PPO |
$893.06
|
| Rate for Payer: BCN Commercial |
$893.06
|
| Rate for Payer: BCN Medicare Advantage |
$271.58
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.58
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Mclaren Medicaid |
$191.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$201.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$298.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PACE Senior Care Partners |
$258.00
|
| Rate for Payer: PACE SWMI |
$271.58
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: PHP Medicare Advantage |
$271.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$945.09
|
| Rate for Payer: Priority Health Medicare |
$274.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.07
|
| Rate for Payer: Railroad Medicare Medicare |
$271.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.95
|
| Rate for Payer: UHC Core |
$907.07
|
| Rate for Payer: UHC Exchange |
$271.58
|
| Rate for Payer: UHC Medicaid |
$191.52
|
| Rate for Payer: UHC Medicare Advantage |
$271.58
|
| Rate for Payer: UHCCP Medicaid |
$191.52
|
| Rate for Payer: VA VA |
$271.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$756.07 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: BCBS Trust/PPO |
$897.18
|
| Rate for Payer: BCN Commercial |
$897.18
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Nomi Health Commercial |
$890.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$945.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.95
|
| Rate for Payer: UHC Core |
$907.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.31 |
| Max. Negotiated Rate |
$67.97 |
| Rate for Payer: Aetna Commercial |
$64.19
|
| Rate for Payer: Aetna Medicare |
$19.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.60
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$18.88
|
| Rate for Payer: BCBS Trust/PPO |
$62.08
|
| Rate for Payer: BCN Commercial |
$62.08
|
| Rate for Payer: BCN Medicare Advantage |
$18.88
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$64.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.64
|
| Rate for Payer: Mclaren Medicaid |
$13.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.82
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: PACE Senior Care Partners |
$17.94
|
| Rate for Payer: PACE SWMI |
$18.88
|
| Rate for Payer: PHP Commercial |
$64.19
|
| Rate for Payer: PHP Medicare Advantage |
$18.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.70
|
| Rate for Payer: Priority Health Medicare |
$19.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.46
|
| Rate for Payer: UHC Core |
$63.06
|
| Rate for Payer: UHC Exchange |
$18.88
|
| Rate for Payer: UHC Medicaid |
$13.31
|
| Rate for Payer: UHC Medicare Advantage |
$18.88
|
| Rate for Payer: UHCCP Medicaid |
$13.31
|
| Rate for Payer: VA VA |
$18.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.64
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.56 |
| Max. Negotiated Rate |
$67.97 |
| Rate for Payer: Aetna Commercial |
$64.19
|
| Rate for Payer: BCBS Trust/PPO |
$62.37
|
| Rate for Payer: BCN Commercial |
$62.37
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$64.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: PHP Commercial |
$64.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.46
|
| Rate for Payer: UHC Core |
$63.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.64
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$41.20
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Senior Care Partners |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Medicare |
$12.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: UHC Exchange |
$12.47
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$12.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$24.06
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.24 |
| Max. Negotiated Rate |
$21.65 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna Medicare |
$6.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.52
|
| Rate for Payer: BCBS Complete |
$4.45
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$19.78
|
| Rate for Payer: BCN Commercial |
$19.78
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cofinity Commercial |
$20.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$21.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.05
|
| Rate for Payer: Mclaren Medicaid |
$4.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$4.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.45
|
| Rate for Payer: Nomi Health Commercial |
$19.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.05
|
| Rate for Payer: PACE Senior Care Partners |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$20.45
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.93
|
| Rate for Payer: Priority Health Medicare |
$6.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.75
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.17
|
| Rate for Payer: UHC Core |
$20.09
|
| Rate for Payer: UHC Exchange |
$6.01
|
| Rate for Payer: UHC Medicaid |
$4.24
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: UHCCP Medicaid |
$4.24
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.05
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$24.06
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$21.65 |
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: BCBS Trust/PPO |
$19.87
|
| Rate for Payer: BCN Commercial |
$19.87
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cofinity Commercial |
