|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,220.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,664.75 |
| Max. Negotiated Rate |
$16,235.80 |
| Rate for Payer: Aetna Commercial |
$9,537.00
|
| Rate for Payer: Aetna Medicare |
$2,917.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,506.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,506.25
|
| Rate for Payer: BCBS Complete |
$16,235.80
|
| Rate for Payer: BCBS MAPPO |
$2,805.00
|
| Rate for Payer: BCBS Trust/PPO |
$8,723.55
|
| Rate for Payer: BCN Commercial |
$8,723.55
|
| Rate for Payer: BCN Medicare Advantage |
$2,805.00
|
| Rate for Payer: Cash Price |
$8,976.00
|
| Rate for Payer: Cash Price |
$8,976.00
|
| Rate for Payer: Cofinity Commercial |
$9,649.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,976.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,805.00
|
| Rate for Payer: Healthscope Commercial |
$10,098.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,415.00
|
| Rate for Payer: Mclaren Medicaid |
$15,462.66
|
| Rate for Payer: Meridian Medicaid |
$16,235.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,945.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,225.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,537.00
|
| Rate for Payer: PACE Senior Care Partners |
$2,664.75
|
| Rate for Payer: PACE SWMI |
$2,805.00
|
| Rate for Payer: PHP Commercial |
$9,537.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,805.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,462.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,761.40
|
| Rate for Payer: Priority Health Medicare |
$2,805.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,843.08
|
| Rate for Payer: Railroad Medicare Medicare |
$2,805.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,873.60
|
| Rate for Payer: UHC Core |
$9,368.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,805.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,889.15
|
| Rate for Payer: VA VA |
$2,805.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,415.00
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,664.59
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,625.13 |
| Max. Negotiated Rate |
$2,398.13 |
| Rate for Payer: Aetna Commercial |
$2,264.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,059.20
|
| Rate for Payer: BCN Commercial |
$2,059.20
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cofinity Commercial |
$2,291.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,131.67
|
| Rate for Payer: Healthscope Commercial |
$2,398.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,998.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,264.90
|
| Rate for Payer: PHP Commercial |
$2,264.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,865.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,318.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,625.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,344.84
|
| Rate for Payer: UHC Core |
$2,224.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,998.44
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,664.59
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$632.84 |
| Max. Negotiated Rate |
$2,704.89 |
| Rate for Payer: Aetna Commercial |
$2,264.90
|
| Rate for Payer: Aetna Medicare |
$692.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$832.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$832.68
|
| Rate for Payer: BCBS Complete |
$2,704.89
|
| Rate for Payer: BCBS MAPPO |
$666.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.72
|
| Rate for Payer: BCN Commercial |
$2,071.72
|
| Rate for Payer: BCN Medicare Advantage |
$666.15
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cash Price |
$2,131.67
|
| Rate for Payer: Cofinity Commercial |
$2,291.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,131.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$666.15
|
| Rate for Payer: Healthscope Commercial |
$2,398.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,998.44
|
| Rate for Payer: Mclaren Medicaid |
$2,576.08
|
| Rate for Payer: Meridian Medicaid |
$2,704.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$699.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$766.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,264.90
|
| Rate for Payer: PACE Senior Care Partners |
$632.84
|
| Rate for Payer: PACE SWMI |
$666.15
|
| Rate for Payer: PHP Commercial |
$2,264.90
|
| Rate for Payer: PHP Medicare Advantage |
$666.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,576.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,865.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,318.19
|
| Rate for Payer: Priority Health Medicare |
$666.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,625.13
|
| Rate for Payer: Railroad Medicare Medicare |
$666.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,344.84
|
