|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,213.39 |
| Max. Negotiated Rate |
$4,598.09 |
| Rate for Payer: Aetna Commercial |
$4,342.64
|
| Rate for Payer: Aetna Medicare |
$1,328.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,596.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,596.56
|
| Rate for Payer: BCBS Complete |
$4,104.01
|
| Rate for Payer: BCBS MAPPO |
$1,277.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,200.10
|
| Rate for Payer: BCN Commercial |
$3,972.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.25
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,393.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.25
|
| Rate for Payer: Healthscope Commercial |
$4,598.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,831.74
|
| Rate for Payer: Mclaren Medicaid |
$3,908.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.11
|
| Rate for Payer: Meridian Medicaid |
$4,104.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,468.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,213.39
|
| Rate for Payer: PACE SWMI |
$1,277.25
|
| Rate for Payer: PHP Commercial |
$4,342.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,908.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health HMO/PPO |
$4,444.82
|
| Rate for Payer: Priority Health Medicare |
$1,290.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,423.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,277.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,495.91
|
| Rate for Payer: UHC Core |
$4,266.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,277.25
|
| Rate for Payer: UHC Exchange |
$1,277.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,277.25
|
| Rate for Payer: UHCCP Medicaid |
$3,908.32
|
| Rate for Payer: VA VA |
$1,277.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,831.74
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,108.99
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,320.84 |
| Max. Negotiated Rate |
$4,598.09 |
| Rate for Payer: Aetna Commercial |
$4,342.64
|
| Rate for Payer: BCBS Trust/PPO |
$4,170.47
|
| Rate for Payer: BCN Commercial |
$3,948.23
|
| Rate for Payer: Cash Price |
$4,087.19
|
| Rate for Payer: Cofinity Commercial |
$4,393.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,087.19
|
| Rate for Payer: Healthscope Commercial |
$4,598.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,831.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,342.64
|
| Rate for Payer: Nomi Health Commercial |
$4,189.37
|
| Rate for Payer: PHP Commercial |
$4,342.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,320.84
|
| Rate for Payer: Priority Health HMO/PPO |
$4,444.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,423.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,495.91
|
| Rate for Payer: UHC Core |
$4,266.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,831.74
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$561.57 |
| Max. Negotiated Rate |
$777.56 |
| Rate for Payer: Aetna Commercial |
$734.37
|
| Rate for Payer: BCBS Trust/PPO |
$705.25
|
| Rate for Payer: BCN Commercial |
$667.67
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$743.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Healthscope Commercial |
$777.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$647.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: PHP Commercial |
$734.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health HMO/PPO |
$751.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.28
|
| Rate for Payer: UHC Core |
$721.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$647.97
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$863.96
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$777.56 |
| Rate for Payer: Aetna Commercial |
$734.37
|
| Rate for Payer: Aetna Medicare |
$224.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.99
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$215.99
|
| Rate for Payer: BCBS Trust/PPO |
$710.26
|
| Rate for Payer: BCN Commercial |
$671.73
|
| Rate for Payer: BCN Medicare Advantage |
$215.99
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cash Price |
$691.17
|
| Rate for Payer: Cofinity Commercial |
$743.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.99
|
| Rate for Payer: Healthscope Commercial |
$777.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$647.97
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.79
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$734.37
|
| Rate for Payer: Nomi Health Commercial |
$708.45
|
| Rate for Payer: PACE Senior Care Partners |
$205.19
|
| Rate for Payer: PACE SWMI |
$215.99
|
| Rate for Payer: PHP Commercial |
$734.37
|
| Rate for Payer: PHP Medicare Advantage |
$215.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.57
|
| Rate for Payer: Priority Health HMO/PPO |
$751.65
|
| Rate for Payer: Priority Health Medicare |
$218.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.85
|
| Rate for Payer: Railroad Medicare Medicare |
$215.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.28
|
| Rate for Payer: UHC Core |
$721.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.99
|
| Rate for Payer: UHC Exchange |
$215.99
|
| Rate for Payer: UHC Medicare Advantage |
$215.99
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$215.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$647.97
