|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
IP
|
$1,242.36
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.72 |
| Max. Negotiated Rate |
$1,118.12 |
| Rate for Payer: Aetna Commercial |
$1,056.01
|
| Rate for Payer: BCBS Trust/PPO |
$960.10
|
| Rate for Payer: BCN Commercial |
$960.10
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,068.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Healthscope Commercial |
$1,118.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: PHP Commercial |
$1,056.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.28
|
| Rate for Payer: UHC Core |
$1,037.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.77
|
|
|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
OP
|
$1,242.36
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.06 |
| Max. Negotiated Rate |
$1,118.12 |
| Rate for Payer: Aetna Commercial |
$1,056.01
|
| Rate for Payer: Aetna Medicare |
$323.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.24
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.59
|
| Rate for Payer: BCBS Trust/PPO |
$965.93
|
| Rate for Payer: BCN Commercial |
$965.93
|
| Rate for Payer: BCN Medicare Advantage |
$310.59
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,068.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.59
|
| Rate for Payer: Healthscope Commercial |
$1,118.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.77
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: PACE Senior Care Partners |
$295.06
|
| Rate for Payer: PACE SWMI |
$310.59
|
| Rate for Payer: PHP Commercial |
$1,056.01
|
| Rate for Payer: PHP Medicare Advantage |
$310.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.85
|
| Rate for Payer: Priority Health Medicare |
$310.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.72
|
| Rate for Payer: Railroad Medicare Medicare |
$310.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.28
|
| Rate for Payer: UHC Core |
$1,037.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.59
|
| Rate for Payer: UHC Medicare Advantage |
$319.91
|
| Rate for Payer: VA VA |
$310.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.77
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
IP
|
$1,818.84
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,109.31 |
| Max. Negotiated Rate |
$1,636.96 |
| Rate for Payer: Aetna Commercial |
$1,546.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.60
|
| Rate for Payer: BCN Commercial |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cofinity Commercial |
$1,564.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.07
|
| Rate for Payer: Healthscope Commercial |
$1,636.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.01
|
| Rate for Payer: PHP Commercial |
$1,546.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,582.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,600.58
|
| Rate for Payer: UHC Core |
$1,518.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.13
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
OP
|
$1,818.84
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$431.97 |
| Max. Negotiated Rate |
$1,636.96 |
| Rate for Payer: Aetna Commercial |
$1,546.01
|
| Rate for Payer: Aetna Medicare |
$472.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$568.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$568.39
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$454.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.15
|
| Rate for Payer: BCN Commercial |
$1,414.15
|
| Rate for Payer: BCN Medicare Advantage |
$454.71
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cash Price |
$1,455.07
|
| Rate for Payer: Cofinity Commercial |
$1,564.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.71
|
| Rate for Payer: Healthscope Commercial |
$1,636.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.13
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$477.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$522.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.01
|
| Rate for Payer: PACE Senior Care Partners |
$431.97
|
| Rate for Payer: PACE SWMI |
$454.71
|
| Rate for Payer: PHP Commercial |
$1,546.01
|
| Rate for Payer: PHP Medicare Advantage |
$454.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,582.39
|
| Rate for Payer: Priority Health Medicare |
$454.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.31
|
| Rate for Payer: Railroad Medicare Medicare |
$454.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,600.58
|
| Rate for Payer: UHC Core |
$1,518.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.71
|
| Rate for Payer: UHC Medicare Advantage |
$468.35
|
| Rate for Payer: VA VA |
$454.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.13
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
IP
|
$1,242.36
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.72 |
| Max. Negotiated Rate |
$1,118.12 |
| Rate for Payer: Aetna Commercial |
$1,056.01
|
| Rate for Payer: BCBS Trust/PPO |
$960.10
|
| Rate for Payer: BCN Commercial |
$960.10
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,068.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Healthscope Commercial |
$1,118.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: PHP Commercial |
$1,056.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.28
|
| Rate for Payer: UHC Core |
$1,037.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.77
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
OP
|
$1,242.36
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.06 |
| Max. Negotiated Rate |
$1,118.12 |
| Rate for Payer: Aetna Commercial |
$1,056.01
|
| Rate for Payer: Aetna Medicare |
$323.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.24
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.59
|
| Rate for Payer: BCBS Trust/PPO |
$965.93
|
| Rate for Payer: BCN Commercial |
$965.93
|
| Rate for Payer: BCN Medicare Advantage |
$310.59
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cash Price |
$993.89
|
| Rate for Payer: Cofinity Commercial |
$1,068.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.59
|
| Rate for Payer: Healthscope Commercial |
$1,118.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.77
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.01
|
| Rate for Payer: PACE Senior Care Partners |
$295.06
|
| Rate for Payer: PACE SWMI |
$310.59
|
| Rate for Payer: PHP Commercial |
$1,056.01
|
| Rate for Payer: PHP Medicare Advantage |
$310.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.85
|
| Rate for Payer: Priority Health Medicare |
$310.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.72
|
| Rate for Payer: Railroad Medicare Medicare |
$310.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.28
|
| Rate for Payer: UHC Core |
$1,037.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.59
