|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$70,725.38
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16,797.28 |
| Max. Negotiated Rate |
$63,652.84 |
| Rate for Payer: Aetna Commercial |
$60,116.57
|
| Rate for Payer: Aetna Medicare |
$18,388.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,101.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,101.68
|
| Rate for Payer: BCBS Complete |
$28,290.15
|
| Rate for Payer: BCBS MAPPO |
$17,681.34
|
| Rate for Payer: BCBS Trust/PPO |
$54,988.98
|
| Rate for Payer: BCN Commercial |
$54,988.98
|
| Rate for Payer: BCN Medicare Advantage |
$17,681.34
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cofinity Commercial |
$60,823.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56,580.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,681.34
|
| Rate for Payer: Healthscope Commercial |
$63,652.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53,044.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18,565.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,333.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60,116.57
|
| Rate for Payer: PACE Senior Care Partners |
$16,797.28
|
| Rate for Payer: PACE SWMI |
$17,681.34
|
| Rate for Payer: PHP Commercial |
$60,116.57
|
| Rate for Payer: PHP Medicare Advantage |
$17,681.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49,507.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61,531.08
|
| Rate for Payer: Priority Health Medicare |
$17,681.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43,135.41
|
| Rate for Payer: Railroad Medicare Medicare |
$17,681.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62,238.33
|
| Rate for Payer: UHC Core |
$59,055.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,681.34
|
| Rate for Payer: UHC Medicare Advantage |
$18,211.79
|
| Rate for Payer: VA VA |
$17,681.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53,044.04
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.51 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: Aetna Medicare |
$138.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.46
|
| Rate for Payer: BCBS Complete |
$274.44
|
| Rate for Payer: BCBS MAPPO |
$133.17
|
| Rate for Payer: BCBS Trust/PPO |
$414.16
|
| Rate for Payer: BCN Commercial |
$414.16
|
| Rate for Payer: BCN Medicare Advantage |
$133.17
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Mclaren Medicaid |
$261.37
|
| Rate for Payer: Meridian Medicaid |
$274.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PACE Senior Care Partners |
$126.51
|
| Rate for Payer: PACE SWMI |
$133.17
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: PHP Medicare Advantage |
$133.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.43
|
| Rate for Payer: Priority Health Medicare |
$133.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: Railroad Medicare Medicare |
$133.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.76
|
| Rate for Payer: UHC Core |
$444.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.17
|
| Rate for Payer: UHC Medicare Advantage |
$137.17
|
| Rate for Payer: VA VA |
$133.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.88 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: BCBS Trust/PPO |
$411.66
|
| Rate for Payer: BCN Commercial |
$411.66
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.76
|
| Rate for Payer: UHC Core |
$444.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$6,985.98
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$4,260.75 |
| Max. Negotiated Rate |
$6,287.38 |
| Rate for Payer: Aetna Commercial |
$5,938.08
|
| Rate for Payer: Aetna Commercial |
$6,227.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,662.31
|
| Rate for Payer: BCBS Trust/PPO |
$5,398.77
|
| Rate for Payer: BCN Commercial |
$5,398.77
|
| Rate for Payer: BCN Commercial |
$5,662.31
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cofinity Commercial |
$6,007.94
|
| Rate for Payer: Cofinity Commercial |
$6,301.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Healthscope Commercial |
$6,287.38
|
| Rate for Payer: Healthscope Commercial |
$6,594.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,495.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,239.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: PHP Commercial |
$5,938.08
|
| Rate for Payer: PHP Commercial |
$6,227.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,077.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,374.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,260.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,468.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,447.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,147.66
|
| Rate for Payer: UHC Core |
$5,833.29
|
| Rate for Payer: UHC Core |
$6,118.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,239.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,495.25
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$6,985.98
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$908.96 |
| Max. Negotiated Rate |
$6,287.38 |
| Rate for Payer: Aetna Commercial |
$5,938.08
|
| Rate for Payer: Aetna Commercial |
$6,227.95
|
| Rate for Payer: Aetna Medicare |
$1,905.02
|
| Rate for Payer: Aetna Medicare |
$1,816.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,183.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,289.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,289.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,183.12
