|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.59 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.22
|
| Rate for Payer: BCN Commercial |
$760.42
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS INITIAL
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32561
|
| Hospital Charge Code |
36100323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.70 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$255.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.49
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$246.00
|
| Rate for Payer: BCBS Trust/PPO |
$808.93
|
| Rate for Payer: BCN Commercial |
$765.04
|
| Rate for Payer: BCN Medicare Advantage |
$246.00
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.00
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PACE Senior Care Partners |
$233.70
|
| Rate for Payer: PACE SWMI |
$246.00
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$246.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Medicare |
$248.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: Railroad Medicare Medicare |
$246.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.00
|
| Rate for Payer: UHC Exchange |
$246.00
|
| Rate for Payer: UHC Medicare Advantage |
$246.00
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$246.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.59 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.22
|
| Rate for Payer: BCN Commercial |
$760.42
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT PLEURAL FIBRINOLYSIS SUB DAY
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32562
|
| Hospital Charge Code |
36100322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.70 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$255.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.49
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$246.00
|
| Rate for Payer: BCBS Trust/PPO |
$808.93
|
| Rate for Payer: BCN Commercial |
$765.04
|
| Rate for Payer: BCN Medicare Advantage |
$246.00
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.00
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.29
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PACE Senior Care Partners |
$233.70
|
| Rate for Payer: PACE SWMI |
$246.00
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$246.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Medicare |
$248.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: Railroad Medicare Medicare |
$246.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.00
|
| Rate for Payer: UHC Exchange |
$246.00
|
| Rate for Payer: UHC Medicare Advantage |
$246.00
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$246.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
IP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$712.78 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: BCBS Trust/PPO |
$895.14
|
| Rate for Payer: BCN Commercial |
$847.44
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO |
$954.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.99
|
| Rate for Payer: UHC Core |
$915.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.44
|
|
|
HC CT RF/MICROWAVE ABLATION
|
Facility
|
OP
|
$1,096.58
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000042
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$260.44 |
| Max. Negotiated Rate |
$986.92 |
| Rate for Payer: Aetna Commercial |
$932.09
|
| Rate for Payer: Aetna Medicare |
$285.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.68
|
| Rate for Payer: BCBS Complete |
$438.63
|
| Rate for Payer: BCBS MAPPO |
$274.14
|
| Rate for Payer: BCBS Trust/PPO |
$901.50
|
| Rate for Payer: BCN Commercial |
$852.59
|
| Rate for Payer: BCN Medicare Advantage |
$274.14
|
| Rate for Payer: Cash Price |
$877.26
|
| Rate for Payer: Cofinity Commercial |
$943.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.14
|
| Rate for Payer: Healthscope Commercial |
$986.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$932.09
|
| Rate for Payer: Nomi Health Commercial |
$899.20
|
| Rate for Payer: PACE Senior Care Partners |
$260.44
|
| Rate for Payer: PACE SWMI |
$274.14
|
| Rate for Payer: PHP Commercial |
$932.09
|
| Rate for Payer: PHP Medicare Advantage |
$274.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.78
|
| Rate for Payer: Priority Health HMO/PPO |
$954.02
|
| Rate for Payer: Priority Health Medicare |
$276.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.71
|
| Rate for Payer: Railroad Medicare Medicare |
$274.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.99
|
| Rate for Payer: UHC Core |
$915.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.14
|
| Rate for Payer: UHC Exchange |
$274.14
|
| Rate for Payer: UHC Medicare Advantage |
$274.14
|
| Rate for Payer: VA VA |
$274.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.44
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
OP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.31 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: Aetna Medicare |
$114.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.70
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$110.16
|
| Rate for Payer: BCBS Trust/PPO |
$362.25
|
| Rate for Payer: BCN Commercial |
$342.60
|
| Rate for Payer: BCN Medicare Advantage |
$110.16
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.16
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.67
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: PACE Senior Care Partners |
$104.65
|
| Rate for Payer: PACE SWMI |
$110.16
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: PHP Medicare Advantage |
$110.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO |
$383.36
|
| Rate for Payer: Priority Health Medicare |
$111.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.23
|
| Rate for Payer: Railroad Medicare Medicare |
$110.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.76
|
| Rate for Payer: UHC Core |
$367.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.16
|
| Rate for Payer: UHC Exchange |
$110.16
|
| Rate for Payer: UHC Medicare Advantage |
$110.16
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$110.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG ANT COMPLEX
|
Facility
|
IP
|
$440.64
|
|
|
Service Code
|
CPT 30903
|
| Hospital Charge Code |
76100414
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.42 |
| Max. Negotiated Rate |
$396.58 |
| Rate for Payer: Aetna Commercial |
$374.54
|
| Rate for Payer: BCBS Trust/PPO |
$359.69
|
| Rate for Payer: BCN Commercial |
$340.53
|
| Rate for Payer: Cash Price |
$352.51
|
| Rate for Payer: Cofinity Commercial |
$378.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.51
|
| Rate for Payer: Healthscope Commercial |
$396.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.54
|
| Rate for Payer: Nomi Health Commercial |
$361.32
|
| Rate for Payer: PHP Commercial |
$374.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.42
|
| Rate for Payer: Priority Health HMO/PPO |
$383.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.76
|
| Rate for Payer: UHC Core |
$367.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.48
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
IP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.86 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna Commercial |
$507.20
|
| Rate for Payer: BCBS Trust/PPO |
$487.09
|
| Rate for Payer: BCN Commercial |
$461.13
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.20
|
| Rate for Payer: Nomi Health Commercial |
$489.29
|
| Rate for Payer: PHP Commercial |
$507.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health HMO/PPO |
