|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.32 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: Aetna Medicare |
$413.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$496.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$496.88
|
| Rate for Payer: BCBS Complete |
$294.31
|
| Rate for Payer: BCBS MAPPO |
$397.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.14
|
| Rate for Payer: BCN Commercial |
$1,307.14
|
| Rate for Payer: BCN Medicare Advantage |
$397.50
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.50
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: Mclaren Medicaid |
$280.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.38
|
| Rate for Payer: Meridian Medicaid |
$294.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$457.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: PACE Senior Care Partners |
$377.62
|
| Rate for Payer: PACE SWMI |
$397.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: PHP Medicare Advantage |
$397.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,383.30
|
| Rate for Payer: Priority Health Medicare |
$401.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.64
|
| Rate for Payer: Railroad Medicare Medicare |
$397.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.20
|
| Rate for Payer: UHC Core |
$1,327.65
|
| Rate for Payer: UHC Exchange |
$397.50
|
| Rate for Payer: UHC Medicaid |
$280.32
|
| Rate for Payer: UHC Medicare Advantage |
$397.50
|
| Rate for Payer: UHCCP Medicaid |
$280.32
|
| Rate for Payer: VA VA |
$397.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,106.64 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.18
|
| Rate for Payer: BCN Commercial |
$1,313.18
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,383.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.20
|
| Rate for Payer: UHC Core |
$1,327.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna Medicare |
$60.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.67
|
| Rate for Payer: BCBS Complete |
$43.05
|
| Rate for Payer: BCBS MAPPO |
$58.14
|
| Rate for Payer: BCBS Trust/PPO |
$191.19
|
| Rate for Payer: BCN Commercial |
$191.19
|
| Rate for Payer: BCN Medicare Advantage |
$58.14
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.14
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: Mclaren Medicaid |
$41.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.05
|
| Rate for Payer: Meridian Medicaid |
$43.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PACE Senior Care Partners |
$55.23
|
| Rate for Payer: PACE SWMI |
$58.14
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: PHP Medicare Advantage |
$58.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$202.33
|
| Rate for Payer: Priority Health Medicare |
$58.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.86
|
| Rate for Payer: Railroad Medicare Medicare |
$58.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.65
|
| Rate for Payer: UHC Core |
$194.19
|
| Rate for Payer: UHC Exchange |
$58.14
|
| Rate for Payer: UHC Medicaid |
$41.00
|
| Rate for Payer: UHC Medicare Advantage |
$58.14
|
| Rate for Payer: UHCCP Medicaid |
$41.00
|
| Rate for Payer: VA VA |
$58.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.86 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: BCBS Trust/PPO |
$192.07
|
| Rate for Payer: BCN Commercial |
$192.07
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$202.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.65
|
| Rate for Payer: UHC Core |
$194.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.97 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna Medicare |
$100.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.49
|
| Rate for Payer: BCBS Complete |
$71.37
|
| Rate for Payer: BCBS MAPPO |
$96.39
|
| Rate for Payer: BCBS Trust/PPO |
$316.97
|
| Rate for Payer: BCN Commercial |
$316.97
|
| Rate for Payer: BCN Medicare Advantage |
$96.39
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.39
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: Mclaren Medicaid |
$67.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.21
|
| Rate for Payer: Meridian Medicaid |
$71.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PACE Senior Care Partners |
$91.57
|
| Rate for Payer: PACE SWMI |
$96.39
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: PHP Medicare Advantage |
$96.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.44
|
| Rate for Payer: Priority Health Medicare |
$97.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.35
|
| Rate for Payer: Railroad Medicare Medicare |
$96.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.29
|
| Rate for Payer: UHC Core |
$321.94
|
| Rate for Payer: UHC Exchange |
$96.39
|
| Rate for Payer: UHC Medicaid |
$67.97
|
| Rate for Payer: UHC Medicare Advantage |
$96.39
|
| Rate for Payer: UHCCP Medicaid |
$67.97
|
| Rate for Payer: VA VA |
$96.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$268.35 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: BCBS Trust/PPO |
$318.43
|
| Rate for Payer: BCN Commercial |
$318.43
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.29
|
| Rate for Payer: UHC Core |
$321.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
OP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$615.46 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: Aetna Medicare |
$907.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.94
|
| Rate for Payer: BCBS Complete |
$646.18
|
| Rate for Payer: BCBS MAPPO |
