|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$770.00
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$469.62 |
| Max. Negotiated Rate |
$693.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: BCBS Trust/PPO |
$595.06
|
| Rate for Payer: BCN Commercial |
$595.06
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cofinity Commercial |
$662.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.00
|
| Rate for Payer: Healthscope Commercial |
$693.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.50
|
| Rate for Payer: PHP Commercial |
$654.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$669.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.60
|
| Rate for Payer: UHC Core |
$642.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.50
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$770.00
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.88 |
| Max. Negotiated Rate |
$693.00 |
| Rate for Payer: Aetna Commercial |
$654.50
|
| Rate for Payer: Aetna Medicare |
$200.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.62
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$192.50
|
| Rate for Payer: BCBS Trust/PPO |
$598.68
|
| Rate for Payer: BCN Commercial |
$598.68
|
| Rate for Payer: BCN Medicare Advantage |
$192.50
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cash Price |
$616.00
|
| Rate for Payer: Cofinity Commercial |
$662.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.50
|
| Rate for Payer: Healthscope Commercial |
$693.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.50
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.50
|
| Rate for Payer: PACE Senior Care Partners |
$182.88
|
| Rate for Payer: PACE SWMI |
$192.50
|
| Rate for Payer: PHP Commercial |
$654.50
|
| Rate for Payer: PHP Medicare Advantage |
$192.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$669.90
|
| Rate for Payer: Priority Health Medicare |
$192.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.62
|
| Rate for Payer: Railroad Medicare Medicare |
$192.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.60
|
| Rate for Payer: UHC Core |
$642.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.50
|
| Rate for Payer: UHC Medicare Advantage |
$198.28
|
| Rate for Payer: VA VA |
$192.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.50
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$51.03
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.82
|
| Rate for Payer: Healthscope Commercial |
$45.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.38
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.91
|
| Rate for Payer: UHC Core |
$42.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.27
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$51.03
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.12 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Aetna Commercial |
$43.38
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.95
|
| Rate for Payer: BCBS Complete |
$20.51
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCBS Trust/PPO |
$39.68
|
| Rate for Payer: BCN Commercial |
$39.68
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cash Price |
$40.82
|
| Rate for Payer: Cofinity Commercial |
$43.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.76
|
| Rate for Payer: Healthscope Commercial |
$45.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.27
|
| Rate for Payer: Mclaren Medicaid |
$19.53
|
| Rate for Payer: Meridian Medicaid |
$20.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.38
|
| Rate for Payer: PACE Senior Care Partners |
$12.12
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$43.38
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.40
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.91
|
| Rate for Payer: UHC Core |
$42.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.76
|
| Rate for Payer: UHC Medicare Advantage |
$13.14
|
| Rate for Payer: VA VA |
$12.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.27
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$588.31
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$358.81 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: BCBS Trust/PPO |
$454.65
|
| Rate for Payer: BCN Commercial |
$454.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$588.31
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$529.48 |
| Rate for Payer: Aetna Commercial |
$500.06
|
| Rate for Payer: Aetna Medicare |
$152.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.85
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$147.08
|
| Rate for Payer: BCBS Trust/PPO |
$457.41
|
| Rate for Payer: BCN Commercial |
$457.41
|
| Rate for Payer: BCN Medicare Advantage |
$147.08
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cash Price |
$470.65
|
| Rate for Payer: Cofinity Commercial |
$505.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.08
|
| Rate for Payer: Healthscope Commercial |
$529.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$441.23
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$500.06
|
| Rate for Payer: PACE Senior Care Partners |
$139.72
|
| Rate for Payer: PACE SWMI |
$147.08
|
| Rate for Payer: PHP Commercial |
$500.06
|
| Rate for Payer: PHP Medicare Advantage |
$147.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$411.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$511.83
|
| Rate for Payer: Priority Health Medicare |
$147.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.81
|
| Rate for Payer: Railroad Medicare Medicare |
$147.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.71
|
| Rate for Payer: UHC Core |
$491.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.08
|
| Rate for Payer: UHC Medicare Advantage |
$151.49
|
| Rate for Payer: VA VA |
$147.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$441.23
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.21 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: BCBS Trust/PPO |
$891.03
|
