|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$901.11
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$549.59 |
| Max. Negotiated Rate |
$811.00 |
| Rate for Payer: Aetna Commercial |
$765.94
|
| Rate for Payer: BCBS Trust/PPO |
$696.38
|
| Rate for Payer: BCN Commercial |
$696.38
|
| Rate for Payer: Cash Price |
$720.89
|
| Rate for Payer: Cofinity Commercial |
$774.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.89
|
| Rate for Payer: Healthscope Commercial |
$811.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.94
|
| Rate for Payer: PHP Commercial |
$765.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.98
|
| Rate for Payer: UHC Core |
$752.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.83
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$901.11
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.01 |
| Max. Negotiated Rate |
$811.00 |
| Rate for Payer: Aetna Commercial |
$765.94
|
| Rate for Payer: Aetna Medicare |
$234.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.60
|
| Rate for Payer: BCBS Complete |
$360.44
|
| Rate for Payer: BCBS MAPPO |
$225.28
|
| Rate for Payer: BCBS Trust/PPO |
$700.61
|
| Rate for Payer: BCN Commercial |
$700.61
|
| Rate for Payer: BCN Medicare Advantage |
$225.28
|
| Rate for Payer: Cash Price |
$720.89
|
| Rate for Payer: Cofinity Commercial |
$774.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.28
|
| Rate for Payer: Healthscope Commercial |
$811.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$765.94
|
| Rate for Payer: PACE Senior Care Partners |
$214.01
|
| Rate for Payer: PACE SWMI |
$225.28
|
| Rate for Payer: PHP Commercial |
$765.94
|
| Rate for Payer: PHP Medicare Advantage |
$225.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.97
|
| Rate for Payer: Priority Health Medicare |
$225.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.59
|
| Rate for Payer: Railroad Medicare Medicare |
$225.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.98
|
| Rate for Payer: UHC Core |
$752.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.28
|
| Rate for Payer: UHC Medicare Advantage |
$232.04
|
| Rate for Payer: VA VA |
$225.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.83
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,198.74
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,560.81 |
| Max. Negotiated Rate |
$3,778.87 |
| Rate for Payer: Aetna Commercial |
$3,568.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,244.79
|
| Rate for Payer: BCN Commercial |
$3,244.79
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cofinity Commercial |
$3,610.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.99
|
| Rate for Payer: Healthscope Commercial |
$3,778.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,149.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,568.93
|
| Rate for Payer: PHP Commercial |
$3,568.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,652.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,560.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,694.89
|
| Rate for Payer: UHC Core |
$3,505.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,149.06
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,198.74
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$997.20 |
| Max. Negotiated Rate |
$3,778.87 |
| Rate for Payer: Aetna Commercial |
$3,568.93
|
| Rate for Payer: Aetna Medicare |
$1,091.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,312.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,312.11
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,049.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,264.52
|
| Rate for Payer: BCN Commercial |
$3,264.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,049.68
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cash Price |
$3,358.99
|
| Rate for Payer: Cofinity Commercial |
$3,610.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,358.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,049.68
|
| Rate for Payer: Healthscope Commercial |
$3,778.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,149.06
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,102.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,207.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,568.93
|
| Rate for Payer: PACE Senior Care Partners |
$997.20
|
| Rate for Payer: PACE SWMI |
$1,049.68
|
| Rate for Payer: PHP Commercial |
$3,568.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,049.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,939.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,652.90
|
| Rate for Payer: Priority Health Medicare |
$1,049.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,560.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,049.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,694.89
|
| Rate for Payer: UHC Core |
$3,505.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,049.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,081.18
|
| Rate for Payer: VA VA |
$1,049.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,149.06
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$311.05 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: BCBS Trust/PPO |
$394.13
|
| Rate for Payer: BCN Commercial |
$394.13
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$443.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.12 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: Aetna Medicare |
$132.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.38
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$396.52
|
| Rate for Payer: BCN Commercial |
$396.52
|
| Rate for Payer: BCN Medicare Advantage |
$127.50
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.50
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$133.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PACE Senior Care Partners |
$121.12
|
| Rate for Payer: PACE SWMI |
$127.50
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: PHP Medicare Advantage |
$127.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$443.70
|
| Rate for Payer: Priority Health Medicare |
$127.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.05
|
| Rate for Payer: Railroad Medicare Medicare |
$127.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.50
|
| Rate for Payer: UHC Medicare Advantage |
$131.32
|
| Rate for Payer: VA VA |
$127.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,053.41
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$487.68 |
| Max. Negotiated Rate |
$1,848.07 |
| Rate for Payer: Aetna Commercial |
$1,745.40
|
| Rate for Payer: Aetna Medicare |