|
| Rate for Payer: UHC Medicare Advantage |
$319.91
|
| Rate for Payer: VA VA |
$310.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.77
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
IP
|
$1,873.76
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,142.81 |
| Max. Negotiated Rate |
$1,686.38 |
| Rate for Payer: Aetna Commercial |
$1,592.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,448.04
|
| Rate for Payer: BCN Commercial |
$1,448.04
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cofinity Commercial |
$1,611.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.01
|
| Rate for Payer: Healthscope Commercial |
$1,686.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,592.70
|
| Rate for Payer: PHP Commercial |
$1,592.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,630.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,648.91
|
| Rate for Payer: UHC Core |
$1,564.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.32
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
OP
|
$1,873.76
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$445.02 |
| Max. Negotiated Rate |
$1,686.38 |
| Rate for Payer: Aetna Commercial |
$1,592.70
|
| Rate for Payer: Aetna Medicare |
$487.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$585.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$585.55
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$468.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.85
|
| Rate for Payer: BCN Commercial |
$1,456.85
|
| Rate for Payer: BCN Medicare Advantage |
$468.44
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cash Price |
$1,499.01
|
| Rate for Payer: Cofinity Commercial |
$1,611.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.44
|
| Rate for Payer: Healthscope Commercial |
$1,686.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.32
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$491.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$538.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,592.70
|
| Rate for Payer: PACE Senior Care Partners |
$445.02
|
| Rate for Payer: PACE SWMI |
$468.44
|
| Rate for Payer: PHP Commercial |
$1,592.70
|
| Rate for Payer: PHP Medicare Advantage |
$468.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,630.17
|
| Rate for Payer: Priority Health Medicare |
$468.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,142.81
|
| Rate for Payer: Railroad Medicare Medicare |
$468.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,648.91
|
| Rate for Payer: UHC Core |
$1,564.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.44
|
| Rate for Payer: UHC Medicare Advantage |
$482.49
|
| Rate for Payer: VA VA |
$468.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.32
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
OP
|
$3,109.92
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$597.92 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: Aetna Medicare |
$808.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$971.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$971.85
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$777.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,417.96
|
| Rate for Payer: BCN Commercial |
$2,417.96
|
| Rate for Payer: BCN Medicare Advantage |
$777.48
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.48
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$894.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PACE Senior Care Partners |
$738.61
|
| Rate for Payer: PACE SWMI |
$777.48
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: PHP Medicare Advantage |
$777.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,705.63
|
| Rate for Payer: Priority Health Medicare |
$777.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,896.74
|
| Rate for Payer: Railroad Medicare Medicare |
$777.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,736.73
|
| Rate for Payer: UHC Core |
$2,596.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.48
|
| Rate for Payer: UHC Medicare Advantage |
$800.80
|
| Rate for Payer: VA VA |
$777.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
IP
|
$3,109.92
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,896.74 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.35
|
| Rate for Payer: BCN Commercial |
$2,403.35
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,705.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,896.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,736.73
|
| Rate for Payer: UHC Core |
$2,596.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
OP
|
$2,549.64
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$453.65 |
| Max. Negotiated Rate |
$2,294.68 |
| Rate for Payer: Aetna Commercial |
$2,167.19
|
| Rate for Payer: Aetna Medicare |
$662.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.76
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$637.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.35
|
| Rate for Payer: BCN Commercial |
$1,982.35
|
| Rate for Payer: BCN Medicare Advantage |
$637.41
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cofinity Commercial |
$2,192.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,039.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.41
|
| Rate for Payer: Healthscope Commercial |
$2,294.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.23
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$669.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,167.19
|
| Rate for Payer: PACE Senior Care Partners |
$605.54
|
| Rate for Payer: PACE SWMI |
$637.41
|
| Rate for Payer: PHP Commercial |
$2,167.19
|
| Rate for Payer: PHP Medicare Advantage |
$637.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,784.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,218.19
|
| Rate for Payer: Priority Health Medicare |
$637.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,555.03
|
| Rate for Payer: Railroad Medicare Medicare |
$637.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,243.68
|
| Rate for Payer: UHC Core |
$2,128.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.41
|
| Rate for Payer: UHC Medicare Advantage |
$656.53
|
| Rate for Payer: VA VA |
$637.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.23
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
IP
|
$2,549.64
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,555.03 |
| Max. Negotiated Rate |
$2,294.68 |
| Rate for Payer: Aetna Commercial |
$2,167.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,970.36
|
| Rate for Payer: BCN Commercial |
$1,970.36
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cofinity Commercial |
$2,192.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,039.71
|
| Rate for Payer: Healthscope Commercial |
$2,294.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,167.19