| Rate for Payer: BCN Commercial |
$891.03
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$299.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.31
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$288.25
|
| Rate for Payer: BCBS Trust/PPO |
$896.45
|
| Rate for Payer: BCN Commercial |
$896.45
|
| Rate for Payer: BCN Medicare Advantage |
$288.25
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.25
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Senior Care Partners |
$273.84
|
| Rate for Payer: PACE SWMI |
$288.25
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$288.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,003.10
|
| Rate for Payer: Priority Health Medicare |
$288.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.21
|
| Rate for Payer: Railroad Medicare Medicare |
$288.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.63
|
| Rate for Payer: UHC Core |
$962.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.25
|
| Rate for Payer: UHC Medicare Advantage |
$296.89
|
| Rate for Payer: VA VA |
$288.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,538.16 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,216.08
|
| Rate for Payer: BCN Commercial |
$3,216.08
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,620.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,538.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$988.38 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna Medicare |
$1,082.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,300.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,300.50
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,040.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,235.64
|
| Rate for Payer: BCN Commercial |
$3,235.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.40
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.40
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,092.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,196.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: PACE Senior Care Partners |
$988.38
|
| Rate for Payer: PACE SWMI |
$1,040.40
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,620.59
|
| Rate for Payer: Priority Health Medicare |
$1,040.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,538.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,040.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.61
|
| Rate for Payer: VA VA |
$1,040.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,538.16 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,216.08
|
| Rate for Payer: BCN Commercial |
$3,216.08
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,620.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,538.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$988.38 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna Medicare |
$1,082.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,300.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,300.50
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,040.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,235.64
|
| Rate for Payer: BCN Commercial |
$3,235.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.40
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.40
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,092.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,196.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,537.36
|
| Rate for Payer: PACE Senior Care Partners |
$988.38
|
| Rate for Payer: PACE SWMI |
$1,040.40
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,913.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,620.59
|
| Rate for Payer: Priority Health Medicare |
$1,040.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,538.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,040.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.61
|
| Rate for Payer: VA VA |
$1,040.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,275.68 |
| Max. Negotiated Rate |
$6,309.41 |
| Rate for Payer: Aetna Commercial |
$5,958.89
|
| Rate for Payer: BCBS Trust/PPO |
$5,417.68
|
| Rate for Payer: BCN Commercial |
$5,417.68
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$6,029.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,608.37
|
| Rate for Payer: Healthscope Commercial |
$6,309.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,257.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: PHP Commercial |
$5,958.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,099.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,275.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,169.20
|
| Rate for Payer: UHC Core |
$5,853.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,257.84
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,010.46
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,664.98 |
| Max. Negotiated Rate |
$6,309.41 |
| Rate for Payer: Aetna Commercial |
$5,958.89
|
| Rate for Payer: Aetna Medicare |
$1,822.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,190.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,190.77
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$1,752.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,450.63
|
| Rate for Payer: BCN Commercial |
$5,450.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,752.62
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cash Price |
$5,608.37
|
| Rate for Payer: Cofinity Commercial |
$6,029.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,608.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,752.62
|
| Rate for Payer: Healthscope Commercial |
$6,309.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,257.84
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,840.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,015.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,958.89
|
| Rate for Payer: PACE Senior Care Partners |
$1,664.98
|
| Rate for Payer: PACE SWMI |
$1,752.62
|
