|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$17.34
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
IP
|
$217.45
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.62 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna Commercial |
$184.83
|
| Rate for Payer: BCBS Trust/PPO |
$168.05
|
| Rate for Payer: BCN Commercial |
$168.05
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cofinity Commercial |
$187.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.96
|
| Rate for Payer: Healthscope Commercial |
$195.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.83
|
| Rate for Payer: PHP Commercial |
$184.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.36
|
| Rate for Payer: UHC Core |
$181.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.09
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
OP
|
$217.45
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna Commercial |
$184.83
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.95
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$54.36
|
| Rate for Payer: BCBS Trust/PPO |
$169.07
|
| Rate for Payer: BCCCP Commercial |
$163.43
|
| Rate for Payer: BCN Commercial |
$169.07
|
| Rate for Payer: BCN Medicare Advantage |
$54.36
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cofinity Commercial |
$187.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.36
|
| Rate for Payer: Healthscope Commercial |
$195.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.09
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.83
|
| Rate for Payer: PACE Senior Care Partners |
$51.64
|
| Rate for Payer: PACE SWMI |
$54.36
|
| Rate for Payer: PHP Commercial |
$184.83
|
| Rate for Payer: PHP Medicare Advantage |
$54.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.18
|
| Rate for Payer: Priority Health Medicare |
$54.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.62
|
| Rate for Payer: Railroad Medicare Medicare |
$54.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.36
|
| Rate for Payer: UHC Core |
$181.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.36
|
| Rate for Payer: UHC Medicare Advantage |
$55.99
|
| Rate for Payer: VA VA |
$54.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.09
|
|
|
HC FOLATE SERUM
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$11.39
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$10.85
|
| Rate for Payer: Meridian Medicaid |
$11.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FOLATE SERUM
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
OP
|
$490.51
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.50 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna Medicare |
$127.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.28
|
| Rate for Payer: BCBS Complete |
$196.20
|
| Rate for Payer: BCBS MAPPO |
$122.63
|
| Rate for Payer: BCBS Trust/PPO |
$381.37
|
| Rate for Payer: BCN Commercial |
$381.37
|
| Rate for Payer: BCN Medicare Advantage |
$122.63
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.63
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PACE Senior Care Partners |
$116.50
|
| Rate for Payer: PACE SWMI |
$122.63
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: PHP Medicare Advantage |
$122.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.74
|
| Rate for Payer: Priority Health Medicare |
$122.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.16
|
| Rate for Payer: Railroad Medicare Medicare |
$122.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.65
|
| Rate for Payer: UHC Core |
$409.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.63
|
| Rate for Payer: UHC Medicare Advantage |
$126.31
|
| Rate for Payer: VA VA |
$122.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
IP
|
$490.51
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$299.16 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: BCBS Trust/PPO |
$379.07
|
| Rate for Payer: BCN Commercial |
$379.07
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.65
|
| Rate for Payer: UHC Core |
$409.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.08
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$16.06
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$49.96
|
| Rate for Payer: BCN Medicare Advantage |
$16.06
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Mclaren Medicaid |
$13.71
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$15.26
|
| Rate for Payer: PACE SWMI |
$16.06
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: PHP Medicare Advantage |
$16.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.19
|
| Rate for Payer: Railroad Medicare Medicare |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.55
|
| Rate for Payer: UHC Core |
$53.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.06
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: BCBS Trust/PPO |
$49.66
|
| Rate for Payer: BCN Commercial |
$49.66
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.55
|
| Rate for Payer: UHC Core |
$53.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
IP
|
$637.50
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$388.81 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$541.88
|
| Rate for Payer: BCBS Trust/PPO |
$492.66
|
| Rate for Payer: BCN Commercial |
$492.66
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cofinity Commercial |
$548.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.00
|
| Rate for Payer: Healthscope Commercial |
$573.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.88
|
| Rate for Payer: PHP Commercial |
$541.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.00
|
| Rate for Payer: UHC Core |
$532.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.12
|
|
|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
OP
|
$637.50
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$151.41 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$541.88
|
| Rate for Payer: Aetna Medicare |
$165.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$199.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$199.22
|
| Rate for Payer: BCBS Complete |
$255.00
|
| Rate for Payer: BCBS MAPPO |
$159.38
|
| Rate for Payer: BCBS Trust/PPO |
$495.66
|
| Rate for Payer: BCN Commercial |
$495.66
|
| Rate for Payer: BCN Medicare Advantage |
$159.38
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cofinity Commercial |
$548.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.38
|
| Rate for Payer: Healthscope Commercial |
$573.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.88
|
| Rate for Payer: PACE Senior Care Partners |
$151.41
|
| Rate for Payer: PACE SWMI |
$159.38
|
| Rate for Payer: PHP Commercial |
$541.88
|
| Rate for Payer: PHP Medicare Advantage |
$159.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.62
|
| Rate for Payer: Priority Health Medicare |
$159.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.81
|
| Rate for Payer: Railroad Medicare Medicare |
$159.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.00
|
| Rate for Payer: UHC Core |
$532.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.38
|
| Rate for Payer: UHC Medicare Advantage |
$164.16
|
| Rate for Payer: VA VA |
$159.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.12
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$450.54
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$274.78 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: BCBS Trust/PPO |
$348.18
|
| Rate for Payer: BCN Commercial |
$348.18
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$387.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Healthscope Commercial |
$405.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PHP Commercial |
$382.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.48
|
| Rate for Payer: UHC Core |
$376.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$450.54
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.00 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: Aetna Medicare |
$117.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.79
|
| Rate for Payer: BCBS Complete |
$180.22
|
