|
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
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,736.85
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,904.85 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,260.36
|
| Rate for Payer: BCN Commercial |
$2,260.36
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$2,244.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.43
|
| Rate for Payer: UHC Core |
$2,285.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,736.85
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.51 |
| Max. Negotiated Rate |
$2,463.16 |
| Rate for Payer: Aetna Commercial |
$2,326.32
|
| Rate for Payer: Aetna Medicare |
$711.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$855.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$855.27
|
| Rate for Payer: BCBS Complete |
$506.59
|
| Rate for Payer: BCBS MAPPO |
$684.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.96
|
| Rate for Payer: BCN Commercial |
$2,249.96
|
| Rate for Payer: BCN Medicare Advantage |
$684.21
|
| Rate for Payer: Cash Price |
$2,189.48
|
| Rate for Payer: Cofinity Commercial |
$2,353.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.21
|
| Rate for Payer: Healthscope Commercial |
$2,463.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.64
|
| Rate for Payer: Mclaren Medicaid |
$482.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.42
|
| Rate for Payer: Meridian Medicaid |
$506.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.32
|
| Rate for Payer: Nomi Health Commercial |
$2,244.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.64
|
| Rate for Payer: PACE Senior Care Partners |
$650.00
|
| Rate for Payer: PACE SWMI |
$684.21
|
| Rate for Payer: PHP Commercial |
$2,326.32
|
| Rate for Payer: PHP Medicare Advantage |
$684.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.06
|
| Rate for Payer: Priority Health Medicare |
$691.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.85
|
| Rate for Payer: Railroad Medicare Medicare |
$684.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.43
|
| Rate for Payer: UHC Core |
$2,285.27
|
| Rate for Payer: UHC Exchange |
$684.21
|
| Rate for Payer: UHC Medicaid |
$482.51
|
| Rate for Payer: UHC Medicare Advantage |
$684.21
|
| Rate for Payer: UHCCP Medicaid |
$482.51
|
| Rate for Payer: VA VA |
$684.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.64
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$336.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.95
|
| Rate for Payer: BCBS Complete |
$239.27
|
| Rate for Payer: BCBS MAPPO |
$323.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.68
|
| Rate for Payer: BCN Commercial |
$1,062.68
|
| Rate for Payer: BCN Medicare Advantage |
$323.16
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.16
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Mclaren Medicaid |
$227.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.32
|
| Rate for Payer: Meridian Medicaid |
$239.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Senior Care Partners |
$307.00
|
| Rate for Payer: PACE SWMI |
$323.16
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$323.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Medicare |
$326.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: Railroad Medicare Medicare |
$323.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: UHC Exchange |
$323.16
|
| Rate for Payer: UHC Medicaid |
$227.89
|
| Rate for Payer: UHC Medicare Advantage |
$323.16
|
| Rate for Payer: UHCCP Medicaid |
$227.89
|
| Rate for Payer: VA VA |
$323.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.59
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$336.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.95
|
| Rate for Payer: BCBS Complete |
$239.27
|
| Rate for Payer: BCBS MAPPO |
$323.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.68
|
| Rate for Payer: BCN Commercial |
$1,062.68
|
| Rate for Payer: BCN Medicare Advantage |
$323.16
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.16
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Mclaren Medicaid |
$227.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.32
|
| Rate for Payer: Meridian Medicaid |
$239.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Senior Care Partners |
$307.00
|
| Rate for Payer: PACE SWMI |
$323.16
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$323.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Medicare |
$326.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: Railroad Medicare Medicare |
$323.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: UHC Exchange |
$323.16
|
| Rate for Payer: UHC Medicaid |
$227.89
|
| Rate for Payer: UHC Medicare Advantage |
$323.16
|
| Rate for Payer: UHCCP Medicaid |
$227.89
|
| Rate for Payer: VA VA |
$323.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.59
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.59
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$336.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.95
|
| Rate for Payer: BCBS Complete |
$239.27
|
| Rate for Payer: BCBS MAPPO |
$323.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.68
|
| Rate for Payer: BCN Commercial |
$1,062.68
|
| Rate for Payer: BCN Medicare Advantage |
$323.16
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.16
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Mclaren Medicaid |
$227.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.32
|
| Rate for Payer: Meridian Medicaid |
$239.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Senior Care Partners |
$307.00
|
| Rate for Payer: PACE SWMI |
$323.16
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$323.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Medicare |
$326.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: Railroad Medicare Medicare |
$323.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: UHC Exchange |
$323.16
|
| Rate for Payer: UHC Medicaid |
$227.89
|
| Rate for Payer: UHC Medicare Advantage |
$323.16
|
| Rate for Payer: UHCCP Medicaid |
$227.89
|
| Rate for Payer: VA VA |
$323.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: Aetna Medicare |