| Rate for Payer: UHC Core |
$2,224.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$666.15
|
| Rate for Payer: UHC Medicare Advantage |
$686.13
|
| Rate for Payer: VA VA |
$666.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,998.44
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,102.18
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$736.77 |
| Max. Negotiated Rate |
$2,791.96 |
| Rate for Payer: Aetna Commercial |
$2,636.85
|
| Rate for Payer: Aetna Medicare |
$806.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.43
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$775.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,411.94
|
| Rate for Payer: BCN Commercial |
$2,411.94
|
| Rate for Payer: BCN Medicare Advantage |
$775.54
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cofinity Commercial |
$2,667.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.54
|
| Rate for Payer: Healthscope Commercial |
$2,791.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.64
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,636.85
|
| Rate for Payer: PACE Senior Care Partners |
$736.77
|
| Rate for Payer: PACE SWMI |
$775.54
|
| Rate for Payer: PHP Commercial |
$2,636.85
|
| Rate for Payer: PHP Medicare Advantage |
$775.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,698.90
|
| Rate for Payer: Priority Health Medicare |
$775.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,892.02
|
| Rate for Payer: Railroad Medicare Medicare |
$775.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.92
|
| Rate for Payer: UHC Core |
$2,590.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.54
|
| Rate for Payer: UHC Medicare Advantage |
$798.81
|
| Rate for Payer: VA VA |
$775.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.64
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,102.18
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.02 |
| Max. Negotiated Rate |
$2,791.96 |
| Rate for Payer: Aetna Commercial |
$2,636.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,397.36
|
| Rate for Payer: BCN Commercial |
$2,397.36
|
| Rate for Payer: Cash Price |
$2,481.74
|
| Rate for Payer: Cofinity Commercial |
$2,667.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.74
|
| Rate for Payer: Healthscope Commercial |
$2,791.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,636.85
|
| Rate for Payer: PHP Commercial |
$2,636.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,171.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,698.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,892.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.92
|
| Rate for Payer: UHC Core |
$2,590.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.64
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$17,340.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,118.25 |
| Max. Negotiated Rate |
$22,660.63 |
| Rate for Payer: Aetna Commercial |
$14,739.00
|
| Rate for Payer: Aetna Medicare |
$4,508.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,418.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,418.75
|
| Rate for Payer: BCBS Complete |
$22,660.63
|
| Rate for Payer: BCBS MAPPO |
$4,335.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,481.85
|
| Rate for Payer: BCN Commercial |
$13,481.85
|
| Rate for Payer: BCN Medicare Advantage |
$4,335.00
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cofinity Commercial |
$14,912.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,872.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,335.00
|
| Rate for Payer: Healthscope Commercial |
$15,606.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,005.00
|
| Rate for Payer: Mclaren Medicaid |
$21,581.55
|
| Rate for Payer: Meridian Medicaid |
$22,660.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,551.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,985.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,739.00
|
| Rate for Payer: PACE Senior Care Partners |
$4,118.25
|
| Rate for Payer: PACE SWMI |
$4,335.00
|
| Rate for Payer: PHP Commercial |
$14,739.00
|
| Rate for Payer: PHP Medicare Advantage |
$4,335.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,581.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,138.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,085.80
|
| Rate for Payer: Priority Health Medicare |
$4,335.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,575.67
|
| Rate for Payer: Railroad Medicare Medicare |
$4,335.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,259.20
|
| Rate for Payer: UHC Core |
$14,478.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,335.00
|
| Rate for Payer: UHC Medicare Advantage |
$4,465.05
|
| Rate for Payer: VA VA |
$4,335.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,005.00
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$17,340.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,575.67 |
