|
HC BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
76100462
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.04 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$358.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.31
|
| Rate for Payer: BCBS Complete |
$378.80
|
| Rate for Payer: BCBS MAPPO |
$344.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.03
|
| Rate for Payer: BCN Commercial |
$1,070.62
|
| Rate for Payer: BCN Medicare Advantage |
$344.25
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.25
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Mclaren Medicaid |
$360.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.46
|
| Rate for Payer: Meridian Medicaid |
$378.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Senior Care Partners |
$327.04
|
| Rate for Payer: PACE SWMI |
$344.25
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$344.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Medicare |
$347.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: Railroad Medicare Medicare |
$344.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.25
|
| Rate for Payer: UHC Exchange |
$344.25
|
| Rate for Payer: UHC Medicare Advantage |
$344.25
|
| Rate for Payer: UHCCP Medicaid |
$360.74
|
| Rate for Payer: VA VA |
$344.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
76100462
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.05
|
| Rate for Payer: BCN Commercial |
$1,064.15
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
76100463
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,913.78 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$2,095.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,518.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,518.12
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$2,014.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,624.48
|
| Rate for Payer: BCN Commercial |
$6,265.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,913.78
|
| Rate for Payer: PACE SWMI |
$2,014.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Medicare |
$2,034.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,014.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.50
|
| Rate for Payer: UHC Exchange |
$2,014.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.50
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
76100463
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,577.75
|
| Rate for Payer: BCN Commercial |
$6,227.22
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
IP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,090.61 |
| Max. Negotiated Rate |
$1,510.07 |
| Rate for Payer: Aetna Commercial |
$1,426.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.64
|
| Rate for Payer: BCN Commercial |
$1,296.65
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,442.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Healthscope Commercial |
$1,510.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: Nomi Health Commercial |
$1,375.85
|
| Rate for Payer: PHP Commercial |
$1,426.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,459.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,124.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,476.52
|
| Rate for Payer: UHC Core |
$1,401.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.40
|
|
|
HC BIOPSY TRANSCATHETER
|
Facility
|
OP
|
$1,677.86
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
36100154
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.49 |
| Max. Negotiated Rate |
$4,021.03 |
| Rate for Payer: Aetna Commercial |
$1,426.18
|
| Rate for Payer: Aetna Medicare |
$436.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$524.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$524.33
|
| Rate for Payer: BCBS Complete |
$4,021.03
|
| Rate for Payer: BCBS MAPPO |
$419.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.37
|
| Rate for Payer: BCN Commercial |
$1,304.54
|
| Rate for Payer: BCN Medicare Advantage |
$419.46
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cash Price |
$1,342.29
|
| Rate for Payer: Cofinity Commercial |
$1,442.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.46
|
| Rate for Payer: Healthscope Commercial |
$1,510.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.40
|
| Rate for Payer: Mclaren Medicaid |
$3,829.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.44
|
| Rate for Payer: Meridian Medicaid |
$4,021.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$482.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.18
|
| Rate for Payer: Nomi Health Commercial |
$1,375.85
|
| Rate for Payer: PACE Senior Care Partners |
$398.49
|
| Rate for Payer: PACE SWMI |
$419.46
|
| Rate for Payer: PHP Commercial |
$1,426.18
|
| Rate for Payer: PHP Medicare Advantage |
$419.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,829.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,459.74
|
| Rate for Payer: Priority Health Medicare |
$423.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,124.17