|
| Rate for Payer: BCBS Complete |
$954.41
|
| Rate for Payer: BCBS Complete |
$954.41
|
| Rate for Payer: BCBS MAPPO |
$1,831.75
|
| Rate for Payer: BCBS MAPPO |
$1,746.50
|
| Rate for Payer: BCBS Trust/PPO |
$5,696.74
|
| Rate for Payer: BCBS Trust/PPO |
$5,431.60
|
| Rate for Payer: BCN Commercial |
$5,696.74
|
| Rate for Payer: BCN Commercial |
$5,431.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,831.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,746.50
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cofinity Commercial |
$6,007.94
|
| Rate for Payer: Cofinity Commercial |
$6,301.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,831.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,746.50
|
| Rate for Payer: Healthscope Commercial |
$6,287.38
|
| Rate for Payer: Healthscope Commercial |
$6,594.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,495.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,239.48
|
| Rate for Payer: Mclaren Medicaid |
$908.96
|
| Rate for Payer: Mclaren Medicaid |
$908.96
|
| Rate for Payer: Meridian Medicaid |
$954.41
|
| Rate for Payer: Meridian Medicaid |
$954.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,923.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,833.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,008.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,106.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,659.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,740.16
|
| Rate for Payer: PACE SWMI |
$1,831.75
|
| Rate for Payer: PACE SWMI |
$1,746.50
|
| Rate for Payer: PHP Commercial |
$6,227.95
|
| Rate for Payer: PHP Commercial |
$5,938.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,831.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,746.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$908.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$908.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,077.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,374.49
|
| Rate for Payer: Priority Health Medicare |
$1,746.50
|
| Rate for Payer: Priority Health Medicare |
$1,831.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,468.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,260.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,831.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,746.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,447.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,147.66
|
| Rate for Payer: UHC Core |
$6,118.04
|
| Rate for Payer: UHC Core |
$5,833.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,746.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,831.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,798.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,886.70
|
| Rate for Payer: VA VA |
$1,746.50
|
| Rate for Payer: VA VA |
$1,831.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,495.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,239.48
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$468.81 |
| Max. Negotiated Rate |
$691.79 |
| Rate for Payer: Aetna Commercial |
$653.36
|
| Rate for Payer: BCBS Trust/PPO |
$594.02
|
| Rate for Payer: BCN Commercial |
$594.02
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$661.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Healthscope Commercial |
$691.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: PHP Commercial |
$653.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.42
|
| Rate for Payer: UHC Core |
$641.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.50
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$182.56 |
| Max. Negotiated Rate |
$691.79 |
| Rate for Payer: Aetna Commercial |
$653.36
|
| Rate for Payer: Aetna Medicare |
$199.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.21
|
| Rate for Payer: BCBS Complete |
$307.46
|
| Rate for Payer: BCBS MAPPO |
$192.16
|
| Rate for Payer: BCBS Trust/PPO |
$597.63
|
| Rate for Payer: BCN Commercial |
$597.63
|
| Rate for Payer: BCN Medicare Advantage |
$192.16
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$661.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.16
|
| Rate for Payer: Healthscope Commercial |
$691.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: PACE Senior Care Partners |
$182.56
|
| Rate for Payer: PACE SWMI |
$192.16
|
| Rate for Payer: PHP Commercial |
$653.36
|
| Rate for Payer: PHP Medicare Advantage |
$192.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.73
|
| Rate for Payer: Priority Health Medicare |
$192.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.81
|
| Rate for Payer: Railroad Medicare Medicare |
$192.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.42
|
| Rate for Payer: UHC Core |
$641.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.16
|
| Rate for Payer: UHC Medicare Advantage |
$197.93
|
| Rate for Payer: VA VA |
$192.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.50
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,260.04 |
| Max. Negotiated Rate |
$4,774.88 |
| Rate for Payer: Aetna Commercial |
$4,509.61
|
| Rate for Payer: Aetna Medicare |
$1,379.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,657.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,657.94
|
| Rate for Payer: BCBS Complete |
$2,122.17
|
| Rate for Payer: BCBS MAPPO |
$1,326.36
|
