|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
OP
|
$737.54
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$663.79 |
| Rate for Payer: Aetna Commercial |
$626.91
|
| Rate for Payer: Aetna Medicare |
$191.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.48
|
| Rate for Payer: BCBS Complete |
$136.52
|
| Rate for Payer: BCBS MAPPO |
$184.38
|
| Rate for Payer: BCBS Trust/PPO |
$606.33
|
| Rate for Payer: BCCCP Commercial |
$49.12
|
| Rate for Payer: BCN Commercial |
$606.33
|
| Rate for Payer: BCN Medicare Advantage |
$184.38
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cofinity Commercial |
$634.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.38
|
| Rate for Payer: Healthscope Commercial |
$663.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.15
|
| Rate for Payer: Mclaren Medicaid |
$130.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.60
|
| Rate for Payer: Meridian Medicaid |
$136.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.91
|
| Rate for Payer: Nomi Health Commercial |
$604.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.15
|
| Rate for Payer: PACE Senior Care Partners |
$175.17
|
| Rate for Payer: PACE SWMI |
$184.38
|
| Rate for Payer: PHP Commercial |
$626.91
|
| Rate for Payer: PHP Medicare Advantage |
$184.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$641.66
|
| Rate for Payer: Priority Health Medicare |
$186.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$513.33
|
| Rate for Payer: Railroad Medicare Medicare |
$184.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.04
|
| Rate for Payer: UHC Core |
$615.85
|
| Rate for Payer: UHC Exchange |
$184.38
|
| Rate for Payer: UHC Medicaid |
$130.03
|
| Rate for Payer: UHC Medicare Advantage |
$184.38
|
| Rate for Payer: UHCCP Medicaid |
$130.03
|
| Rate for Payer: VA VA |
$184.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.15
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.48 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.97
|
| Rate for Payer: BCBS Complete |
$41.45
|
| Rate for Payer: BCBS MAPPO |
$55.98
|
| Rate for Payer: BCBS Trust/PPO |
$184.08
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$184.08
|
| Rate for Payer: BCN Medicare Advantage |
$55.98
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.98
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Mclaren Medicaid |
$39.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.78
|
| Rate for Payer: Meridian Medicaid |
$41.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Senior Care Partners |
$53.18
|
| Rate for Payer: PACE SWMI |
$55.98
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: PHP Medicare Advantage |
$55.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.80
|
| Rate for Payer: Priority Health Medicare |
$56.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.84
|
| Rate for Payer: Railroad Medicare Medicare |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.04
|
| Rate for Payer: UHC Core |
$186.96
|
| Rate for Payer: UHC Exchange |
$55.98
|
| Rate for Payer: UHC Medicaid |
$39.48
|
| Rate for Payer: UHC Medicare Advantage |
$55.98
|
| Rate for Payer: UHCCP Medicaid |
$39.48
|
| Rate for Payer: VA VA |
$55.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.84 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: BCBS Trust/PPO |
$184.93
|
| Rate for Payer: BCN Commercial |
$184.93
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$183.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.04
|
| Rate for Payer: UHC Core |
$186.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
OP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$515.35 |
| Max. Negotiated Rate |
$2,630.81 |
| Rate for Payer: Aetna Commercial |
$2,484.65
|
| Rate for Payer: Aetna Medicare |
$760.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$913.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$913.48
|
| Rate for Payer: BCBS Complete |
$541.07
|
| Rate for Payer: BCBS MAPPO |
$730.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.10
|
| Rate for Payer: BCN Commercial |
$2,403.10
|
| Rate for Payer: BCN Medicare Advantage |
$730.78
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.78
|
| Rate for Payer: Healthscope Commercial |
$2,630.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,192.34
|
| Rate for Payer: Mclaren Medicaid |
$515.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.32
|
| Rate for Payer: Meridian Medicaid |
$541.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$840.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$803.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Nomi Health Commercial |
$2,396.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: PACE Senior Care Partners |
$694.24
|
| Rate for Payer: PACE SWMI |
$730.78
|
| Rate for Payer: PHP Commercial |
$2,484.65
|
| Rate for Payer: PHP Medicare Advantage |
$730.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,543.11
|
| Rate for Payer: Priority Health Medicare |
$738.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,034.49
|
| Rate for Payer: Railroad Medicare Medicare |
$730.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,572.35
|
| Rate for Payer: UHC Core |
$2,440.81
|
| Rate for Payer: UHC Exchange |
$730.78
|
| Rate for Payer: UHC Medicaid |
$515.35
|
| Rate for Payer: UHC Medicare Advantage |
$730.78
|
| Rate for Payer: UHCCP Medicaid |
$515.35
|
| Rate for Payer: VA VA |
$730.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,192.34
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
IP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,034.49 |
| Max. Negotiated Rate |
$2,630.81 |
| Rate for Payer: Aetna Commercial |
$2,484.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.20
|
| Rate for Payer: BCN Commercial |