|
| Rate for Payer: Railroad Medicare Medicare |
$419.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,476.52
|
| Rate for Payer: UHC Core |
$1,401.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.46
|
| Rate for Payer: UHC Exchange |
$419.46
|
| Rate for Payer: UHC Medicare Advantage |
$419.46
|
| Rate for Payer: UHCCP Medicaid |
$3,829.30
|
| Rate for Payer: VA VA |
$419.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.40
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.04 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$358.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.31
|
| Rate for Payer: BCBS Complete |
$378.80
|
| Rate for Payer: BCBS MAPPO |
$344.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.03
|
| Rate for Payer: BCN Commercial |
$1,070.62
|
| Rate for Payer: BCN Medicare Advantage |
$344.25
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.25
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Mclaren Medicaid |
$360.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.46
|
| Rate for Payer: Meridian Medicaid |
$378.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Senior Care Partners |
$327.04
|
| Rate for Payer: PACE SWMI |
$344.25
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$344.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Medicare |
$347.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: Railroad Medicare Medicare |
$344.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.25
|
| Rate for Payer: UHC Exchange |
$344.25
|
| Rate for Payer: UHC Medicare Advantage |
$344.25
|
| Rate for Payer: UHCCP Medicaid |
$360.74
|
| Rate for Payer: VA VA |
$344.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC BIOPSY VESTIBULE MOUTH
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
76100460
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.05
|
| Rate for Payer: BCN Commercial |
$1,064.15
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
IP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$566.07 |
| Max. Negotiated Rate |
$783.79 |
| Rate for Payer: Aetna Commercial |
$740.25
|
| Rate for Payer: BCBS Trust/PPO |
$710.90
|
| Rate for Payer: BCN Commercial |
$673.02
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Healthscope Commercial |
$783.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.25
|
| Rate for Payer: Nomi Health Commercial |
$714.12
|
| Rate for Payer: PHP Commercial |
$740.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.07
|
| Rate for Payer: Priority Health HMO/PPO |
$757.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.37
|
| Rate for Payer: UHC Core |
$727.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.16
|
|
|
HC BIOPSY VULVA PERINEUM ONE LESN
|
Facility
|
OP
|
$870.88
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
76100201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$206.83 |
| Max. Negotiated Rate |
$783.79 |
| Rate for Payer: Aetna Commercial |
$740.25
|
| Rate for Payer: Aetna Medicare |
$226.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.15
|
| Rate for Payer: BCBS Complete |
$647.70
|
| Rate for Payer: BCBS MAPPO |
$217.72
|
| Rate for Payer: BCBS Trust/PPO |
$715.95
|
| Rate for Payer: BCN Commercial |
$677.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.72
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cash Price |
$696.70
|
| Rate for Payer: Cofinity Commercial |
$748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$696.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.72
|
| Rate for Payer: Healthscope Commercial |
$783.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.16
|
| Rate for Payer: Mclaren Medicaid |
$616.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.61
|
| Rate for Payer: Meridian Medicaid |
$647.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.25
|
| Rate for Payer: Nomi Health Commercial |
$714.12
|
| Rate for Payer: PACE Senior Care Partners |
$206.83
|
| Rate for Payer: PACE SWMI |
$217.72
|
| Rate for Payer: PHP Commercial |
$740.25
|
| Rate for Payer: PHP Medicare Advantage |
$217.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.07
|
| Rate for Payer: Priority Health HMO/PPO |
$757.67
|
| Rate for Payer: Priority Health Medicare |
$219.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.49
|
| Rate for Payer: Railroad Medicare Medicare |
$217.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$766.37
|
| Rate for Payer: UHC Core |
$727.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.72
|
| Rate for Payer: UHC Exchange |
$217.72
|
| Rate for Payer: UHC Medicare Advantage |
$217.72
|
| Rate for Payer: UHCCP Medicaid |
$616.81
|
| Rate for Payer: VA VA |
$217.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.16
|
|
|
HC BIOTINIDASE
|
Facility
|
IP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.79
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO |
$59.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BIOTINIDASE
|
Facility
|
OP
|
$68.34
