|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$4,024.27
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,615.78 |
| Max. Negotiated Rate |
$3,621.84 |
| Rate for Payer: Aetna Commercial |
$3,420.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,285.01
|
| Rate for Payer: BCN Commercial |
$3,109.96
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cofinity Commercial |
$3,460.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.42
|
| Rate for Payer: Healthscope Commercial |
$3,621.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,018.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.63
|
| Rate for Payer: Nomi Health Commercial |
$3,299.90
|
| Rate for Payer: PHP Commercial |
$3,420.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,615.78
|
| Rate for Payer: Priority Health HMO/PPO |
$3,501.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,696.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,541.36
|
| Rate for Payer: UHC Core |
$3,360.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,018.20
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,683.19
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.07 |
| Max. Negotiated Rate |
$2,414.87 |
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.29
|
| Rate for Payer: BCN Commercial |
$2,073.57
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.21
|
| Rate for Payer: UHC Core |
$2,240.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,683.19
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.26 |
| Max. Negotiated Rate |
$2,414.87 |
| Rate for Payer: Aetna Commercial |
$2,280.71
|
| Rate for Payer: Aetna Medicare |
$697.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$838.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$838.50
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$670.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.85
|
| Rate for Payer: BCN Commercial |
$2,086.18
|
| Rate for Payer: BCN Medicare Advantage |
$670.80
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cash Price |
$2,146.55
|
| Rate for Payer: Cofinity Commercial |
$2,307.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.80
|
| Rate for Payer: Healthscope Commercial |
$2,414.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.39
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.34
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$771.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.71
|
| Rate for Payer: Nomi Health Commercial |
$2,200.22
|
| Rate for Payer: PACE Senior Care Partners |
$637.26
|
| Rate for Payer: PACE SWMI |
$670.80
|
| Rate for Payer: PHP Commercial |
$2,280.71
|
| Rate for Payer: PHP Medicare Advantage |
$670.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.38
|
| Rate for Payer: Priority Health Medicare |
$677.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.74
|
| Rate for Payer: Railroad Medicare Medicare |
$670.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.21
|
| Rate for Payer: UHC Core |
$2,240.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.80
|
| Rate for Payer: UHC Exchange |
$670.80
|
| Rate for Payer: UHC Medicare Advantage |
$670.80
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.39
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.49
|
| Rate for Payer: BCN Commercial |
$979.36
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.98 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: Aetna Medicare |
$329.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.03
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$316.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.84
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: BCN Medicare Advantage |
$316.82
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.82
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.66
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Senior Care Partners |
$300.98
|
| Rate for Payer: PACE SWMI |
$316.82
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: PHP Medicare Advantage |
$316.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Medicare |
$319.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: Railroad Medicare Medicare |
$316.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.82
|
| Rate for Payer: UHC Exchange |
$316.82
|
| Rate for Payer: UHC Medicare Advantage |
$316.82
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$316.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.49
|
| Rate for Payer: BCN Commercial |
$979.36
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.98 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: Aetna Medicare |
$329.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.03
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$316.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.84
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: BCN Medicare Advantage |
$316.82
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.82
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.66
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Senior Care Partners |
$300.98
|
| Rate for Payer: PACE SWMI |
$316.82
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: PHP Medicare Advantage |
$316.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Medicare |
$319.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: Railroad Medicare Medicare |
$316.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.82
|
| Rate for Payer: UHC Exchange |
$316.82
|
| Rate for Payer: UHC Medicare Advantage |
$316.82
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$316.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.98 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: Aetna Medicare |
$329.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.03
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$316.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.84
