|
HC INJECTION LUMBAR DISKOGRAPHY
|
Facility
|
IP
|
$2,303.46
|
|
|
Service Code
|
CPT 62290
|
| Hospital Charge Code |
36100282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,404.88 |
| Max. Negotiated Rate |
$2,073.11 |
| Rate for Payer: Aetna Commercial |
$1,957.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.11
|
| Rate for Payer: BCN Commercial |
$1,780.11
|
| Rate for Payer: Cash Price |
$1,842.77
|
| Rate for Payer: Cofinity Commercial |
$1,980.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.77
|
| Rate for Payer: Healthscope Commercial |
$2,073.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,957.94
|
| Rate for Payer: PHP Commercial |
$1,957.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,004.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,404.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,027.04
|
| Rate for Payer: UHC Core |
$1,923.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.60
|
|
|
HC INJECTION LUMBAR DISKOGRAPHY
|
Facility
|
OP
|
$2,303.46
|
|
|
Service Code
|
CPT 62290
|
| Hospital Charge Code |
36100282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$547.07 |
| Max. Negotiated Rate |
$2,073.11 |
| Rate for Payer: Aetna Commercial |
$1,957.94
|
| Rate for Payer: Aetna Medicare |
$598.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$719.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$719.83
|
| Rate for Payer: BCBS Complete |
$921.38
|
| Rate for Payer: BCBS MAPPO |
$575.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,790.94
|
| Rate for Payer: BCN Commercial |
$1,790.94
|
| Rate for Payer: BCN Medicare Advantage |
$575.86
|
| Rate for Payer: Cash Price |
$1,842.77
|
| Rate for Payer: Cofinity Commercial |
$1,980.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.86
|
| Rate for Payer: Healthscope Commercial |
$2,073.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$604.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$662.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,957.94
|
| Rate for Payer: PACE Senior Care Partners |
$547.07
|
| Rate for Payer: PACE SWMI |
$575.86
|
| Rate for Payer: PHP Commercial |
$1,957.94
|
| Rate for Payer: PHP Medicare Advantage |
$575.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,612.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,004.01
|
| Rate for Payer: Priority Health Medicare |
$575.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,404.88
|
| Rate for Payer: Railroad Medicare Medicare |
$575.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,027.04
|
| Rate for Payer: UHC Core |
$1,923.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$575.86
|
| Rate for Payer: UHC Medicare Advantage |
$593.14
|
| Rate for Payer: VA VA |
$575.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.60
|
|
|
HC INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG
|
Facility
|
IP
|
$1.02
|
|
|
Service Code
|
CPT J1050
|
| Hospital Charge Code |
63600096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: BCBS Trust/PPO |
$0.79
|
| Rate for Payer: BCN Commercial |
$0.79
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.87
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.90
|
| Rate for Payer: UHC Core |
$0.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG
|
Facility
|
OP
|
$1.02
|
|
|
Service Code
|
CPT J1050
|
| Hospital Charge Code |
63600096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna Medicare |
$0.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.32
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS MAPPO |
$0.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.79
|
| Rate for Payer: BCN Commercial |
$0.79
|
| Rate for Payer: BCN Medicare Advantage |
$0.26
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.26
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.87
|
| Rate for Payer: PACE Senior Care Partners |
$0.24
|
| Rate for Payer: PACE SWMI |
$0.26
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: PHP Medicare Advantage |
$0.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.89
|
| Rate for Payer: Priority Health Medicare |
$0.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.62
|
| Rate for Payer: Railroad Medicare Medicare |
$0.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.90
|
| Rate for Payer: UHC Core |
$0.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.26
|
| Rate for Payer: UHC Medicare Advantage |
$0.26
|
| Rate for Payer: VA VA |
$0.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG
|
Facility
|
OP
|
$10.20
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
63600093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna Medicare |