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare |
$17.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.36
|
| Rate for Payer: BCBS Complete |
$12.81
|
| Rate for Payer: BCBS MAPPO |
$17.08
|
| Rate for Payer: BCBS Trust/PPO |
$56.18
|
| Rate for Payer: BCN Commercial |
$53.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.08
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.08
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Mclaren Medicaid |
$12.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.94
|
| Rate for Payer: Meridian Medicaid |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE Senior Care Partners |
$16.23
|
| Rate for Payer: PACE SWMI |
$17.08
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO |
$59.46
|
| Rate for Payer: Priority Health Medicare |
$17.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: Railroad Medicare Medicare |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.08
|
| Rate for Payer: UHC Exchange |
$17.08
|
| Rate for Payer: UHC Medicare Advantage |
$17.08
|
| Rate for Payer: UHCCP Medicaid |
$12.20
|
| Rate for Payer: VA VA |
$17.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,287.53 |
| Max. Negotiated Rate |
$8,668.54 |
| Rate for Payer: Aetna Commercial |
$8,186.95
|
| Rate for Payer: Aetna Medicare |
$2,504.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,009.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,009.91
|
| Rate for Payer: BCBS Complete |
$3,852.68
|
| Rate for Payer: BCBS MAPPO |
$2,407.93
|
| Rate for Payer: BCBS Trust/PPO |
$7,918.23
|
| Rate for Payer: BCN Commercial |
$7,488.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,407.93
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$8,283.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,407.93
|
| Rate for Payer: Healthscope Commercial |
$8,668.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,223.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,528.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,769.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: Nomi Health Commercial |
$7,898.00
|
| Rate for Payer: PACE Senior Care Partners |
$2,287.53
|
| Rate for Payer: PACE SWMI |
$2,407.93
|
| Rate for Payer: PHP Commercial |
$8,186.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,407.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: Priority Health HMO/PPO |
$8,379.59
|
| Rate for Payer: Priority Health Medicare |
$2,432.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,453.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,407.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,475.90
|
| Rate for Payer: UHC Core |
$8,042.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,407.93
|
| Rate for Payer: UHC Exchange |
$2,407.93
|
| Rate for Payer: UHC Medicare Advantage |
$2,407.93
|
| Rate for Payer: VA VA |
$2,407.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,223.78
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,631.71
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,260.61 |
| Max. Negotiated Rate |
$8,668.54 |
| Rate for Payer: Aetna Commercial |
$8,186.95
|
| Rate for Payer: BCBS Trust/PPO |
$7,862.36
|
| Rate for Payer: BCN Commercial |
$7,443.39
|
| Rate for Payer: Cash Price |
$7,705.37
|
| Rate for Payer: Cofinity Commercial |
$8,283.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,705.37
|
| Rate for Payer: Healthscope Commercial |
$8,668.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,223.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,186.95
|
| Rate for Payer: Nomi Health Commercial |
$7,898.00
|
| Rate for Payer: PHP Commercial |
$8,186.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,260.61
|
| Rate for Payer: Priority Health HMO/PPO |
$8,379.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,453.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,475.90
|
| Rate for Payer: UHC Core |
$8,042.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,223.78
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.27 |
| Max. Negotiated Rate |
$1,581.23 |
| Rate for Payer: Aetna Commercial |
$1,493.38
|
| Rate for Payer: Aetna Medicare |
$456.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.04
|
| Rate for Payer: BCBS Complete |
$702.77
|
| Rate for Payer: BCBS MAPPO |
$439.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.36
|
| Rate for Payer: BCN Commercial |
$1,366.01
|
| Rate for Payer: BCN Medicare Advantage |
$439.23
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,510.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.23
|
| Rate for Payer: Healthscope Commercial |
$1,581.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: Nomi Health Commercial |
$1,440.67
|
| Rate for Payer: PACE Senior Care Partners |
$417.27
|
| Rate for Payer: PACE SWMI |
$439.23
|
| Rate for Payer: PHP Commercial |
$1,493.38
|
| Rate for Payer: PHP Medicare Advantage |
$439.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.52
|
| Rate for Payer: Priority Health Medicare |