|
| Rate for Payer: PHP Commercial |
$2,167.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,784.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,218.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,555.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,243.68
|
| Rate for Payer: UHC Core |
$2,128.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.23
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.27 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: BCBS Trust/PPO |
$739.05
|
| Rate for Payer: BCN Commercial |
$739.05
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.57
|
| Rate for Payer: UHC Core |
$798.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.13 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna Medicare |
$248.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.85
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$239.08
|
| Rate for Payer: BCBS Trust/PPO |
$743.55
|
| Rate for Payer: BCN Commercial |
$743.55
|
| Rate for Payer: BCN Medicare Advantage |
$239.08
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.08
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Senior Care Partners |
$227.13
|
| Rate for Payer: PACE SWMI |
$239.08
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: PHP Medicare Advantage |
$239.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.01
|
| Rate for Payer: Priority Health Medicare |
$239.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.27
|
| Rate for Payer: Railroad Medicare Medicare |
$239.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.57
|
| Rate for Payer: UHC Core |
$798.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.08
|
| Rate for Payer: UHC Medicare Advantage |
$246.25
|
| Rate for Payer: VA VA |
$239.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
IP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$917.41 |
| Max. Negotiated Rate |
$1,353.77 |
| Rate for Payer: Aetna Commercial |
$1,278.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,162.44
|
| Rate for Payer: BCN Commercial |
$1,162.44
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,293.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Healthscope Commercial |
$1,353.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,128.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: PHP Commercial |
$1,278.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,323.69
|
| Rate for Payer: UHC Core |
$1,256.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,128.14
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
OP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$357.25 |
| Max. Negotiated Rate |
$1,353.77 |
| Rate for Payer: Aetna Commercial |
$1,278.56
|
| Rate for Payer: Aetna Medicare |
$391.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$470.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$470.06
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$376.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,169.51
|
| Rate for Payer: BCN Commercial |
$1,169.51
|
| Rate for Payer: BCN Medicare Advantage |
$376.05
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,293.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.05
|
| Rate for Payer: Healthscope Commercial |
$1,353.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,128.14
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$394.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$432.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: PACE Senior Care Partners |
$357.25
|
| Rate for Payer: PACE SWMI |
$376.05
|
| Rate for Payer: PHP Commercial |
$1,278.56
|
| Rate for Payer: PHP Medicare Advantage |
$376.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,308.65
|
| Rate for Payer: Priority Health Medicare |
$376.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.41
|
| Rate for Payer: Railroad Medicare Medicare |
$376.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,323.69
|
| Rate for Payer: UHC Core |
$1,256.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.05
|
| Rate for Payer: UHC Medicare Advantage |
$387.33
|
| Rate for Payer: VA VA |
$376.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,128.14
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
IP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$532.36 |
| Max. Negotiated Rate |
$785.58 |
| Rate for Payer: Aetna Commercial |
$741.94
|
| Rate for Payer: BCBS Trust/PPO |
$674.55
|
| Rate for Payer: BCN Commercial |
$674.55
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Healthscope Commercial |
$785.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: PHP Commercial |
$741.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.13
|
| Rate for Payer: UHC Core |
$728.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.65
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
OP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.31 |
| Max. Negotiated Rate |
$785.58 |
| Rate for Payer: Aetna Commercial |
$741.94
|
| Rate for Payer: Aetna Medicare |
$226.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.77
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$218.22
|
| Rate for Payer: BCBS Trust/PPO |
$678.66
|
| Rate for Payer: BCN Commercial |
$678.66
|
| Rate for Payer: BCN Medicare Advantage |
$218.22
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.22
|
| Rate for Payer: Healthscope Commercial |
$785.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.65
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: PACE Senior Care Partners |
$207.31
|
| Rate for Payer: PACE SWMI |
$218.22
|
| Rate for Payer: PHP Commercial |
$741.94
|
| Rate for Payer: PHP Medicare Advantage |
$218.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$759.40
|
| Rate for Payer: Priority Health Medicare |
$218.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$532.36
|
| Rate for Payer: Railroad Medicare Medicare |
$218.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.13
|
| Rate for Payer: UHC Core |
$728.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.22
|
| Rate for Payer: UHC Medicare Advantage |
$224.76
|
| Rate for Payer: VA VA |
$218.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.65
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
IP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,896.74 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.35
|
| Rate for Payer: BCN Commercial |
$2,403.35
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,705.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,896.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,736.73
|
| Rate for Payer: UHC Core |
$2,596.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
OP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$597.92 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: Aetna Medicare |