$2.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.19
|
| Rate for Payer: BCBS Complete |
$4.08
|
| Rate for Payer: BCBS MAPPO |
$2.55
|
| Rate for Payer: BCBS Trust/PPO |
$7.93
|
| Rate for Payer: BCN Commercial |
$7.93
|
| Rate for Payer: BCN Medicare Advantage |
$2.55
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.55
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PACE Senior Care Partners |
$2.42
|
| Rate for Payer: PACE SWMI |
$2.55
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: PHP Medicare Advantage |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$2.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.98
|
| Rate for Payer: UHC Core |
$8.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.55
|
| Rate for Payer: UHC Medicare Advantage |
$2.63
|
| Rate for Payer: VA VA |
$2.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG
|
Facility
|
IP
|
$10.20
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
63600093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: BCBS Trust/PPO |
$7.88
|
| Rate for Payer: BCN Commercial |
$7.88
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.98
|
| Rate for Payer: UHC Core |
$8.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
63600094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
63600094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.82
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
63600095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
63600095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC INJECTION MYELOGRAM
|
Facility
|
IP
|
$1,046.41
|
|
|
Service Code
|
CPT 62284
|
| Hospital Charge Code |
36100281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$638.21 |
| Max. Negotiated Rate |
$941.77 |
| Rate for Payer: Aetna Commercial |
$889.45
|
| Rate for Payer: BCBS Trust/PPO |
$808.67
|
| Rate for Payer: BCN Commercial |
$808.67
|
| Rate for Payer: Cash Price |
$837.13
|
| Rate for Payer: Cofinity Commercial |
$899.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$837.13
|
| Rate for Payer: Healthscope Commercial |
$941.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$889.45
|
| Rate for Payer: PHP Commercial |
$889.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.84
|
| Rate for Payer: UHC Core |
$873.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.81
|
|
|
HC INJECTION MYELOGRAM
|
Facility
|
OP
|
$1,046.41
|
|
|
Service Code
|
CPT 62284
|
| Hospital Charge Code |
36100281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.52 |
| Max. Negotiated Rate |
$941.77 |
| Rate for Payer: Aetna Commercial |
$889.45
|
| Rate for Payer: Aetna Medicare |
$272.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$327.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$327.00
|
| Rate for Payer: BCBS Complete |
$418.56
|
| Rate for Payer: BCBS MAPPO |
$261.60
|
| Rate for Payer: BCBS Trust/PPO |
$813.58
|
| Rate for Payer: BCN Commercial |
$813.58
|
| Rate for Payer: BCN Medicare Advantage |
$261.60
|
| Rate for Payer: Cash Price |
$837.13
|
| Rate for Payer: Cofinity Commercial |
$899.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$837.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.60
|
| Rate for Payer: Healthscope Commercial |
$941.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$274.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$889.45
|
| Rate for Payer: PACE Senior Care Partners |
$248.52
|
| Rate for Payer: PACE SWMI |
$261.60
|
| Rate for Payer: PHP Commercial |
$889.45
|
| Rate for Payer: PHP Medicare Advantage |
$261.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$910.38
|
| Rate for Payer: Priority Health Medicare |
$261.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$638.21
|
| Rate for Payer: Railroad Medicare Medicare |
$261.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$920.84
|
| Rate for Payer: UHC Core |
$873.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.60
|
| Rate for Payer: UHC Medicare Advantage |
$269.45
|
| Rate for Payer: VA VA |
$261.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.81
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
IP
|
$344.76
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.27 |
| Max. Negotiated Rate |
$310.28 |
| Rate for Payer: Aetna Commercial |
$293.05
|
| Rate for Payer: BCBS Trust/PPO |
$266.43
|
| Rate for Payer: BCN Commercial |
$266.43
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.81
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.05
|
| Rate for Payer: PHP Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.39
|
| Rate for Payer: UHC Core |
$287.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.57