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: BCN Medicare Advantage |
$316.82
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.82
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.66
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Senior Care Partners |
$300.98
|
| Rate for Payer: PACE SWMI |
$316.82
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: PHP Medicare Advantage |
$316.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Medicare |
$319.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: Railroad Medicare Medicare |
$316.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.82
|
| Rate for Payer: UHC Exchange |
$316.82
|
| Rate for Payer: UHC Medicare Advantage |
$316.82
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$316.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.49
|
| Rate for Payer: BCN Commercial |
$979.36
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.74 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.49
|
| Rate for Payer: BCN Commercial |
$979.36
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,267.29
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.98 |
| Max. Negotiated Rate |
$1,140.56 |
| Rate for Payer: Aetna Commercial |
$1,077.20
|
| Rate for Payer: Aetna Medicare |
$329.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$396.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$396.03
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$316.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.84
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: BCN Medicare Advantage |
$316.82
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cash Price |
$1,013.83
|
| Rate for Payer: Cofinity Commercial |
$1,089.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,013.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.82
|
| Rate for Payer: Healthscope Commercial |
$1,140.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.47
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.66
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$364.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.20
|
| Rate for Payer: Nomi Health Commercial |
$1,039.18
|
| Rate for Payer: PACE Senior Care Partners |
$300.98
|
| Rate for Payer: PACE SWMI |
$316.82
|
| Rate for Payer: PHP Commercial |
$1,077.20
|
| Rate for Payer: PHP Medicare Advantage |
$316.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$823.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,102.54
|
| Rate for Payer: Priority Health Medicare |
$319.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$849.08
|
| Rate for Payer: Railroad Medicare Medicare |
$316.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,115.22
|
| Rate for Payer: UHC Core |
$1,058.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.82
|
| Rate for Payer: UHC Exchange |
$316.82
|
| Rate for Payer: UHC Medicare Advantage |
$316.82
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$316.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.47
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,558.71
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,563.16 |
| Max. Negotiated Rate |
$7,702.84 |
| Rate for Payer: Aetna Commercial |
$7,274.90
|
| Rate for Payer: BCBS Trust/PPO |
$6,986.47
|
| Rate for Payer: BCN Commercial |
$6,614.17
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cofinity Commercial |
$7,360.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,846.97
|
| Rate for Payer: Healthscope Commercial |
$7,702.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,419.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,274.90
|
| Rate for Payer: Nomi Health Commercial |
$7,018.14
|
| Rate for Payer: PHP Commercial |
$7,274.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,563.16
|
| Rate for Payer: Priority Health HMO/PPO |
$7,446.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,734.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,531.66
|
| Rate for Payer: UHC Core |
$7,146.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,419.03
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,558.71
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,032.69 |
| Max. Negotiated Rate |
$7,702.84 |
| Rate for Payer: Aetna Commercial |
$7,274.90
|
| Rate for Payer: Aetna Medicare |
$2,225.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,674.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,674.60
|
| Rate for Payer: BCBS Complete |
$5,760.89
|
| Rate for Payer: BCBS MAPPO |
$2,139.68
|
| Rate for Payer: BCBS Trust/PPO |
$7,036.12
|
| Rate for Payer: BCN Commercial |
$6,654.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,139.68
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cash Price |
$6,846.97
|
| Rate for Payer: Cofinity Commercial |
$7,360.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,846.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,139.68
|
| Rate for Payer: Healthscope Commercial |
$7,702.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,419.03
|
| Rate for Payer: Mclaren Medicaid |
$5,486.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,246.66
|
| Rate for Payer: Meridian Medicaid |
$5,760.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,460.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,274.90
|
| Rate for Payer: Nomi Health Commercial |
$7,018.14
|
| Rate for Payer: PACE Senior Care Partners |
$2,032.69
|
| Rate for Payer: PACE SWMI |
$2,139.68
|
| Rate for Payer: PHP Commercial |
$7,274.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,139.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,486.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,563.16
|
| Rate for Payer: Priority Health HMO/PPO |
$7,446.08
|
| Rate for Payer: Priority Health Medicare |
$2,161.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,734.34
|
| Rate for Payer: Railroad Medicare Medicare |
