|
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 |
$273.10
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$849.36
|
| Rate for Payer: BCN Medicare Advantage |
$273.10
|
| 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 |
$273.10
|
| 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 |
$273.10
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.10
|
| 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 |
$273.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.10
|
| Rate for Payer: UHC Exchange |
$273.10
|
| Rate for Payer: UHC Medicare Advantage |
$273.10
|
| Rate for Payer: VA VA |
$273.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
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 |
$1,452.56
|
| 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 |
$2,012.42
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.35
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| 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 |
$1,383.30
|
| 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 |
$1,383.30
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.42
|
|
|
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 |
$2,012.42
|
| 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 |
$2,012.42
|
|
|
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 |
$273.10
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$849.36
|
| Rate for Payer: BCN Medicare Advantage |
$273.10
|
| 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 |
$273.10
|
| 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 |
$273.10
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.10
|
| 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 |
$273.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.10
|
| Rate for Payer: UHC Exchange |
$273.10
|
| Rate for Payer: UHC Medicare Advantage |
$273.10
|
| Rate for Payer: VA VA |
$273.10
|
| 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
|
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 |
$1,452.56
|
| 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 |
$2,012.42
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$704.35
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| 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 |
$1,383.30
|
| 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 |
$1,383.30
|
| Rate for Payer: VA VA |
$670.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.42
|
|
|
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 |
$2,012.42
|
| 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 |
$2,012.42
|
|
|
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
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,404.15 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: Aetna Medicare |
$1,537.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,847.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,847.57
|
| Rate for Payer: BCBS Complete |
$2,364.89
|
| Rate for Payer: BCBS MAPPO |
$1,478.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,860.44
|
| Rate for Payer: BCN Commercial |
$4,596.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,478.06
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,478.06
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,434.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,551.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,699.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: Nomi Health Commercial |
$4,848.02
|
| Rate for Payer: PACE Senior Care Partners |
$1,404.15
|
| Rate for Payer: PACE SWMI |
$1,478.06
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,478.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health HMO/PPO |
$5,143.63
|
| Rate for Payer: Priority Health Medicare |
$1,492.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,961.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,478.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,202.75
|
| Rate for Payer: UHC Core |
$4,936.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,478.06
|
| Rate for Payer: UHC Exchange |
$1,478.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,478.06
|
| Rate for Payer: VA VA |
$1,478.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,434.16
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,912.22
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,842.94 |
| Max. Negotiated Rate |
$5,321.00 |
| Rate for Payer: Aetna Commercial |
$5,025.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,826.15
|
| Rate for Payer: BCN Commercial |
$4,568.96
|
| Rate for Payer: Cash Price |
$4,729.78
|
| Rate for Payer: Cofinity Commercial |
$5,084.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,729.78
|
| Rate for Payer: Healthscope Commercial |
$5,321.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,434.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,025.39
|
| Rate for Payer: Nomi Health Commercial |
$4,848.02
|
| Rate for Payer: PHP Commercial |
$5,025.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,842.94
|
| Rate for Payer: Priority Health HMO/PPO |
$5,143.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,961.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,202.75
|
| Rate for Payer: UHC Core |
$4,936.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,434.16
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,694.60 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: BCBS Trust/PPO |
$5,895.69
|
| Rate for Payer: BCN Commercial |
$5,581.52
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,416.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: Nomi Health Commercial |
$5,922.42
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,355.76
|
| Rate for Payer: UHC Core |
$6,030.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,416.84
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,222.46
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,715.33 |
| Max. Negotiated Rate |
$6,500.21 |
| Rate for Payer: Aetna Commercial |
$6,139.09
|
| Rate for Payer: Aetna Medicare |
$1,877.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,257.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,257.02
|
| Rate for Payer: BCBS Complete |
$2,888.98
|
| Rate for Payer: BCBS MAPPO |
$1,805.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,937.58
|
| Rate for Payer: BCN Commercial |
