|
HC CT NEEDLE PLACE HEAD AND NECK
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 41019
|
| Hospital Charge Code |
36100396
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,301.76 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,916.55
|
| Rate for Payer: BCN Commercial |
$2,916.55
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,283.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,301.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,321.12
|
| Rate for Payer: UHC Core |
$3,151.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC CTO CATHETER
|
Facility
|
IP
|
$6,335.36
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,863.94 |
| Max. Negotiated Rate |
$5,701.82 |
| Rate for Payer: Aetna Commercial |
$5,385.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,895.97
|
| Rate for Payer: BCN Commercial |
$4,895.97
|
| Rate for Payer: Cash Price |
$5,068.29
|
| Rate for Payer: Cofinity Commercial |
$5,448.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,068.29
|
| Rate for Payer: Healthscope Commercial |
$5,701.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,751.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,385.06
|
| Rate for Payer: PHP Commercial |
$5,385.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,434.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,511.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,863.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,575.12
|
| Rate for Payer: UHC Core |
$5,290.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,751.52
|
|
|
HC CTO CATHETER
|
Facility
|
OP
|
$6,335.36
|
|
| Hospital Charge Code |
27200117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,504.65 |
| Max. Negotiated Rate |
$5,701.82 |
| Rate for Payer: Aetna Commercial |
$5,385.06
|
| Rate for Payer: Aetna Medicare |
$1,647.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,979.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,979.80
|
| Rate for Payer: BCBS Complete |
$2,534.14
|
| Rate for Payer: BCBS MAPPO |
$1,583.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,925.74
|
| Rate for Payer: BCN Commercial |
$4,925.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,583.84
|
| Rate for Payer: Cash Price |
$5,068.29
|
| Rate for Payer: Cofinity Commercial |
$5,448.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,068.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,583.84
|
| Rate for Payer: Healthscope Commercial |
$5,701.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,751.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,663.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,821.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,385.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,504.65
|
| Rate for Payer: PACE SWMI |
$1,583.84
|
| Rate for Payer: PHP Commercial |
$5,385.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,583.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,434.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,511.76
|
| Rate for Payer: Priority Health Medicare |
$1,583.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,863.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,583.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,575.12
|
| Rate for Payer: UHC Core |
$5,290.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,583.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,631.36
|
| Rate for Payer: VA VA |
$1,583.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,751.52
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
OP
|
$1,548.67
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,393.80 |
| Rate for Payer: Aetna Commercial |
$1,316.37
|
| Rate for Payer: Aetna Medicare |
$402.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$483.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$483.96
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$387.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.09
|
| Rate for Payer: BCN Commercial |
$1,204.09
|
| Rate for Payer: BCN Medicare Advantage |
$387.17
|
| Rate for Payer: Cash Price |
$1,238.94
|
| Rate for Payer: Cash Price |
$1,238.94
|
| Rate for Payer: Cofinity Commercial |
$1,331.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.17
|
| Rate for Payer: Healthscope Commercial |
$1,393.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.50
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$406.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$445.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,316.37
|
| Rate for Payer: PACE Senior Care Partners |
$367.81
|
| Rate for Payer: PACE SWMI |
$387.17
|
| Rate for Payer: PHP Commercial |
$1,316.37
|
| Rate for Payer: PHP Medicare Advantage |
$387.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,347.34
|
| Rate for Payer: Priority Health Medicare |
$387.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$944.53
|
| Rate for Payer: Railroad Medicare Medicare |
$387.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,362.83
|
| Rate for Payer: UHC Core |
$1,293.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.17
|
| Rate for Payer: UHC Medicare Advantage |
$398.78
|
| Rate for Payer: VA VA |
$387.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.50
|
|
|
HC CT ORBIT/SELLA/POST FOSSA/EAR W CON
|
Facility
|
IP
|
$1,548.67
|
|
|
Service Code
|
CPT 70481
|
| Hospital Charge Code |
35100005
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$944.53 |
| Max. Negotiated Rate |
$1,393.80 |
| Rate for Payer: Aetna Commercial |
$1,316.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.81
|
| Rate for Payer: BCN Commercial |
$1,196.81
|
