|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.28
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$6.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Senior Care Partners |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Medicare |
$9.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$9.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
IP
|
$127.13
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$88.48 |
| Max. Negotiated Rate |
$114.42 |
| Rate for Payer: Aetna Commercial |
$108.06
|
| Rate for Payer: BCBS Trust/PPO |
$105.00
|
| Rate for Payer: BCN Commercial |
$105.00
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cofinity Commercial |
$109.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.70
|
| Rate for Payer: Healthscope Commercial |
$114.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.06
|
| Rate for Payer: Nomi Health Commercial |
$104.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.35
|
| Rate for Payer: PHP Commercial |
$108.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.87
|
| Rate for Payer: UHC Core |
$106.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.35
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
OP
|
$127.13
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$114.42 |
| Rate for Payer: Aetna Commercial |
$108.06
|
| Rate for Payer: Aetna Medicare |
$33.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.73
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$31.78
|
| Rate for Payer: BCBS Trust/PPO |
$104.51
|
| Rate for Payer: BCN Commercial |
$104.51
|
| Rate for Payer: BCN Medicare Advantage |
$31.78
|
| Rate for Payer: Cash Price |
$101.70
|
| Rate for Payer: Cofinity Commercial |
$109.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.78
|
| Rate for Payer: Healthscope Commercial |
$114.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.35
|
| Rate for Payer: Mclaren Medicaid |
$22.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.37
|
| Rate for Payer: Meridian Medicaid |
$23.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.06
|
| Rate for Payer: Nomi Health Commercial |
$104.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.35
|
| Rate for Payer: PACE Senior Care Partners |
$30.19
|
| Rate for Payer: PACE SWMI |
$31.78
|
| Rate for Payer: PHP Commercial |
$108.06
|
| Rate for Payer: PHP Medicare Advantage |
$31.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.60
|
| Rate for Payer: Priority Health Medicare |
$32.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.48
|
| Rate for Payer: Railroad Medicare Medicare |
$31.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.87
|
| Rate for Payer: UHC Core |
$106.15
|
| Rate for Payer: UHC Exchange |
$31.78
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$31.78
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: VA VA |
$31.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.35
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$2,253.05
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$397.21 |
| Max. Negotiated Rate |
$2,027.74 |
| Rate for Payer: Aetna Commercial |
$1,915.09
|
| Rate for Payer: Aetna Medicare |
$585.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$704.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$704.08
|
| Rate for Payer: BCBS Complete |
$417.04
|
| Rate for Payer: BCBS MAPPO |
$563.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.23
|
| Rate for Payer: BCN Commercial |
$1,852.23
|
| Rate for Payer: BCN Medicare Advantage |
$563.26
|
| Rate for Payer: Cash Price |
$1,802.44
|
| Rate for Payer: Cofinity Commercial |
$1,937.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,802.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.26
|
| Rate for Payer: Healthscope Commercial |
$2,027.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.79
|
| Rate for Payer: Mclaren Medicaid |
$397.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.43
|
| Rate for Payer: Meridian Medicaid |
$417.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$619.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.09
|
| Rate for Payer: Nomi Health Commercial |
$1,847.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,689.79
|
| Rate for Payer: PACE Senior Care Partners |
$535.10
|
| Rate for Payer: PACE SWMI |
$563.26
|
| Rate for Payer: PHP Commercial |
$1,915.09
|
| Rate for Payer: PHP Medicare Advantage |
$563.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,960.15
|
| Rate for Payer: Priority Health Medicare |
$568.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,568.12
|
| Rate for Payer: Railroad Medicare Medicare |
$563.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,982.68
|
| Rate for Payer: UHC Core |
$1,881.30
|
| Rate for Payer: UHC Exchange |
$563.26
|
| Rate for Payer: UHC Medicaid |
$397.21
|
| Rate for Payer: UHC Medicare Advantage |
$563.26
|
| Rate for Payer: UHCCP Medicaid |
$397.21
|
| Rate for Payer: VA VA |
$563.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.79
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$2,253.05
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,568.12 |
| Max. Negotiated Rate |
$2,027.74 |
| Rate for Payer: Aetna Commercial |