| Max. Negotiated Rate |
$15,606.00 |
| Rate for Payer: Aetna Commercial |
$14,739.00
|
| Rate for Payer: BCBS Trust/PPO |
$13,400.35
|
| Rate for Payer: BCN Commercial |
$13,400.35
|
| Rate for Payer: Cash Price |
$13,872.00
|
| Rate for Payer: Cofinity Commercial |
$14,912.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,872.00
|
| Rate for Payer: Healthscope Commercial |
$15,606.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,005.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,739.00
|
| Rate for Payer: PHP Commercial |
$14,739.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,138.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,085.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,575.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,259.20
|
| Rate for Payer: UHC Core |
$14,478.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,005.00
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$1,957.50
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$464.91 |
| Max. Negotiated Rate |
$1,761.75 |
| Rate for Payer: Aetna Commercial |
$1,663.88
|
| Rate for Payer: Aetna Medicare |
$508.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.72
|
| Rate for Payer: BCBS Complete |
$783.00
|
| Rate for Payer: BCBS MAPPO |
$489.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,521.96
|
| Rate for Payer: BCN Commercial |
$1,521.96
|
| Rate for Payer: BCN Medicare Advantage |
$489.38
|
| Rate for Payer: Cash Price |
$1,566.00
|
| Rate for Payer: Cofinity Commercial |
$1,683.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.38
|
| Rate for Payer: Healthscope Commercial |
$1,761.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,663.88
|
| Rate for Payer: PACE Senior Care Partners |
$464.91
|
| Rate for Payer: PACE SWMI |
$489.38
|
| Rate for Payer: PHP Commercial |
$1,663.88
|
| Rate for Payer: PHP Medicare Advantage |
$489.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.02
|
| Rate for Payer: Priority Health Medicare |
$489.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,193.88
|
| Rate for Payer: Railroad Medicare Medicare |
$489.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,722.60
|
| Rate for Payer: UHC Core |
$1,634.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.38
|
| Rate for Payer: UHC Medicare Advantage |
$504.06
|
| Rate for Payer: VA VA |
$489.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.12
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$1,957.50
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,193.88 |
| Max. Negotiated Rate |
$1,761.75 |
| Rate for Payer: Aetna Commercial |
$1,663.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,512.76
|
| Rate for Payer: BCN Commercial |
$1,512.76
|
| Rate for Payer: Cash Price |
$1,566.00
|
| Rate for Payer: Cofinity Commercial |
$1,683.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,566.00
|
| Rate for Payer: Healthscope Commercial |
$1,761.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,468.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,663.88
|
| Rate for Payer: PHP Commercial |
$1,663.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,370.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,703.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,193.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,722.60
|
| Rate for Payer: UHC Core |
$1,634.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,468.12
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$253.98
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.90 |
| Max. Negotiated Rate |
$228.58 |
| Rate for Payer: Aetna Commercial |
$215.88
|
| Rate for Payer: BCBS Trust/PPO |
$196.28
|
| Rate for Payer: BCN Commercial |
$196.28
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$218.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.18
|
| Rate for Payer: Healthscope Commercial |
$228.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.88
|
| Rate for Payer: PHP Commercial |
$215.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.50
|
| Rate for Payer: UHC Core |
$212.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.48
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$253.98
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.32 |
| Max. Negotiated Rate |
$228.58 |
| Rate for Payer: Aetna Commercial |
$215.88
|
| Rate for Payer: Aetna Medicare |
$66.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.37
|
| Rate for Payer: BCBS Complete |
$137.25
|
| Rate for Payer: BCBS MAPPO |
$63.50
|
| Rate for Payer: BCBS Trust/PPO |
$197.47
|
| Rate for Payer: BCN Commercial |
$197.47
|
| Rate for Payer: BCN Medicare Advantage |
$63.50
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cash Price |
$203.18
|
| Rate for Payer: Cofinity Commercial |
$218.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.50
|
| Rate for Payer: Healthscope Commercial |