$872.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,869.95
|
| Rate for Payer: BCN Commercial |
$2,869.95
|
| Rate for Payer: BCN Medicare Advantage |
$872.75
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.75
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,618.25
|
| Rate for Payer: Mclaren Medicaid |
$615.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$916.39
|
| Rate for Payer: Meridian Medicaid |
$646.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$960.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Nomi Health Commercial |
$2,862.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PACE Senior Care Partners |
$829.11
|
| Rate for Payer: PACE SWMI |
$872.75
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: PHP Medicare Advantage |
$872.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$615.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,037.17
|
| Rate for Payer: Priority Health Medicare |
$881.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,429.74
|
| Rate for Payer: Railroad Medicare Medicare |
$872.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,072.08
|
| Rate for Payer: UHC Core |
$2,914.99
|
| Rate for Payer: UHC Exchange |
$872.75
|
| Rate for Payer: UHC Medicaid |
$615.46
|
| Rate for Payer: UHC Medicare Advantage |
$872.75
|
| Rate for Payer: UHCCP Medicaid |
$615.46
|
| Rate for Payer: VA VA |
$872.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,618.25
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
IP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,429.74 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,883.22
|
| Rate for Payer: BCN Commercial |
$2,883.22
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,618.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Nomi Health Commercial |
$2,862.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,037.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,429.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,072.08
|
| Rate for Payer: UHC Core |
$2,914.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,618.25
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$374.84 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: BCBS Trust/PPO |
$444.80
|
| Rate for Payer: BCN Commercial |
$444.80
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$468.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.93
|
| Rate for Payer: UHC Core |
$449.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$94.95 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna Medicare |
$140.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.30
|
| Rate for Payer: BCBS Complete |
$99.69
|
| Rate for Payer: BCBS MAPPO |
$134.64
|
| Rate for Payer: BCBS Trust/PPO |
$442.75
|
| Rate for Payer: BCN Commercial |
$442.75
|
| Rate for Payer: BCN Medicare Advantage |
$134.64
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: Mclaren Medicaid |
$94.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.37
|
| Rate for Payer: Meridian Medicaid |
$99.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PACE Senior Care Partners |
$127.91
|
| Rate for Payer: PACE SWMI |
$134.64
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: PHP Medicare Advantage |
$134.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$468.55
|
| Rate for Payer: Priority Health Medicare |
$135.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.84
|
| Rate for Payer: Railroad Medicare Medicare |
$134.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.93
|
| Rate for Payer: UHC Core |
$449.70
|
| Rate for Payer: UHC Exchange |
$134.64
|
| Rate for Payer: UHC Medicaid |
$94.95
|
| Rate for Payer: UHC Medicare Advantage |
$134.64
|
| Rate for Payer: UHCCP Medicaid |
$94.95
|
| Rate for Payer: VA VA |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$639.71 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: BCBS Trust/PPO |
$759.11
|
| Rate for Payer: BCN Commercial |
$759.11
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$799.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.83
|
| Rate for Payer: UHC Core |
$767.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$162.04 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna Medicare |
$238.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.23
|
| Rate for Payer: BCBS Complete |
$170.13
|
| Rate for Payer: BCBS MAPPO |
$229.78
|
| Rate for Payer: BCBS Trust/PPO |
$755.62
|
| Rate for Payer: BCN Commercial |
$755.62
|
| Rate for Payer: BCN Medicare Advantage |
$229.78
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: Mclaren Medicaid |
$162.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.27
|
| Rate for Payer: Meridian Medicaid |
$170.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$252.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PACE Senior Care Partners |
$218.29
|
| Rate for Payer: PACE SWMI |
$229.78
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: PHP Medicare Advantage |
$229.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$799.64
|
| Rate for Payer: Priority Health Medicare |
$232.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.71
|
| Rate for Payer: Railroad Medicare Medicare |
$229.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.83
|
| Rate for Payer: UHC Core |
$767.47
|
| Rate for Payer: UHC Exchange |
$229.78
|
| Rate for Payer: UHC Medicaid |
$162.04
|
| Rate for Payer: UHC Medicare Advantage |
$229.78
|
| Rate for Payer: UHCCP Medicaid |
$162.04
|
| Rate for Payer: VA VA |