| Rate for Payer: Cash Price |
$1,238.94
|
| Rate for Payer: Cofinity Commercial |
$1,331.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.94
|
| Rate for Payer: Healthscope Commercial |
$1,393.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,316.37
|
| Rate for Payer: PHP Commercial |
$1,316.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,084.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,347.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$944.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,362.83
|
| Rate for Payer: UHC Core |
$1,293.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.50
|
|
|
HC CT ORBIT WO CON
|
Facility
|
OP
|
$1,407.29
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$1,266.56 |
| Rate for Payer: Aetna Commercial |
$1,196.20
|
| Rate for Payer: Aetna Medicare |
$365.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$439.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$439.78
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$351.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,094.17
|
| Rate for Payer: BCN Commercial |
$1,094.17
|
| Rate for Payer: BCN Medicare Advantage |
$351.82
|
| Rate for Payer: Cash Price |
$1,125.83
|
| Rate for Payer: Cash Price |
$1,125.83
|
| Rate for Payer: Cofinity Commercial |
$1,210.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.82
|
| Rate for Payer: Healthscope Commercial |
$1,266.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.47
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$404.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.20
|
| Rate for Payer: PACE Senior Care Partners |
$334.23
|
| Rate for Payer: PACE SWMI |
$351.82
|
| Rate for Payer: PHP Commercial |
$1,196.20
|
| Rate for Payer: PHP Medicare Advantage |
$351.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.34
|
| Rate for Payer: Priority Health Medicare |
$351.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.31
|
| Rate for Payer: Railroad Medicare Medicare |
$351.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.42
|
| Rate for Payer: UHC Core |
$1,175.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.82
|
| Rate for Payer: UHC Medicare Advantage |
$362.38
|
| Rate for Payer: VA VA |
$351.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.47
|
|
|
HC CT ORBIT WO CON
|
Facility
|
IP
|
$1,407.29
|
|
|
Service Code
|
CPT 70480
|
| Hospital Charge Code |
35100004
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$858.31 |
| Max. Negotiated Rate |
$1,266.56 |
| Rate for Payer: Aetna Commercial |
$1,196.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.55
|
| Rate for Payer: BCN Commercial |
$1,087.55
|
| Rate for Payer: Cash Price |
$1,125.83
|
| Rate for Payer: Cofinity Commercial |
$1,210.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,125.83
|
| Rate for Payer: Healthscope Commercial |
$1,266.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,055.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,196.20
|
| Rate for Payer: PHP Commercial |
$1,196.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,224.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,238.42
|
| Rate for Payer: UHC Core |
$1,175.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,055.47
|
|
|
HC CT ORBIT WO W CON
|
Facility
|
OP
|
$1,469.30
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,322.37 |
| Rate for Payer: Aetna Commercial |
$1,248.90
|
| Rate for Payer: Aetna Medicare |
$382.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$459.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$459.16
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$367.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,142.38
|
| Rate for Payer: BCN Commercial |
$1,142.38
|
| Rate for Payer: BCN Medicare Advantage |
$367.32
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cofinity Commercial |
$1,263.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,175.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.32
|
| Rate for Payer: Healthscope Commercial |
$1,322.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,101.98
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,248.90
|
| Rate for Payer: PACE Senior Care Partners |
$348.96
|
| Rate for Payer: PACE SWMI |
$367.32
|
| Rate for Payer: PHP Commercial |
$1,248.90
|
| Rate for Payer: PHP Medicare Advantage |
$367.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,278.29
|
| Rate for Payer: Priority Health Medicare |
$367.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$896.13
|
| Rate for Payer: Railroad Medicare Medicare |
$367.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,292.98
|
| Rate for Payer: UHC Core |
$1,226.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$367.32
|
| Rate for Payer: UHC Medicare Advantage |
$378.34
|
| Rate for Payer: VA VA |
$367.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,101.98
|
|
|
HC CT ORBIT WO W CON
|
Facility
|
IP
|
$1,469.30
|
|
|
Service Code
|
CPT 70482
|
| Hospital Charge Code |
35100006
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$896.13 |
| Max. Negotiated Rate |
$1,322.37 |
| Rate for Payer: Aetna Commercial |
$1,248.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.48
|
| Rate for Payer: BCN Commercial |
$1,135.48
|
| Rate for Payer: Cash Price |
$1,175.44
|
| Rate for Payer: Cofinity Commercial |
$1,263.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,175.44
|
| Rate for Payer: Healthscope Commercial |
$1,322.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,101.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,248.90
|
| Rate for Payer: PHP Commercial |