$2,414.20
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Healthscope Commercial |
$2,630.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,192.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Nomi Health Commercial |
$2,396.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: PHP Commercial |
$2,484.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,543.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,034.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,572.35
|
| Rate for Payer: UHC Core |
$2,440.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,192.34
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
IP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$69.45
|
| Rate for Payer: BCBS Trust/PPO |
$67.48
|
| Rate for Payer: BCN Commercial |
$67.48
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$70.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$73.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.45
|
| Rate for Payer: Nomi Health Commercial |
$67.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: PHP Commercial |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.90
|
| Rate for Payer: UHC Core |
$68.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.28
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
OP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna Commercial |
$69.45
|
| Rate for Payer: Aetna Medicare |
$21.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.53
|
| Rate for Payer: BCBS Complete |
$15.12
|
| Rate for Payer: BCBS MAPPO |
$20.43
|
| Rate for Payer: BCBS Trust/PPO |
$67.17
|
| Rate for Payer: BCN Commercial |
$67.17
|
| Rate for Payer: BCN Medicare Advantage |
$20.43
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$70.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.43
|
| Rate for Payer: Healthscope Commercial |
$73.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.28
|
| Rate for Payer: Mclaren Medicaid |
$14.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.45
|
| Rate for Payer: Meridian Medicaid |
$15.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.45
|
| Rate for Payer: Nomi Health Commercial |
$67.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: PACE Senior Care Partners |
$19.41
|
| Rate for Payer: PACE SWMI |
$20.43
|
| Rate for Payer: PHP Commercial |
$69.45
|
| Rate for Payer: PHP Medicare Advantage |
$20.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.09
|
| Rate for Payer: Priority Health Medicare |
$20.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.87
|
| Rate for Payer: Railroad Medicare Medicare |
$20.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.90
|
| Rate for Payer: UHC Core |
$68.23
|
| Rate for Payer: UHC Exchange |
$20.43
|
| Rate for Payer: UHC Medicaid |
$14.41
|
| Rate for Payer: UHC Medicare Advantage |
$20.43
|
| Rate for Payer: UHCCP Medicaid |
$14.41
|
| Rate for Payer: VA VA |
$20.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.28
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
IP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$146.92 |
| Rate for Payer: Aetna Commercial |
$138.75
|
| Rate for Payer: BCBS Trust/PPO |
$134.82
|
| Rate for Payer: BCN Commercial |
$134.82
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Commercial |
$140.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$146.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Nomi Health Commercial |
$133.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: PHP Commercial |
$138.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.65
|
| Rate for Payer: UHC Core |
$136.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.43
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
OP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.78 |
| Max. Negotiated Rate |
$146.92 |
| Rate for Payer: Aetna Commercial |
$138.75
|
| Rate for Payer: Aetna Medicare |
$42.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.01
|
| Rate for Payer: BCBS Complete |
$30.22
|
| Rate for Payer: BCBS MAPPO |
$40.81
|
| Rate for Payer: BCBS Trust/PPO |
$134.20
|
| Rate for Payer: BCN Commercial |
$134.20
|
| Rate for Payer: BCN Medicare Advantage |
$40.81
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Commercial |
$140.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.81
|
| Rate for Payer: Healthscope Commercial |
$146.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.43
|
| Rate for Payer: Mclaren Medicaid |
$28.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.85
|
| Rate for Payer: Meridian Medicaid |
$30.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Nomi Health Commercial |
$133.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: PACE Senior Care Partners |
$38.77
|
| Rate for Payer: PACE SWMI |
$40.81
|
| Rate for Payer: PHP Commercial |
$138.75
|
| Rate for Payer: PHP Medicare Advantage |
$40.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.02
|
| Rate for Payer: Priority Health Medicare |
$41.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.62
|
| Rate for Payer: Railroad Medicare Medicare |
$40.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.65
|
| Rate for Payer: UHC Core |
$136.31
|
| Rate for Payer: UHC Exchange |
$40.81
|
| Rate for Payer: UHC Medicaid |
$28.78
|
| Rate for Payer: UHC Medicare Advantage |
$40.81
|
| Rate for Payer: UHCCP Medicaid |
$28.78
|
| Rate for Payer: VA VA |
$40.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.43
|
|
|
HC ENDOPLEGE
|
Facility
|
IP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,761.67 |
| Max. Negotiated Rate |
$4,864.23 |
| Rate for Payer: Aetna Commercial |
$4,593.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,463.74
|
| Rate for Payer: BCN Commercial |
$4,463.74
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Commercial |