| Rate for Payer: BCBS MAPPO |
$112.64
|
| Rate for Payer: BCBS Trust/PPO |
$350.29
|
| Rate for Payer: BCN Commercial |
$350.29
|
| Rate for Payer: BCN Medicare Advantage |
$112.64
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$387.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.64
|
| Rate for Payer: Healthscope Commercial |
$405.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PACE Senior Care Partners |
$107.00
|
| Rate for Payer: PACE SWMI |
$112.64
|
| Rate for Payer: PHP Commercial |
$382.96
|
| Rate for Payer: PHP Medicare Advantage |
$112.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.97
|
| Rate for Payer: Priority Health Medicare |
$112.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.78
|
| Rate for Payer: Railroad Medicare Medicare |
$112.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.48
|
| Rate for Payer: UHC Core |
$376.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.64
|
| Rate for Payer: UHC Medicare Advantage |
$116.01
|
| Rate for Payer: VA VA |
$112.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
OP
|
$212.50
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.47 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna Commercial |
$180.62
|
| Rate for Payer: Aetna Medicare |
$55.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.41
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$53.12
|
| Rate for Payer: BCBS Trust/PPO |
$165.22
|
| Rate for Payer: BCN Commercial |
$165.22
|
| Rate for Payer: BCN Medicare Advantage |
$53.12
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cofinity Commercial |
$182.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.12
|
| Rate for Payer: Healthscope Commercial |
$191.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.38
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.62
|
| Rate for Payer: PACE Senior Care Partners |
$50.47
|
| Rate for Payer: PACE SWMI |
$53.12
|
| Rate for Payer: PHP Commercial |
$180.62
|
| Rate for Payer: PHP Medicare Advantage |
$53.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.88
|
| Rate for Payer: Priority Health Medicare |
$53.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.60
|
| Rate for Payer: Railroad Medicare Medicare |
$53.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.00
|
| Rate for Payer: UHC Core |
$177.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.12
|
| Rate for Payer: UHC Medicare Advantage |
$54.72
|
| Rate for Payer: VA VA |
$53.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.38
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$212.50
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.60 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna Commercial |
$180.62
|
| Rate for Payer: BCBS Trust/PPO |
$164.22
|
| Rate for Payer: BCN Commercial |
$164.22
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cofinity Commercial |
$182.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.00
|
| Rate for Payer: Healthscope Commercial |
$191.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.62
|
| Rate for Payer: PHP Commercial |
$180.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.00
|
| Rate for Payer: UHC Core |
$177.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.38
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.84 |
| Max. Negotiated Rate |
$1,116.73 |
| 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 |
$1,116.73
|
| 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 |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| 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 |
$1,063.55
|
| 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 FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
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 FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$227.11
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.51 |
| Max. Negotiated Rate |
$204.40 |
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: BCBS Trust/PPO |
$175.51
|
| Rate for Payer: BCN Commercial |
$175.51
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.04
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.86
|
| Rate for Payer: UHC Core |
$189.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$227.11
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.94 |
| Max. Negotiated Rate |
$204.40 |
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: Aetna Medicare |
$59.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.97
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$56.78
|
| Rate for Payer: BCBS Trust/PPO |
$176.58
|
| Rate for Payer: BCN Commercial |
$176.58
|
| Rate for Payer: BCN Medicare Advantage |
$56.78
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.04
|
| Rate for Payer: PACE Senior Care Partners |
$53.94
|
| Rate for Payer: PACE SWMI |
$56.78
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: PHP Medicare Advantage |
$56.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.59
|
| Rate for Payer: Priority Health Medicare |
$56.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.51
|
| Rate for Payer: Railroad Medicare Medicare |
$56.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.86
|
| Rate for Payer: UHC Core |
$189.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.78
|
| Rate for Payer: UHC Medicare Advantage |
$58.48
|
| Rate for Payer: VA VA |
$56.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$3,820.61
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.39 |
| Max. Negotiated Rate |
$3,438.55 |
| Rate for Payer: Aetna Commercial |
$3,247.52
|
| Rate for Payer: Aetna Medicare |
$993.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,193.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,193.94
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$955.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,970.52
|
| Rate for Payer: BCN Commercial |
$2,970.52
|
| Rate for Payer: BCN Medicare Advantage |
$955.15
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cofinity Commercial |
$3,285.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.15
|
| Rate for Payer: Healthscope Commercial |
$3,438.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.46
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,002.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,098.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,247.52
|
| Rate for Payer: PACE Senior Care Partners |
$907.39
|
| Rate for Payer: PACE SWMI |
$955.15
|
| Rate for Payer: PHP Commercial |
$3,247.52
|
| Rate for Payer: PHP Medicare Advantage |
$955.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,674.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,323.93
|
| Rate for Payer: Priority Health Medicare |
$955.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,330.19
|
| Rate for Payer: Railroad Medicare Medicare |
$955.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,362.14
|
| Rate for Payer: UHC Core |
$3,190.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$955.15
|
| Rate for Payer: UHC Medicare Advantage |
$983.81
|
| Rate for Payer: VA VA |
$955.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.46
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$3,820.61
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,330.19 |
| Max. Negotiated Rate |
$3,438.55 |
| Rate for Payer: Aetna Commercial |
$3,247.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,952.57
|
| Rate for Payer: BCN Commercial |
$2,952.57
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cofinity Commercial |
$3,285.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.49
|
| Rate for Payer: Healthscope Commercial |
$3,438.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,247.52
|
| Rate for Payer: PHP Commercial |
$3,247.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,674.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,323.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,330.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,362.14
|
| Rate for Payer: UHC Core |
$3,190.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.46
|
|
