|
HC GGTP
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.47 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: BCBS Trust/PPO |
$52.55
|
| Rate for Payer: BCN Commercial |
$52.55
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC GGTP
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.25
|
| Rate for Payer: BCBS Complete |
$5.58
|
| Rate for Payer: BCBS MAPPO |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$52.87
|
| Rate for Payer: BCN Commercial |
$52.87
|
| Rate for Payer: BCN Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Mclaren Medicaid |
$5.31
|
| Rate for Payer: Meridian Medicaid |
$5.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PACE Senior Care Partners |
$16.15
|
| Rate for Payer: PACE SWMI |
$17.00
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: Railroad Medicare Medicare |
$17.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: VA VA |
$17.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,761.21
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,074.16 |
| Max. Negotiated Rate |
$1,585.09 |
| Rate for Payer: Aetna Commercial |
$1,497.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,361.06
|
| Rate for Payer: BCN Commercial |
$1,361.06
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cofinity Commercial |
$1,514.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.97
|
| Rate for Payer: Healthscope Commercial |
$1,585.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,497.03
|
| Rate for Payer: PHP Commercial |
$1,497.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.86
|
| Rate for Payer: UHC Core |
$1,470.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.91
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,761.21
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$418.29 |
| Max. Negotiated Rate |
$1,585.09 |
| Rate for Payer: Aetna Commercial |
$1,497.03
|
| Rate for Payer: Aetna Medicare |
$457.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$550.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$550.38
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$440.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.34
|
| Rate for Payer: BCN Commercial |
$1,369.34
|
| Rate for Payer: BCN Medicare Advantage |
$440.30
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cash Price |
$1,408.97
|
| Rate for Payer: Cofinity Commercial |
$1,514.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.30
|
| Rate for Payer: Healthscope Commercial |
$1,585.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.91
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,497.03
|
| Rate for Payer: PACE Senior Care Partners |
$418.29
|
| Rate for Payer: PACE SWMI |
$440.30
|
| Rate for Payer: PHP Commercial |
$1,497.03
|
| Rate for Payer: PHP Medicare Advantage |
$440.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.25
|
| Rate for Payer: Priority Health Medicare |
$440.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,074.16
|
| Rate for Payer: Railroad Medicare Medicare |
$440.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,549.86
|
| Rate for Payer: UHC Core |
$1,470.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.30
|
| Rate for Payer: UHC Medicare Advantage |
$453.51
|
| Rate for Payer: VA VA |
$440.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.91
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,775.59
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$421.70 |
| Max. Negotiated Rate |
$1,598.03 |
| Rate for Payer: Aetna Commercial |
$1,509.25
|
| Rate for Payer: Aetna Medicare |
$461.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$554.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$554.87
|
| Rate for Payer: BCBS Complete |
$710.24
|
| Rate for Payer: BCBS MAPPO |
$443.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.52
|
| Rate for Payer: BCN Commercial |
$1,380.52
|
| Rate for Payer: BCN Medicare Advantage |
$443.90
|
| Rate for Payer: Cash Price |
$1,420.47
|
| Rate for Payer: Cofinity Commercial |
$1,527.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.90
|
| Rate for Payer: Healthscope Commercial |
$1,598.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,331.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$466.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$510.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,509.25
|
| Rate for Payer: PACE Senior Care Partners |
$421.70
|
| Rate for Payer: PACE SWMI |
$443.90
|
| Rate for Payer: PHP Commercial |
$1,509.25
|
| Rate for Payer: PHP Medicare Advantage |
$443.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.76
|
| Rate for Payer: Priority Health Medicare |
$443.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,082.93
|
| Rate for Payer: Railroad Medicare Medicare |
$443.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,562.52
|
| Rate for Payer: UHC Core |
$1,482.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.90
|
| Rate for Payer: UHC Medicare Advantage |
$457.21
|
| Rate for Payer: VA VA |
$443.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,331.69
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,775.59
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,082.93 |
| Max. Negotiated Rate |
$1,598.03 |
| Rate for Payer: Aetna Commercial |
$1,509.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,372.18
|
| Rate for Payer: BCN Commercial |
$1,372.18
|
| Rate for Payer: Cash Price |
$1,420.47
|
| Rate for Payer: Cofinity Commercial |
$1,527.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.47
|
| Rate for Payer: Healthscope Commercial |
$1,598.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,331.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,509.25
|
