|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$21.88
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Aetna Commercial |
$18.60
|
| Rate for Payer: Aetna Medicare |
$5.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.84
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$5.47
|
| Rate for Payer: BCBS Trust/PPO |
$17.01
|
| Rate for Payer: BCN Commercial |
$17.01
|
| Rate for Payer: BCN Medicare Advantage |
$5.47
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.47
|
| Rate for Payer: Healthscope Commercial |
$19.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.60
|
| Rate for Payer: PACE Senior Care Partners |
$5.20
|
| Rate for Payer: PACE SWMI |
$5.47
|
| Rate for Payer: PHP Commercial |
$18.60
|
| Rate for Payer: PHP Medicare Advantage |
$5.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.04
|
| Rate for Payer: Priority Health Medicare |
$5.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.25
|
| Rate for Payer: UHC Core |
$18.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.47
|
| Rate for Payer: UHC Medicare Advantage |
$5.63
|
| Rate for Payer: VA VA |
$5.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.41
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$21.88
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.34 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Aetna Commercial |
$18.60
|
| Rate for Payer: BCBS Trust/PPO |
$16.91
|
| Rate for Payer: BCN Commercial |
$16.91
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$19.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.60
|
| Rate for Payer: PHP Commercial |
$18.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.25
|
| Rate for Payer: UHC Core |
$18.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.41
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$996.54
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$607.79 |
| Max. Negotiated Rate |
$896.89 |
| Rate for Payer: Aetna Commercial |
$847.06
|
| Rate for Payer: BCBS Trust/PPO |
$770.13
|
| Rate for Payer: BCN Commercial |
$770.13
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cofinity Commercial |
$857.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.23
|
| Rate for Payer: Healthscope Commercial |
$896.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$847.06
|
| Rate for Payer: PHP Commercial |
$847.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.96
|
| Rate for Payer: UHC Core |
$832.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.40
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$996.54
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.68 |
| Max. Negotiated Rate |
$896.89 |
| Rate for Payer: Aetna Commercial |
$847.06
|
| Rate for Payer: Aetna Medicare |
$259.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.42
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$249.14
|
| Rate for Payer: BCBS Trust/PPO |
$774.81
|
| Rate for Payer: BCN Commercial |
$774.81
|
| Rate for Payer: BCN Medicare Advantage |
$249.14
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cofinity Commercial |
$857.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.14
|
| Rate for Payer: Healthscope Commercial |
$896.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.40
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$261.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$847.06
|
| Rate for Payer: PACE Senior Care Partners |
$236.68
|
| Rate for Payer: PACE SWMI |
$249.14
|
| Rate for Payer: PHP Commercial |
$847.06
|
| Rate for Payer: PHP Medicare Advantage |
$249.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.99
|
| Rate for Payer: Priority Health Medicare |
$249.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.79
|
| Rate for Payer: Railroad Medicare Medicare |
$249.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.96
|
| Rate for Payer: UHC Core |
$832.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.14
|
| Rate for Payer: UHC Medicare Advantage |
$256.61
|
| Rate for Payer: VA VA |
$249.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.40
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,648.61
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,225.29 |
| Max. Negotiated Rate |
$3,283.75 |
| Rate for Payer: Aetna Commercial |
$3,101.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,819.65
|
| Rate for Payer: BCN Commercial |
$2,819.65
|
| Rate for Payer: Cash Price |
$2,918.89
|
| Rate for Payer: Cofinity Commercial |
$3,137.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,918.89
|
| Rate for Payer: Healthscope Commercial |
$3,283.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,736.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,101.32
|
| Rate for Payer: PHP Commercial |
$3,101.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,554.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,174.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,225.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,210.78
|
| Rate for Payer: UHC Core |
$3,046.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,736.46
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,648.61
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$866.54 |
| Max. Negotiated Rate |
$3,283.75 |
| Rate for Payer: Aetna Commercial |
$3,101.32
|
| Rate for Payer: Aetna Medicare |
$948.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,140.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,140.19