| Rate for Payer: PHP Commercial |
$5,958.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,752.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,907.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,099.10
|
| Rate for Payer: Priority Health Medicare |
$1,752.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,275.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,752.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,169.20
|
| Rate for Payer: UHC Core |
$5,853.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,752.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,805.19
|
| Rate for Payer: VA VA |
$1,752.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,257.84
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$596.76 |
| Max. Negotiated Rate |
$2,261.42 |
| Rate for Payer: Aetna Commercial |
$2,135.79
|
| Rate for Payer: Aetna Medicare |
$653.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$785.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$785.22
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$628.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.62
|
| Rate for Payer: BCN Commercial |
$1,953.62
|
| Rate for Payer: BCN Medicare Advantage |
$628.17
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$2,160.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,010.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.17
|
| Rate for Payer: Healthscope Commercial |
$2,261.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,884.52
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$659.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$722.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: PACE Senior Care Partners |
$596.76
|
| Rate for Payer: PACE SWMI |
$628.17
|
| Rate for Payer: PHP Commercial |
$2,135.79
|
| Rate for Payer: PHP Medicare Advantage |
$628.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,186.04
|
| Rate for Payer: Priority Health Medicare |
$628.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,532.49
|
| Rate for Payer: Railroad Medicare Medicare |
$628.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,211.17
|
| Rate for Payer: UHC Core |
$2,098.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.17
|
| Rate for Payer: UHC Medicare Advantage |
$647.02
|
| Rate for Payer: VA VA |
$628.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,884.52
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,512.69
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,532.49 |
| Max. Negotiated Rate |
$2,261.42 |
| Rate for Payer: Aetna Commercial |
$2,135.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,941.81
|
| Rate for Payer: BCN Commercial |
$1,941.81
|
| Rate for Payer: Cash Price |
$2,010.15
|
| Rate for Payer: Cofinity Commercial |
$2,160.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,010.15
|
| Rate for Payer: Healthscope Commercial |
$2,261.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,884.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,135.79
|
| Rate for Payer: PHP Commercial |
$2,135.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,186.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,532.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,211.17
|
| Rate for Payer: UHC Core |
$2,098.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,884.52
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,422.46 |
| Max. Negotiated Rate |
$3,574.71 |
| Rate for Payer: Aetna Commercial |
$3,376.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,069.48
|
| Rate for Payer: BCN Commercial |
$3,069.48
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$3,415.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.52
|
| Rate for Payer: Healthscope Commercial |
$3,574.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,978.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: PHP Commercial |
$3,376.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,455.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,422.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,495.27
|
| Rate for Payer: UHC Core |
$3,316.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,978.92
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$3,971.90
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$943.33 |
| Max. Negotiated Rate |
$3,574.71 |
| Rate for Payer: Aetna Commercial |
$3,376.12
|
| Rate for Payer: Aetna Medicare |
$1,032.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,241.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,241.22
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$992.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,088.15
|
| Rate for Payer: BCN Commercial |
$3,088.15
|
| Rate for Payer: BCN Medicare Advantage |
$992.98
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cash Price |
$3,177.52
|
| Rate for Payer: Cofinity Commercial |
$3,415.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.98
|
| Rate for Payer: Healthscope Commercial |
$3,574.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,978.92
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,042.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,376.12
|
| Rate for Payer: PACE Senior Care Partners |
$943.33
|
| Rate for Payer: PACE SWMI |
$992.98
|
| Rate for Payer: PHP Commercial |
$3,376.12
|
| Rate for Payer: PHP Medicare Advantage |
$992.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,455.55
|
| Rate for Payer: Priority Health Medicare |
$992.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,422.46
|
| Rate for Payer: Railroad Medicare Medicare |
$992.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,495.27
|
| Rate for Payer: UHC Core |
$3,316.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,022.76
|
| Rate for Payer: VA VA |
$992.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,978.92
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,800.39 |
| Max. Negotiated Rate |
$2,656.75 |
| Rate for Payer: Aetna Commercial |