$5,615.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,805.62
|
| Rate for Payer: Cash Price |
$5,777.97
|
| Rate for Payer: Cofinity Commercial |
$6,211.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,777.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,805.62
|
| Rate for Payer: Healthscope Commercial |
$6,500.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,416.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,895.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,076.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.09
|
| Rate for Payer: Nomi Health Commercial |
$5,922.42
|
| Rate for Payer: PACE Senior Care Partners |
$1,715.33
|
| Rate for Payer: PACE SWMI |
$1,805.62
|
| Rate for Payer: PHP Commercial |
$6,139.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,805.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.60
|
| Rate for Payer: Priority Health HMO/PPO |
$6,283.54
|
| Rate for Payer: Priority Health Medicare |
$1,823.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,839.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,805.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,355.76
|
| Rate for Payer: UHC Core |
$6,030.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,805.62
|
| Rate for Payer: UHC Exchange |
$1,805.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,805.62
|
| Rate for Payer: VA VA |
$1,805.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,416.84
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$302.81 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$331.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.44
|
| Rate for Payer: BCBS Complete |
$510.00
|
| Rate for Payer: BCBS MAPPO |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,048.18
|
| Rate for Payer: BCN Commercial |
$991.31
|
| Rate for Payer: BCN Medicare Advantage |
$318.75
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: PACE Senior Care Partners |
$302.81
|
| Rate for Payer: PACE SWMI |
$318.75
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: PHP Medicare Advantage |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Medicare |
$321.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.25
|
| Rate for Payer: Railroad Medicare Medicare |
$318.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.75
|
| Rate for Payer: UHC Exchange |
$318.75
|
| Rate for Payer: UHC Medicare Advantage |
$318.75
|
| Rate for Payer: VA VA |
$318.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT LVL 12
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$828.75 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.78
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,083.75
|
| Rate for Payer: Nomi Health Commercial |
$1,045.50
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$828.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$854.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
IP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,035.94 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.98
|
| Rate for Payer: BCN Commercial |
$1,231.65
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION CATH NON CARD ENDOVASC IMPLANT LVL 15
|
Facility
|
OP
|
$1,593.75
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
27200358
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$378.52 |
| Max. Negotiated Rate |
$1,434.38 |
| Rate for Payer: Aetna Commercial |
$1,354.69
|
| Rate for Payer: Aetna Medicare |
$414.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$498.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$498.05
|
| Rate for Payer: BCBS Complete |
$637.50
|
| Rate for Payer: BCBS MAPPO |
$398.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.22
|
| Rate for Payer: BCN Commercial |
$1,239.14
|
| Rate for Payer: BCN Medicare Advantage |
$398.44
|
| Rate for Payer: Cash Price |
$1,275.00
|
| Rate for Payer: Cofinity Commercial |
$1,370.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,275.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.44
|
| Rate for Payer: Healthscope Commercial |
$1,434.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,195.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,354.69
|
| Rate for Payer: Nomi Health Commercial |
$1,306.88
|
| Rate for Payer: PACE Senior Care Partners |
$378.52
|
| Rate for Payer: PACE SWMI |
$398.44
|
| Rate for Payer: PHP Commercial |
$1,354.69
|
| Rate for Payer: PHP Medicare Advantage |
$398.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,035.94
|
| Rate for Payer: Priority Health HMO/PPO |
$1,386.56
|
| Rate for Payer: Priority Health Medicare |
$402.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,067.81
|
| Rate for Payer: Railroad Medicare Medicare |
$398.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,402.50
|
| Rate for Payer: UHC Core |
$1,330.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$398.44
|
| Rate for Payer: UHC Exchange |
$398.44
|
| Rate for Payer: UHC Medicare Advantage |
$398.44
|
| Rate for Payer: VA VA |
$398.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,195.31
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.12 |
| Max. Negotiated Rate |
$5,415.62 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: Aetna Medicare |
$1,564.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,880.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,880.42
|
| Rate for Payer: BCBS Complete |
$4,339.88
|
| Rate for Payer: BCBS MAPPO |
$1,504.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,946.87
|
| Rate for Payer: BCN Commercial |
$4,678.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,504.34
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,504.34
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,513.02
|
| Rate for Payer: Mclaren Medicaid |
$4,132.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,579.56
|
| Rate for Payer: Meridian Medicaid |
$4,339.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,729.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: Nomi Health Commercial |
$4,934.24
|
| Rate for Payer: PACE Senior Care Partners |
$1,429.12
|
| Rate for Payer: PACE SWMI |
$1,504.34
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,504.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,132.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,235.10
|