$443.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.14
|
| Rate for Payer: Railroad Medicare Medicare |
$439.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.09
|
| Rate for Payer: UHC Core |
$1,467.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.23
|
| Rate for Payer: UHC Exchange |
$439.23
|
| Rate for Payer: UHC Medicare Advantage |
$439.23
|
| Rate for Payer: VA VA |
$439.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.69
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,756.92
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.00 |
| Max. Negotiated Rate |
$1,581.23 |
| Rate for Payer: Aetna Commercial |
$1,493.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.17
|
| Rate for Payer: BCN Commercial |
$1,357.75
|
| Rate for Payer: Cash Price |
$1,405.54
|
| Rate for Payer: Cofinity Commercial |
$1,510.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.54
|
| Rate for Payer: Healthscope Commercial |
$1,581.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.38
|
| Rate for Payer: Nomi Health Commercial |
$1,440.67
|
| Rate for Payer: PHP Commercial |
$1,493.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.00
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.09
|
| Rate for Payer: UHC Core |
$1,467.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.69
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$144.08 |
| Max. Negotiated Rate |
$787.60 |
| Rate for Payer: Aetna Commercial |
$743.84
|
| Rate for Payer: Aetna Medicare |
$227.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.47
|
| Rate for Payer: BCBS Complete |
$151.29
|
| Rate for Payer: BCBS MAPPO |
$218.78
|
| Rate for Payer: BCBS Trust/PPO |
$719.43
|
| Rate for Payer: BCN Commercial |
$680.40
|
| Rate for Payer: BCN Medicare Advantage |
$218.78
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.78
|
| Rate for Payer: Healthscope Commercial |
$787.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.33
|
| Rate for Payer: Mclaren Medicaid |
$144.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.72
|
| Rate for Payer: Meridian Medicaid |
$151.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: Nomi Health Commercial |
$717.59
|
| Rate for Payer: PACE Senior Care Partners |
$207.84
|
| Rate for Payer: PACE SWMI |
$218.78
|
| Rate for Payer: PHP Commercial |
$743.84
|
| Rate for Payer: PHP Medicare Advantage |
$218.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: Priority Health HMO/PPO |
$761.35
|
| Rate for Payer: Priority Health Medicare |
$220.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.32
|
| Rate for Payer: Railroad Medicare Medicare |
$218.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.10
|
| Rate for Payer: UHC Core |
$730.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.78
|
| Rate for Payer: UHC Exchange |
$218.78
|
| Rate for Payer: UHC Medicare Advantage |
$218.78
|
| Rate for Payer: UHCCP Medicaid |
$144.08
|
| Rate for Payer: VA VA |
$218.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.33
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$875.11
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$568.82 |
| Max. Negotiated Rate |
$787.60 |
| Rate for Payer: Aetna Commercial |
$743.84
|
| Rate for Payer: BCBS Trust/PPO |
$714.35
|
| Rate for Payer: BCN Commercial |
$676.29
|
| Rate for Payer: Cash Price |
$700.09
|
| Rate for Payer: Cofinity Commercial |
$752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$700.09
|
| Rate for Payer: Healthscope Commercial |
$787.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.84
|
| Rate for Payer: Nomi Health Commercial |
$717.59
|
| Rate for Payer: PHP Commercial |
$743.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.82
|
| Rate for Payer: Priority Health HMO/PPO |
$761.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.10
|
| Rate for Payer: UHC Core |
$730.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.33
|
|
|
HC BIRCH IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,325.15 |
| Max. Negotiated Rate |
$1,834.82 |
| Rate for Payer: Aetna Commercial |
$1,732.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,664.18
|
| Rate for Payer: BCN Commercial |
$1,575.50
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,753.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Healthscope Commercial |
$1,834.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,529.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: Nomi Health Commercial |
$1,671.73
|
| Rate for Payer: PHP Commercial |
$1,732.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,773.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,365.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.05
|
| Rate for Payer: UHC Core |
$1,702.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,529.02
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,038.69
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$484.19 |
| Max. Negotiated Rate |
$1,834.82 |
| Rate for Payer: Aetna Commercial |
$1,732.89
|
| Rate for Payer: Aetna Medicare |