$336.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.95
|
| Rate for Payer: BCBS Complete |
$239.27
|
| Rate for Payer: BCBS MAPPO |
$323.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.68
|
| Rate for Payer: BCN Commercial |
$1,062.68
|
| Rate for Payer: BCN Medicare Advantage |
$323.16
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.16
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Mclaren Medicaid |
$227.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.32
|
| Rate for Payer: Meridian Medicaid |
$239.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PACE Senior Care Partners |
$307.00
|
| Rate for Payer: PACE SWMI |
$323.16
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: PHP Medicare Advantage |
$323.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Medicare |
$326.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: Railroad Medicare Medicare |
$323.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: UHC Exchange |
$323.16
|
| Rate for Payer: UHC Medicaid |
$227.89
|
| Rate for Payer: UHC Medicare Advantage |
$323.16
|
| Rate for Payer: UHCCP Medicaid |
$227.89
|
| Rate for Payer: VA VA |
$323.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,292.64
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.68 |
| Max. Negotiated Rate |
$1,163.38 |
| Rate for Payer: Aetna Commercial |
$1,098.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.59
|
| Rate for Payer: BCN Commercial |
$1,067.59
|
| Rate for Payer: Cash Price |
$1,034.11
|
| Rate for Payer: Cofinity Commercial |
$1,111.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.11
|
| Rate for Payer: Healthscope Commercial |
$1,163.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.74
|
| Rate for Payer: Nomi Health Commercial |
$1,059.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.48
|
| Rate for Payer: PHP Commercial |
$1,098.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.52
|
| Rate for Payer: UHC Core |
$1,079.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.48
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,729.88
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,539.08 |
| Max. Negotiated Rate |
$7,856.89 |
| Rate for Payer: Aetna Commercial |
$7,420.40
|
| Rate for Payer: Aetna Medicare |
$2,269.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,728.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,728.09
|
| Rate for Payer: BCBS Complete |
$1,615.90
|
| Rate for Payer: BCBS MAPPO |
$2,182.47
|
| Rate for Payer: BCBS Trust/PPO |
$7,176.83
|
| Rate for Payer: BCN Commercial |
$7,176.83
|
| Rate for Payer: BCN Medicare Advantage |
$2,182.47
|
| Rate for Payer: Cash Price |
$6,983.90
|
| Rate for Payer: Cofinity Commercial |
$7,507.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,983.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,182.47
|
| Rate for Payer: Healthscope Commercial |
$7,856.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,547.41
|
| Rate for Payer: Mclaren Medicaid |
$1,539.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,291.59
|
| Rate for Payer: Meridian Medicaid |
$1,615.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,509.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,400.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,420.40
|
| Rate for Payer: Nomi Health Commercial |
$7,158.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,547.41
|
| Rate for Payer: PACE Senior Care Partners |
$2,073.35
|
| Rate for Payer: PACE SWMI |
$2,182.47
|
| Rate for Payer: PHP Commercial |
$7,420.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,182.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,539.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,595.00
|
| Rate for Payer: Priority Health Medicare |
$2,204.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,076.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,182.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,682.29
|
| Rate for Payer: UHC Core |
$7,289.45
|
| Rate for Payer: UHC Exchange |
$2,182.47
|
| Rate for Payer: UHC Medicaid |
$1,539.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,182.47
|
| Rate for Payer: UHCCP Medicaid |
$1,539.08
|
| Rate for Payer: VA VA |
$2,182.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,547.41
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,729.88
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,076.00 |
| Max. Negotiated Rate |
$7,856.89 |
| Rate for Payer: Aetna Commercial |
$7,420.40
|
| Rate for Payer: BCBS Trust/PPO |
$7,210.01
|
| Rate for Payer: BCN Commercial |
$7,210.01
|
| Rate for Payer: Cash Price |
$6,983.90
|
| Rate for Payer: Cofinity Commercial |
$7,507.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,983.90
|
| Rate for Payer: Healthscope Commercial |
$7,856.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,547.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,420.40
|
| Rate for Payer: Nomi Health Commercial |
$7,158.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,547.41
|
| Rate for Payer: PHP Commercial |
$7,420.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,595.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,076.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,682.29
|
| Rate for Payer: UHC Core |
$7,289.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,547.41
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,911.45
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,810.37 |
| Max. Negotiated Rate |
$6,220.31 |
| Rate for Payer: Aetna Commercial |
$5,874.73
|
| Rate for Payer: BCBS Trust/PPO |
$5,708.17
|
| Rate for Payer: BCN Commercial |
$5,708.17
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cofinity Commercial |
$5,943.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,529.16
|
| Rate for Payer: Healthscope Commercial |
$6,220.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,183.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,874.73
|
| Rate for Payer: Nomi Health Commercial |
$5,667.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,183.59
|
| Rate for Payer: PHP Commercial |