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$470.99 |
| Max. Negotiated Rate |
$652.14 |
| Rate for Payer: Aetna Commercial |
$615.91
|
| Rate for Payer: BCBS Trust/PPO |
$591.49
|
| Rate for Payer: BCN Commercial |
$559.97
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$623.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Healthscope Commercial |
$652.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PHP Commercial |
$615.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health HMO/PPO |
$630.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.65
|
| Rate for Payer: UHC Core |
$605.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.45
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$724.60
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$652.14 |
| Rate for Payer: Aetna Commercial |
$615.91
|
| Rate for Payer: Aetna Medicare |
$188.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$226.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$226.44
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$181.15
|
| Rate for Payer: BCBS Trust/PPO |
$595.69
|
| Rate for Payer: BCN Commercial |
$563.38
|
| Rate for Payer: BCN Medicare Advantage |
$181.15
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cash Price |
$579.68
|
| Rate for Payer: Cofinity Commercial |
$623.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.15
|
| Rate for Payer: Healthscope Commercial |
$652.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.45
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.21
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$615.91
|
| Rate for Payer: Nomi Health Commercial |
$594.17
|
| Rate for Payer: PACE Senior Care Partners |
$172.09
|
| Rate for Payer: PACE SWMI |
$181.15
|
| Rate for Payer: PHP Commercial |
$615.91
|
| Rate for Payer: PHP Medicare Advantage |
$181.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.99
|
| Rate for Payer: Priority Health HMO/PPO |
$630.40
|
| Rate for Payer: Priority Health Medicare |
$182.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.48
|
| Rate for Payer: Railroad Medicare Medicare |
$181.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.65
|
| Rate for Payer: UHC Core |
$605.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.15
|
| Rate for Payer: UHC Exchange |
$181.15
|
| Rate for Payer: UHC Medicare Advantage |
$181.15
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$181.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.45
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$612.62 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$801.12
|
| Rate for Payer: BCBS Trust/PPO |
$769.36
|
| Rate for Payer: BCN Commercial |
$728.36
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$810.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Healthscope Commercial |
$848.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: PHP Commercial |
$801.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health HMO/PPO |
$819.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.40
|
| Rate for Payer: UHC Core |
$786.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.88
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$942.50
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$848.25 |
| Rate for Payer: Aetna Commercial |
$801.12
|
| Rate for Payer: Aetna Medicare |
$245.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.53
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$235.62
|
| Rate for Payer: BCBS Trust/PPO |
$774.83
|
| Rate for Payer: BCN Commercial |
$732.79
|
| Rate for Payer: BCN Medicare Advantage |
$235.62
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cash Price |
$754.00
|
| Rate for Payer: Cofinity Commercial |
$810.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.62
|
| Rate for Payer: Healthscope Commercial |
$848.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.88
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.41
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.12
|
| Rate for Payer: Nomi Health Commercial |
$772.85
|
| Rate for Payer: PACE Senior Care Partners |
$223.84
|
| Rate for Payer: PACE SWMI |
$235.62
|
| Rate for Payer: PHP Commercial |
$801.12
|
| Rate for Payer: PHP Medicare Advantage |
$235.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.62
|
| Rate for Payer: Priority Health HMO/PPO |
$819.98
|
| Rate for Payer: Priority Health Medicare |
$237.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.48
|
| Rate for Payer: Railroad Medicare Medicare |
$235.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.40
|
| Rate for Payer: UHC Core |
$786.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.62
|
| Rate for Payer: UHC Exchange |
$235.62
|
| Rate for Payer: UHC Medicare Advantage |
$235.62
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$235.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.88
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$711.42 |
| Rate for Payer: Aetna Commercial |
$671.90
|
| Rate for Payer: Aetna Medicare |
$205.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.02
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$197.62
|
| Rate for Payer: BCBS Trust/PPO |
$649.85
|
| Rate for Payer: BCN Commercial |
$614.59
|
| Rate for Payer: BCN Medicare Advantage |
$197.62
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$679.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.62
|
| Rate for Payer: Healthscope Commercial |