$1,248.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,028.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,278.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$896.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,292.98
|
| Rate for Payer: UHC Core |
$1,226.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,101.98
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
OP
|
$1,911.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna Medicare |
$496.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$597.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$597.19
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$477.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,485.80
|
| Rate for Payer: BCN Commercial |
$1,485.80
|
| Rate for Payer: BCN Medicare Advantage |
$477.75
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.75
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,624.35
|
| Rate for Payer: PACE Senior Care Partners |
$453.86
|
| Rate for Payer: PACE SWMI |
$477.75
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: PHP Medicare Advantage |
$477.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,337.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,662.57
|
| Rate for Payer: Priority Health Medicare |
$477.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,165.52
|
| Rate for Payer: Railroad Medicare Medicare |
$477.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,681.68
|
| Rate for Payer: UHC Core |
$1,595.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$477.75
|
| Rate for Payer: UHC Medicare Advantage |
$492.08
|
| Rate for Payer: VA VA |
$477.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
HC CT PELVIS ANGIO
|
Facility
|
IP
|
$1,911.00
|
|
|
Service Code
|
CPT 72191
|
| Hospital Charge Code |
35000009
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,165.52 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.82
|
| Rate for Payer: BCN Commercial |
$1,476.82
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,624.35
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,337.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,662.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,165.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,681.68
|
| Rate for Payer: UHC Core |
$1,595.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
HC CT PELVIS W CON
|
Facility
|
IP
|
$1,898.80
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,158.08 |
| Max. Negotiated Rate |
$1,708.92 |
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,467.39
|
| Rate for Payer: BCN Commercial |
$1,467.39
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cofinity Commercial |
$1,632.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,519.04
|
| Rate for Payer: Healthscope Commercial |
$1,708.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,424.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.98
|
| Rate for Payer: PHP Commercial |
$1,613.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,329.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,158.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.94
|
| Rate for Payer: UHC Core |
$1,585.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,424.10
|
|
|
HC CT PELVIS W CON
|
Facility
|
OP
|
$1,898.80
|
|
|
Service Code
|
CPT 72193
|
| Hospital Charge Code |
35200011
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,708.92 |
| Rate for Payer: Aetna Commercial |
$1,613.98
|
| Rate for Payer: Aetna Medicare |
$493.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.38
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$474.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.32
|
| Rate for Payer: BCN Commercial |
$1,476.32
|
| Rate for Payer: BCN Medicare Advantage |
$474.70
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cash Price |
$1,519.04
|
| Rate for Payer: Cofinity Commercial |
$1,632.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,519.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.70
|
| Rate for Payer: Healthscope Commercial |
$1,708.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,424.10
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$498.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$545.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,613.98
|
| Rate for Payer: PACE Senior Care Partners |
$450.96
|
| Rate for Payer: PACE SWMI |
$474.70
|
| Rate for Payer: PHP Commercial |
$1,613.98
|
| Rate for Payer: PHP Medicare Advantage |
$474.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,329.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.96
|
| Rate for Payer: Priority Health Medicare |
$474.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,158.08
|
| Rate for Payer: Railroad Medicare Medicare |
$474.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.94
|
| Rate for Payer: UHC Core |
$1,585.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.70
|
| Rate for Payer: UHC Medicare Advantage |
$488.94
|
| Rate for Payer: VA VA |
$474.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,424.10
|
|
|
HC CT PELVIS WO CON
|
Facility
|
IP
|
$1,392.30
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$849.16 |
| Max. Negotiated Rate |
$1,253.07 |
| Rate for Payer: Aetna Commercial |
$1,183.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,075.97
|
| Rate for Payer: BCN Commercial |
$1,075.97
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cofinity Commercial |
$1,197.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,113.84
|
| Rate for Payer: Healthscope Commercial |
$1,253.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,183.46
|
| Rate for Payer: PHP Commercial |