$530.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$637.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$637.09
|
| Rate for Payer: BCBS Complete |
$815.48
|
| Rate for Payer: BCBS MAPPO |
$509.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.01
|
| Rate for Payer: BCN Commercial |
$1,585.08
|
| Rate for Payer: BCN Medicare Advantage |
$509.67
|
| Rate for Payer: Cash Price |
$1,630.95
|
| Rate for Payer: Cofinity Commercial |
$1,753.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,630.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.67
|
| Rate for Payer: Healthscope Commercial |
$1,834.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,529.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$586.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,732.89
|
| Rate for Payer: Nomi Health Commercial |
$1,671.73
|
| Rate for Payer: PACE Senior Care Partners |
$484.19
|
| Rate for Payer: PACE SWMI |
$509.67
|
| Rate for Payer: PHP Commercial |
$1,732.89
|
| Rate for Payer: PHP Medicare Advantage |
$509.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,325.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,773.66
|
| Rate for Payer: Priority Health Medicare |
$514.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,365.92
|
| Rate for Payer: Railroad Medicare Medicare |
$509.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,794.05
|
| Rate for Payer: UHC Core |
$1,702.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.67
|
| Rate for Payer: UHC Exchange |
$509.67
|
| Rate for Payer: UHC Medicare Advantage |
$509.67
|
| Rate for Payer: VA VA |
$509.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,529.02
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,634.90 |
| Max. Negotiated Rate |
$25,142.78 |
| Rate for Payer: Aetna Commercial |
$23,745.96
|
| Rate for Payer: Aetna Medicare |
$7,263.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,730.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,730.13
|
| Rate for Payer: BCBS Complete |
$11,174.57
|
| Rate for Payer: BCBS MAPPO |
$6,984.10
|
| Rate for Payer: BCBS Trust/PPO |
$22,966.53
|
| Rate for Payer: BCN Commercial |
$21,720.57
|
| Rate for Payer: BCN Medicare Advantage |
$6,984.10
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$24,025.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,984.10
|
| Rate for Payer: Healthscope Commercial |
$25,142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,952.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,333.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,031.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: Nomi Health Commercial |
$22,907.86
|
| Rate for Payer: PACE Senior Care Partners |
$6,634.90
|
| Rate for Payer: PACE SWMI |
$6,984.10
|
| Rate for Payer: PHP Commercial |
$23,745.96
|
| Rate for Payer: PHP Medicare Advantage |
$6,984.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: Priority Health HMO/PPO |
$24,304.69
|
| Rate for Payer: Priority Health Medicare |
$7,053.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,717.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6,984.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,584.05
|
| Rate for Payer: UHC Core |
$23,326.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,984.10
|
| Rate for Payer: UHC Exchange |
$6,984.10
|
| Rate for Payer: UHC Medicare Advantage |
$6,984.10
|
| Rate for Payer: VA VA |
$6,984.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,952.32
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,936.42
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,158.67 |
| Max. Negotiated Rate |
$25,142.78 |
| Rate for Payer: Aetna Commercial |
$23,745.96
|
| Rate for Payer: BCBS Trust/PPO |
$22,804.50
|
| Rate for Payer: BCN Commercial |
$21,589.27
|
| Rate for Payer: Cash Price |
$22,349.14
|
| Rate for Payer: Cofinity Commercial |
$24,025.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,349.14
|
| Rate for Payer: Healthscope Commercial |
$25,142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,952.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,745.96
|
| Rate for Payer: Nomi Health Commercial |
$22,907.86
|
| Rate for Payer: PHP Commercial |
$23,745.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,158.67
|
| Rate for Payer: Priority Health HMO/PPO |
$24,304.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,717.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,584.05
|
| Rate for Payer: UHC Core |
$23,326.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,952.32
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$73.71 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: BCBS Trust/PPO |
$92.57
|
| Rate for Payer: BCN Commercial |
$87.64
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$92.99
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health HMO/PPO |
$98.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.79
|
| Rate for Payer: UHC Core |
$94.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.05
|
|