| Rate for Payer: PHP Commercial |
$1,509.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,082.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,562.52
|
| Rate for Payer: UHC Core |
$1,482.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,331.69
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,243.08
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$758.15 |
| Max. Negotiated Rate |
$1,118.77 |
| Rate for Payer: Aetna Commercial |
$1,056.62
|
| Rate for Payer: BCBS Trust/PPO |
$960.65
|
| Rate for Payer: BCN Commercial |
$960.65
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cofinity Commercial |
$1,069.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.46
|
| Rate for Payer: Healthscope Commercial |
$1,118.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.62
|
| Rate for Payer: PHP Commercial |
$1,056.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,081.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$758.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.91
|
| Rate for Payer: UHC Core |
$1,037.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.31
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,243.08
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.12 |
| Max. Negotiated Rate |
$1,118.77 |
| Rate for Payer: Aetna Commercial |
$1,056.62
|
| Rate for Payer: Aetna Medicare |
$323.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.46
|
| Rate for Payer: BCBS Complete |
$170.23
|
| Rate for Payer: BCBS MAPPO |
$310.77
|
| Rate for Payer: BCBS Trust/PPO |
$966.49
|
| Rate for Payer: BCN Commercial |
$966.49
|
| Rate for Payer: BCN Medicare Advantage |
$310.77
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cash Price |
$994.46
|
| Rate for Payer: Cofinity Commercial |
$1,069.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.77
|
| Rate for Payer: Healthscope Commercial |
$1,118.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.31
|
| Rate for Payer: Mclaren Medicaid |
$162.12
|
| Rate for Payer: Meridian Medicaid |
$170.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.62
|
| Rate for Payer: PACE Senior Care Partners |
$295.23
|
| Rate for Payer: PACE SWMI |
$310.77
|
| Rate for Payer: PHP Commercial |
$1,056.62
|
| Rate for Payer: PHP Medicare Advantage |
$310.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,081.48
|
| Rate for Payer: Priority Health Medicare |
$310.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$758.15
|
| Rate for Payer: Railroad Medicare Medicare |
$310.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.91
|
| Rate for Payer: UHC Core |
$1,037.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.77
|
| Rate for Payer: UHC Medicare Advantage |
$320.09
|
| Rate for Payer: VA VA |
$310.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.31
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,202.46
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$285.58 |
| Max. Negotiated Rate |
$1,082.21 |
| Rate for Payer: Aetna Commercial |
$1,022.09
|
| Rate for Payer: Aetna Medicare |
$312.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.77
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$300.62
|
| Rate for Payer: BCBS Trust/PPO |
$934.91
|
| Rate for Payer: BCN Commercial |
$934.91
|
| Rate for Payer: BCN Medicare Advantage |
$300.62
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,034.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.62
|
| Rate for Payer: Healthscope Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.84
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: PACE Senior Care Partners |
$285.58
|
| Rate for Payer: PACE SWMI |
$300.62
|
| Rate for Payer: PHP Commercial |
$1,022.09
|
| Rate for Payer: PHP Medicare Advantage |
$300.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.14
|
| Rate for Payer: Priority Health Medicare |
$300.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.38
|
| Rate for Payer: Railroad Medicare Medicare |
$300.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,058.16
|
| Rate for Payer: UHC Core |
$1,004.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.62
|
| Rate for Payer: UHC Medicare Advantage |
$309.63
|
| Rate for Payer: VA VA |
$300.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.84
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,202.46
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$733.38 |
| Max. Negotiated Rate |
$1,082.21 |
| Rate for Payer: Aetna Commercial |
$1,022.09
|
| Rate for Payer: BCBS Trust/PPO |
$929.26
|
| Rate for Payer: BCN Commercial |
$929.26
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,034.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Healthscope Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: PHP Commercial |
$1,022.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,058.16
|
| Rate for Payer: UHC Core |
$1,004.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.84
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,322.71
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$314.14 |
| Max. Negotiated Rate |
$1,190.44 |
| Rate for Payer: Aetna Commercial |
$1,124.30
|
| Rate for Payer: Aetna Medicare |
$343.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$413.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$413.35
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$330.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.41
|
| Rate for Payer: BCN Commercial |
$1,028.41
|
| Rate for Payer: BCN Medicare Advantage |
$330.68
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cofinity Commercial |
$1,137.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,058.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$330.68
|
| Rate for Payer: Healthscope Commercial |