$533.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$641.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$641.69
|
| Rate for Payer: BCBS Complete |
$821.36
|
| Rate for Payer: BCBS MAPPO |
$513.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.53
|
| Rate for Payer: BCN Commercial |
$1,596.53
|
| Rate for Payer: BCN Medicare Advantage |
$513.35
|
| Rate for Payer: Cash Price |
$1,642.73
|
| Rate for Payer: Cofinity Commercial |
$1,765.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,642.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.35
|
| Rate for Payer: Healthscope Commercial |
$1,848.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,540.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$539.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,745.40
|
| Rate for Payer: PACE Senior Care Partners |
$487.68
|
| Rate for Payer: PACE SWMI |
$513.35
|
| Rate for Payer: PHP Commercial |
$1,745.40
|
| Rate for Payer: PHP Medicare Advantage |
$513.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.47
|
| Rate for Payer: Priority Health Medicare |
$513.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,252.37
|
| Rate for Payer: Railroad Medicare Medicare |
$513.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,807.00
|
| Rate for Payer: UHC Core |
$1,714.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$513.35
|
| Rate for Payer: UHC Medicare Advantage |
$528.75
|
| Rate for Payer: VA VA |
$513.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,540.06
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,053.41
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,252.37 |
| Max. Negotiated Rate |
$1,848.07 |
| Rate for Payer: Aetna Commercial |
$1,745.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.88
|
| Rate for Payer: BCN Commercial |
$1,586.88
|
| Rate for Payer: Cash Price |
$1,642.73
|
| Rate for Payer: Cofinity Commercial |
$1,765.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,642.73
|
| Rate for Payer: Healthscope Commercial |
$1,848.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,540.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,745.40
|
| Rate for Payer: PHP Commercial |
$1,745.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,437.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,252.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,807.00
|
| Rate for Payer: UHC Core |
$1,714.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,540.06
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,182.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$993.22 |
| Max. Negotiated Rate |
$3,763.80 |
| Rate for Payer: Aetna Commercial |
$3,554.70
|
| Rate for Payer: Aetna Medicare |
$1,087.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,306.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,306.88
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,045.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,251.50
|
| Rate for Payer: BCN Commercial |
$3,251.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,045.50
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$3,596.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,045.50
|
| Rate for Payer: Healthscope Commercial |
$3,763.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,136.50
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,097.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,202.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,554.70
|
| Rate for Payer: PACE Senior Care Partners |
$993.22
|
| Rate for Payer: PACE SWMI |
$1,045.50
|
| Rate for Payer: PHP Commercial |
$3,554.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,045.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,927.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,638.34
|
| Rate for Payer: Priority Health Medicare |
$1,045.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,550.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,045.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,680.16
|
| Rate for Payer: UHC Core |
$3,491.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,045.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,076.86
|
| Rate for Payer: VA VA |
$1,045.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,136.50
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,182.00
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,550.60 |
| Max. Negotiated Rate |
$3,763.80 |
| Rate for Payer: Aetna Commercial |
$3,554.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,231.85
|
| Rate for Payer: BCN Commercial |
$3,231.85
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cofinity Commercial |
$3,596.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,345.60
|
| Rate for Payer: Healthscope Commercial |
$3,763.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,136.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,554.70
|
| Rate for Payer: PHP Commercial |
$3,554.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,927.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,638.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,550.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,680.16
|
| Rate for Payer: UHC Core |
$3,491.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,136.50
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,091.76
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$734.29 |
| Max. Negotiated Rate |
$2,782.58 |
| Rate for Payer: Aetna Commercial |
$2,628.00
|
| Rate for Payer: Aetna Medicare |
$803.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$966.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$966.18
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$772.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.84
|
| Rate for Payer: BCN Commercial |
$2,403.84
|
| Rate for Payer: BCN Medicare Advantage |
$772.94
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cofinity Commercial |
$2,658.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,473.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.94
|
| Rate for Payer: Healthscope Commercial |
$2,782.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,318.82
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$811.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,628.00
|
| Rate for Payer: PACE Senior Care Partners |
$734.29
|
| Rate for Payer: PACE SWMI |
$772.94
|
| Rate for Payer: PHP Commercial |
$2,628.00
|
| Rate for Payer: PHP Medicare Advantage |
$772.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,164.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,689.83
|
| Rate for Payer: Priority Health Medicare |