|
| Rate for Payer: BCBS Complete |
$1,459.44
|
| Rate for Payer: BCBS MAPPO |
$912.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,836.79
|
| Rate for Payer: BCN Commercial |
$2,836.79
|
| Rate for Payer: BCN Medicare Advantage |
$912.15
|
| Rate for Payer: Cash Price |
$2,918.89
|
| Rate for Payer: Cofinity Commercial |
$3,137.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,918.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$912.15
|
| Rate for Payer: Healthscope Commercial |
$3,283.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,736.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$957.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,048.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,101.32
|
| Rate for Payer: PACE Senior Care Partners |
$866.54
|
| Rate for Payer: PACE SWMI |
$912.15
|
| Rate for Payer: PHP Commercial |
$3,101.32
|
| Rate for Payer: PHP Medicare Advantage |
$912.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,554.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,174.29
|
| Rate for Payer: Priority Health Medicare |
$912.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,225.29
|
| Rate for Payer: Railroad Medicare Medicare |
$912.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,210.78
|
| Rate for Payer: UHC Core |
$3,046.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$912.15
|
| Rate for Payer: UHC Medicare Advantage |
$939.52
|
| Rate for Payer: VA VA |
$912.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,736.46
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$290.92
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.43 |
| Max. Negotiated Rate |
$261.83 |
| Rate for Payer: Aetna Commercial |
$247.28
|
| Rate for Payer: BCBS Trust/PPO |
$224.82
|
| Rate for Payer: BCN Commercial |
$224.82
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.74
|
| Rate for Payer: Healthscope Commercial |
$261.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$247.28
|
| Rate for Payer: PHP Commercial |
$247.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.01
|
| Rate for Payer: UHC Core |
$242.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.19
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$290.92
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.09 |
| Max. Negotiated Rate |
$261.83 |
| Rate for Payer: Aetna Commercial |
$247.28
|
| Rate for Payer: Aetna Medicare |
$75.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.91
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$72.73
|
| Rate for Payer: BCBS Trust/PPO |
$226.19
|
| Rate for Payer: BCN Commercial |
$226.19
|
| Rate for Payer: BCN Medicare Advantage |
$72.73
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.73
|
| Rate for Payer: Healthscope Commercial |
$261.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.19
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$247.28
|
| Rate for Payer: PACE Senior Care Partners |
$69.09
|
| Rate for Payer: PACE SWMI |
$72.73
|
| Rate for Payer: PHP Commercial |
$247.28
|
| Rate for Payer: PHP Medicare Advantage |
$72.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$253.10
|
| Rate for Payer: Priority Health Medicare |
$72.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.43
|
| Rate for Payer: Railroad Medicare Medicare |
$72.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.01
|
| Rate for Payer: UHC Core |
$242.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.73
|
| Rate for Payer: UHC Medicare Advantage |
$74.91
|
| Rate for Payer: VA VA |
$72.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.19
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,076.22
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$968.60 |
| Rate for Payer: Aetna Commercial |
$914.79
|
| Rate for Payer: Aetna Medicare |
$279.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$336.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$336.32
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$269.06
|
| Rate for Payer: BCBS Trust/PPO |
$836.76
|
| Rate for Payer: BCN Commercial |
$836.76
|
| Rate for Payer: BCN Medicare Advantage |
$269.06
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cofinity Commercial |
$925.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.06
|
| Rate for Payer: Healthscope Commercial |
$968.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.16
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$282.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.79
|
| Rate for Payer: PACE Senior Care Partners |
$255.60
|
| Rate for Payer: PACE SWMI |
$269.06
|
| Rate for Payer: PHP Commercial |
$914.79
|
| Rate for Payer: PHP Medicare Advantage |
$269.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.31
|
| Rate for Payer: Priority Health Medicare |
$269.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.39
|
| Rate for Payer: Railroad Medicare Medicare |
$269.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$947.07
|
| Rate for Payer: UHC Core |
$898.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.06
|
| Rate for Payer: UHC Medicare Advantage |
$277.13
|
| Rate for Payer: VA VA |
$269.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.16
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,076.22
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$656.39 |
| Max. Negotiated Rate |
$968.60 |
| Rate for Payer: Aetna Commercial |