$4,648.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Healthscope Commercial |
$4,864.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,053.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Nomi Health Commercial |
$4,431.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: PHP Commercial |
$4,593.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,702.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,761.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,756.14
|
| Rate for Payer: UHC Core |
$4,512.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,053.53
|
|
|
HC ENDOPLEGE
|
Facility
|
OP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$952.85 |
| Max. Negotiated Rate |
$4,864.23 |
| Rate for Payer: Aetna Commercial |
$4,593.99
|
| Rate for Payer: Aetna Medicare |
$1,405.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,688.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,688.97
|
| Rate for Payer: BCBS Complete |
$1,000.41
|
| Rate for Payer: BCBS MAPPO |
$1,351.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,443.20
|
| Rate for Payer: BCN Commercial |
$4,443.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,351.17
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Commercial |
$4,648.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,351.17
|
| Rate for Payer: Healthscope Commercial |
$4,864.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,053.53
|
| Rate for Payer: Mclaren Medicaid |
$952.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,418.73
|
| Rate for Payer: Meridian Medicaid |
$1,000.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,553.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,486.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Nomi Health Commercial |
$4,431.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,283.62
|
| Rate for Payer: PACE SWMI |
$1,351.17
|
| Rate for Payer: PHP Commercial |
$4,593.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,351.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$952.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,702.09
|
| Rate for Payer: Priority Health Medicare |
$1,364.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,761.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,351.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,756.14
|
| Rate for Payer: UHC Core |
$4,512.92
|
| Rate for Payer: UHC Exchange |
$1,351.17
|
| Rate for Payer: UHC Medicaid |
$952.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,351.17
|
| Rate for Payer: UHCCP Medicaid |
$952.85
|
| Rate for Payer: VA VA |
$1,351.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,053.53
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
OP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,703.67 |
| Max. Negotiated Rate |
$8,697.13 |
| Rate for Payer: Aetna Commercial |
$8,213.96
|
| Rate for Payer: Aetna Medicare |
$2,512.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,019.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,019.84
|
| Rate for Payer: BCBS Complete |
$1,788.71
|
| Rate for Payer: BCBS MAPPO |
$2,415.87
|
| Rate for Payer: BCBS Trust/PPO |
$7,944.35
|
| Rate for Payer: BCN Commercial |
$7,944.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,415.87
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$8,310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,415.87
|
| Rate for Payer: Healthscope Commercial |
$8,697.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,247.61
|
| Rate for Payer: Mclaren Medicaid |
$1,703.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,536.66
|
| Rate for Payer: Meridian Medicaid |
$1,788.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,778.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,657.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PACE Senior Care Partners |
$2,295.08
|
| Rate for Payer: PACE SWMI |
$2,415.87
|
| Rate for Payer: PHP Commercial |
$8,213.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,415.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,407.23
|
| Rate for Payer: Priority Health Medicare |
$2,440.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,725.78
|
| Rate for Payer: Railroad Medicare Medicare |
$2,415.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,503.86
|
| Rate for Payer: UHC Core |
$8,069.01
|
| Rate for Payer: UHC Exchange |
$2,415.87
|
| Rate for Payer: UHC Medicaid |
$1,703.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,415.87
|
| Rate for Payer: UHCCP Medicaid |
$1,703.67
|
| Rate for Payer: VA VA |
$2,415.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,247.61
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
IP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,725.78 |
| Max. Negotiated Rate |
$8,697.13 |
| Rate for Payer: Aetna Commercial |
$8,213.96
|
| Rate for Payer: BCBS Trust/PPO |
$7,981.07
|
| Rate for Payer: BCN Commercial |
$7,981.07
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Commercial |
$8,310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Healthscope Commercial |
$8,697.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,247.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$7,924.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PHP Commercial |
$8,213.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,407.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,725.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,503.86
|
| Rate for Payer: UHC Core |
$8,069.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,247.61
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
OP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.01 |
| Max. Negotiated Rate |
$454.41 |
| Rate for Payer: Aetna Commercial |
$429.17
|