$228.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.48
|
| Rate for Payer: Mclaren Medicaid |
$130.71
|
| Rate for Payer: Meridian Medicaid |
$137.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.88
|
| Rate for Payer: PACE Senior Care Partners |
$60.32
|
| Rate for Payer: PACE SWMI |
$63.50
|
| Rate for Payer: PHP Commercial |
$215.88
|
| Rate for Payer: PHP Medicare Advantage |
$63.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.96
|
| Rate for Payer: Priority Health Medicare |
$63.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.90
|
| Rate for Payer: Railroad Medicare Medicare |
$63.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.50
|
| Rate for Payer: UHC Core |
$212.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.50
|
| Rate for Payer: UHC Medicare Advantage |
$65.40
|
| Rate for Payer: VA VA |
$63.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.48
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$29.27
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.85 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: BCBS Trust/PPO |
$22.62
|
| Rate for Payer: BCN Commercial |
$22.62
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.88
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.76
|
| Rate for Payer: UHC Core |
$24.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.95
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$29.27
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Aetna Commercial |
$24.88
|
| Rate for Payer: Aetna Medicare |
$7.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.15
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.32
|
| Rate for Payer: BCBS Trust/PPO |
$22.76
|
| Rate for Payer: BCN Commercial |
$22.76
|
| Rate for Payer: BCN Medicare Advantage |
$7.32
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cash Price |
$23.42
|
| Rate for Payer: Cofinity Commercial |
$25.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.32
|
| Rate for Payer: Healthscope Commercial |
$26.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.95
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.88
|
| Rate for Payer: PACE Senior Care Partners |
$6.95
|
| Rate for Payer: PACE SWMI |
$7.32
|
| Rate for Payer: PHP Commercial |
$24.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.46
|
| Rate for Payer: Priority Health Medicare |
$7.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.85
|
| Rate for Payer: Railroad Medicare Medicare |
$7.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.76
|
| Rate for Payer: UHC Core |
$24.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.32
|
| Rate for Payer: UHC Medicare Advantage |
$7.54
|
| Rate for Payer: VA VA |
$7.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.95
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$525.01
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$320.20 |
| Max. Negotiated Rate |
$472.51 |
| Rate for Payer: Aetna Commercial |
$446.26
|
| Rate for Payer: BCBS Trust/PPO |
$405.73
|
| Rate for Payer: BCN Commercial |
$405.73
|
| Rate for Payer: Cash Price |
$420.01
|
| Rate for Payer: Cofinity Commercial |
$451.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.01
|
| Rate for Payer: Healthscope Commercial |
$472.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.26
|
| Rate for Payer: PHP Commercial |
$446.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.01
|
| Rate for Payer: UHC Core |
$438.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.76
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$525.01
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$124.69 |
| Max. Negotiated Rate |
$472.51 |
| Rate for Payer: Aetna Commercial |
$446.26
|
| Rate for Payer: Aetna Medicare |
$136.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.07
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: BCBS MAPPO |
$131.25
|
| Rate for Payer: BCBS Trust/PPO |
$408.20
|
| Rate for Payer: BCN Commercial |
$408.20
|
| Rate for Payer: BCN Medicare Advantage |
$131.25
|
| Rate for Payer: Cash Price |
$420.01
|
| Rate for Payer: Cofinity Commercial |
$451.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.25
|
| Rate for Payer: Healthscope Commercial |
$472.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.26
|
| Rate for Payer: PACE Senior Care Partners |
$124.69
|
| Rate for Payer: PACE SWMI |
$131.25
|
| Rate for Payer: PHP Commercial |
$446.26
|
| Rate for Payer: PHP Medicare Advantage |
$131.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.76
|
| Rate for Payer: Priority Health Medicare |
$131.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.20
|
| Rate for Payer: Railroad Medicare Medicare |
$131.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.01
|
| Rate for Payer: UHC Core |
$438.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.25
|
| Rate for Payer: UHC Medicare Advantage |
$135.19
|
| Rate for Payer: VA VA |