$914.79
|
| Rate for Payer: BCBS Trust/PPO |
$831.70
|
| Rate for Payer: BCN Commercial |
$831.70
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cofinity Commercial |
$925.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.98
|
| Rate for Payer: Healthscope Commercial |
$968.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.79
|
| Rate for Payer: PHP Commercial |
$914.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$947.07
|
| Rate for Payer: UHC Core |
$898.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.16
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
OP
|
$3,140.44
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$745.85 |
| Max. Negotiated Rate |
$2,826.40 |
| Rate for Payer: Aetna Commercial |
$2,669.37
|
| Rate for Payer: Aetna Medicare |
$816.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$981.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$981.39
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$785.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,441.69
|
| Rate for Payer: BCN Commercial |
$2,441.69
|
| Rate for Payer: BCN Medicare Advantage |
$785.11
|
| Rate for Payer: Cash Price |
$2,512.35
|
| Rate for Payer: Cash Price |
$2,512.35
|
| Rate for Payer: Cofinity Commercial |
$2,700.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,512.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$785.11
|
| Rate for Payer: Healthscope Commercial |
$2,826.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,355.33
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$824.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$902.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,669.37
|
| Rate for Payer: PACE Senior Care Partners |
$745.85
|
| Rate for Payer: PACE SWMI |
$785.11
|
| Rate for Payer: PHP Commercial |
$2,669.37
|
| Rate for Payer: PHP Medicare Advantage |
$785.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,198.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,732.18
|
| Rate for Payer: Priority Health Medicare |
$785.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,915.35
|
| Rate for Payer: Railroad Medicare Medicare |
$785.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,763.59
|
| Rate for Payer: UHC Core |
$2,622.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$785.11
|
| Rate for Payer: UHC Medicare Advantage |
$808.66
|
| Rate for Payer: VA VA |
$785.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,355.33
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,140.44
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,915.35 |
| Max. Negotiated Rate |
$2,826.40 |
| Rate for Payer: Aetna Commercial |
$2,669.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,426.93
|
| Rate for Payer: BCN Commercial |
$2,426.93
|
| Rate for Payer: Cash Price |
$2,512.35
|
| Rate for Payer: Cofinity Commercial |
$2,700.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,512.35
|
| Rate for Payer: Healthscope Commercial |
$2,826.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,355.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,669.37
|
| Rate for Payer: PHP Commercial |
$2,669.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,198.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,732.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,915.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,763.59
|
| Rate for Payer: UHC Core |
$2,622.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,355.33
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
OP
|
$1,917.60
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$453.65 |
| Max. Negotiated Rate |
$1,725.84 |
| Rate for Payer: Aetna Commercial |
$1,629.96
|
| Rate for Payer: Aetna Medicare |
$498.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$599.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$599.25
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$479.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,490.93
|
| Rate for Payer: BCN Commercial |
$1,490.93
|
| Rate for Payer: BCN Medicare Advantage |
$479.40
|
| Rate for Payer: Cash Price |
$1,534.08
|
| Rate for Payer: Cash Price |
$1,534.08
|
| Rate for Payer: Cofinity Commercial |
$1,649.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,534.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$479.40
|
| Rate for Payer: Healthscope Commercial |
$1,725.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,438.20
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$503.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$551.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,629.96
|
| Rate for Payer: PACE Senior Care Partners |
$455.43
|
| Rate for Payer: PACE SWMI |
$479.40
|
| Rate for Payer: PHP Commercial |
$1,629.96
|
| Rate for Payer: PHP Medicare Advantage |
$479.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.31
|
| Rate for Payer: Priority Health Medicare |
$479.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.54
|
| Rate for Payer: Railroad Medicare Medicare |
$479.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,687.49
|
| Rate for Payer: UHC Core |
$1,601.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$479.40
|
| Rate for Payer: UHC Medicare Advantage |
$493.78
|
| Rate for Payer: VA VA |
$479.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,438.20
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
IP
|
$1,917.60