| Rate for Payer: Aetna Medicare |
$131.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.78
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS MAPPO |
$126.22
|
| Rate for Payer: BCBS Trust/PPO |
$415.08
|
| Rate for Payer: BCN Commercial |
$415.08
|
| Rate for Payer: BCN Medicare Advantage |
$126.22
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Commercial |
$434.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.22
|
| Rate for Payer: Healthscope Commercial |
$454.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.68
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.54
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Nomi Health Commercial |
$414.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: PACE Senior Care Partners |
$119.91
|
| Rate for Payer: PACE SWMI |
$126.22
|
| Rate for Payer: PHP Commercial |
$429.17
|
| Rate for Payer: PHP Medicare Advantage |
$126.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$439.26
|
| Rate for Payer: Priority Health Medicare |
$127.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.41
|
| Rate for Payer: Railroad Medicare Medicare |
$126.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.31
|
| Rate for Payer: UHC Core |
$421.59
|
| Rate for Payer: UHC Exchange |
$126.22
|
| Rate for Payer: UHC Medicaid |
$89.01
|
| Rate for Payer: UHC Medicare Advantage |
$126.22
|
| Rate for Payer: UHCCP Medicaid |
$89.01
|
| Rate for Payer: VA VA |
$126.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.68
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
IP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$351.41 |
| Max. Negotiated Rate |
$454.41 |
| Rate for Payer: Aetna Commercial |
$429.17
|
| Rate for Payer: BCBS Trust/PPO |
$417.00
|
| Rate for Payer: BCN Commercial |
$417.00
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Commercial |
$434.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Healthscope Commercial |
$454.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Nomi Health Commercial |
$414.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: PHP Commercial |
$429.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$439.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.31
|
| Rate for Payer: UHC Core |
$421.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.68
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
IP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$211.46 |
| Max. Negotiated Rate |
$273.44 |
| Rate for Payer: Aetna Commercial |
$258.25
|
| Rate for Payer: BCBS Trust/PPO |
$250.92
|
| Rate for Payer: BCN Commercial |
$250.92
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Commercial |
$261.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$273.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Nomi Health Commercial |
$249.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: PHP Commercial |
$258.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$264.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.36
|
| Rate for Payer: UHC Core |
$253.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.87
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
OP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.56 |
| Max. Negotiated Rate |
$273.44 |
| Rate for Payer: Aetna Commercial |
$258.25
|
| Rate for Payer: Aetna Medicare |
$78.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.94
|
| Rate for Payer: BCBS Complete |
$56.24
|
| Rate for Payer: BCBS MAPPO |
$75.95
|
| Rate for Payer: BCBS Trust/PPO |
$249.77
|
| Rate for Payer: BCN Commercial |
$249.77
|
| Rate for Payer: BCN Medicare Advantage |
$75.95
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Commercial |
$261.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.95
|
| Rate for Payer: Healthscope Commercial |
$273.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.87
|
| Rate for Payer: Mclaren Medicaid |
$53.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.75
|
| Rate for Payer: Meridian Medicaid |
$56.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Nomi Health Commercial |
$249.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: PACE Senior Care Partners |
$72.16
|
| Rate for Payer: PACE SWMI |
$75.95
|
| Rate for Payer: PHP Commercial |
$258.25
|
| Rate for Payer: PHP Medicare Advantage |
$75.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$264.32
|
| Rate for Payer: Priority Health Medicare |
$76.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.46
|
| Rate for Payer: Railroad Medicare Medicare |
$75.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.36
|
| Rate for Payer: UHC Core |
$253.69
|
| Rate for Payer: UHC Exchange |
$75.95
|
| Rate for Payer: UHC Medicaid |
$53.56
|
| Rate for Payer: UHC Medicare Advantage |
$75.95
|
| Rate for Payer: UHCCP Medicaid |
$53.56
|
| Rate for Payer: VA VA |
$75.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.87
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$2,826.77
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$498.36 |
| Max. Negotiated Rate |
$2,544.09 |
| Rate for Payer: Aetna Commercial |
$2,402.75
|
| Rate for Payer: Aetna Medicare |
$734.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$883.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$883.37
|
| Rate for Payer: BCBS Complete |
$523.24
|
| Rate for Payer: BCBS MAPPO |
$706.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,323.89
|
| Rate for Payer: BCN Commercial |
$2,323.89
|
| Rate for Payer: BCN Medicare Advantage |
$706.69
|
| Rate for Payer: Cash Price |
$2,261.42
|
| Rate for Payer: Cofinity Commercial |
$2,431.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$706.69
|
| Rate for Payer: Healthscope Commercial |
$2,544.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.08
|