$1,915.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,860.79
|
| Rate for Payer: BCN Commercial |
$1,860.79
|
| Rate for Payer: Cash Price |
$1,802.44
|
| Rate for Payer: Cofinity Commercial |
$1,937.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,802.44
|
| Rate for Payer: Healthscope Commercial |
$2,027.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,915.09
|
| Rate for Payer: Nomi Health Commercial |
$1,847.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,689.79
|
| Rate for Payer: PHP Commercial |
$1,915.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,960.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,568.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,982.68
|
| Rate for Payer: UHC Core |
$1,881.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.79
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
IP
|
$545.88
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$379.93 |
| Max. Negotiated Rate |
$491.29 |
| Rate for Payer: Aetna Commercial |
$464.00
|
| Rate for Payer: BCBS Trust/PPO |
$450.84
|
| Rate for Payer: BCN Commercial |
$450.84
|
| Rate for Payer: Cash Price |
$436.70
|
| Rate for Payer: Cofinity Commercial |
$469.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.70
|
| Rate for Payer: Healthscope Commercial |
$491.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.00
|
| Rate for Payer: Nomi Health Commercial |
$447.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.41
|
| Rate for Payer: PHP Commercial |
$464.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$474.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.37
|
| Rate for Payer: UHC Core |
$455.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.41
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
OP
|
$545.88
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.24 |
| Max. Negotiated Rate |
$491.29 |
| Rate for Payer: Aetna Commercial |
$464.00
|
| Rate for Payer: Aetna Medicare |
$141.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.59
|
| Rate for Payer: BCBS Complete |
$101.04
|
| Rate for Payer: BCBS MAPPO |
$136.47
|
| Rate for Payer: BCBS Trust/PPO |
$448.77
|
| Rate for Payer: BCN Commercial |
$448.77
|
| Rate for Payer: BCN Medicare Advantage |
$136.47
|
| Rate for Payer: Cash Price |
$436.70
|
| Rate for Payer: Cofinity Commercial |
$469.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.47
|
| Rate for Payer: Healthscope Commercial |
$491.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.41
|
| Rate for Payer: Mclaren Medicaid |
$96.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.29
|
| Rate for Payer: Meridian Medicaid |
$101.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.00
|
| Rate for Payer: Nomi Health Commercial |
$447.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.41
|
| Rate for Payer: PACE Senior Care Partners |
$129.65
|
| Rate for Payer: PACE SWMI |
$136.47
|
| Rate for Payer: PHP Commercial |
$464.00
|
| Rate for Payer: PHP Medicare Advantage |
$136.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$474.92
|
| Rate for Payer: Priority Health Medicare |
$137.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.93
|
| Rate for Payer: Railroad Medicare Medicare |
$136.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.37
|
| Rate for Payer: UHC Core |
$455.81
|
| Rate for Payer: UHC Exchange |
$136.47
|
| Rate for Payer: UHC Medicaid |
$96.24
|
| Rate for Payer: UHC Medicare Advantage |
$136.47
|
| Rate for Payer: UHCCP Medicaid |
$96.24
|
| Rate for Payer: VA VA |
$136.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.41
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
OP
|
$1,369.17
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.38 |
| Max. Negotiated Rate |
$1,232.25 |
| Rate for Payer: Aetna Commercial |
$1,163.79
|
| Rate for Payer: Aetna Commercial |
$1,745.69
|
| Rate for Payer: Aetna Medicare |
$533.98
|
| Rate for Payer: Aetna Medicare |
$355.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$641.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$641.80
|
| Rate for Payer: BCBS Complete |
$253.43
|
| Rate for Payer: BCBS Complete |
$380.15
|
| Rate for Payer: BCBS MAPPO |
$342.29
|
| Rate for Payer: BCBS MAPPO |
$513.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.39
|
| Rate for Payer: BCN Commercial |
$1,688.39
|
| Rate for Payer: BCN Commercial |
$1,125.59
|
| Rate for Payer: BCN Medicare Advantage |
$513.44
|
| Rate for Payer: BCN Medicare Advantage |
$342.29
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cash Price |
$1,643.00
|
| Rate for Payer: Cofinity Commercial |
$1,177.49
|
| Rate for Payer: Cofinity Commercial |
$1,766.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$513.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.29
|
| Rate for Payer: Healthscope Commercial |
$1,232.25
|
| Rate for Payer: Healthscope Commercial |
$1,848.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,026.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,540.31
|
| Rate for Payer: Mclaren Medicaid |
$362.08
|
| Rate for Payer: Mclaren Medicaid |
$241.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$539.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.41