$2,509.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,281.26
|
| Rate for Payer: BCN Commercial |
$2,281.26
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,538.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,361.55
|
| Rate for Payer: Healthscope Commercial |
$2,656.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,213.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: PHP Commercial |
$2,509.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,568.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,800.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,597.71
|
| Rate for Payer: UHC Core |
$2,464.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,213.96
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$2,951.94
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$701.09 |
| Max. Negotiated Rate |
$2,656.75 |
| Rate for Payer: Aetna Commercial |
$2,509.15
|
| Rate for Payer: Aetna Medicare |
$767.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$922.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$922.48
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$737.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,295.13
|
| Rate for Payer: BCN Commercial |
$2,295.13
|
| Rate for Payer: BCN Medicare Advantage |
$737.98
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cash Price |
$2,361.55
|
| Rate for Payer: Cofinity Commercial |
$2,538.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,361.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.98
|
| Rate for Payer: Healthscope Commercial |
$2,656.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,213.96
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$774.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$848.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,509.15
|
| Rate for Payer: PACE Senior Care Partners |
$701.09
|
| Rate for Payer: PACE SWMI |
$737.98
|
| Rate for Payer: PHP Commercial |
$2,509.15
|
| Rate for Payer: PHP Medicare Advantage |
$737.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,066.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,568.19
|
| Rate for Payer: Priority Health Medicare |
$737.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,800.39
|
| Rate for Payer: Railroad Medicare Medicare |
$737.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,597.71
|
| Rate for Payer: UHC Core |
$2,464.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$737.98
|
| Rate for Payer: UHC Medicare Advantage |
$760.12
|
| Rate for Payer: VA VA |
$737.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,213.96
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$911.29 |
| Max. Negotiated Rate |
$1,344.75 |
| Rate for Payer: Aetna Commercial |
$1,270.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,154.69
|
| Rate for Payer: BCN Commercial |
$1,154.69
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,284.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,195.34
|
| Rate for Payer: Healthscope Commercial |
$1,344.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,120.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: PHP Commercial |
$1,270.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,299.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$911.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,314.87
|
| Rate for Payer: UHC Core |
$1,247.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,120.63
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,494.17
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$284.77 |
| Max. Negotiated Rate |
$1,344.75 |
| Rate for Payer: Aetna Commercial |
$1,270.04
|
| Rate for Payer: Aetna Medicare |
$388.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.93
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$373.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.72
|
| Rate for Payer: BCN Commercial |
$1,161.72
|
| Rate for Payer: BCN Medicare Advantage |
$373.54
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cash Price |
$1,195.34
|
| Rate for Payer: Cofinity Commercial |
$1,284.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,195.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.54
|
| Rate for Payer: Healthscope Commercial |
$1,344.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,120.63
|
| Rate for Payer: Mclaren Medicaid |
$284.77
|
| Rate for Payer: Meridian Medicaid |
$299.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$392.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,270.04
|
| Rate for Payer: PACE Senior Care Partners |
$354.87
|
| Rate for Payer: PACE SWMI |
$373.54
|
| Rate for Payer: PHP Commercial |
$1,270.04
|
| Rate for Payer: PHP Medicare Advantage |
$373.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,299.93
|
| Rate for Payer: Priority Health Medicare |
$373.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$911.29
|
| Rate for Payer: Railroad Medicare Medicare |
$373.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,314.87
|
| Rate for Payer: UHC Core |
$1,247.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.54
|
| Rate for Payer: UHC Medicare Advantage |
$384.75
|
| Rate for Payer: VA VA |
$373.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,120.63
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$539.47
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$329.02 |
| Max. Negotiated Rate |
$485.52 |
| Rate for Payer: Aetna Commercial |
$458.55
|
| Rate for Payer: BCBS Trust/PPO |
$416.90
|
| Rate for Payer: BCN Commercial |
$416.90
|
| Rate for Payer: Cash Price |
$431.58
|
| Rate for Payer: Cofinity Commercial |
$463.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.58
|
| Rate for Payer: Healthscope Commercial |
$485.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.55
|
| Rate for Payer: PHP Commercial |
$458.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.73
|
| Rate for Payer: UHC Core |
$450.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.60
|
|