$2,139.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,531.66
|
| Rate for Payer: UHC Core |
$7,146.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,139.68
|
| Rate for Payer: UHC Exchange |
$2,139.68
|
| Rate for Payer: UHC Medicare Advantage |
$2,139.68
|
| Rate for Payer: UHCCP Medicaid |
$5,486.20
|
| Rate for Payer: VA VA |
$2,139.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,419.03
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,775.93
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,609.28 |
| Max. Negotiated Rate |
$9,768.49 |
| Rate for Payer: Aetna Commercial |
$5,759.54
|
| Rate for Payer: Aetna Medicare |
$1,761.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,117.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,117.48
|
| Rate for Payer: BCBS Complete |
$9,768.49
|
| Rate for Payer: BCBS MAPPO |
$1,693.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,570.49
|
| Rate for Payer: BCN Commercial |
$5,268.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,693.98
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cofinity Commercial |
$5,827.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,420.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,693.98
|
| Rate for Payer: Healthscope Commercial |
$6,098.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,081.95
|
| Rate for Payer: Mclaren Medicaid |
$9,302.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,778.68
|
| Rate for Payer: Meridian Medicaid |
$9,768.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,948.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,759.54
|
| Rate for Payer: Nomi Health Commercial |
$5,556.26
|
| Rate for Payer: PACE Senior Care Partners |
$1,609.28
|
| Rate for Payer: PACE SWMI |
$1,693.98
|
| Rate for Payer: PHP Commercial |
$5,759.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,693.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,302.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,404.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,895.06
|
| Rate for Payer: Priority Health Medicare |
$1,710.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,539.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,693.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,962.82
|
| Rate for Payer: UHC Core |
$5,657.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,693.98
|
| Rate for Payer: UHC Exchange |
$1,693.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,693.98
|
| Rate for Payer: UHCCP Medicaid |
$9,302.71
|
| Rate for Payer: VA VA |
$1,693.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,081.95
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,775.93
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,404.35 |
| Max. Negotiated Rate |
$6,098.34 |
| Rate for Payer: Aetna Commercial |
$5,759.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,531.19
|
| Rate for Payer: BCN Commercial |
$5,236.44
|
| Rate for Payer: Cash Price |
$5,420.74
|
| Rate for Payer: Cofinity Commercial |
$5,827.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,420.74
|
| Rate for Payer: Healthscope Commercial |
$6,098.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,081.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,759.54
|
| Rate for Payer: Nomi Health Commercial |
$5,556.26
|
| Rate for Payer: PHP Commercial |
$5,759.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,404.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,895.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,539.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,962.82
|
| Rate for Payer: UHC Core |
$5,657.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,081.95
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: BCBS Trust/PPO |
$891.74
|
| Rate for Payer: BCN Commercial |
$844.22
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$259.45 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna Medicare |
$284.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.38
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS MAPPO |
$273.11
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$849.36
|
| Rate for Payer: BCN Medicare Advantage |
$273.11
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.11
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PACE Senior Care Partners |
$259.45
|
| Rate for Payer: PACE SWMI |
$273.11
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Medicare |
$275.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: Railroad Medicare Medicare |
$273.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.11
|
| Rate for Payer: UHC Exchange |
$273.11
|
| Rate for Payer: UHC Medicare Advantage |
$273.11
|
| Rate for Payer: VA VA |
$273.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.31
|
| Rate for Payer: BCN Commercial |
$2,073.59
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.26 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$697.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$838.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$838.51
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$670.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.88
|
| Rate for Payer: BCN Commercial |
$2,086.20
|
| Rate for Payer: BCN Medicare Advantage |
$670.80
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.80
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.35
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$771.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PACE Senior Care Partners |
$637.26
|
| Rate for Payer: PACE SWMI |
$670.80
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$670.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Medicare |
$677.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: Railroad Medicare Medicare |
$670.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.80
|
| Rate for Payer: UHC Exchange |
$670.80