$711.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.85
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.50
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: PACE Senior Care Partners |
$187.74
|
| Rate for Payer: PACE SWMI |
$197.62
|
| Rate for Payer: PHP Commercial |
$671.90
|
| Rate for Payer: PHP Medicare Advantage |
$197.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: Priority Health HMO/PPO |
$687.71
|
| Rate for Payer: Priority Health Medicare |
$199.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.61
|
| Rate for Payer: Railroad Medicare Medicare |
$197.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.61
|
| Rate for Payer: UHC Core |
$660.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.62
|
| Rate for Payer: UHC Exchange |
$197.62
|
| Rate for Payer: UHC Medicare Advantage |
$197.62
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$197.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.85
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$790.47
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$513.81 |
| Max. Negotiated Rate |
$711.42 |
| Rate for Payer: Aetna Commercial |
$671.90
|
| Rate for Payer: BCBS Trust/PPO |
$645.26
|
| Rate for Payer: BCN Commercial |
$610.88
|
| Rate for Payer: Cash Price |
$632.38
|
| Rate for Payer: Cofinity Commercial |
$679.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.38
|
| Rate for Payer: Healthscope Commercial |
$711.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$671.90
|
| Rate for Payer: Nomi Health Commercial |
$648.19
|
| Rate for Payer: PHP Commercial |
$671.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.81
|
| Rate for Payer: Priority Health HMO/PPO |
$687.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.61
|
| Rate for Payer: UHC Core |
$660.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.85
|
|
|
HC ARTHROCENTESIS
|
Facility
|
IP
|
$377.89
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: BCBS Trust/PPO |
$308.47
|
| Rate for Payer: BCN Commercial |
$292.03
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC ARTHROCENTESIS
|
Facility
|
OP
|
$377.89
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.75 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: Aetna Medicare |
$98.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.09
|
| Rate for Payer: BCBS Complete |
$151.16
|
| Rate for Payer: BCBS MAPPO |
$94.47
|
| Rate for Payer: BCBS Trust/PPO |
$310.66
|
| Rate for Payer: BCN Commercial |
$293.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.47
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.47
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PACE Senior Care Partners |
$89.75
|
| Rate for Payer: PACE SWMI |
$94.47
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: PHP Medicare Advantage |
$94.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Medicare |
$95.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: Railroad Medicare Medicare |
$94.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.47
|
| Rate for Payer: UHC Exchange |
$94.47
|
| Rate for Payer: UHC Medicare Advantage |
$94.47
|
| Rate for Payer: VA VA |
$94.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.22 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: BCBS Trust/PPO |
$277.82
|
| Rate for Payer: BCN Commercial |
$263.01
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.83 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$88.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.36
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$85.08
|
| Rate for Payer: BCBS Trust/PPO |
$279.79
|
| Rate for Payer: BCN Commercial |
$264.61
|
| Rate for Payer: BCN Medicare Advantage |
$85.08
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.08
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.34
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: Nomi Health Commercial |
$279.08
|
| Rate for Payer: PACE Senior Care Partners |
$80.83
|
| Rate for Payer: PACE SWMI |
$85.08
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health HMO/PPO |
$296.10
|
| Rate for Payer: Priority Health Medicare |
$85.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.50
|
| Rate for Payer: UHC Core |
$284.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.08
|
| Rate for Payer: UHC Exchange |
$85.08
|
| Rate for Payer: UHC Medicare Advantage |
$85.08
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$85.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.94 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,463.18
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$347.51 |
| Max. Negotiated Rate |
$1,316.86 |
| Rate for Payer: Aetna Commercial |
$1,243.70
|
| Rate for Payer: Aetna Medicare |
$380.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$457.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$457.24
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$365.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.88
|
| Rate for Payer: BCN Commercial |
$1,137.62
|
| Rate for Payer: BCN Medicare Advantage |
$365.80
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cofinity Commercial |
$1,258.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$1,316.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.38
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$384.08
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$420.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.70