|
| Rate for Payer: Meridian Medicaid |
$253.43
|
| Rate for Payer: Meridian Medicaid |
$380.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$564.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$376.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,745.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,684.08
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,540.31
|
| Rate for Payer: PACE Senior Care Partners |
$487.77
|
| Rate for Payer: PACE Senior Care Partners |
$325.18
|
| Rate for Payer: PACE SWMI |
$513.44
|
| Rate for Payer: PACE SWMI |
$342.29
|
| Rate for Payer: PHP Commercial |
$1,163.79
|
| Rate for Payer: PHP Commercial |
$1,745.69
|
| Rate for Payer: PHP Medicare Advantage |
$342.29
|
| Rate for Payer: PHP Medicare Advantage |
$513.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,786.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,191.18
|
| Rate for Payer: Priority Health Medicare |
$518.57
|
| Rate for Payer: Priority Health Medicare |
$345.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$952.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.41
|
| Rate for Payer: Railroad Medicare Medicare |
$342.29
|
| Rate for Payer: Railroad Medicare Medicare |
$513.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,807.30
|
| Rate for Payer: UHC Core |
$1,714.88
|
| Rate for Payer: UHC Core |
$1,143.26
|
| Rate for Payer: UHC Exchange |
$513.44
|
| Rate for Payer: UHC Exchange |
$342.29
|
| Rate for Payer: UHC Medicaid |
$362.08
|
| Rate for Payer: UHC Medicaid |
$241.38
|
| Rate for Payer: UHC Medicare Advantage |
$342.29
|
| Rate for Payer: UHC Medicare Advantage |
$513.44
|
| Rate for Payer: UHCCP Medicaid |
$241.38
|
| Rate for Payer: UHCCP Medicaid |
$362.08
|
| Rate for Payer: VA VA |
$342.29
|
| Rate for Payer: VA VA |
$513.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,540.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,026.88
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
IP
|
$1,369.17
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$952.94 |
| Max. Negotiated Rate |
$1,232.25 |
| Rate for Payer: Aetna Commercial |
$1,163.79
|
| Rate for Payer: Aetna Commercial |
$1,745.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,696.19
|
| Rate for Payer: BCN Commercial |
$1,130.80
|
| Rate for Payer: BCN Commercial |
$1,696.19
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cash Price |
$1,643.00
|
| Rate for Payer: Cofinity Commercial |
$1,766.22
|
| Rate for Payer: Cofinity Commercial |
$1,177.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Healthscope Commercial |
$1,232.25
|
| Rate for Payer: Healthscope Commercial |
$1,848.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,026.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,540.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,745.69
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Nomi Health Commercial |
$1,684.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,540.31
|
| Rate for Payer: PHP Commercial |
$1,745.69
|
| Rate for Payer: PHP Commercial |
$1,163.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,786.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,191.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$952.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,807.30
|
| Rate for Payer: UHC Core |
$1,143.26
|
| Rate for Payer: UHC Core |
$1,714.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,026.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,540.31
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$1,690.34
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,176.48 |
| Max. Negotiated Rate |
$1,521.31 |
| Rate for Payer: Aetna Commercial |
$1,436.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,396.05
|
| Rate for Payer: BCN Commercial |
$1,396.05
|
| Rate for Payer: Cash Price |
$1,352.27
|
| Rate for Payer: Cofinity Commercial |
$1,453.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.27
|
| Rate for Payer: Healthscope Commercial |
$1,521.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,267.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,436.79
|
| Rate for Payer: Nomi Health Commercial |
$1,386.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,267.76
|
| Rate for Payer: PHP Commercial |
$1,436.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,470.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,176.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.50
|
| Rate for Payer: UHC Core |
$1,411.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,267.76
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$1,690.34
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.01 |
| Max. Negotiated Rate |
$1,521.31 |
| Rate for Payer: Aetna Commercial |
$1,436.79
|
| Rate for Payer: Aetna Medicare |
$439.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$528.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$528.23
|
| Rate for Payer: BCBS Complete |
$312.88
|
| Rate for Payer: BCBS MAPPO |
$422.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,389.63
|
| Rate for Payer: BCN Commercial |
$1,389.63
|
| Rate for Payer: BCN Medicare Advantage |
$422.58