| Rate for Payer: BCBS Trust/PPO |
$4,124.96
|
| Rate for Payer: BCN Commercial |
$4,124.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,326.36
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$4,562.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,326.36
|
| Rate for Payer: Healthscope Commercial |
$4,774.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,392.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,525.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,260.04
|
| Rate for Payer: PACE SWMI |
$1,326.36
|
| Rate for Payer: PHP Commercial |
$4,509.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,326.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,615.72
|
| Rate for Payer: Priority Health Medicare |
$1,326.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,235.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,326.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,668.77
|
| Rate for Payer: UHC Core |
$4,430.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,326.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,366.15
|
| Rate for Payer: VA VA |
$1,326.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.06
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,235.78 |
| Max. Negotiated Rate |
$4,774.88 |
| Rate for Payer: Aetna Commercial |
$4,509.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,100.03
|
| Rate for Payer: BCN Commercial |
$4,100.03
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$4,562.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Healthscope Commercial |
$4,774.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: PHP Commercial |
$4,509.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,615.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,235.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,668.77
|
| Rate for Payer: UHC Core |
$4,430.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.06
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,299.04 |
| Max. Negotiated Rate |
$4,868.24 |
| Rate for Payer: Aetna Commercial |
$4,597.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,180.19
|
| Rate for Payer: BCN Commercial |
$4,180.19
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$4,651.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Healthscope Commercial |
$4,868.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,056.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: PHP Commercial |
$4,597.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,705.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,299.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,760.05
|
| Rate for Payer: UHC Core |
$4,516.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,056.86
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,284.67 |
| Max. Negotiated Rate |
$4,868.24 |
| Rate for Payer: Aetna Commercial |
$4,597.78
|
| Rate for Payer: Aetna Medicare |
$1,406.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,690.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,690.36
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$1,352.29
|
| Rate for Payer: BCBS Trust/PPO |
$4,205.61
|
| Rate for Payer: BCN Commercial |
$4,205.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.29
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$4,651.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.29
|
| Rate for Payer: Healthscope Commercial |
$4,868.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,056.86
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,419.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,555.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,284.67
|
| Rate for Payer: PACE SWMI |
$1,352.29
|
| Rate for Payer: PHP Commercial |
$4,597.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,705.96
|
| Rate for Payer: Priority Health Medicare |
$1,352.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,299.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,352.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,760.05
|
| Rate for Payer: UHC Core |
$4,516.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,392.86
|
| Rate for Payer: VA VA |
$1,352.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,056.86
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.56 |
| Max. Negotiated Rate |
$98.23 |
| Rate for Payer: Aetna Commercial |
$92.77
|
| Rate for Payer: BCBS Trust/PPO |
$84.34
|
| Rate for Payer: BCN Commercial |
$84.34
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$93.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Healthscope Commercial |
$98.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: PHP Commercial |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.04
|
| Rate for Payer: UHC Core |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.86
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.92 |
| Max. Negotiated Rate |
$98.23 |
| Rate for Payer: Aetna Commercial |
$92.77
|
| Rate for Payer: Aetna Medicare |
$28.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.11
|
| Rate for Payer: BCBS Complete |
$43.66
|
| Rate for Payer: BCBS MAPPO |
$27.28
|
| Rate for Payer: BCBS Trust/PPO |
$84.86
|
| Rate for Payer: BCN Commercial |
$84.86
|
| Rate for Payer: BCN Medicare Advantage |
$27.28
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$93.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.28
|
| Rate for Payer: Healthscope Commercial |