$20.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.25
|
| Rate for Payer: Healthscope Commercial |
$21.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.45
|
| Rate for Payer: Nomi Health Commercial |
$19.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.05
|
| Rate for Payer: PHP Commercial |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.17
|
| Rate for Payer: UHC Core |
$20.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.05
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,616.68
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$461.32 |
| Max. Negotiated Rate |
$2,355.01 |
| Rate for Payer: Aetna Commercial |
$2,224.18
|
| Rate for Payer: Aetna Medicare |
$680.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.71
|
| Rate for Payer: BCBS Complete |
$484.35
|
| Rate for Payer: BCBS MAPPO |
$654.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,151.17
|
| Rate for Payer: BCN Commercial |
$2,151.17
|
| Rate for Payer: BCN Medicare Advantage |
$654.17
|
| Rate for Payer: Cash Price |
$2,093.34
|
| Rate for Payer: Cofinity Commercial |
$2,250.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,093.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.17
|
| Rate for Payer: Healthscope Commercial |
$2,355.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.51
|
| Rate for Payer: Mclaren Medicaid |
$461.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.88
|
| Rate for Payer: Meridian Medicaid |
$484.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,224.18
|
| Rate for Payer: Nomi Health Commercial |
$2,145.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.51
|
| Rate for Payer: PACE Senior Care Partners |
$621.46
|
| Rate for Payer: PACE SWMI |
$654.17
|
| Rate for Payer: PHP Commercial |
$2,224.18
|
| Rate for Payer: PHP Medicare Advantage |
$654.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.51
|
| Rate for Payer: Priority Health Medicare |
$660.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,821.21
|
| Rate for Payer: Railroad Medicare Medicare |
$654.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.68
|
| Rate for Payer: UHC Core |
$2,184.93
|
| Rate for Payer: UHC Exchange |
$654.17
|
| Rate for Payer: UHC Medicaid |
$461.32
|
| Rate for Payer: UHC Medicare Advantage |
$654.17
|
| Rate for Payer: UHCCP Medicaid |
$461.32
|
| Rate for Payer: VA VA |
$654.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.51
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,616.68
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,821.21 |
| Max. Negotiated Rate |
$2,355.01 |
| Rate for Payer: Aetna Commercial |
$2,224.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,161.12
|
| Rate for Payer: BCN Commercial |
$2,161.12
|
| Rate for Payer: Cash Price |
$2,093.34
|
| Rate for Payer: Cofinity Commercial |
$2,250.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,093.34
|
| Rate for Payer: Healthscope Commercial |
$2,355.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,224.18
|
| Rate for Payer: Nomi Health Commercial |
$2,145.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.51
|
| Rate for Payer: PHP Commercial |
$2,224.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,821.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.68
|
| Rate for Payer: UHC Core |
$2,184.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.51
|
|
|
HC ABDOMINAL PARACENTESIS W/O IMAGE GUIDE
|
Facility
|
OP
|
$2,900.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
76100542
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$511.27 |
| Max. Negotiated Rate |
$2,610.00 |
| Rate for Payer: Aetna Commercial |
$2,465.00
|
| Rate for Payer: Aetna Medicare |
$754.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$906.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$906.25
|
| Rate for Payer: BCBS Complete |
$536.79
|
| Rate for Payer: BCBS MAPPO |
$725.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.09
|
| Rate for Payer: BCN Commercial |
$2,384.09
|
| Rate for Payer: BCN Medicare Advantage |
$725.00
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Commercial |
$2,494.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$725.00
|
| Rate for Payer: Healthscope Commercial |
$2,610.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,175.00
|
| Rate for Payer: Mclaren Medicaid |
$511.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$761.25
|
| Rate for Payer: Meridian Medicaid |
$536.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$833.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$797.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,465.00
|
| Rate for Payer: Nomi Health Commercial |
$2,378.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PACE Senior Care Partners |
$688.75
|
| Rate for Payer: PACE SWMI |
$725.00
|
| Rate for Payer: PHP Commercial |
$2,465.00
|
| Rate for Payer: PHP Medicare Advantage |
$725.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$511.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,523.00
|
| Rate for Payer: Priority Health Medicare |
$732.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,018.40
|
| Rate for Payer: Railroad Medicare Medicare |
$725.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,552.00
|
| Rate for Payer: UHC Core |
$2,421.50
|
| Rate for Payer: UHC Exchange |
$725.00
|
| Rate for Payer: UHC Medicaid |
$511.27
|
| Rate for Payer: UHC Medicare Advantage |
$725.00
|
| Rate for Payer: UHCCP Medicaid |
$511.27