$1,183.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.22
|
| Rate for Payer: UHC Core |
$1,162.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.22
|
|
|
HC CT PELVIS WO CON
|
Facility
|
OP
|
$1,392.30
|
|
|
Service Code
|
CPT 72192
|
| Hospital Charge Code |
35200010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$1,253.07 |
| Rate for Payer: Aetna Commercial |
$1,183.46
|
| Rate for Payer: Aetna Medicare |
$362.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.09
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$348.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,082.51
|
| Rate for Payer: BCN Commercial |
$1,082.51
|
| Rate for Payer: BCN Medicare Advantage |
$348.08
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cash Price |
$1,113.84
|
| Rate for Payer: Cofinity Commercial |
$1,197.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,113.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.08
|
| Rate for Payer: Healthscope Commercial |
$1,253.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,044.22
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$365.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,183.46
|
| Rate for Payer: PACE Senior Care Partners |
$330.67
|
| Rate for Payer: PACE SWMI |
$348.08
|
| Rate for Payer: PHP Commercial |
$1,183.46
|
| Rate for Payer: PHP Medicare Advantage |
$348.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$974.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,211.30
|
| Rate for Payer: Priority Health Medicare |
$348.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.16
|
| Rate for Payer: Railroad Medicare Medicare |
$348.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.22
|
| Rate for Payer: UHC Core |
$1,162.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.08
|
| Rate for Payer: UHC Medicare Advantage |
$358.52
|
| Rate for Payer: VA VA |
$348.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,044.22
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
OP
|
$2,162.45
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$1,946.20 |
| Rate for Payer: Aetna Commercial |
$1,838.08
|
| Rate for Payer: Aetna Medicare |
$562.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$675.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$675.77
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$540.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.30
|
| Rate for Payer: BCN Commercial |
$1,681.30
|
| Rate for Payer: BCN Medicare Advantage |
$540.61
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cofinity Commercial |
$1,859.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,729.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.61
|
| Rate for Payer: Healthscope Commercial |
$1,946.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.84
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$567.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$621.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,838.08
|
| Rate for Payer: PACE Senior Care Partners |
$513.58
|
| Rate for Payer: PACE SWMI |
$540.61
|
| Rate for Payer: PHP Commercial |
$1,838.08
|
| Rate for Payer: PHP Medicare Advantage |
$540.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.33
|
| Rate for Payer: Priority Health Medicare |
$540.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,318.88
|
| Rate for Payer: Railroad Medicare Medicare |
$540.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,902.96
|
| Rate for Payer: UHC Core |
$1,805.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.61
|
| Rate for Payer: UHC Medicare Advantage |
$556.83
|
| Rate for Payer: VA VA |
$540.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.84
|
|
|
HC CT PELVIS WO W CON
|
Facility
|
IP
|
$2,162.45
|
|
|
Service Code
|
CPT 72194
|
| Hospital Charge Code |
35200012
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,318.88 |
| Max. Negotiated Rate |
$1,946.20 |
| Rate for Payer: Aetna Commercial |
$1,838.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.14
|
| Rate for Payer: BCN Commercial |
$1,671.14
|
| Rate for Payer: Cash Price |
$1,729.96
|
| Rate for Payer: Cofinity Commercial |
$1,859.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,729.96
|
| Rate for Payer: Healthscope Commercial |
$1,946.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,838.08
|
| Rate for Payer: PHP Commercial |
$1,838.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,318.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,902.96
|
| Rate for Payer: UHC Core |
$1,805.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.84
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.11 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna Medicare |
$250.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$301.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$301.47
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$241.17
|
| Rate for Payer: BCBS Trust/PPO |
$750.05
|
| Rate for Payer: BCN Commercial |
$750.05
|
| Rate for Payer: BCN Medicare Advantage |
$241.17
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.17
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Senior Care Partners |
$229.11
|
| Rate for Payer: PACE SWMI |
$241.17
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: PHP Medicare Advantage |
$241.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Medicare |
$241.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: Railroad Medicare Medicare |
$241.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.17
|
| Rate for Payer: UHC Medicare Advantage |
$248.41
|
| Rate for Payer: VA VA |