|
| Rate for Payer: Nomi Health Commercial |
$1,199.81
|
| Rate for Payer: PACE Senior Care Partners |
$347.51
|
| Rate for Payer: PACE SWMI |
$365.80
|
| Rate for Payer: PHP Commercial |
$1,243.70
|
| Rate for Payer: PHP Medicare Advantage |
$365.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,272.97
|
| Rate for Payer: Priority Health Medicare |
$369.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$980.33
|
| Rate for Payer: Railroad Medicare Medicare |
$365.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.60
|
| Rate for Payer: UHC Core |
$1,221.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$365.80
|
| Rate for Payer: UHC Exchange |
$365.80
|
| Rate for Payer: UHC Medicare Advantage |
$365.80
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$365.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.38
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,463.18
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$951.07 |
| Max. Negotiated Rate |
$1,316.86 |
| Rate for Payer: Aetna Commercial |
$1,243.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.39
|
| Rate for Payer: BCN Commercial |
$1,130.75
|
| Rate for Payer: Cash Price |
$1,170.54
|
| Rate for Payer: Cofinity Commercial |
$1,258.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.54
|
| Rate for Payer: Healthscope Commercial |
$1,316.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.70
|
| Rate for Payer: Nomi Health Commercial |
$1,199.81
|
| Rate for Payer: PHP Commercial |
$1,243.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.07
|
| Rate for Payer: Priority Health HMO/PPO |
$1,272.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$980.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.60
|
| Rate for Payer: UHC Core |
$1,221.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.38
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,084.72
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.62 |
| Max. Negotiated Rate |
$976.25 |
| Rate for Payer: Aetna Commercial |
$922.01
|
| Rate for Payer: Aetna Medicare |
$282.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$338.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$338.98
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$271.18
|
| Rate for Payer: BCBS Trust/PPO |
$891.75
|
| Rate for Payer: BCN Commercial |
$843.37
|
| Rate for Payer: BCN Medicare Advantage |
$271.18
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cofinity Commercial |
$932.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.18
|
| Rate for Payer: Healthscope Commercial |
$976.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.54
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.74
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.01
|
| Rate for Payer: Nomi Health Commercial |
$889.47
|
| Rate for Payer: PACE Senior Care Partners |
$257.62
|
| Rate for Payer: PACE SWMI |
$271.18
|
| Rate for Payer: PHP Commercial |
$922.01
|
| Rate for Payer: PHP Medicare Advantage |
$271.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.07
|
| Rate for Payer: Priority Health HMO/PPO |
$943.71
|
| Rate for Payer: Priority Health Medicare |
$273.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.76
|
| Rate for Payer: Railroad Medicare Medicare |
$271.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.55
|
| Rate for Payer: UHC Core |
$905.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.18
|
| Rate for Payer: UHC Exchange |
$271.18
|
| Rate for Payer: UHC Medicare Advantage |
$271.18
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$271.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.54
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,084.72
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$705.07 |
| Max. Negotiated Rate |
$976.25 |
| Rate for Payer: Aetna Commercial |
$922.01
|
| Rate for Payer: BCBS Trust/PPO |
$885.46
|
| Rate for Payer: BCN Commercial |
$838.27
|
| Rate for Payer: Cash Price |
$867.78
|
| Rate for Payer: Cofinity Commercial |
$932.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.78
|
| Rate for Payer: Healthscope Commercial |
$976.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.01
|
| Rate for Payer: Nomi Health Commercial |
$889.47
|
| Rate for Payer: PHP Commercial |
$922.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.07
|
| Rate for Payer: Priority Health HMO/PPO |
$943.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$726.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.55
|
| Rate for Payer: UHC Core |
$905.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.54
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$329.18
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.97 |
| Max. Negotiated Rate |
$296.26 |
| Rate for Payer: Aetna Commercial |
$279.80
|
| Rate for Payer: BCBS Trust/PPO |
$268.71
|
| Rate for Payer: BCN Commercial |
$254.39
|
| Rate for Payer: Cash Price |
$263.34
|
| Rate for Payer: Cofinity Commercial |
$283.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.34
|
| Rate for Payer: Healthscope Commercial |
$296.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.80
|
| Rate for Payer: Nomi Health Commercial |
$269.93
|
| Rate for Payer: PHP Commercial |
$279.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.97
|
| Rate for Payer: Priority Health HMO/PPO |
$286.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.68
|