|
| Rate for Payer: Cash Price |
$1,352.27
|
| Rate for Payer: Cofinity Commercial |
$1,453.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.58
|
| Rate for Payer: Healthscope Commercial |
$1,521.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,267.76
|
| Rate for Payer: Mclaren Medicaid |
$298.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.71
|
| Rate for Payer: Meridian Medicaid |
$312.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$485.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$464.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,436.79
|
| Rate for Payer: Nomi Health Commercial |
$1,386.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,267.76
|
| Rate for Payer: PACE Senior Care Partners |
$401.46
|
| Rate for Payer: PACE SWMI |
$422.58
|
| Rate for Payer: PHP Commercial |
$1,436.79
|
| Rate for Payer: PHP Medicare Advantage |
$422.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,470.60
|
| Rate for Payer: Priority Health Medicare |
$426.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,176.48
|
| Rate for Payer: Railroad Medicare Medicare |
$422.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,487.50
|
| Rate for Payer: UHC Core |
$1,411.43
|
| Rate for Payer: UHC Exchange |
$422.58
|
| Rate for Payer: UHC Medicaid |
$298.01
|
| Rate for Payer: UHC Medicare Advantage |
$422.58
|
| Rate for Payer: UHCCP Medicaid |
$298.01
|
| Rate for Payer: VA VA |
$422.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,267.76
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
OP
|
$382.87
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna Medicare |
$99.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.65
|
| Rate for Payer: BCBS Complete |
$70.87
|
| Rate for Payer: BCBS MAPPO |
$95.72
|
| Rate for Payer: BCBS Trust/PPO |
$314.76
|
| Rate for Payer: BCN Commercial |
$314.76
|
| Rate for Payer: BCN Medicare Advantage |
$95.72
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Mclaren Medicaid |
$67.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.50
|
| Rate for Payer: Meridian Medicaid |
$70.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: PACE Senior Care Partners |
$90.93
|
| Rate for Payer: PACE SWMI |
$95.72
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: PHP Medicare Advantage |
$95.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.10
|
| Rate for Payer: Priority Health Medicare |
$96.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.48
|
| Rate for Payer: Railroad Medicare Medicare |
$95.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.93
|
| Rate for Payer: UHC Core |
$319.70
|
| Rate for Payer: UHC Exchange |
$95.72
|
| Rate for Payer: UHC Medicaid |
$67.50
|
| Rate for Payer: UHC Medicare Advantage |
$95.72
|
| Rate for Payer: UHCCP Medicaid |
$67.50
|
| Rate for Payer: VA VA |
$95.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
IP
|
$382.87
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.48 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: BCBS Trust/PPO |
$316.21
|
| Rate for Payer: BCN Commercial |
$316.21
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.93
|
| Rate for Payer: UHC Core |
$319.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
IP
|
$390.53
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.81 |
| Max. Negotiated Rate |
$351.48 |
| Rate for Payer: Aetna Commercial |
$331.95
|
| Rate for Payer: BCBS Trust/PPO |
$322.54
|
| Rate for Payer: BCN Commercial |
$322.54
|
| Rate for Payer: Cash Price |
$312.42
|
| Rate for Payer: Cofinity Commercial |
$335.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.42
|
| Rate for Payer: Healthscope Commercial |
$351.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.95
|
| Rate for Payer: Nomi Health Commercial |
$320.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.90
|
| Rate for Payer: PHP Commercial |
$331.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.67
|
| Rate for Payer: UHC Core |
$326.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.90
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
OP
|
$390.53
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.85 |
| Max. Negotiated Rate |
$351.48 |
| Rate for Payer: Aetna Commercial |
$331.95
|
| Rate for Payer: Aetna Medicare |
$101.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.04
|
| Rate for Payer: BCBS Complete |
$72.29
|
| Rate for Payer: BCBS MAPPO |
$97.63
|
| Rate for Payer: BCBS Trust/PPO |
$321.05
|
| Rate for Payer: BCN Commercial |
$321.05
|
| Rate for Payer: BCN Medicare Advantage |
$97.63
|
| Rate for Payer: Cash Price |
$312.42
|
| Rate for Payer: Cofinity Commercial |
$335.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$351.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.90
|
| Rate for Payer: Mclaren Medicaid |
$68.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.51
|
| Rate for Payer: Meridian Medicaid |
$72.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.95
|
| Rate for Payer: Nomi Health Commercial |
$320.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.90
|
| Rate for Payer: PACE Senior Care Partners |
$92.75
|
| Rate for Payer: PACE SWMI |
$97.63
|
| Rate for Payer: PHP Commercial |