$5,874.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,012.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,810.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,082.08
|
| Rate for Payer: UHC Core |
$5,771.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,183.59
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,911.45
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,218.49 |
| Max. Negotiated Rate |
$6,220.31 |
| Rate for Payer: Aetna Commercial |
$5,874.73
|
| Rate for Payer: Aetna Medicare |
$1,796.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,159.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,159.83
|
| Rate for Payer: BCBS Complete |
$1,279.31
|
| Rate for Payer: BCBS MAPPO |
$1,727.86
|
| Rate for Payer: BCBS Trust/PPO |
$5,681.90
|
| Rate for Payer: BCN Commercial |
$5,681.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,727.86
|
| Rate for Payer: Cash Price |
$5,529.16
|
| Rate for Payer: Cofinity Commercial |
$5,943.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,529.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,727.86
|
| Rate for Payer: Healthscope Commercial |
$6,220.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,183.59
|
| Rate for Payer: Mclaren Medicaid |
$1,218.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,814.26
|
| Rate for Payer: Meridian Medicaid |
$1,279.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,987.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,900.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,874.73
|
| Rate for Payer: Nomi Health Commercial |
$5,667.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,183.59
|
| Rate for Payer: PACE Senior Care Partners |
$1,641.47
|
| Rate for Payer: PACE SWMI |
$1,727.86
|
| Rate for Payer: PHP Commercial |
$5,874.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,727.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,218.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,012.96
|
| Rate for Payer: Priority Health Medicare |
$1,745.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,810.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,727.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,082.08
|
| Rate for Payer: UHC Core |
$5,771.06
|
| Rate for Payer: UHC Exchange |
$1,727.86
|
| Rate for Payer: UHC Medicaid |
$1,218.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,727.86
|
| Rate for Payer: UHCCP Medicaid |
$1,218.49
|
| Rate for Payer: VA VA |
$1,727.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,183.59
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$775.53 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: BCBS Trust/PPO |
$920.28
|
| Rate for Payer: BCN Commercial |
$920.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.45 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$289.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.21
|
| Rate for Payer: BCBS Complete |
$206.25
|
| Rate for Payer: BCBS MAPPO |
$278.57
|
| Rate for Payer: BCBS Trust/PPO |
$916.04
|
| Rate for Payer: BCN Commercial |
$916.04
|
| Rate for Payer: BCN Medicare Advantage |
$278.57
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.57
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Mclaren Medicaid |
$196.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.50
|
| Rate for Payer: Meridian Medicaid |
$206.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PACE Senior Care Partners |
$264.64
|
| Rate for Payer: PACE SWMI |
$278.57
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: PHP Medicare Advantage |
$278.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Medicare |
$281.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: Railroad Medicare Medicare |
$278.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: UHC Exchange |
$278.57
|
| Rate for Payer: UHC Medicaid |
$196.45
|
| Rate for Payer: UHC Medicare Advantage |
$278.57
|
| Rate for Payer: UHCCP Medicaid |
$196.45
|
| Rate for Payer: VA VA |
$278.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,904.87 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,260.39
|
| Rate for Payer: BCN Commercial |
$2,260.39
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.45
|
| Rate for Payer: UHC Core |
$2,285.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.51 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna Medicare |
$711.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$855.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$855.27
|
| Rate for Payer: BCBS Complete |
$506.60
|
| Rate for Payer: BCBS MAPPO |
$684.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.99
|
| Rate for Payer: BCN Commercial |
$2,249.99
|
| Rate for Payer: BCN Medicare Advantage |
$684.22
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.22
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Mclaren Medicaid |
$482.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.43
|
| Rate for Payer: Meridian Medicaid |
$506.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Senior Care Partners |
$650.01
|
| Rate for Payer: PACE SWMI |
$684.22
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: PHP Medicare Advantage |
$684.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.09
|
| Rate for Payer: Priority Health Medicare |
$691.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.87
|
| Rate for Payer: Railroad Medicare Medicare |
$684.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.45
|
| Rate for Payer: UHC Core |
$2,285.29
|
| Rate for Payer: UHC Exchange |
$684.22
|
| Rate for Payer: UHC Medicaid |
$482.51
|
| Rate for Payer: UHC Medicare Advantage |
$684.22
|
| Rate for Payer: UHCCP Medicaid |
$482.51
|
| Rate for Payer: VA VA |
$684.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,114.27
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.45 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$289.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.21
|
| Rate for Payer: BCBS Complete |
$206.25
|
| Rate for Payer: BCBS MAPPO |
$278.57
|
| Rate for Payer: BCBS Trust/PPO |
$916.04
|
| Rate for Payer: BCN Commercial |
$916.04
|
| Rate for Payer: BCN Medicare Advantage |
$278.57
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.57