$1,190.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$992.03
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$347.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$380.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,124.30
|
| Rate for Payer: PACE Senior Care Partners |
$314.14
|
| Rate for Payer: PACE SWMI |
$330.68
|
| Rate for Payer: PHP Commercial |
$1,124.30
|
| Rate for Payer: PHP Medicare Advantage |
$330.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.76
|
| Rate for Payer: Priority Health Medicare |
$330.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.72
|
| Rate for Payer: Railroad Medicare Medicare |
$330.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.98
|
| Rate for Payer: UHC Core |
$1,104.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$330.68
|
| Rate for Payer: UHC Medicare Advantage |
$340.60
|
| Rate for Payer: VA VA |
$330.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$992.03
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,322.71
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$806.72 |
| Max. Negotiated Rate |
$1,190.44 |
| Rate for Payer: Aetna Commercial |
$1,124.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,022.19
|
| Rate for Payer: BCN Commercial |
$1,022.19
|
| Rate for Payer: Cash Price |
$1,058.17
|
| Rate for Payer: Cofinity Commercial |
$1,137.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,058.17
|
| Rate for Payer: Healthscope Commercial |
$1,190.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$992.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,124.30
|
| Rate for Payer: PHP Commercial |
$1,124.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$925.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,163.98
|
| Rate for Payer: UHC Core |
$1,104.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$992.03
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,251.48
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.28 |
| Max. Negotiated Rate |
$1,126.33 |
| Rate for Payer: Aetna Commercial |
$1,063.76
|
| Rate for Payer: BCBS Trust/PPO |
$967.14
|
| Rate for Payer: BCN Commercial |
$967.14
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cofinity Commercial |
$1,076.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,001.18
|
| Rate for Payer: Healthscope Commercial |
$1,126.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,063.76
|
| Rate for Payer: PHP Commercial |
$1,063.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$763.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.30
|
| Rate for Payer: UHC Core |
$1,044.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.61
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,251.48
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.23 |
| Max. Negotiated Rate |
$1,126.33 |
| Rate for Payer: Aetna Commercial |
$1,063.76
|
| Rate for Payer: Aetna Medicare |
$325.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$391.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$391.09
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$312.87
|
| Rate for Payer: BCBS Trust/PPO |
$973.03
|
| Rate for Payer: BCN Commercial |
$973.03
|
| Rate for Payer: BCN Medicare Advantage |
$312.87
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cash Price |
$1,001.18
|
| Rate for Payer: Cofinity Commercial |
$1,076.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,001.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$312.87
|
| Rate for Payer: Healthscope Commercial |
$1,126.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.61
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$328.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$359.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,063.76
|
| Rate for Payer: PACE Senior Care Partners |
$297.23
|
| Rate for Payer: PACE SWMI |
$312.87
|
| Rate for Payer: PHP Commercial |
$1,063.76
|
| Rate for Payer: PHP Medicare Advantage |
$312.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,088.79
|
| Rate for Payer: Priority Health Medicare |
$312.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$763.28
|
| Rate for Payer: Railroad Medicare Medicare |
$312.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,101.30
|
| Rate for Payer: UHC Core |
$1,044.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$312.87
|
| Rate for Payer: UHC Medicare Advantage |
$322.26
|
| Rate for Payer: VA VA |
$312.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.61
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$206.62 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: Aetna Medicare |
$226.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.86
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$217.49
|
| Rate for Payer: BCBS Trust/PPO |
$676.39
|
| Rate for Payer: BCN Commercial |
$676.39
|
| Rate for Payer: BCN Medicare Advantage |
$217.49
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.49
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Senior Care Partners |
$206.62
|
| Rate for Payer: PACE SWMI |
$217.49
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: PHP Medicare Advantage |
$217.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Medicare |
$217.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: Railroad Medicare Medicare |
$217.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.49
|
| Rate for Payer: UHC Medicare Advantage |
$224.01
|
| Rate for Payer: VA VA |
$217.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$530.59 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: BCBS Trust/PPO |
$672.31
|
| Rate for Payer: BCN Commercial |
$672.31
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$704.62
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$167.35 |