$331.95
|
| Rate for Payer: PHP Medicare Advantage |
$97.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.76
|
| Rate for Payer: Priority Health Medicare |
$98.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.81
|
| Rate for Payer: Railroad Medicare Medicare |
$97.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.67
|
| Rate for Payer: UHC Core |
$326.09
|
| Rate for Payer: UHC Exchange |
$97.63
|
| Rate for Payer: UHC Medicaid |
$68.85
|
| Rate for Payer: UHC Medicare Advantage |
$97.63
|
| Rate for Payer: UHCCP Medicaid |
$68.85
|
| Rate for Payer: VA VA |
$97.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.90
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
OP
|
$530.60
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.54 |
| Max. Negotiated Rate |
$477.54 |
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna Commercial |
$676.52
|
| Rate for Payer: Aetna Medicare |
$206.94
|
| Rate for Payer: Aetna Medicare |
$137.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.72
|
| Rate for Payer: BCBS Complete |
$98.21
|
| Rate for Payer: BCBS Complete |
$147.32
|
| Rate for Payer: BCBS MAPPO |
$132.65
|
| Rate for Payer: BCBS MAPPO |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$436.21
|
| Rate for Payer: BCBS Trust/PPO |
$654.32
|
| Rate for Payer: BCN Commercial |
$654.32
|
| Rate for Payer: BCN Commercial |
$436.21
|
| Rate for Payer: BCN Medicare Advantage |
$198.98
|
| Rate for Payer: BCN Medicare Advantage |
$132.65
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$636.73
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Cofinity Commercial |
$684.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.65
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Healthscope Commercial |
$716.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.93
|
| Rate for Payer: Mclaren Medicaid |
$140.32
|
| Rate for Payer: Mclaren Medicaid |
$93.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.28
|
| Rate for Payer: Meridian Medicaid |
$98.21
|
| Rate for Payer: Meridian Medicaid |
$147.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$652.65
|
| Rate for Payer: Nomi Health Commercial |
$435.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.93
|
| Rate for Payer: PACE Senior Care Partners |
$189.03
|
| Rate for Payer: PACE Senior Care Partners |
$126.02
|
| Rate for Payer: PACE SWMI |
$198.98
|
| Rate for Payer: PACE SWMI |
$132.65
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: PHP Commercial |
$676.52
|
| Rate for Payer: PHP Medicare Advantage |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$198.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$692.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$461.62
|
| Rate for Payer: Priority Health Medicare |
$200.97
|
| Rate for Payer: Priority Health Medicare |
$133.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$553.95
|
| Rate for Payer: Railroad Medicare Medicare |
$132.65
|
| Rate for Payer: Railroad Medicare Medicare |
$198.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.40
|
| Rate for Payer: UHC Core |
$664.58
|
| Rate for Payer: UHC Core |
$443.05
|
| Rate for Payer: UHC Exchange |
$198.98
|
| Rate for Payer: UHC Exchange |
$132.65
|
| Rate for Payer: UHC Medicaid |
$140.32
|
| Rate for Payer: UHC Medicaid |
$93.54
|
| Rate for Payer: UHC Medicare Advantage |
$132.65
|
| Rate for Payer: UHC Medicare Advantage |
$198.98
|
| Rate for Payer: UHCCP Medicaid |
$93.54
|
| Rate for Payer: UHCCP Medicaid |
$140.32
|
| Rate for Payer: VA VA |
$132.65
|
| Rate for Payer: VA VA |
$198.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
IP
|
$530.60
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.30 |
| Max. Negotiated Rate |
$477.54 |
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna Commercial |
$676.52
|
| Rate for Payer: BCBS Trust/PPO |
$438.22
|
| Rate for Payer: BCBS Trust/PPO |
$657.34
|
| Rate for Payer: BCN Commercial |
$438.22
|
| Rate for Payer: BCN Commercial |
$657.34
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$636.73
|
| Rate for Payer: Cofinity Commercial |
$684.48
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Healthscope Commercial |
$716.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.52
|
| Rate for Payer: Nomi Health Commercial |
$435.09
|
| Rate for Payer: Nomi Health Commercial |
$652.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$596.93
|
| Rate for Payer: PHP Commercial |
$676.52
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$692.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$461.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$553.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.40
|
| Rate for Payer: UHC Core |
$443.05
|
| Rate for Payer: UHC Core |
$664.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.93
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$868.17
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$604.25 |
| Max. Negotiated Rate |
$781.35 |
| Rate for Payer: Aetna Commercial |
$737.94
|
| Rate for Payer: BCBS Trust/PPO |
$717.02
|
| Rate for Payer: BCN Commercial |
$717.02
|
| Rate for Payer: Cash Price |
$694.54
|
| Rate for Payer: Cofinity Commercial |