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Mclaren Medicaid |
$196.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.50
|
| Rate for Payer: Meridian Medicaid |
$206.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PACE Senior Care Partners |
$264.64
|
| Rate for Payer: PACE SWMI |
$278.57
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: PHP Medicare Advantage |
$278.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Medicare |
$281.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: Railroad Medicare Medicare |
$278.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: UHC Exchange |
$278.57
|
| Rate for Payer: UHC Medicaid |
$196.45
|
| Rate for Payer: UHC Medicare Advantage |
$278.57
|
| Rate for Payer: UHCCP Medicaid |
$196.45
|
| Rate for Payer: VA VA |
$278.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,114.27
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$775.53 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: BCBS Trust/PPO |
$920.28
|
| Rate for Payer: BCN Commercial |
$920.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$969.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.56
|
| Rate for Payer: UHC Core |
$930.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,904.87 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,260.39
|
| Rate for Payer: BCN Commercial |
$2,260.39
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.45
|
| Rate for Payer: UHC Core |
$2,285.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.51 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna Medicare |
$711.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$855.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$855.27
|
| Rate for Payer: BCBS Complete |
$506.60
|
| Rate for Payer: BCBS MAPPO |
$684.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.99
|
| Rate for Payer: BCN Commercial |
$2,249.99
|
| Rate for Payer: BCN Medicare Advantage |
$684.22
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$684.22
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Mclaren Medicaid |
$482.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.43
|
| Rate for Payer: Meridian Medicaid |
$506.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$2,244.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Senior Care Partners |
$650.01
|
| Rate for Payer: PACE SWMI |
$684.22
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: PHP Medicare Advantage |
$684.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,381.09
|
| Rate for Payer: Priority Health Medicare |
$691.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,904.87
|
| Rate for Payer: Railroad Medicare Medicare |
$684.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,408.45
|
| Rate for Payer: UHC Core |
$2,285.29
|
| Rate for Payer: UHC Exchange |
$684.22
|
| Rate for Payer: UHC Medicaid |
$482.51
|
| Rate for Payer: UHC Medicare Advantage |
$684.22
|
| Rate for Payer: UHCCP Medicaid |
$482.51
|
| Rate for Payer: VA VA |
$684.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,433.70
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$781.66 |
| Max. Negotiated Rate |
$3,990.33 |
| Rate for Payer: Aetna Commercial |
$3,768.64
|
| Rate for Payer: Aetna Medicare |
$1,152.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,385.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,385.53
|
| Rate for Payer: BCBS Complete |
$820.68
|
| Rate for Payer: BCBS MAPPO |
$1,108.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,644.94
|
| Rate for Payer: BCN Commercial |
$3,644.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,108.42
|
| Rate for Payer: Cash Price |
$3,546.96
|
| Rate for Payer: Cofinity Commercial |
$3,812.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,108.42
|
| Rate for Payer: Healthscope Commercial |
$3,990.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.28
|
| Rate for Payer: Mclaren Medicaid |
$781.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,163.85
|
| Rate for Payer: Meridian Medicaid |
$820.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,274.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,219.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.64
|
| Rate for Payer: Nomi Health Commercial |
$3,635.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,325.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,053.00
|
| Rate for Payer: PACE SWMI |
$1,108.42
|
| Rate for Payer: PHP Commercial |
$3,768.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,108.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,857.32
|
| Rate for Payer: Priority Health Medicare |
$1,119.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,085.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,108.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,901.66
|
| Rate for Payer: UHC Core |
$3,702.14
|
| Rate for Payer: UHC Exchange |
$1,108.42
|
| Rate for Payer: UHC Medicaid |
$781.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,108.42
|
| Rate for Payer: UHCCP Medicaid |
$781.66
|
| Rate for Payer: VA VA |
$1,108.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.28
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,433.70
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,085.86 |
| Max. Negotiated Rate |
$3,990.33 |
| Rate for Payer: Aetna Commercial |
$3,768.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,661.79
|
| Rate for Payer: BCN Commercial |
$3,661.79
|
| Rate for Payer: Cash Price |
$3,546.96
|
| Rate for Payer: Cofinity Commercial |
$3,812.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,546.96
|
| Rate for Payer: Healthscope Commercial |
$3,990.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,325.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,768.64
|
| Rate for Payer: Nomi Health Commercial |
$3,635.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,325.28
|
| Rate for Payer: PHP Commercial |
$3,768.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,857.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,085.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,901.66
|
| Rate for Payer: UHC Core |
$3,702.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,325.28
|
|