$131.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.76
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$913.63
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.99 |
| Max. Negotiated Rate |
$822.27 |
| Rate for Payer: Aetna Commercial |
$776.59
|
| Rate for Payer: Aetna Medicare |
$237.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$285.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$285.51
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$228.41
|
| Rate for Payer: BCBS Trust/PPO |
$710.35
|
| Rate for Payer: BCN Commercial |
$710.35
|
| Rate for Payer: BCN Medicare Advantage |
$228.41
|
| Rate for Payer: Cash Price |
$730.90
|
| Rate for Payer: Cash Price |
$730.90
|
| Rate for Payer: Cofinity Commercial |
$785.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.41
|
| Rate for Payer: Healthscope Commercial |
$822.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$685.22
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$239.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$262.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$776.59
|
| Rate for Payer: PACE Senior Care Partners |
$216.99
|
| Rate for Payer: PACE SWMI |
$228.41
|
| Rate for Payer: PHP Commercial |
$776.59
|
| Rate for Payer: PHP Medicare Advantage |
$228.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.86
|
| Rate for Payer: Priority Health Medicare |
$228.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.22
|
| Rate for Payer: Railroad Medicare Medicare |
$228.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.99
|
| Rate for Payer: UHC Core |
$762.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.41
|
| Rate for Payer: UHC Medicare Advantage |
$235.26
|
| Rate for Payer: VA VA |
$228.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$685.22
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$913.63
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$557.22 |
| Max. Negotiated Rate |
$822.27 |
| Rate for Payer: Aetna Commercial |
$776.59
|
| Rate for Payer: BCBS Trust/PPO |
$706.05
|
| Rate for Payer: BCN Commercial |
$706.05
|
| Rate for Payer: Cash Price |
$730.90
|
| Rate for Payer: Cofinity Commercial |
$785.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.90
|
| Rate for Payer: Healthscope Commercial |
$822.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$685.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$776.59
|
| Rate for Payer: PHP Commercial |
$776.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.99
|
| Rate for Payer: UHC Core |
$762.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$685.22
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$480.54
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.13 |
| Max. Negotiated Rate |
$432.49 |
| Rate for Payer: Aetna Commercial |
$408.46
|
| Rate for Payer: Aetna Medicare |
$124.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.17
|
| Rate for Payer: BCBS Complete |
$192.22
|
| Rate for Payer: BCBS MAPPO |
$120.14
|
| Rate for Payer: BCBS Trust/PPO |
$373.62
|
| Rate for Payer: BCN Commercial |
$373.62
|
| Rate for Payer: BCN Medicare Advantage |
$120.14
|
| Rate for Payer: Cash Price |
$384.43
|
| Rate for Payer: Cofinity Commercial |
$413.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.14
|
| Rate for Payer: Healthscope Commercial |
$432.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.46
|
| Rate for Payer: PACE Senior Care Partners |
$114.13
|
| Rate for Payer: PACE SWMI |
$120.14
|
| Rate for Payer: PHP Commercial |
$408.46
|
| Rate for Payer: PHP Medicare Advantage |
$120.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.07
|
| Rate for Payer: Priority Health Medicare |
$120.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.08
|
| Rate for Payer: Railroad Medicare Medicare |
$120.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.88
|
| Rate for Payer: UHC Core |
$401.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.14
|
| Rate for Payer: UHC Medicare Advantage |
$123.74
|
| Rate for Payer: VA VA |
$120.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.40
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$480.54
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$293.08 |
| Max. Negotiated Rate |
$432.49 |
| Rate for Payer: Aetna Commercial |
$408.46
|
| Rate for Payer: BCBS Trust/PPO |
$371.36
|
| Rate for Payer: BCN Commercial |
$371.36
|
| Rate for Payer: Cash Price |
$384.43
|
| Rate for Payer: Cofinity Commercial |
$413.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.43
|
| Rate for Payer: Healthscope Commercial |
$432.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.46
|
| Rate for Payer: PHP Commercial |
$408.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.88
|
| Rate for Payer: UHC Core |
$401.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.40
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$832.62