$229.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,040.38 |
| Max. Negotiated Rate |
$3,931.52 |
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,607.83
|
| Rate for Payer: BCN Commercial |
$3,607.83
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,276.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$3,582.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,800.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,844.16
|
| Rate for Payer: UHC Core |
$3,647.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,276.27
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$770.14 |
| Max. Negotiated Rate |
$3,931.52 |
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: Aetna Medicare |
$1,135.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,365.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,365.11
|
| Rate for Payer: BCBS Complete |
$808.58
|
| Rate for Payer: BCBS MAPPO |
$1,092.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,591.23
|
| Rate for Payer: BCN Commercial |
$3,591.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,092.09
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,092.09
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,276.27
|
| Rate for Payer: Mclaren Medicaid |
$770.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,146.69
|
| Rate for Payer: Meridian Medicaid |
$808.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,255.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,201.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$3,582.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PACE Senior Care Partners |
$1,037.49
|
| Rate for Payer: PACE SWMI |
$1,092.09
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,092.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$770.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,800.47
|
| Rate for Payer: Priority Health Medicare |
$1,103.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,092.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,844.16
|
| Rate for Payer: UHC Core |
$3,647.58
|
| Rate for Payer: UHC Exchange |
$1,092.09
|
| Rate for Payer: UHC Medicaid |
$770.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,092.09
|
| Rate for Payer: UHCCP Medicaid |
$770.14
|
| Rate for Payer: VA VA |
$1,092.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,276.27
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.30 |
| Max. Negotiated Rate |
$477.54 |
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: BCBS Trust/PPO |
$438.22
|
| Rate for Payer: BCN Commercial |
$438.22
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$435.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PHP Commercial |
$451.01
|
| 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: UHC All Payor (Choice/PPO) |
$466.93
|
| Rate for Payer: UHC Core |
$443.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
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 Medicare |
$137.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.81
|
| Rate for Payer: BCBS Complete |
$98.21
|
| Rate for Payer: BCBS MAPPO |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$436.21
|
| Rate for Payer: BCN Commercial |
$436.21
|
| Rate for Payer: BCN Medicare Advantage |
$132.65
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.65
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Mclaren Medicaid |
$93.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.28
|
| Rate for Payer: Meridian Medicaid |
$98.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$435.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PACE Senior Care Partners |
$126.02
|
| Rate for Payer: PACE SWMI |
$132.65
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: PHP Medicare Advantage |
$132.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$461.62
|
| Rate for Payer: Priority Health Medicare |
$133.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.30
|
| Rate for Payer: Railroad Medicare Medicare |
$132.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.93
|
| Rate for Payer: UHC Core |
$443.05
|
| Rate for Payer: UHC Exchange |
$132.65
|
| Rate for Payer: UHC Medicaid |
$93.54
|
| Rate for Payer: UHC Medicare Advantage |
$132.65
|
| Rate for Payer: UHCCP Medicaid |
$93.54
|
| Rate for Payer: VA VA |
$132.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,486.91 |
| Max. Negotiated Rate |
$1,922.73 |
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.43
|
| Rate for Payer: BCN Commercial |
$1,764.43
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,602.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Nomi Health Commercial |
$1,751.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,858.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,486.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,880.01
|
| Rate for Payer: UHC Core |
$1,783.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,602.28
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$376.64 |
| Max. Negotiated Rate |
$1,922.73 |
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: Aetna Medicare |
$555.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$667.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$667.62
|
| Rate for Payer: BCBS Complete |
$395.44
|
| Rate for Payer: BCBS MAPPO |
$534.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,756.31
|
| Rate for Payer: BCN Commercial |
$1,756.31
|
| Rate for Payer: BCN Medicare Advantage |
$534.09
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.09
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,602.28