| Max. Negotiated Rate |
$634.16 |
| Rate for Payer: Aetna Commercial |
$598.93
|
| Rate for Payer: Aetna Medicare |
$183.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.19
|
| Rate for Payer: BCBS Complete |
$322.96
|
| Rate for Payer: BCBS MAPPO |
$176.16
|
| Rate for Payer: BCBS Trust/PPO |
$547.84
|
| Rate for Payer: BCN Commercial |
$547.84
|
| Rate for Payer: BCN Medicare Advantage |
$176.16
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cofinity Commercial |
$605.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.16
|
| Rate for Payer: Healthscope Commercial |
$634.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.46
|
| Rate for Payer: Mclaren Medicaid |
$307.58
|
| Rate for Payer: Meridian Medicaid |
$322.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$598.93
|
| Rate for Payer: PACE Senior Care Partners |
$167.35
|
| Rate for Payer: PACE SWMI |
$176.16
|
| Rate for Payer: PHP Commercial |
$598.93
|
| Rate for Payer: PHP Medicare Advantage |
$176.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.02
|
| Rate for Payer: Priority Health Medicare |
$176.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.75
|
| Rate for Payer: Railroad Medicare Medicare |
$176.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.07
|
| Rate for Payer: UHC Core |
$588.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.16
|
| Rate for Payer: UHC Medicare Advantage |
$181.44
|
| Rate for Payer: VA VA |
$176.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.46
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$704.62
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$429.75 |
| Max. Negotiated Rate |
$634.16 |
| Rate for Payer: Aetna Commercial |
$598.93
|
| Rate for Payer: BCBS Trust/PPO |
$544.53
|
| Rate for Payer: BCN Commercial |
$544.53
|
| Rate for Payer: Cash Price |
$563.70
|
| Rate for Payer: Cofinity Commercial |
$605.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.70
|
| Rate for Payer: Healthscope Commercial |
$634.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$598.93
|
| Rate for Payer: PHP Commercial |
$598.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$429.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.07
|
| Rate for Payer: UHC Core |
$588.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.46
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$206.62 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: Aetna Medicare |
$226.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.86
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$217.49
|
| Rate for Payer: BCBS Trust/PPO |
$676.39
|
| Rate for Payer: BCN Commercial |
$676.39
|
| Rate for Payer: BCN Medicare Advantage |
$217.49
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.49
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Senior Care Partners |
$206.62
|
| Rate for Payer: PACE SWMI |
$217.49
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: PHP Medicare Advantage |
$217.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Medicare |
$217.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: Railroad Medicare Medicare |
$217.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.49
|
| Rate for Payer: UHC Medicare Advantage |
$224.01
|
| Rate for Payer: VA VA |
$217.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$530.59 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: BCBS Trust/PPO |
$672.31
|
| Rate for Payer: BCN Commercial |
$672.31
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$206.62 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: Aetna Medicare |
$226.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.86
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$217.49
|
| Rate for Payer: BCBS Trust/PPO |
$676.39
|
| Rate for Payer: BCN Commercial |
$676.39
|
| Rate for Payer: BCN Medicare Advantage |
$217.49
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.49
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Senior Care Partners |
$206.62
|
| Rate for Payer: PACE SWMI |
$217.49
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: PHP Medicare Advantage |
$217.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Medicare |
$217.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: Railroad Medicare Medicare |
$217.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.49
|
| Rate for Payer: UHC Medicare Advantage |
$224.01
|
| Rate for Payer: VA VA |
$217.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$530.59 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: BCBS Trust/PPO |
$672.31
|
| Rate for Payer: BCN Commercial |
$672.31
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
OP
|
$869.96
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$206.62 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: Aetna Medicare |
$226.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.86
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$217.49
|
| Rate for Payer: BCBS Trust/PPO |
$676.39
|
| Rate for Payer: BCN Commercial |
$676.39
|
| Rate for Payer: BCN Medicare Advantage |
$217.49
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.49
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PACE Senior Care Partners |
$206.62
|
| Rate for Payer: PACE SWMI |
$217.49
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: PHP Medicare Advantage |
$217.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Medicare |
$217.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: Railroad Medicare Medicare |
$217.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.49
|
| Rate for Payer: UHC Medicare Advantage |
$224.01
|
| Rate for Payer: VA VA |
$217.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