|
| Rate for Payer: VA VA |
$725.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,175.00
|
|
|
HC ABDOMINAL PARACENTESIS W/O IMAGE GUIDE
|
Facility
|
IP
|
$2,900.00
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
76100542
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,018.40 |
| Max. Negotiated Rate |
$2,610.00 |
| Rate for Payer: Aetna Commercial |
$2,465.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,395.11
|
| Rate for Payer: BCN Commercial |
$2,395.11
|
| Rate for Payer: Cash Price |
$2,320.00
|
| Rate for Payer: Cofinity Commercial |
$2,494.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,320.00
|
| Rate for Payer: Healthscope Commercial |
$2,610.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,175.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,465.00
|
| Rate for Payer: Nomi Health Commercial |
$2,378.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,175.00
|
| Rate for Payer: PHP Commercial |
$2,465.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,523.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,018.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,552.00
|
| Rate for Payer: UHC Core |
$2,421.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,175.00
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,608.48
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$283.58 |
| Max. Negotiated Rate |
$1,447.63 |
| Rate for Payer: Aetna Commercial |
$1,367.21
|
| Rate for Payer: Aetna Medicare |
$418.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$502.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$502.65
|
| Rate for Payer: BCBS Complete |
$297.73
|
| Rate for Payer: BCBS MAPPO |
$402.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,322.33
|
| Rate for Payer: BCN Commercial |
$1,322.33
|
| Rate for Payer: BCN Medicare Advantage |
$402.12
|
| Rate for Payer: Cash Price |
$1,286.78
|
| Rate for Payer: Cofinity Commercial |
$1,383.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.12
|
| Rate for Payer: Healthscope Commercial |
$1,447.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,206.36
|
| Rate for Payer: Mclaren Medicaid |
$283.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.23
|
| Rate for Payer: Meridian Medicaid |
$297.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$462.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$442.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,367.21
|
| Rate for Payer: Nomi Health Commercial |
$1,318.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.36
|
| Rate for Payer: PACE Senior Care Partners |
$382.01
|
| Rate for Payer: PACE SWMI |
$402.12
|
| Rate for Payer: PHP Commercial |
$1,367.21
|
| Rate for Payer: PHP Medicare Advantage |
$402.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,399.38
|
| Rate for Payer: Priority Health Medicare |
$406.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,119.50
|
| Rate for Payer: Railroad Medicare Medicare |
$402.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,415.46
|
| Rate for Payer: UHC Core |
$1,343.08
|
| Rate for Payer: UHC Exchange |
$402.12
|
| Rate for Payer: UHC Medicaid |
$283.58
|
| Rate for Payer: UHC Medicare Advantage |
$402.12
|
| Rate for Payer: UHCCP Medicaid |
$283.58
|
| Rate for Payer: VA VA |
$402.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,206.36
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,608.48
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,119.50 |
| Max. Negotiated Rate |
$1,447.63 |
| Rate for Payer: Aetna Commercial |
$1,367.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.44
|
| Rate for Payer: BCN Commercial |
$1,328.44
|
| Rate for Payer: Cash Price |
$1,286.78
|
| Rate for Payer: Cofinity Commercial |
$1,383.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,286.78
|
| Rate for Payer: Healthscope Commercial |
$1,447.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,206.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,367.21
|
| Rate for Payer: Nomi Health Commercial |
$1,318.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,206.36
|
| Rate for Payer: PHP Commercial |
$1,367.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,399.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,119.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,415.46
|
| Rate for Payer: UHC Core |
$1,343.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,206.36
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$4,104.76
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,856.91 |
| Max. Negotiated Rate |
$3,694.28 |
| Rate for Payer: Aetna Commercial |
$3,489.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,390.12
|
| Rate for Payer: BCN Commercial |
$3,390.12
|
| Rate for Payer: Cash Price |
$3,283.81
|
| Rate for Payer: Cofinity Commercial |
$3,530.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,283.81
|
| Rate for Payer: Healthscope Commercial |
$3,694.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,078.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,489.05
|
| Rate for Payer: Nomi Health Commercial |
$3,365.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,078.57
|
| Rate for Payer: PHP Commercial |
$3,489.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,571.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,856.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,612.19
|
| Rate for Payer: UHC Core |
$3,427.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,078.57
|
|