| Rate for Payer: Mclaren Medicaid |
$498.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$742.03
|
| Rate for Payer: Meridian Medicaid |
$523.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$812.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$777.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.75
|
| Rate for Payer: Nomi Health Commercial |
$2,317.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.08
|
| Rate for Payer: PACE Senior Care Partners |
$671.36
|
| Rate for Payer: PACE SWMI |
$706.69
|
| Rate for Payer: PHP Commercial |
$2,402.75
|
| Rate for Payer: PHP Medicare Advantage |
$706.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,459.29
|
| Rate for Payer: Priority Health Medicare |
$713.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.43
|
| Rate for Payer: Railroad Medicare Medicare |
$706.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,487.56
|
| Rate for Payer: UHC Core |
$2,360.35
|
| Rate for Payer: UHC Exchange |
$706.69
|
| Rate for Payer: UHC Medicaid |
$498.36
|
| Rate for Payer: UHC Medicare Advantage |
$706.69
|
| Rate for Payer: UHCCP Medicaid |
$498.36
|
| Rate for Payer: VA VA |
$706.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.08
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
IP
|
$2,826.77
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,967.43 |
| Max. Negotiated Rate |
$2,544.09 |
| Rate for Payer: Aetna Commercial |
$2,402.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,334.63
|
| Rate for Payer: BCN Commercial |
$2,334.63
|
| Rate for Payer: Cash Price |
$2,261.42
|
| Rate for Payer: Cofinity Commercial |
$2,431.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.42
|
| Rate for Payer: Healthscope Commercial |
$2,544.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.75
|
| Rate for Payer: Nomi Health Commercial |
$2,317.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.08
|
| Rate for Payer: PHP Commercial |
$2,402.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,459.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,487.56
|
| Rate for Payer: UHC Core |
$2,360.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.08
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
IP
|
$8,177.54
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,691.57 |
| Max. Negotiated Rate |
$7,359.79 |
| Rate for Payer: Aetna Commercial |
$6,950.91
|
| Rate for Payer: BCBS Trust/PPO |
$6,753.83
|
| Rate for Payer: BCN Commercial |
$6,753.83
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,032.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,359.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,133.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: PHP Commercial |
$6,950.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,114.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,691.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,196.24
|
| Rate for Payer: UHC Core |
$6,828.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,133.15
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION COLD
|
Facility
|
OP
|
$8,177.54
|
|
| Hospital Charge Code |
36000121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,441.70 |
| Max. Negotiated Rate |
$7,359.79 |
| Rate for Payer: Aetna Commercial |
$6,950.91
|
| Rate for Payer: Aetna Medicare |
$2,126.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,555.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,555.48
|
| Rate for Payer: BCBS Complete |
$1,513.66
|
| Rate for Payer: BCBS MAPPO |
$2,044.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,722.76
|
| Rate for Payer: BCN Commercial |
$6,722.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,044.38
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,032.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,044.38
|
| Rate for Payer: Healthscope Commercial |
$7,359.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,133.15
|
| Rate for Payer: Mclaren Medicaid |
$1,441.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,146.60
|
| Rate for Payer: Meridian Medicaid |
$1,513.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,351.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,248.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: PACE Senior Care Partners |
$1,942.17
|
| Rate for Payer: PACE SWMI |
$2,044.38
|
| Rate for Payer: PHP Commercial |
$6,950.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,044.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,441.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,114.46
|
| Rate for Payer: Priority Health Medicare |
$2,064.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,691.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,044.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,196.24
|
| Rate for Payer: UHC Core |
$6,828.25
|
| Rate for Payer: UHC Exchange |
$2,044.38
|
| Rate for Payer: UHC Medicaid |
$1,441.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,044.38
|
| Rate for Payer: UHCCP Medicaid |
$1,441.70
|
| Rate for Payer: VA VA |
$2,044.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,133.15
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
IP
|
$8,177.54
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,691.57 |
| Max. Negotiated Rate |
$7,359.79 |
| Rate for Payer: Aetna Commercial |
$6,950.91
|
| Rate for Payer: BCBS Trust/PPO |
$6,753.83
|
| Rate for Payer: BCN Commercial |
$6,753.83
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,032.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Healthscope Commercial |
$7,359.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,133.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: PHP Commercial |
$6,950.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,114.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,691.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,196.24