$772.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,885.66
|
| Rate for Payer: Railroad Medicare Medicare |
$772.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,720.75
|
| Rate for Payer: UHC Core |
$2,581.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.94
|
| Rate for Payer: UHC Medicare Advantage |
$796.13
|
| Rate for Payer: VA VA |
$772.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,318.82
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,091.76
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,885.66 |
| Max. Negotiated Rate |
$2,782.58 |
| Rate for Payer: Aetna Commercial |
$2,628.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,389.31
|
| Rate for Payer: BCN Commercial |
$2,389.31
|
| Rate for Payer: Cash Price |
$2,473.41
|
| Rate for Payer: Cofinity Commercial |
$2,658.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,473.41
|
| Rate for Payer: Healthscope Commercial |
$2,782.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,318.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,628.00
|
| Rate for Payer: PHP Commercial |
$2,628.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,164.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,689.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,885.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,720.75
|
| Rate for Payer: UHC Core |
$2,581.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,318.82
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,280.84 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.94
|
| Rate for Payer: BCN Commercial |
$1,622.94
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.07
|
| Rate for Payer: UHC Core |
$1,753.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$498.77 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna Medicare |
$546.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.28
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$525.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.81
|
| Rate for Payer: BCN Commercial |
$1,632.81
|
| Rate for Payer: BCN Medicare Advantage |
$525.02
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.02
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Senior Care Partners |
$498.77
|
| Rate for Payer: PACE SWMI |
$525.02
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: PHP Medicare Advantage |
$525.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.07
|
| Rate for Payer: Priority Health Medicare |
$525.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.84
|
| Rate for Payer: Railroad Medicare Medicare |
$525.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.07
|
| Rate for Payer: UHC Core |
$1,753.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.02
|
| Rate for Payer: UHC Medicare Advantage |
$540.77
|
| Rate for Payer: VA VA |
$525.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,112.41
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$461.54 |
| Max. Negotiated Rate |
$2,801.17 |
| Rate for Payer: Aetna Commercial |
$2,645.55
|
| Rate for Payer: Aetna Medicare |
$809.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$972.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$972.63
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$778.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,419.90
|
| Rate for Payer: BCN Commercial |
$2,419.90
|
| Rate for Payer: BCN Medicare Advantage |
$778.10
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cofinity Commercial |
$2,676.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.10
|
| Rate for Payer: Healthscope Commercial |
$2,801.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,334.31
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$817.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$894.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.55
|
| Rate for Payer: PACE Senior Care Partners |
$739.20
|
| Rate for Payer: PACE SWMI |
$778.10
|
| Rate for Payer: PHP Commercial |
$2,645.55
|
| Rate for Payer: PHP Medicare Advantage |
$778.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,707.80
|
| Rate for Payer: Priority Health Medicare |
$778.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,898.26
|
| Rate for Payer: Railroad Medicare Medicare |
$778.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,738.92
|
| Rate for Payer: UHC Core |
$2,598.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$778.10
|
| Rate for Payer: UHC Medicare Advantage |
$801.45
|
| Rate for Payer: VA VA |
$778.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,334.31
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
IP
|
$3,112.41
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,898.26 |
| Max. Negotiated Rate |
$2,801.17 |
| Rate for Payer: Aetna Commercial |
$2,645.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,405.27
|
| Rate for Payer: BCN Commercial |
$2,405.27
|
| Rate for Payer: Cash Price |
$2,489.93
|
| Rate for Payer: Cofinity Commercial |
$2,676.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,489.93
|
| Rate for Payer: Healthscope Commercial |
$2,801.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,334.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,645.55
|
| Rate for Payer: PHP Commercial |
$2,645.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,178.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,707.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,898.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,738.92
|
| Rate for Payer: UHC Core |
$2,598.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,334.31
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
IP
|
$3,984.73
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,430.29 |
| Max. Negotiated Rate |
$3,586.26 |
| Rate for Payer: Aetna Commercial |
$3,387.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.40
|
| Rate for Payer: BCN Commercial |
$3,079.40
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cofinity Commercial |
$3,426.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,187.78
|
| Rate for Payer: Healthscope Commercial |
$3,586.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,988.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,387.02
|
| Rate for Payer: PHP Commercial |
$3,387.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,466.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,430.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,506.56
|
| Rate for Payer: UHC Core |
$3,327.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,988.55
|
|
|
HC DRAINAGE VISCERAL
|
Facility
|
OP
|
$3,984.73
|
|
|
Service Code
|
CPT 49405
|
| Hospital Charge Code |