$746.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.54
|
| Rate for Payer: Healthscope Commercial |
$781.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.94
|
| Rate for Payer: Nomi Health Commercial |
$711.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.13
|
| Rate for Payer: PHP Commercial |
$737.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$755.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.99
|
| Rate for Payer: UHC Core |
$724.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.13
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$868.17
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.06 |
| Max. Negotiated Rate |
$781.35 |
| Rate for Payer: Aetna Commercial |
$737.94
|
| Rate for Payer: Aetna Medicare |
$225.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.30
|
| Rate for Payer: BCBS Complete |
$160.70
|
| Rate for Payer: BCBS MAPPO |
$217.04
|
| Rate for Payer: BCBS Trust/PPO |
$713.72
|
| Rate for Payer: BCN Commercial |
$713.72
|
| Rate for Payer: BCN Medicare Advantage |
$217.04
|
| Rate for Payer: Cash Price |
$694.54
|
| Rate for Payer: Cofinity Commercial |
$746.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.04
|
| Rate for Payer: Healthscope Commercial |
$781.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.13
|
| Rate for Payer: Mclaren Medicaid |
$153.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.89
|
| Rate for Payer: Meridian Medicaid |
$160.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$238.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.94
|
| Rate for Payer: Nomi Health Commercial |
$711.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.13
|
| Rate for Payer: PACE Senior Care Partners |
$206.19
|
| Rate for Payer: PACE SWMI |
$217.04
|
| Rate for Payer: PHP Commercial |
$737.94
|
| Rate for Payer: PHP Medicare Advantage |
$217.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$755.31
|
| Rate for Payer: Priority Health Medicare |
$219.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.25
|
| Rate for Payer: Railroad Medicare Medicare |
$217.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$763.99
|
| Rate for Payer: UHC Core |
$724.92
|
| Rate for Payer: UHC Exchange |
$217.04
|
| Rate for Payer: UHC Medicaid |
$153.06
|
| Rate for Payer: UHC Medicare Advantage |
$217.04
|
| Rate for Payer: UHCCP Medicaid |
$153.06
|
| Rate for Payer: VA VA |
$217.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.13
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
IP
|
$96.31
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.03 |
| Max. Negotiated Rate |
$86.68 |
| Rate for Payer: Aetna Commercial |
$81.86
|
| Rate for Payer: BCBS Trust/PPO |
$79.54
|
| Rate for Payer: BCN Commercial |
$79.54
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cofinity Commercial |
$82.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.05
|
| Rate for Payer: Healthscope Commercial |
$86.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.86
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.23
|
| Rate for Payer: PHP Commercial |
$81.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.75
|
| Rate for Payer: UHC Core |
$80.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.23
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
OP
|
$96.31
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.98 |
| Max. Negotiated Rate |
$86.68 |
| Rate for Payer: Aetna Commercial |
$81.86
|
| Rate for Payer: Aetna Medicare |
$25.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.10
|
| Rate for Payer: BCBS Complete |
$17.83
|
| Rate for Payer: BCBS MAPPO |
$24.08
|
| Rate for Payer: BCBS Trust/PPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: BCN Medicare Advantage |
$24.08
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cofinity Commercial |
$82.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$86.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.23
|
| Rate for Payer: Mclaren Medicaid |
$16.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.28
|
| Rate for Payer: Meridian Medicaid |
$17.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.86
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.87
|
| Rate for Payer: PACE SWMI |
$24.08
|
| Rate for Payer: PHP Commercial |
$81.86
|
| Rate for Payer: PHP Medicare Advantage |
$24.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.79
|
| Rate for Payer: Priority Health Medicare |
$24.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.03
|
| Rate for Payer: Railroad Medicare Medicare |
$24.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.75
|
| Rate for Payer: UHC Core |
$80.42
|
| Rate for Payer: UHC Exchange |
$24.08
|
| Rate for Payer: UHC Medicaid |
$16.98
|
| Rate for Payer: UHC Medicare Advantage |
$24.08
|
| Rate for Payer: UHCCP Medicaid |
$16.98
|
| Rate for Payer: VA VA |
$24.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.23
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
IP
|
$116.75
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.26 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$99.24
|
| Rate for Payer: BCBS Trust/PPO |
$96.42
|
| Rate for Payer: BCN Commercial |
$96.42