|
| Rate for Payer: Mclaren Medicaid |
$376.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$560.80
|
| Rate for Payer: Meridian Medicaid |
$395.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$587.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Nomi Health Commercial |
$1,751.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PACE Senior Care Partners |
$507.39
|
| Rate for Payer: PACE SWMI |
$534.09
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: PHP Medicare Advantage |
$534.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,858.64
|
| Rate for Payer: Priority Health Medicare |
$539.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,486.91
|
| Rate for Payer: Railroad Medicare Medicare |
$534.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,880.01
|
| Rate for Payer: UHC Core |
$1,783.87
|
| Rate for Payer: UHC Exchange |
$534.09
|
| Rate for Payer: UHC Medicaid |
$376.64
|
| Rate for Payer: UHC Medicare Advantage |
$534.09
|
| Rate for Payer: UHCCP Medicaid |
$376.64
|
| Rate for Payer: VA VA |
$534.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,602.28
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,350.95
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$767.07 |
| Max. Negotiated Rate |
$3,915.86 |
| Rate for Payer: Aetna Commercial |
$3,698.31
|
| Rate for Payer: Aetna Medicare |
$1,131.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,359.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,359.67
|
| Rate for Payer: BCBS Complete |
$805.36
|
| Rate for Payer: BCBS MAPPO |
$1,087.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,576.92
|
| Rate for Payer: BCN Commercial |
$3,576.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.74
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cofinity Commercial |
$3,741.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.74
|
| Rate for Payer: Healthscope Commercial |
$3,915.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,263.21
|
| Rate for Payer: Mclaren Medicaid |
$767.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,142.12
|
| Rate for Payer: Meridian Medicaid |
$805.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,250.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,196.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,698.31
|
| Rate for Payer: Nomi Health Commercial |
$3,567.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,263.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,033.35
|
| Rate for Payer: PACE SWMI |
$1,087.74
|
| Rate for Payer: PHP Commercial |
$3,698.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$767.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,785.33
|
| Rate for Payer: Priority Health Medicare |
$1,098.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,028.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,087.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,828.84
|
| Rate for Payer: UHC Core |
$3,633.04
|
| Rate for Payer: UHC Exchange |
$1,087.74
|
| Rate for Payer: UHC Medicaid |
$767.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,087.74
|
| Rate for Payer: UHCCP Medicaid |
$767.07
|
| Rate for Payer: VA VA |
$1,087.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,263.21
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,350.95
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,028.26 |
| Max. Negotiated Rate |
$3,915.86 |
| Rate for Payer: Aetna Commercial |
$3,698.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,593.45
|
| Rate for Payer: BCN Commercial |
$3,593.45
|
| Rate for Payer: Cash Price |
$3,480.76
|
| Rate for Payer: Cofinity Commercial |
$3,741.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.76
|
| Rate for Payer: Healthscope Commercial |
$3,915.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,263.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,698.31
|
| Rate for Payer: Nomi Health Commercial |
$3,567.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,263.21
|
| Rate for Payer: PHP Commercial |
$3,698.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,785.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,028.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,828.84
|
| Rate for Payer: UHC Core |
$3,633.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,263.21
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,216.67
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$567.10 |
| Max. Negotiated Rate |
$2,895.00 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: Aetna Medicare |
$836.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,005.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,005.21
|
| Rate for Payer: BCBS Complete |
$595.41
|
| Rate for Payer: BCBS MAPPO |
$804.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,644.42
|
| Rate for Payer: BCN Commercial |
$2,644.42
|
| Rate for Payer: BCN Medicare Advantage |
$804.17
|
| Rate for Payer: Cash Price |
$2,573.34
|
| Rate for Payer: Cofinity Commercial |
$2,766.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,573.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.17
|
| Rate for Payer: Healthscope Commercial |
$2,895.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,412.50
|
| Rate for Payer: Mclaren Medicaid |
$567.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$844.38
|
| Rate for Payer: Meridian Medicaid |
$595.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$924.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$884.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,734.17