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.75 |
| Max. Negotiated Rate |
$749.36 |
| Rate for Payer: Aetna Commercial |
$707.73
|
| Rate for Payer: Aetna Medicare |
$216.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.19
|
| Rate for Payer: BCBS Complete |
$220.97
|
| Rate for Payer: BCBS MAPPO |
$208.16
|
| Rate for Payer: BCBS Trust/PPO |
$647.36
|
| Rate for Payer: BCN Commercial |
$647.36
|
| Rate for Payer: BCN Medicare Advantage |
$208.16
|
| Rate for Payer: Cash Price |
$666.10
|
| Rate for Payer: Cash Price |
$666.10
|
| Rate for Payer: Cofinity Commercial |
$716.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.16
|
| Rate for Payer: Healthscope Commercial |
$749.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.46
|
| Rate for Payer: Mclaren Medicaid |
$210.45
|
| Rate for Payer: Meridian Medicaid |
$220.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$707.73
|
| Rate for Payer: PACE Senior Care Partners |
$197.75
|
| Rate for Payer: PACE SWMI |
$208.16
|
| Rate for Payer: PHP Commercial |
$707.73
|
| Rate for Payer: PHP Medicare Advantage |
$208.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.38
|
| Rate for Payer: Priority Health Medicare |
$208.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.81
|
| Rate for Payer: Railroad Medicare Medicare |
$208.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.71
|
| Rate for Payer: UHC Core |
$695.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.16
|
| Rate for Payer: UHC Medicare Advantage |
$214.40
|
| Rate for Payer: VA VA |
$208.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.46
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$832.62
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$507.81 |
| Max. Negotiated Rate |
$749.36 |
| Rate for Payer: Aetna Commercial |
$707.73
|
| Rate for Payer: BCBS Trust/PPO |
$643.45
|
| Rate for Payer: BCN Commercial |
$643.45
|
| Rate for Payer: Cash Price |
$666.10
|
| Rate for Payer: Cofinity Commercial |
$716.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.10
|
| Rate for Payer: Healthscope Commercial |
$749.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$707.73
|
| Rate for Payer: PHP Commercial |
$707.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$582.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$724.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.71
|
| Rate for Payer: UHC Core |
$695.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.46
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
OP
|
$13.20
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: Aetna Medicare |
$3.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.12
|
| Rate for Payer: BCBS Complete |
$6.21
|
| Rate for Payer: BCBS MAPPO |
$3.30
|
| Rate for Payer: BCBS Trust/PPO |
$10.26
|
| Rate for Payer: BCN Commercial |
$10.26
|
| Rate for Payer: BCN Medicare Advantage |
$3.30
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: Cofinity Commercial |
$11.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.30
|
| Rate for Payer: Healthscope Commercial |
$11.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.90
|
| Rate for Payer: Mclaren Medicaid |
$5.92
|
| Rate for Payer: Meridian Medicaid |
$6.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.22
|
| Rate for Payer: PACE Senior Care Partners |
$3.14
|
| Rate for Payer: PACE SWMI |
$3.30
|
| Rate for Payer: PHP Commercial |
$11.22
|
| Rate for Payer: PHP Medicare Advantage |
$3.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.48
|
| Rate for Payer: Priority Health Medicare |
$3.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.62
|
| Rate for Payer: UHC Core |
$11.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.30
|
| Rate for Payer: UHC Medicare Advantage |
$3.40
|
| Rate for Payer: VA VA |
$3.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.90
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
IP
|
$13.20
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Aetna Commercial |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$10.20
|
| Rate for Payer: BCN Commercial |
$10.20
|
| Rate for Payer: Cash Price |
$10.56
|
| Rate for Payer: Cofinity Commercial |
$11.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.56
|
| Rate for Payer: Healthscope Commercial |
$11.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.22
|
| Rate for Payer: PHP Commercial |
$11.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.62
|
| Rate for Payer: UHC Core |
$11.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.90
|
|
|
HC IGG SYNTHESIS RATE CSF
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100212
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC IGG SYNTHESIS RATE CSF
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100212
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$7.21
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$7.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