| Rate for Payer: UHC Core |
$274.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.88
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$329.18
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.18 |
| Max. Negotiated Rate |
$296.26 |
| Rate for Payer: Aetna Commercial |
$279.80
|
| Rate for Payer: Aetna Medicare |
$85.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.87
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$82.30
|
| Rate for Payer: BCBS Trust/PPO |
$270.62
|
| Rate for Payer: BCN Commercial |
$255.94
|
| Rate for Payer: BCN Medicare Advantage |
$82.30
|
| Rate for Payer: Cash Price |
$263.34
|
| Rate for Payer: Cash Price |
$263.34
|
| Rate for Payer: Cofinity Commercial |
$283.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.30
|
| Rate for Payer: Healthscope Commercial |
$296.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.88
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.41
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.80
|
| Rate for Payer: Nomi Health Commercial |
$269.93
|
| Rate for Payer: PACE Senior Care Partners |
$78.18
|
| Rate for Payer: PACE SWMI |
$82.30
|
| Rate for Payer: PHP Commercial |
$279.80
|
| Rate for Payer: PHP Medicare Advantage |
$82.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.97
|
| Rate for Payer: Priority Health HMO/PPO |
$286.39
|
| Rate for Payer: Priority Health Medicare |
$83.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.55
|
| Rate for Payer: Railroad Medicare Medicare |
$82.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.68
|
| Rate for Payer: UHC Core |
$274.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.30
|
| Rate for Payer: UHC Exchange |
$82.30
|
| Rate for Payer: UHC Medicare Advantage |
$82.30
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$82.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.88
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
IP
|
$421.27
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.83 |
| Max. Negotiated Rate |
$379.14 |
| Rate for Payer: Aetna Commercial |
$358.08
|
| Rate for Payer: BCBS Trust/PPO |
$343.88
|
| Rate for Payer: BCN Commercial |
$325.56
|
| Rate for Payer: Cash Price |
$337.02
|
| Rate for Payer: Cofinity Commercial |
$362.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.02
|
| Rate for Payer: Healthscope Commercial |
$379.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.08
|
| Rate for Payer: Nomi Health Commercial |
$345.44
|
| Rate for Payer: PHP Commercial |
$358.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.83
|
| Rate for Payer: Priority Health HMO/PPO |
$366.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.72
|
| Rate for Payer: UHC Core |
$351.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.95
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
OP
|
$421.27
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.05 |
| Max. Negotiated Rate |
$379.14 |
| Rate for Payer: Aetna Commercial |
$358.08
|
| Rate for Payer: Aetna Medicare |
$109.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.65
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$105.32
|
| Rate for Payer: BCBS Trust/PPO |
$346.33
|
| Rate for Payer: BCN Commercial |
$327.54
|
| Rate for Payer: BCN Medicare Advantage |
$105.32
|
| Rate for Payer: Cash Price |
$337.02
|
| Rate for Payer: Cash Price |
$337.02
|
| Rate for Payer: Cofinity Commercial |
$362.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.32
|
| Rate for Payer: Healthscope Commercial |
$379.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.95
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.58
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.08
|
| Rate for Payer: Nomi Health Commercial |
$345.44
|
| Rate for Payer: PACE Senior Care Partners |
$100.05
|
| Rate for Payer: PACE SWMI |
$105.32
|
| Rate for Payer: PHP Commercial |
$358.08
|
| Rate for Payer: PHP Medicare Advantage |
$105.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.83
|
| Rate for Payer: Priority Health HMO/PPO |
$366.50
|
| Rate for Payer: Priority Health Medicare |
$106.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.25
|
| Rate for Payer: Railroad Medicare Medicare |
$105.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$370.72
|
| Rate for Payer: UHC Core |
$351.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.32
|
| Rate for Payer: UHC Exchange |
$105.32
|
| Rate for Payer: UHC Medicare Advantage |
$105.32
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$105.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.95
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,228.76
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$798.69 |
| Max. Negotiated Rate |
$1,105.88 |
| Rate for Payer: Aetna Commercial |
$1,044.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.04
|
| Rate for Payer: BCN Commercial |
$949.59
|
| Rate for Payer: Cash Price |
$983.01
|
| Rate for Payer: Cofinity Commercial |
$1,056.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.01
|
| Rate for Payer: Healthscope Commercial |
$1,105.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.45
|
| Rate for Payer: Nomi Health Commercial |
$1,007.58
|
| Rate for Payer: PHP Commercial |
$1,044.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,069.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.31
|
| Rate for Payer: UHC Core |
$1,026.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.57
|
|