|
| Rate for Payer: Nomi Health Commercial |
$2,637.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,412.50
|
| Rate for Payer: PACE Senior Care Partners |
$763.96
|
| Rate for Payer: PACE SWMI |
$804.17
|
| Rate for Payer: PHP Commercial |
$2,734.17
|
| Rate for Payer: PHP Medicare Advantage |
$804.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$567.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,798.50
|
| Rate for Payer: Priority Health Medicare |
$812.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,238.80
|
| Rate for Payer: Railroad Medicare Medicare |
$804.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,830.67
|
| Rate for Payer: UHC Core |
$2,685.92
|
| Rate for Payer: UHC Exchange |
$804.17
|
| Rate for Payer: UHC Medicaid |
$567.10
|
| Rate for Payer: UHC Medicare Advantage |
$804.17
|
| Rate for Payer: UHCCP Medicaid |
$567.10
|
| Rate for Payer: VA VA |
$804.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,412.50
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,216.67
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,238.80 |
| Max. Negotiated Rate |
$2,895.00 |
| Rate for Payer: Aetna Commercial |
$2,734.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,656.65
|
| Rate for Payer: BCN Commercial |
$2,656.65
|
| Rate for Payer: Cash Price |
$2,573.34
|
| Rate for Payer: Cofinity Commercial |
$2,766.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,573.34
|
| Rate for Payer: Healthscope Commercial |
$2,895.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,412.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,734.17
|
| Rate for Payer: Nomi Health Commercial |
$2,637.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,412.50
|
| Rate for Payer: PHP Commercial |
$2,734.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,798.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,238.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,830.67
|
| Rate for Payer: UHC Core |
$2,685.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,412.50
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.20 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$568.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.79
|
| Rate for Payer: BCBS Complete |
$404.43
|
| Rate for Payer: BCBS MAPPO |
$546.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.22
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$546.23
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Mclaren Medicaid |
$385.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.54
|
| Rate for Payer: Meridian Medicaid |
$404.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Senior Care Partners |
$518.92
|
| Rate for Payer: PACE SWMI |
$546.23
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$546.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Medicare |
$551.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: Railroad Medicare Medicare |
$546.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: UHC Exchange |
$546.23
|
| Rate for Payer: UHC Medicaid |
$385.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.23
|
| Rate for Payer: UHCCP Medicaid |
$385.20
|
| Rate for Payer: VA VA |
$546.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC DRAINAGE SOFT TISSUE W IMAGE GUIDANCE
|
Facility
|
OP
|
$3,238.15
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
36100422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.89 |
| Max. Negotiated Rate |
$2,914.34 |
| Rate for Payer: Aetna Commercial |
$2,752.43
|
| Rate for Payer: Aetna Medicare |
$841.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,011.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,011.92
|
| Rate for Payer: BCBS Complete |
$599.38
|
| Rate for Payer: BCBS MAPPO |
$809.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,662.08
|
| Rate for Payer: BCN Commercial |
$2,662.08
|
| Rate for Payer: BCN Medicare Advantage |
$809.54
|
| Rate for Payer: Cash Price |
$2,590.52
|
| Rate for Payer: Cofinity Commercial |
$2,784.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,590.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.54
|
| Rate for Payer: Healthscope Commercial |
$2,914.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,428.61
|
| Rate for Payer: Mclaren Medicaid |
$570.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.01
|
| Rate for Payer: Meridian Medicaid |
$599.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$930.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$890.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,752.43
|
| Rate for Payer: Nomi Health Commercial |
$2,655.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,428.61
|
| Rate for Payer: PACE Senior Care Partners |
$769.06
|
| Rate for Payer: PACE SWMI |
$809.54
|
| Rate for Payer: PHP Commercial |
$2,752.43
|
| Rate for Payer: PHP Medicare Advantage |
$809.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,817.19
|
| Rate for Payer: Priority Health Medicare |
$817.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,253.75
|
| Rate for Payer: Railroad Medicare Medicare |
$809.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,849.57
|
| Rate for Payer: UHC Core |
$2,703.86
|
| Rate for Payer: UHC Exchange |
$809.54
|
| Rate for Payer: UHC Medicaid |
$570.89
|
| Rate for Payer: UHC Medicare Advantage |
$809.54
|
| Rate for Payer: UHCCP Medicaid |
$570.89
|
| Rate for Payer: VA VA |
$809.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,428.61
|
|