36100432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$946.37 |
| Max. Negotiated Rate |
$3,586.26 |
| Rate for Payer: Aetna Commercial |
$3,387.02
|
| Rate for Payer: Aetna Medicare |
$1,036.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,245.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,245.23
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$996.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,098.13
|
| Rate for Payer: BCN Commercial |
$3,098.13
|
| Rate for Payer: BCN Medicare Advantage |
$996.18
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cash Price |
$3,187.78
|
| Rate for Payer: Cofinity Commercial |
$3,426.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,187.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.18
|
| Rate for Payer: Healthscope Commercial |
$3,586.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,988.55
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,045.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,145.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,387.02
|
| Rate for Payer: PACE Senior Care Partners |
$946.37
|
| Rate for Payer: PACE SWMI |
$996.18
|
| Rate for Payer: PHP Commercial |
$3,387.02
|
| Rate for Payer: PHP Medicare Advantage |
$996.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,466.72
|
| Rate for Payer: Priority Health Medicare |
$996.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,430.29
|
| Rate for Payer: Railroad Medicare Medicare |
$996.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,506.56
|
| Rate for Payer: UHC Core |
$3,327.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.07
|
| Rate for Payer: VA VA |
$996.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,988.55
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
IP
|
$951.66
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$580.42 |
| Max. Negotiated Rate |
$856.49 |
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: BCBS Trust/PPO |
$735.44
|
| Rate for Payer: BCN Commercial |
$735.44
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.46
|
| Rate for Payer: UHC Core |
$794.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
|
HC DRAIN EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Facility
|
OP
|
$951.66
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
76100298
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.02 |
| Max. Negotiated Rate |
$856.49 |
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: Aetna Medicare |
$247.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.39
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$237.92
|
| Rate for Payer: BCBS Trust/PPO |
$739.92
|
| Rate for Payer: BCN Commercial |
$739.92
|
| Rate for Payer: BCN Medicare Advantage |
$237.92
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.92
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PACE Senior Care Partners |
$226.02
|
| Rate for Payer: PACE SWMI |
$237.92
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: PHP Medicare Advantage |
$237.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.94
|
| Rate for Payer: Priority Health Medicare |
$237.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.42
|
| Rate for Payer: Railroad Medicare Medicare |
$237.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.46
|
| Rate for Payer: UHC Core |
$794.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.92
|
| Rate for Payer: UHC Medicare Advantage |
$245.05
|
| Rate for Payer: VA VA |
$237.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.82
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC DRAW VENIPUNCTURE
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
OP
|
$363.14
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$326.83 |
| Rate for Payer: Aetna Commercial |
$308.67
|
| Rate for Payer: Aetna Medicare |
$94.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.48
|
| Rate for Payer: BCBS Complete |
$145.26
|
| Rate for Payer: BCBS MAPPO |
$90.78
|
| Rate for Payer: BCBS Trust/PPO |
$282.34
|
| Rate for Payer: BCN Commercial |
$282.34
|
| Rate for Payer: BCN Medicare Advantage |
$90.78
|
| Rate for Payer: Cash Price |
$290.51
|
| Rate for Payer: Cofinity Commercial |
$312.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.78
|
| Rate for Payer: Healthscope Commercial |
$326.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.67
|
| Rate for Payer: PACE Senior Care Partners |
$86.25
|
| Rate for Payer: PACE SWMI |
$90.78
|
| Rate for Payer: PHP Commercial |
$308.67
|
| Rate for Payer: PHP Medicare Advantage |
$90.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.93
|
| Rate for Payer: Priority Health Medicare |
$90.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.48
|
| Rate for Payer: Railroad Medicare Medicare |
$90.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.56
|
| Rate for Payer: UHC Core |
$303.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.78
|
| Rate for Payer: UHC Medicare Advantage |
$93.51
|
| Rate for Payer: VA VA |
$90.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.36
|
|
|
HC DRSG MEPILEX AG FOAM 8X20
|
Facility
|
IP
|
$363.14
|
|
|
Service Code
|
HCPCS A6214
|
| Hospital Charge Code |
27000065
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$221.48 |
| Max. Negotiated Rate |
$326.83 |
| Rate for Payer: Aetna Commercial |
$308.67
|
| Rate for Payer: BCBS Trust/PPO |
$280.63
|
| Rate for Payer: BCN Commercial |
$280.63
|
| Rate for Payer: Cash Price |
$290.51
|
| Rate for Payer: Cofinity Commercial |
$312.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.51
|
| Rate for Payer: Healthscope Commercial |
$326.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.67
|
| Rate for Payer: PHP Commercial |
$308.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$315.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.56
|
| Rate for Payer: UHC Core |
$303.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.36
|
|
|
HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
IP
|
$5.53
|
|
|
Service Code
|
HCPCS A6213
|
| Hospital Charge Code |
62300221
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$4.98 |
| Rate for Payer: Aetna Commercial |
$4.70
|
| Rate for Payer: BCBS Trust/PPO |
$4.27
|
| Rate for Payer: BCN Commercial |
$4.27
|
| Rate for Payer: Cash Price |
$4.42
|
| Rate for Payer: Cofinity Commercial |
$4.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.42
|
| Rate for Payer: Healthscope Commercial |
$4.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.70
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.87
|
| Rate for Payer: UHC Core |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.15
|
|