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cofinity Commercial |
$100.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.40
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.24
|
| Rate for Payer: Nomi Health Commercial |
$95.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.56
|
| Rate for Payer: PHP Commercial |
$99.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.74
|
| Rate for Payer: UHC Core |
$97.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.56
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
OP
|
$116.75
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.58 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna Commercial |
$99.24
|
| Rate for Payer: Aetna Medicare |
$30.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.48
|
| Rate for Payer: BCBS Complete |
$21.61
|
| Rate for Payer: BCBS MAPPO |
$29.19
|
| Rate for Payer: BCBS Trust/PPO |
$95.98
|
| Rate for Payer: BCN Commercial |
$95.98
|
| Rate for Payer: BCN Medicare Advantage |
$29.19
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cofinity Commercial |
$100.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.19
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.56
|
| Rate for Payer: Mclaren Medicaid |
$20.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.65
|
| Rate for Payer: Meridian Medicaid |
$21.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.24
|
| Rate for Payer: Nomi Health Commercial |
$95.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.56
|
| Rate for Payer: PACE Senior Care Partners |
$27.73
|
| Rate for Payer: PACE SWMI |
$29.19
|
| Rate for Payer: PHP Commercial |
$99.24
|
| Rate for Payer: PHP Medicare Advantage |
$29.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.57
|
| Rate for Payer: Priority Health Medicare |
$29.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.26
|
| Rate for Payer: Railroad Medicare Medicare |
$29.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.74
|
| Rate for Payer: UHC Core |
$97.49
|
| Rate for Payer: UHC Exchange |
$29.19
|
| Rate for Payer: UHC Medicaid |
$20.58
|
| Rate for Payer: UHC Medicare Advantage |
$29.19
|
| Rate for Payer: UHCCP Medicaid |
$20.58
|
| Rate for Payer: VA VA |
$29.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.56
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$1,135.66
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$790.42 |
| Max. Negotiated Rate |
$1,022.09 |
| Rate for Payer: Aetna Commercial |
$965.31
|
| Rate for Payer: BCBS Trust/PPO |
$937.94
|
| Rate for Payer: BCN Commercial |
$937.94
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cofinity Commercial |
$976.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.53
|
| Rate for Payer: Healthscope Commercial |
$1,022.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.31
|
| Rate for Payer: Nomi Health Commercial |
$931.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.75
|
| Rate for Payer: PHP Commercial |
$965.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$988.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.38
|
| Rate for Payer: UHC Core |
$948.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.75
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,135.66
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.22 |
| Max. Negotiated Rate |
$1,022.09 |
| Rate for Payer: Aetna Commercial |
$965.31
|
| Rate for Payer: Aetna Medicare |
$295.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$354.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$354.89
|
| Rate for Payer: BCBS Complete |
$210.21
|
| Rate for Payer: BCBS MAPPO |
$283.92
|
| Rate for Payer: BCBS Trust/PPO |
$933.63
|
| Rate for Payer: BCN Commercial |
$933.63
|
| Rate for Payer: BCN Medicare Advantage |
$283.92
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cofinity Commercial |
$976.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.92
|
| Rate for Payer: Healthscope Commercial |
$1,022.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.75
|
| Rate for Payer: Mclaren Medicaid |
$200.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.11
|
| Rate for Payer: Meridian Medicaid |
$210.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$326.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$312.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.31
|
| Rate for Payer: Nomi Health Commercial |
$931.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.75
|
| Rate for Payer: PACE Senior Care Partners |
$269.72
|
| Rate for Payer: PACE SWMI |
$283.92
|
| Rate for Payer: PHP Commercial |
$965.31
|
| Rate for Payer: PHP Medicare Advantage |
$283.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$988.02
|
| Rate for Payer: Priority Health Medicare |
$286.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$790.42
|
| Rate for Payer: Railroad Medicare Medicare |
$283.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.38
|
| Rate for Payer: UHC Core |
$948.28
|
| Rate for Payer: UHC Exchange |
$283.92
|
| Rate for Payer: UHC Medicaid |
$200.22
|
| Rate for Payer: UHC Medicare Advantage |
$283.92
|
| Rate for Payer: UHCCP Medicaid |
$200.22
|
| Rate for Payer: VA VA |
$283.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.75
|
|