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,169.54 |
| Max. Negotiated Rate |
$1,725.84 |
| Rate for Payer: Aetna Commercial |
$1,629.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,481.92
|
| Rate for Payer: BCN Commercial |
$1,481.92
|
| Rate for Payer: Cash Price |
$1,534.08
|
| Rate for Payer: Cofinity Commercial |
$1,649.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,534.08
|
| Rate for Payer: Healthscope Commercial |
$1,725.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,438.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,629.96
|
| Rate for Payer: PHP Commercial |
$1,629.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,668.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,169.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,687.49
|
| Rate for Payer: UHC Core |
$1,601.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,438.20
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
OP
|
$378.64
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.93 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: Aetna Medicare |
$98.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.32
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$94.66
|
| Rate for Payer: BCBS Trust/PPO |
$294.39
|
| Rate for Payer: BCN Commercial |
$294.39
|
| Rate for Payer: BCN Medicare Advantage |
$94.66
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PACE Senior Care Partners |
$89.93
|
| Rate for Payer: PACE SWMI |
$94.66
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: PHP Medicare Advantage |
$94.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.42
|
| Rate for Payer: Priority Health Medicare |
$94.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.93
|
| Rate for Payer: Railroad Medicare Medicare |
$94.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.20
|
| Rate for Payer: UHC Core |
$316.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.50
|
| Rate for Payer: VA VA |
$94.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
IP
|
$378.64
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.93 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: BCBS Trust/PPO |
$292.61
|
| Rate for Payer: BCN Commercial |
$292.61
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.20
|
| Rate for Payer: UHC Core |
$316.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
IP
|
$682.78
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$416.43 |
| Max. Negotiated Rate |
$614.50 |
| Rate for Payer: Aetna Commercial |
$580.36
|
| Rate for Payer: BCBS Trust/PPO |
$527.65
|
| Rate for Payer: BCN Commercial |
$527.65
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$587.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Healthscope Commercial |
$614.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: PHP Commercial |
$580.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$594.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.85
|
| Rate for Payer: UHC Core |
$570.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.08
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
OP
|
$682.78
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.16 |
| Max. Negotiated Rate |
$614.50 |
| Rate for Payer: Aetna Commercial |
$580.36
|
| Rate for Payer: Aetna Medicare |
$177.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$213.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$213.37
|
| Rate for Payer: BCBS Complete |
$273.11
|
| Rate for Payer: BCBS MAPPO |
$170.70
|
| Rate for Payer: BCBS Trust/PPO |
$530.86
|
| Rate for Payer: BCN Commercial |
$530.86
|
| Rate for Payer: BCN Medicare Advantage |
$170.70
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$587.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.70
|
| Rate for Payer: Healthscope Commercial |
$614.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$179.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: PACE Senior Care Partners |
$162.16
|
| Rate for Payer: PACE SWMI |
$170.70
|
| Rate for Payer: PHP Commercial |
$580.36
|
| Rate for Payer: PHP Medicare Advantage |
$170.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$594.02
|
| Rate for Payer: Priority Health Medicare |
$170.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.43
|
| Rate for Payer: Railroad Medicare Medicare |
$170.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.85
|
| Rate for Payer: UHC Core |
$570.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.70
|
| Rate for Payer: UHC Medicare Advantage |
$175.82
|
| Rate for Payer: VA VA |
$170.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.08
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
OP
|
$658.22
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.33 |
| Max. Negotiated Rate |
$592.40 |
| Rate for Payer: Aetna Commercial |
$559.49
|
| Rate for Payer: Aetna Medicare |
$171.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.69
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$164.56
|
| Rate for Payer: BCBS Trust/PPO |
$511.77
|
| Rate for Payer: BCN Commercial |
$511.77
|
| Rate for Payer: BCN Medicare Advantage |
$164.56
|
| Rate for Payer: Cash Price |
$526.58
|
| Rate for Payer: Cash Price |
$526.58
|
| Rate for Payer: Cofinity Commercial |
$566.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.56
|
| Rate for Payer: Healthscope Commercial |
$592.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.66
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.49