$241.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$588.36 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: BCBS Trust/PPO |
$745.51
|
| Rate for Payer: BCN Commercial |
$745.51
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.11 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna Medicare |
$250.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$301.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$301.47
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$241.17
|
| Rate for Payer: BCBS Trust/PPO |
$750.05
|
| Rate for Payer: BCN Commercial |
$750.05
|
| Rate for Payer: BCN Medicare Advantage |
$241.17
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.17
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Senior Care Partners |
$229.11
|
| Rate for Payer: PACE SWMI |
$241.17
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: PHP Medicare Advantage |
$241.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Medicare |
$241.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: Railroad Medicare Medicare |
$241.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.17
|
| Rate for Payer: UHC Medicare Advantage |
$248.41
|
| Rate for Payer: VA VA |
$241.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$588.36 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: BCBS Trust/PPO |
$745.51
|
| Rate for Payer: BCN Commercial |
$745.51
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$655.69 |
| Max. Negotiated Rate |
$967.57 |
| Rate for Payer: Aetna Commercial |
$913.82
|
| Rate for Payer: BCBS Trust/PPO |
$830.82
|
| Rate for Payer: BCN Commercial |
$830.82
|
| Rate for Payer: Cash Price |
$860.06
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.06
|
| Rate for Payer: Healthscope Commercial |
$967.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$913.82
|
| Rate for Payer: PHP Commercial |
$913.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$655.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.07
|
| Rate for Payer: UHC Core |
$897.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.31
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,075.08
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$255.33 |
| Max. Negotiated Rate |
$967.57 |
| Rate for Payer: Aetna Commercial |
$913.82
|
| Rate for Payer: Aetna Medicare |
$279.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.96
|
| Rate for Payer: BCBS Complete |
$430.03
|
| Rate for Payer: BCBS MAPPO |
$268.77
|
| Rate for Payer: BCBS Trust/PPO |
$835.87
|
| Rate for Payer: BCN Commercial |
$835.87
|
| Rate for Payer: BCN Medicare Advantage |
$268.77
|
| Rate for Payer: Cash Price |
$860.06
|
| Rate for Payer: Cofinity Commercial |
$924.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.77
|
| Rate for Payer: Healthscope Commercial |
$967.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$282.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$913.82
|
| Rate for Payer: PACE Senior Care Partners |
$255.33
|
| Rate for Payer: PACE SWMI |
$268.77
|
| Rate for Payer: PHP Commercial |
$913.82
|
| Rate for Payer: PHP Medicare Advantage |
$268.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$935.32
|
| Rate for Payer: Priority Health Medicare |
$268.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$655.69
|
| Rate for Payer: Railroad Medicare Medicare |
$268.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$946.07
|
| Rate for Payer: UHC Core |
$897.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.77
|
| Rate for Payer: UHC Medicare Advantage |
$276.83
|
| Rate for Payer: VA VA |
$268.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.31
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$585.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$356.79 |
| Max. Negotiated Rate |
$526.50 |
| Rate for Payer: Aetna Commercial |
$497.25
|
| Rate for Payer: BCBS Trust/PPO |
$452.09
|
| Rate for Payer: BCN Commercial |
$452.09
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.00
|
| Rate for Payer: Healthscope Commercial |
$526.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.25
|
| Rate for Payer: PHP Commercial |
$497.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.80
|
| Rate for Payer: UHC Core |
$488.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.75
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$585.00
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.94 |
| Max. Negotiated Rate |
$526.50 |
| Rate for Payer: Aetna Commercial |
$497.25
|
| Rate for Payer: Aetna Medicare |
$152.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.81
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$146.25
|
| Rate for Payer: BCBS Trust/PPO |
$454.84
|
| Rate for Payer: BCN Commercial |
$454.84
|
| Rate for Payer: BCN Medicare Advantage |
$146.25
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.25
|
| Rate for Payer: Healthscope Commercial |
$526.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.75
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.25
|
| Rate for Payer: PACE Senior Care Partners |
$138.94
|
| Rate for Payer: PACE SWMI |
$146.25
|
| Rate for Payer: PHP Commercial |
$497.25
|
| Rate for Payer: PHP Medicare Advantage |
$146.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.95
|
| Rate for Payer: Priority Health Medicare |
$146.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.79
|
| Rate for Payer: Railroad Medicare Medicare |
$146.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.80
|
| Rate for Payer: UHC Core |
$488.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.25
|
| Rate for Payer: UHC Medicare Advantage |
$150.64
|
| Rate for Payer: VA VA |
$146.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.75
|
|