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
OP
|
$344.76
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.88 |
| Max. Negotiated Rate |
$310.28 |
| Rate for Payer: Aetna Commercial |
$293.05
|
| Rate for Payer: Aetna Medicare |
$89.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.74
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$86.19
|
| Rate for Payer: BCBS Trust/PPO |
$268.05
|
| Rate for Payer: BCN Commercial |
$268.05
|
| Rate for Payer: BCN Medicare Advantage |
$86.19
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.19
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.57
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$81.88
|
| Rate for Payer: PACE SWMI |
$86.19
|
| Rate for Payer: PHP Commercial |
$293.05
|
| Rate for Payer: PHP Medicare Advantage |
$86.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.94
|
| Rate for Payer: Priority Health Medicare |
$86.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.27
|
| Rate for Payer: Railroad Medicare Medicare |
$86.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.39
|
| Rate for Payer: UHC Core |
$287.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.19
|
| Rate for Payer: UHC Medicare Advantage |
$88.78
|
| Rate for Payer: VA VA |
$86.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.57
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
OP
|
$517.14
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.82 |
| Max. Negotiated Rate |
$465.43 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Aetna Medicare |
$134.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.61
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$129.28
|
| Rate for Payer: BCBS Trust/PPO |
$402.08
|
| Rate for Payer: BCN Commercial |
$402.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.28
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.28
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PACE Senior Care Partners |
$122.82
|
| Rate for Payer: PACE SWMI |
$129.28
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: PHP Medicare Advantage |
$129.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.91
|
| Rate for Payer: Priority Health Medicare |
$129.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.40
|
| Rate for Payer: Railroad Medicare Medicare |
$129.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.08
|
| Rate for Payer: UHC Core |
$431.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.28
|
| Rate for Payer: UHC Medicare Advantage |
$133.16
|
| Rate for Payer: VA VA |
$129.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
IP
|
$517.14
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$315.40 |
| Max. Negotiated Rate |
$465.43 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: BCBS Trust/PPO |
$399.65
|
| Rate for Payer: BCN Commercial |
$399.65
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$449.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$315.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.08
|
| Rate for Payer: UHC Core |
$431.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$187.62 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna Medicare |
$205.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.88
|
| Rate for Payer: BCBS Complete |
$274.44
|
| Rate for Payer: BCBS MAPPO |
$197.50
|
| Rate for Payer: BCBS Trust/PPO |
$614.22
|
| Rate for Payer: BCN Commercial |
$614.22
|
| Rate for Payer: BCN Medicare Advantage |
$197.50
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.50
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Mclaren Medicaid |
$261.37
|
| Rate for Payer: Meridian Medicaid |
$274.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$207.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PACE Senior Care Partners |
$187.62
|
| Rate for Payer: PACE SWMI |
$197.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: PHP Medicare Advantage |
$197.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$687.30
|
| Rate for Payer: Priority Health Medicare |
$197.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.82
|
| Rate for Payer: Railroad Medicare Medicare |
$197.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.20
|
| Rate for Payer: UHC Core |
$659.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.50
|
| Rate for Payer: UHC Medicare Advantage |
$203.42
|
| Rate for Payer: VA VA |
$197.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$481.82 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: BCBS Trust/PPO |
$610.51
|
| Rate for Payer: BCN Commercial |
$610.51
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$687.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.20