| Rate for Payer: Priority Health Medicare |
$1,519.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,031.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,504.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,295.28
|
| Rate for Payer: UHC Core |
$5,024.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,504.34
|
| Rate for Payer: UHC Exchange |
$1,504.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,504.34
|
| Rate for Payer: UHCCP Medicaid |
$4,132.95
|
| Rate for Payer: VA VA |
$1,504.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,513.02
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$6,017.36
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,911.28 |
| Max. Negotiated Rate |
$5,415.62 |
| Rate for Payer: Aetna Commercial |
$5,114.76
|
| Rate for Payer: BCBS Trust/PPO |
$4,911.97
|
| Rate for Payer: BCN Commercial |
$4,650.22
|
| Rate for Payer: Cash Price |
$4,813.89
|
| Rate for Payer: Cofinity Commercial |
$5,174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,813.89
|
| Rate for Payer: Healthscope Commercial |
$5,415.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,513.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,114.76
|
| Rate for Payer: Nomi Health Commercial |
$4,934.24
|
| Rate for Payer: PHP Commercial |
$5,114.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,911.28
|
| Rate for Payer: Priority Health HMO/PPO |
$5,235.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,031.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,295.28
|
| Rate for Payer: UHC Core |
$5,024.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,513.02
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,784.97 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: BCBS Trust/PPO |
$7,265.04
|
| Rate for Payer: BCN Commercial |
$6,877.89
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,674.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: Nomi Health Commercial |
$7,297.97
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health HMO/PPO |
$7,742.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,962.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,831.96
|
| Rate for Payer: UHC Core |
$7,431.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,674.97
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,899.96
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$8,009.96 |
| Rate for Payer: Aetna Commercial |
$7,564.97
|
| Rate for Payer: Aetna Medicare |
$2,313.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,781.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,781.24
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$2,224.99
|
| Rate for Payer: BCBS Trust/PPO |
$7,316.66
|
| Rate for Payer: BCN Commercial |
$6,919.72
|
| Rate for Payer: BCN Medicare Advantage |
$2,224.99
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cash Price |
$7,119.97
|
| Rate for Payer: Cofinity Commercial |
$7,653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,224.99
|
| Rate for Payer: Healthscope Commercial |
$8,009.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,674.97
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,336.24
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,558.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,564.97
|
| Rate for Payer: Nomi Health Commercial |
$7,297.97
|
| Rate for Payer: PACE Senior Care Partners |
$2,113.74
|
| Rate for Payer: PACE SWMI |
$2,224.99
|
| Rate for Payer: PHP Commercial |
$7,564.97
|
| Rate for Payer: PHP Medicare Advantage |
$2,224.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,784.97
|
| Rate for Payer: Priority Health HMO/PPO |
$7,742.97
|
| Rate for Payer: Priority Health Medicare |
$2,247.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,962.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2,224.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,831.96
|
| Rate for Payer: UHC Core |
$7,431.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,224.99
|
| Rate for Payer: UHC Exchange |
$2,224.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,224.99
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$2,224.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,674.97
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health HMO/PPO |
$23.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.80
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.54
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.24
|
| Rate for Payer: Priority Health HMO/PPO |
$23.07
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.77
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.12 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: BCBS Trust/PPO |
$407.04
|
| Rate for Payer: BCN Commercial |
$385.35
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO |
$433.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.80
|
| Rate for Payer: UHC Core |
$416.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.43 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna Medicare |
$129.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.82
|
| Rate for Payer: BCBS Complete |
$297.19
|
| Rate for Payer: BCBS MAPPO |
$124.66
|
| Rate for Payer: BCBS Trust/PPO |
$409.93
|
| Rate for Payer: BCN Commercial |
$387.69
|
| Rate for Payer: BCN Medicare Advantage |
$124.66
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.66
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Mclaren Medicaid |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.89
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$408.88
|
| Rate for Payer: PACE Senior Care Partners |
$118.43
|
| Rate for Payer: PACE SWMI |
$124.66
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: PHP Medicare Advantage |
$124.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO |
$433.82
|
| Rate for Payer: Priority Health Medicare |
$125.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.09
|
| Rate for Payer: Railroad Medicare Medicare |
$124.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.80
|
| Rate for Payer: UHC Core |
$416.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.66
|
| Rate for Payer: UHC Exchange |
$124.66
|
| Rate for Payer: UHC Medicare Advantage |
$124.66
|
| Rate for Payer: UHCCP Medicaid |
$283.02
|
| Rate for Payer: VA VA |
$124.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