|
| Rate for Payer: UHC Medicare Advantage |
$670.80
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,092.42
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$259.45 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna Medicare |
$284.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.38
|
| Rate for Payer: BCBS Complete |
$436.97
|
| Rate for Payer: BCBS MAPPO |
$273.11
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$849.36
|
| Rate for Payer: BCN Medicare Advantage |
$273.11
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.11
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PACE Senior Care Partners |
$259.45
|
| Rate for Payer: PACE SWMI |
$273.11
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Medicare |
$275.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: Railroad Medicare Medicare |
$273.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.11
|
| Rate for Payer: UHC Exchange |
$273.11
|
| Rate for Payer: UHC Medicare Advantage |
$273.11
|
| Rate for Payer: VA VA |
$273.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,092.42
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$710.07 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: BCBS Trust/PPO |
$891.74
|
| Rate for Payer: BCN Commercial |
$844.22
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$710.07
|
| Rate for Payer: Priority Health HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$731.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.09 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.31
|
| Rate for Payer: BCN Commercial |
$2,073.59
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$637.26 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$697.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$838.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$838.51
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$670.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,205.88
|
| Rate for Payer: BCN Commercial |
$2,086.20
|
| Rate for Payer: BCN Medicare Advantage |
$670.80
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.80
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.35
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$771.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$2,200.24
|
| Rate for Payer: PACE Senior Care Partners |
$637.26
|
| Rate for Payer: PACE SWMI |
$670.80
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$670.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,334.40
|
| Rate for Payer: Priority Health Medicare |
$677.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,797.76
|
| Rate for Payer: Railroad Medicare Medicare |
$670.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,361.23
|
| Rate for Payer: UHC Core |
$2,240.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$670.80
|
| Rate for Payer: UHC Exchange |
$670.80
|
| Rate for Payer: UHC Medicare Advantage |
$670.80
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,346.76
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,825.39 |
| Max. Negotiated Rate |
$3,912.08 |
| Rate for Payer: Aetna Commercial |
$3,694.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,548.26
|
| Rate for Payer: BCN Commercial |
$3,359.18
|
| Rate for Payer: Cash Price |
$3,477.41
|
| Rate for Payer: Cofinity Commercial |
$3,738.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.41
|
| Rate for Payer: Healthscope Commercial |
$3,912.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,694.75
|
| Rate for Payer: Nomi Health Commercial |
$3,564.34
|
| Rate for Payer: PHP Commercial |
$3,694.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,825.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,781.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,912.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,825.15
|
| Rate for Payer: UHC Core |
$3,629.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.07
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,346.76
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,032.36 |
| Max. Negotiated Rate |
$3,912.08 |
| Rate for Payer: Aetna Commercial |
$3,694.75
|
| Rate for Payer: Aetna Medicare |
$1,130.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,358.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,358.36
|
| Rate for Payer: BCBS Complete |
$1,738.70
|
| Rate for Payer: BCBS MAPPO |
$1,086.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,573.47
|
| Rate for Payer: BCN Commercial |
$3,379.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,086.69
|
| Rate for Payer: Cash Price |
$3,477.41
|
| Rate for Payer: Cofinity Commercial |
$3,738.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,477.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,086.69
|
| Rate for Payer: Healthscope Commercial |
$3,912.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,260.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,141.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,694.75
|
| Rate for Payer: Nomi Health Commercial |
$3,564.34
|
| Rate for Payer: PACE Senior Care Partners |
$1,032.36
|
| Rate for Payer: PACE SWMI |
$1,086.69
|
| Rate for Payer: PHP Commercial |
$3,694.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,086.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,825.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,781.68
|
| Rate for Payer: Priority Health Medicare |
$1,097.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,912.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,086.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,825.15
|
| Rate for Payer: UHC Core |
$3,629.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,086.69
|
| Rate for Payer: UHC Exchange |
$1,086.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,086.69
|
| Rate for Payer: VA VA |
$1,086.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,260.07
|
|