|
| Rate for Payer: PACE Senior Care Partners |
$156.33
|
| Rate for Payer: PACE SWMI |
$164.56
|
| Rate for Payer: PHP Commercial |
$559.49
|
| Rate for Payer: PHP Medicare Advantage |
$164.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.65
|
| Rate for Payer: Priority Health Medicare |
$164.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.45
|
| Rate for Payer: Railroad Medicare Medicare |
$164.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.23
|
| Rate for Payer: UHC Core |
$549.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.56
|
| Rate for Payer: UHC Medicare Advantage |
$169.49
|
| Rate for Payer: VA VA |
$164.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.66
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
IP
|
$658.22
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.45 |
| Max. Negotiated Rate |
$592.40 |
| Rate for Payer: Aetna Commercial |
$559.49
|
| Rate for Payer: BCBS Trust/PPO |
$508.67
|
| Rate for Payer: BCN Commercial |
$508.67
|
| Rate for Payer: Cash Price |
$526.58
|
| Rate for Payer: Cofinity Commercial |
$566.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.58
|
| Rate for Payer: Healthscope Commercial |
$592.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.49
|
| Rate for Payer: PHP Commercial |
$559.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$572.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.23
|
| Rate for Payer: UHC Core |
$549.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.66
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
OP
|
$113.32
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$101.99 |
| Rate for Payer: Aetna Commercial |
$96.32
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.41
|
| Rate for Payer: BCBS Complete |
$45.33
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS Trust/PPO |
$88.11
|
| Rate for Payer: BCN Commercial |
$88.11
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: Cash Price |
$90.66
|
| Rate for Payer: Cofinity Commercial |
$97.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Healthscope Commercial |
$101.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.32
|
| Rate for Payer: PACE Senior Care Partners |
$26.91
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PHP Commercial |
$96.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.59
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.11
|
| Rate for Payer: Railroad Medicare Medicare |
$28.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.72
|
| Rate for Payer: UHC Core |
$94.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$29.18
|
| Rate for Payer: VA VA |
$28.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.99
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
IP
|
$113.32
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.11 |
| Max. Negotiated Rate |
$101.99 |
| Rate for Payer: Aetna Commercial |
$96.32
|
| Rate for Payer: BCBS Trust/PPO |
$87.57
|
| Rate for Payer: BCN Commercial |
$87.57
|
| Rate for Payer: Cash Price |
$90.66
|
| Rate for Payer: Cofinity Commercial |
$97.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.66
|
| Rate for Payer: Healthscope Commercial |
$101.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.32
|
| Rate for Payer: PHP Commercial |
$96.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.72
|
| Rate for Payer: UHC Core |
$94.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.99
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
IP
|
$517.14
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$315.40 |
| Max. Negotiated Rate |
$465.43 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: BCBS Trust/PPO |
$399.65
|
| Rate for Payer: BCN Commercial |
$399.65
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.08
|
| Rate for Payer: UHC Core |
$431.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
OP
|
$517.14
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.82 |
| Max. Negotiated Rate |
$476.33 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Aetna Medicare |
$134.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.61
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$129.28
|
| Rate for Payer: BCBS Trust/PPO |
$402.08
|
| Rate for Payer: BCN Commercial |
$402.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.28
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.28
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PACE Senior Care Partners |
$122.82
|
| Rate for Payer: PACE SWMI |
$129.28
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: PHP Medicare Advantage |
$129.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.91
|
| Rate for Payer: Priority Health Medicare |
$129.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.40
|
| Rate for Payer: Railroad Medicare Medicare |
$129.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.08
|
| Rate for Payer: UHC Core |
$431.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.28
|
| Rate for Payer: UHC Medicare Advantage |
$133.16
|
| Rate for Payer: VA VA |
$129.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
IP
|
$531.36
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.08 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: BCBS Trust/PPO |
$410.64
|
| Rate for Payer: BCN Commercial |
$410.64
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.60
|
| Rate for Payer: UHC Core |
$443.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