|
| Rate for Payer: UHC Core |
$659.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
HC INJECTION PROC CYSTOGRAPHY VOIDING
|
Facility
|
IP
|
$1,284.65
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
36100251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.51 |
| Max. Negotiated Rate |
$1,156.18 |
| Rate for Payer: Aetna Commercial |
$1,091.95
|
| Rate for Payer: BCBS Trust/PPO |
$992.78
|
| Rate for Payer: BCN Commercial |
$992.78
|
| Rate for Payer: Cash Price |
$1,027.72
|
| Rate for Payer: Cofinity Commercial |
$1,104.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.72
|
| Rate for Payer: Healthscope Commercial |
$1,156.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,091.95
|
| Rate for Payer: PHP Commercial |
$1,091.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.49
|
| Rate for Payer: UHC Core |
$1,072.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.49
|
|
|
HC INJECTION PROC CYSTOGRAPHY VOIDING
|
Facility
|
OP
|
$1,284.65
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
36100251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.10 |
| Max. Negotiated Rate |
$1,156.18 |
| Rate for Payer: Aetna Commercial |
$1,091.95
|
| Rate for Payer: Aetna Medicare |
$334.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$401.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$401.45
|
| Rate for Payer: BCBS Complete |
$513.86
|
| Rate for Payer: BCBS MAPPO |
$321.16
|
| Rate for Payer: BCBS Trust/PPO |
$998.82
|
| Rate for Payer: BCN Commercial |
$998.82
|
| Rate for Payer: BCN Medicare Advantage |
$321.16
|
| Rate for Payer: Cash Price |
$1,027.72
|
| Rate for Payer: Cofinity Commercial |
$1,104.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.16
|
| Rate for Payer: Healthscope Commercial |
$1,156.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$337.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,091.95
|
| Rate for Payer: PACE Senior Care Partners |
$305.10
|
| Rate for Payer: PACE SWMI |
$321.16
|
| Rate for Payer: PHP Commercial |
$1,091.95
|
| Rate for Payer: PHP Medicare Advantage |
$321.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,117.65
|
| Rate for Payer: Priority Health Medicare |
$321.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.51
|
| Rate for Payer: Railroad Medicare Medicare |
$321.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.49
|
| Rate for Payer: UHC Core |
$1,072.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.16
|
| Rate for Payer: UHC Medicare Advantage |
$330.80
|
| Rate for Payer: VA VA |
$321.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.49
|
|
|
HC INJECTION PROCEDURE
|
Facility
|
IP
|
$591.65
|
|
| Hospital Charge Code |
36000085
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$360.85 |
| Max. Negotiated Rate |
$532.48 |
| Rate for Payer: Aetna Commercial |
$502.90
|
| Rate for Payer: BCBS Trust/PPO |
$457.23
|
| Rate for Payer: BCN Commercial |
$457.23
|
| Rate for Payer: Cash Price |
$473.32
|
| Rate for Payer: Cofinity Commercial |
$508.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.32
|
| Rate for Payer: Healthscope Commercial |
$532.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$502.90
|
| Rate for Payer: PHP Commercial |
$502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.65
|
| Rate for Payer: UHC Core |
$494.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.74
|
|
|
HC INJECTION PROCEDURE
|
Facility
|
OP
|
$591.65
|
|
| Hospital Charge Code |
36000085
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$140.52 |
| Max. Negotiated Rate |
$532.48 |
| Rate for Payer: Aetna Commercial |
$502.90
|
| Rate for Payer: Aetna Medicare |
$153.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.89
|
| Rate for Payer: BCBS Complete |
$236.66
|
| Rate for Payer: BCBS MAPPO |
$147.91
|
| Rate for Payer: BCBS Trust/PPO |
$460.01
|
| Rate for Payer: BCN Commercial |
$460.01
|
| Rate for Payer: BCN Medicare Advantage |
$147.91
|
| Rate for Payer: Cash Price |
$473.32
|
| Rate for Payer: Cofinity Commercial |
$508.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.91
|
| Rate for Payer: Healthscope Commercial |
$532.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$155.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$502.90
|
| Rate for Payer: PACE Senior Care Partners |
$140.52
|
| Rate for Payer: PACE SWMI |
$147.91
|
| Rate for Payer: PHP Commercial |
$502.90
|
| Rate for Payer: PHP Medicare Advantage |
$147.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.74
|
| Rate for Payer: Priority Health Medicare |
$147.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.85
|