$98.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: PACE Senior Care Partners |
$25.92
|
| Rate for Payer: PACE SWMI |
$27.28
|
| Rate for Payer: PHP Commercial |
$92.77
|
| Rate for Payer: PHP Medicare Advantage |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.95
|
| Rate for Payer: Priority Health Medicare |
$27.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.56
|
| Rate for Payer: Railroad Medicare Medicare |
$27.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.04
|
| Rate for Payer: UHC Core |
$91.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.28
|
| Rate for Payer: UHC Medicare Advantage |
$28.10
|
| Rate for Payer: VA VA |
$27.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.86
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$293.01 |
| Max. Negotiated Rate |
$432.38 |
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: BCBS Trust/PPO |
$371.27
|
| Rate for Payer: BCN Commercial |
$371.27
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.77
|
| Rate for Payer: UHC Core |
$401.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$432.60 |
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: Aetna Medicare |
$124.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.13
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$120.10
|
| Rate for Payer: BCBS Trust/PPO |
$373.53
|
| Rate for Payer: BCN Commercial |
$373.53
|
| Rate for Payer: BCN Medicare Advantage |
$120.10
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.10
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PACE Senior Care Partners |
$114.10
|
| Rate for Payer: PACE SWMI |
$120.10
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: PHP Medicare Advantage |
$120.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.97
|
| Rate for Payer: Priority Health Medicare |
$120.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.01
|
| Rate for Payer: Railroad Medicare Medicare |
$120.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.77
|
| Rate for Payer: UHC Core |
$401.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.10
|
| Rate for Payer: UHC Medicare Advantage |
$123.71
|
| Rate for Payer: VA VA |
$120.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$466.64 |
| Max. Negotiated Rate |
$1,768.34 |
| Rate for Payer: Aetna Commercial |
$1,670.10
|
| Rate for Payer: Aetna Medicare |
$510.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$614.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$614.01
|
| Rate for Payer: BCBS Complete |
$785.93
|
| Rate for Payer: BCBS MAPPO |
$491.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.65
|
| Rate for Payer: BCN Commercial |
$1,527.65
|
| Rate for Payer: BCN Medicare Advantage |
$491.20
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,689.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$491.20
|
| Rate for Payer: Healthscope Commercial |
$1,768.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$515.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$564.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: PACE Senior Care Partners |
$466.64
|
| Rate for Payer: PACE SWMI |
$491.20
|
| Rate for Payer: PHP Commercial |
$1,670.10
|
| Rate for Payer: PHP Medicare Advantage |
$491.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,709.39
|
| Rate for Payer: Priority Health Medicare |
$491.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.34
|
| Rate for Payer: Railroad Medicare Medicare |
$491.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,729.04
|
| Rate for Payer: UHC Core |
$1,640.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$491.20
|
| Rate for Payer: UHC Medicare Advantage |
$505.94
|
| Rate for Payer: VA VA |
$491.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.62
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,198.34 |
| Max. Negotiated Rate |
$1,768.34 |
| Rate for Payer: Aetna Commercial |
$1,670.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.41
|
| Rate for Payer: BCN Commercial |
$1,518.41
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,689.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Healthscope Commercial |
$1,768.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: PHP Commercial |
$1,670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,709.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,198.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,729.04
|
| Rate for Payer: UHC Core |
$1,640.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.62
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.30 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna Medicare |
$160.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.50
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$154.00
|
| Rate for Payer: BCBS Trust/PPO |
$478.94
|
| Rate for Payer: BCN Commercial |
$478.94
|
| Rate for Payer: BCN Medicare Advantage |
$154.00
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.00
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PACE Senior Care Partners |
$146.30
|
| Rate for Payer: PACE SWMI |
$154.00
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: PHP Medicare Advantage |
$154.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.92
|
| Rate for Payer: Priority Health Medicare |
$154.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.70
|
| Rate for Payer: Railroad Medicare Medicare |
$154.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.00
|
| Rate for Payer: UHC Medicare Advantage |