|
| Rate for Payer: UHC Core |
$6,828.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,133.15
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION HOT
|
Facility
|
OP
|
$8,177.54
|
|
| Hospital Charge Code |
36000122
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,441.70 |
| Max. Negotiated Rate |
$7,359.79 |
| Rate for Payer: Aetna Commercial |
$6,950.91
|
| Rate for Payer: Aetna Medicare |
$2,126.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,555.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,555.48
|
| Rate for Payer: BCBS Complete |
$1,513.66
|
| Rate for Payer: BCBS MAPPO |
$2,044.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,722.76
|
| Rate for Payer: BCN Commercial |
$6,722.76
|
| Rate for Payer: BCN Medicare Advantage |
$2,044.38
|
| Rate for Payer: Cash Price |
$6,542.03
|
| Rate for Payer: Cofinity Commercial |
$7,032.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,542.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,044.38
|
| Rate for Payer: Healthscope Commercial |
$7,359.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,133.15
|
| Rate for Payer: Mclaren Medicaid |
$1,441.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,146.60
|
| Rate for Payer: Meridian Medicaid |
$1,513.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,351.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,248.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,950.91
|
| Rate for Payer: Nomi Health Commercial |
$6,705.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,133.15
|
| Rate for Payer: PACE Senior Care Partners |
$1,942.17
|
| Rate for Payer: PACE SWMI |
$2,044.38
|
| Rate for Payer: PHP Commercial |
$6,950.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,044.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,441.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,114.46
|
| Rate for Payer: Priority Health Medicare |
$2,064.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,691.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,044.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,196.24
|
| Rate for Payer: UHC Core |
$6,828.25
|
| Rate for Payer: UHC Exchange |
$2,044.38
|
| Rate for Payer: UHC Medicaid |
$1,441.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,044.38
|
| Rate for Payer: UHCCP Medicaid |
$1,441.70
|
| Rate for Payer: VA VA |
$2,044.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,133.15
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
OP
|
$5,204.08
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$917.48 |
| Max. Negotiated Rate |
$4,683.67 |
| Rate for Payer: Aetna Commercial |
$4,423.47
|
| Rate for Payer: Aetna Medicare |
$1,353.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,626.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,626.28
|
| Rate for Payer: BCBS Complete |
$963.28
|
| Rate for Payer: BCBS MAPPO |
$1,301.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,278.27
|
| Rate for Payer: BCN Commercial |
$4,278.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,301.02
|
| Rate for Payer: Cash Price |
$4,163.26
|
| Rate for Payer: Cofinity Commercial |
$4,475.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,301.02
|
| Rate for Payer: Healthscope Commercial |
$4,683.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,903.06
|
| Rate for Payer: Mclaren Medicaid |
$917.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,366.07
|
| Rate for Payer: Meridian Medicaid |
$963.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,496.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,431.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.47
|
| Rate for Payer: Nomi Health Commercial |
$4,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,235.97
|
| Rate for Payer: PACE SWMI |
$1,301.02
|
| Rate for Payer: PHP Commercial |
$4,423.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,301.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$917.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,527.55
|
| Rate for Payer: Priority Health Medicare |
$1,314.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,622.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,301.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,579.59
|
| Rate for Payer: UHC Core |
$4,345.41
|
| Rate for Payer: UHC Exchange |
$1,301.02
|
| Rate for Payer: UHC Medicaid |
$917.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,301.02
|
| Rate for Payer: UHCCP Medicaid |
$917.48
|
| Rate for Payer: VA VA |
$1,301.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,903.06
|
|
|
HC ENDOSCOPIC SUBMUCOSAL DISSECTION
|
Facility
|
IP
|
$5,204.08
|
|
| Hospital Charge Code |
36000119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,622.04 |
| Max. Negotiated Rate |
$4,683.67 |
| Rate for Payer: Aetna Commercial |
$4,423.47
|
| Rate for Payer: BCBS Trust/PPO |
$4,298.05
|
| Rate for Payer: BCN Commercial |
$4,298.05
|
| Rate for Payer: Cash Price |
$4,163.26
|
| Rate for Payer: Cofinity Commercial |
$4,475.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,163.26
|
| Rate for Payer: Healthscope Commercial |
$4,683.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,903.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,423.47
|
| Rate for Payer: Nomi Health Commercial |
$4,267.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,903.06
|
| Rate for Payer: PHP Commercial |
$4,423.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,527.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,622.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,579.59
|
| Rate for Payer: UHC Core |
$4,345.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,903.06
|
|