| Rate for Payer: Railroad Medicare Medicare |
$147.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.65
|
| Rate for Payer: UHC Core |
$494.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.91
|
| Rate for Payer: UHC Medicare Advantage |
$152.35
|
| Rate for Payer: VA VA |
$147.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.74
|
|
|
HC INJECTION PROCEDURE ILEAL CONDUIT
|
Facility
|
IP
|
$630.91
|
|
|
Service Code
|
CPT 50690
|
| Hospital Charge Code |
36100249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$384.79 |
| Max. Negotiated Rate |
$567.82 |
| Rate for Payer: Aetna Commercial |
$536.27
|
| Rate for Payer: BCBS Trust/PPO |
$487.57
|
| Rate for Payer: BCN Commercial |
$487.57
|
| Rate for Payer: Cash Price |
$504.73
|
| Rate for Payer: Cofinity Commercial |
$542.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.73
|
| Rate for Payer: Healthscope Commercial |
$567.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$473.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$536.27
|
| Rate for Payer: PHP Commercial |
$536.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$555.20
|
| Rate for Payer: UHC Core |
$526.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$473.18
|
|
|
HC INJECTION PROCEDURE ILEAL CONDUIT
|
Facility
|
OP
|
$630.91
|
|
|
Service Code
|
CPT 50690
|
| Hospital Charge Code |
36100249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$149.84 |
| Max. Negotiated Rate |
$567.82 |
| Rate for Payer: Aetna Commercial |
$536.27
|
| Rate for Payer: Aetna Medicare |
$164.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$197.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$197.16
|
| Rate for Payer: BCBS Complete |
$252.36
|
| Rate for Payer: BCBS MAPPO |
$157.73
|
| Rate for Payer: BCBS Trust/PPO |
$490.53
|
| Rate for Payer: BCN Commercial |
$490.53
|
| Rate for Payer: BCN Medicare Advantage |
$157.73
|
| Rate for Payer: Cash Price |
$504.73
|
| Rate for Payer: Cofinity Commercial |
$542.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.73
|
| Rate for Payer: Healthscope Commercial |
$567.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$473.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$536.27
|
| Rate for Payer: PACE Senior Care Partners |
$149.84
|
| Rate for Payer: PACE SWMI |
$157.73
|
| Rate for Payer: PHP Commercial |
$536.27
|
| Rate for Payer: PHP Medicare Advantage |
$157.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.89
|
| Rate for Payer: Priority Health Medicare |
$157.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.79
|
| Rate for Payer: Railroad Medicare Medicare |
$157.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$555.20
|
| Rate for Payer: UHC Core |
$526.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.73
|
| Rate for Payer: UHC Medicare Advantage |
$162.46
|
| Rate for Payer: VA VA |
$157.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$473.18
|
|
|
HC INJECTION PROC RETROGRAD CYSTOGRAPHY
|
Facility
|
OP
|
$816.16
|
|
|
Service Code
|
CPT 51610
|
| Hospital Charge Code |
36100252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$193.84 |
| Max. Negotiated Rate |
$734.54 |
| Rate for Payer: Aetna Commercial |
$693.74
|
| Rate for Payer: Aetna Medicare |
$212.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.05
|
| Rate for Payer: BCBS Complete |
$326.46
|
| Rate for Payer: BCBS MAPPO |
$204.04
|
| Rate for Payer: BCBS Trust/PPO |
$634.56
|
| Rate for Payer: BCN Commercial |
$634.56
|
| Rate for Payer: BCN Medicare Advantage |
$204.04
|
| Rate for Payer: Cash Price |
$652.93
|
| Rate for Payer: Cofinity Commercial |
$701.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$652.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.04
|
| Rate for Payer: Healthscope Commercial |
$734.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$214.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$693.74
|
| Rate for Payer: PACE Senior Care Partners |
$193.84
|
| Rate for Payer: PACE SWMI |
$204.04
|
| Rate for Payer: PHP Commercial |
$693.74
|
| Rate for Payer: PHP Medicare Advantage |
$204.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$571.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$710.06
|
| Rate for Payer: Priority Health Medicare |
$204.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$497.78
|
| Rate for Payer: Railroad Medicare Medicare |
$204.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.22
|
| Rate for Payer: UHC Core |
$681.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.04
|
| Rate for Payer: UHC Medicare Advantage |
$210.16
|
| Rate for Payer: VA VA |
$204.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.12
|
|