$158.62
|
| Rate for Payer: VA VA |
$154.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.70 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: BCBS Trust/PPO |
$476.04
|
| Rate for Payer: BCN Commercial |
$476.04
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$396.44 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: BCBS Trust/PPO |
$502.32
|
| Rate for Payer: BCN Commercial |
$502.32
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.38 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$169.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.12
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$162.50
|
| Rate for Payer: BCBS Trust/PPO |
$505.38
|
| Rate for Payer: BCN Commercial |
$505.38
|
| Rate for Payer: BCN Medicare Advantage |
$162.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.50
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$170.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Senior Care Partners |
$154.38
|
| Rate for Payer: PACE SWMI |
$162.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$162.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.50
|
| Rate for Payer: Priority Health Medicare |
$162.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.44
|
| Rate for Payer: Railroad Medicare Medicare |
$162.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.00
|
| Rate for Payer: UHC Core |
$542.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.50
|
| Rate for Payer: UHC Medicare Advantage |
$167.38
|
| Rate for Payer: VA VA |
$162.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,081.01 |
| Max. Negotiated Rate |
$1,595.19 |
| Rate for Payer: Aetna Commercial |
$1,506.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.73
|
| Rate for Payer: BCN Commercial |
$1,369.73
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,524.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Healthscope Commercial |
$1,595.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,329.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: PHP Commercial |
$1,506.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.74
|
| Rate for Payer: UHC Core |
$1,479.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,329.32
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$420.95 |
| Max. Negotiated Rate |
$1,595.19 |
| Rate for Payer: Aetna Commercial |
$1,506.57
|
| Rate for Payer: Aetna Medicare |
$460.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$553.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$553.88
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$443.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,378.06
|
| Rate for Payer: BCN Commercial |
$1,378.06
|
| Rate for Payer: BCN Medicare Advantage |
$443.11
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,524.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.11
|
| Rate for Payer: Healthscope Commercial |
$1,595.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,329.32
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$465.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$509.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: PACE Senior Care Partners |
$420.95
|
| Rate for Payer: PACE SWMI |
$443.11
|
| Rate for Payer: PHP Commercial |
$1,506.57
|
| Rate for Payer: PHP Medicare Advantage |
$443.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,542.01
|
| Rate for Payer: Priority Health Medicare |
$443.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,081.01
|
| Rate for Payer: Railroad Medicare Medicare |
$443.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,559.74
|
| Rate for Payer: UHC Core |
$1,479.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.11
|
| Rate for Payer: UHC Medicare Advantage |
$456.40
|
| Rate for Payer: VA VA |
$443.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,329.32
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.02 |
| Max. Negotiated Rate |
$856.49 |
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: Aetna Medicare |
$247.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.39
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$237.92
|
| Rate for Payer: BCBS Trust/PPO |
$739.92
|
| Rate for Payer: BCN Commercial |
$739.92
|
| Rate for Payer: BCN Medicare Advantage |
$237.92
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.92
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PACE Senior Care Partners |
$226.02
|
| Rate for Payer: PACE SWMI |
$237.92
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: PHP Medicare Advantage |
$237.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.94
|
| Rate for Payer: Priority Health Medicare |
$237.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.42
|
| Rate for Payer: Railroad Medicare Medicare |
$237.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.46
|
| Rate for Payer: UHC Core |
$794.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.92
|
| Rate for Payer: UHC Medicare Advantage |
$245.05
|
| Rate for Payer: VA VA |
$237.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$580.42 |
| Max. Negotiated Rate |
$856.49 |
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: BCBS Trust/PPO |
$735.44
|
| Rate for Payer: BCN Commercial |
$735.44
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$827.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.46
|
| Rate for Payer: UHC Core |
$794.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