$808.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$971.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$971.85
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$777.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,417.96
|
| Rate for Payer: BCN Commercial |
$2,417.96
|
| Rate for Payer: BCN Medicare Advantage |
$777.48
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.48
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$894.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PACE Senior Care Partners |
$738.61
|
| Rate for Payer: PACE SWMI |
$777.48
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: PHP Medicare Advantage |
$777.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,705.63
|
| Rate for Payer: Priority Health Medicare |
$777.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,896.74
|
| Rate for Payer: Railroad Medicare Medicare |
$777.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,736.73
|
| Rate for Payer: UHC Core |
$2,596.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.48
|
| Rate for Payer: UHC Medicare Advantage |
$800.80
|
| Rate for Payer: VA VA |
$777.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
IP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,901.79 |
| Max. Negotiated Rate |
$2,806.38 |
| Rate for Payer: Aetna Commercial |
$2,650.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,409.74
|
| Rate for Payer: BCN Commercial |
$2,409.74
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,681.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Healthscope Commercial |
$2,806.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,338.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: PHP Commercial |
$2,650.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,712.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,901.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,744.02
|
| Rate for Payer: UHC Core |
$2,603.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,338.65
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
OP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$597.92 |
| Max. Negotiated Rate |
$2,806.38 |
| Rate for Payer: Aetna Commercial |
$2,650.47
|
| Rate for Payer: Aetna Medicare |
$810.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$974.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$974.44
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$779.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,424.40
|
| Rate for Payer: BCN Commercial |
$2,424.40
|
| Rate for Payer: BCN Medicare Advantage |
$779.55
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,681.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.55
|
| Rate for Payer: Healthscope Commercial |
$2,806.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,338.65
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$896.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: PACE Senior Care Partners |
$740.57
|
| Rate for Payer: PACE SWMI |
$779.55
|
| Rate for Payer: PHP Commercial |
$2,650.47
|
| Rate for Payer: PHP Medicare Advantage |
$779.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,712.83
|
| Rate for Payer: Priority Health Medicare |
$779.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,901.79
|
| Rate for Payer: Railroad Medicare Medicare |
$779.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,744.02
|
| Rate for Payer: UHC Core |
$2,603.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$779.55
|
| Rate for Payer: UHC Medicare Advantage |
$802.94
|
| Rate for Payer: VA VA |
$779.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,338.65
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.13 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna Medicare |
$248.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$298.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$298.85
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$239.08
|
| Rate for Payer: BCBS Trust/PPO |
$743.55
|
| Rate for Payer: BCN Commercial |
$743.55
|
| Rate for Payer: BCN Medicare Advantage |
$239.08
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.08
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Senior Care Partners |
$227.13
|
| Rate for Payer: PACE SWMI |
$239.08
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: PHP Medicare Advantage |
$239.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.01
|
| Rate for Payer: Priority Health Medicare |
$239.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.27
|
| Rate for Payer: Railroad Medicare Medicare |
$239.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.57
|
| Rate for Payer: UHC Core |
$798.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.08
|
| Rate for Payer: UHC Medicare Advantage |
$246.25
|
| Rate for Payer: VA VA |
$239.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$583.27 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: BCBS Trust/PPO |
$739.05
|
| Rate for Payer: BCN Commercial |
$739.05
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$832.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$583.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$841.57
|
| Rate for Payer: UHC Core |
$798.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
OP
|
$475.49
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$112.93 |
| Max. Negotiated Rate |
$427.94 |
| Rate for Payer: Aetna Commercial |
$404.17
|
| Rate for Payer: Aetna Medicare |
$123.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.59
|
| Rate for Payer: BCBS Complete |
$253.38
|
| Rate for Payer: BCBS MAPPO |
$118.87
|
| Rate for Payer: BCBS Trust/PPO |
$369.69
|
| Rate for Payer: BCN Commercial |
$369.69
|
| Rate for Payer: BCN Medicare Advantage |
$118.87
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cofinity Commercial |
$408.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.87
|
| Rate for Payer: Healthscope Commercial |
$427.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.62
|
| Rate for Payer: Mclaren Medicaid |
$241.32
|
| Rate for Payer: Meridian Medicaid |
$253.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.17
|
| Rate for Payer: PACE Senior Care Partners |
$112.93
|
| Rate for Payer: PACE SWMI |
$118.87
|
| Rate for Payer: PHP Commercial |
$404.17
|
| Rate for Payer: PHP Medicare Advantage |
$118.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.68
|
| Rate for Payer: Priority Health Medicare |
$118.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.00
|
| Rate for Payer: Railroad Medicare Medicare |
$118.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.43
|
| Rate for Payer: UHC Core |
$397.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.87
|
| Rate for Payer: UHC Medicare Advantage |
$122.44
|
| Rate for Payer: VA VA |
$118.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.62
|
|