$519.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.10
|
| Rate for Payer: UHC Core |
$498.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CTRL NASAL HEMRRG POSTERIOR PACKS/CAUTERY SUBSQ
|
Facility
|
OP
|
$596.70
|
|
|
Service Code
|
CPT 30906
|
| Hospital Charge Code |
76100394
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.72 |
| Max. Negotiated Rate |
$537.03 |
| Rate for Payer: Aetna Commercial |
$507.20
|
| Rate for Payer: Aetna Medicare |
$155.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.47
|
| Rate for Payer: BCBS Complete |
$172.73
|
| Rate for Payer: BCBS MAPPO |
$149.18
|
| Rate for Payer: BCBS Trust/PPO |
$490.55
|
| Rate for Payer: BCN Commercial |
$463.93
|
| Rate for Payer: BCN Medicare Advantage |
$149.18
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cash Price |
$477.36
|
| Rate for Payer: Cofinity Commercial |
$513.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.18
|
| Rate for Payer: Healthscope Commercial |
$537.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.52
|
| Rate for Payer: Mclaren Medicaid |
$164.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.63
|
| Rate for Payer: Meridian Medicaid |
$172.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.20
|
| Rate for Payer: Nomi Health Commercial |
$489.29
|
| Rate for Payer: PACE Senior Care Partners |
$141.72
|
| Rate for Payer: PACE SWMI |
$149.18
|
| Rate for Payer: PHP Commercial |
$507.20
|
| Rate for Payer: PHP Medicare Advantage |
$149.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.86
|
| Rate for Payer: Priority Health HMO/PPO |
$519.13
|
| Rate for Payer: Priority Health Medicare |
$150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.79
|
| Rate for Payer: Railroad Medicare Medicare |
$149.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.10
|
| Rate for Payer: UHC Core |
$498.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.18
|
| Rate for Payer: UHC Exchange |
$149.18
|
| Rate for Payer: UHC Medicare Advantage |
$149.18
|
| Rate for Payer: UHCCP Medicaid |
$164.50
|
| Rate for Payer: VA VA |
$149.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.52
|
|
|
HC CT SI JTS W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$183.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$548.52
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.37
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000025
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: BCBS Trust/PPO |
$575.89
|
| Rate for Payer: BCN Commercial |
$545.20
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$183.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$548.52
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.37
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000023
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: BCBS Trust/PPO |
$575.89
|
| Rate for Payer: BCN Commercial |
$545.20
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
IP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$458.57 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: BCBS Trust/PPO |
$575.89
|
| Rate for Payer: BCN Commercial |
$545.20
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SI JTS WO W CON
|
Facility
|
OP
|
$705.49
|
|
|
Service Code
|
CPT 76380
|
| Hospital Charge Code |
35000026
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$634.94 |
| Rate for Payer: Aetna Commercial |
$599.67
|
| Rate for Payer: Aetna Medicare |
$183.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$548.52
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cash Price |
$564.39
|
| Rate for Payer: Cofinity Commercial |
$606.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Healthscope Commercial |
$634.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.12
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.67
|
| Rate for Payer: Nomi Health Commercial |
$578.50
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PHP Commercial |
$599.67
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.57
|
| Rate for Payer: Priority Health HMO/PPO |
$613.78
|
| Rate for Payer: Priority Health Medicare |
$178.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.68
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.83
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.37
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.12
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
OP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: Aetna Medicare |
$424.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$510.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$510.71
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$408.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,343.53
|
| Rate for Payer: BCN Commercial |
$1,270.64
|
| Rate for Payer: BCN Medicare Advantage |
$408.56
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.56
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.70
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.99
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$469.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: Nomi Health Commercial |
$1,340.09
|
| Rate for Payer: PACE Senior Care Partners |
$388.14
|
| Rate for Payer: PACE SWMI |
$408.56
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: PHP Medicare Advantage |
$408.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,421.81
|
| Rate for Payer: Priority Health Medicare |
$412.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.95
|
| Rate for Payer: Railroad Medicare Medicare |
$408.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,438.15
|
| Rate for Payer: UHC Core |
$1,364.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.56
|
| Rate for Payer: UHC Exchange |
$408.56
|
| Rate for Payer: UHC Medicare Advantage |
$408.56
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$408.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.70
|
|
|
HC CT SOFT TISS NECK W CON
|
Facility
|
IP
|
$1,634.26
|
|
|
Service Code
|
CPT 70491
|
| Hospital Charge Code |
35000002
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,062.27 |
| Max. Negotiated Rate |
$1,470.83 |
| Rate for Payer: Aetna Commercial |
$1,389.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,334.05
|
| Rate for Payer: BCN Commercial |
$1,262.96
|
| Rate for Payer: Cash Price |
$1,307.41
|
| Rate for Payer: Cofinity Commercial |
$1,405.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,307.41
|
| Rate for Payer: Healthscope Commercial |
$1,470.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,225.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,389.12
|
| Rate for Payer: Nomi Health Commercial |
$1,340.09
|
| Rate for Payer: PHP Commercial |
$1,389.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,421.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,438.15
|
| Rate for Payer: UHC Core |
$1,364.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,225.70
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
OP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: Aetna Medicare |
$359.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$432.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$432.26
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$345.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,137.15
|
| Rate for Payer: BCN Commercial |
$1,075.45
|
| Rate for Payer: BCN Medicare Advantage |
$345.80
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.80
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.10
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: Nomi Health Commercial |
$1,134.24
|
| Rate for Payer: PACE Senior Care Partners |
$328.51
|
| Rate for Payer: PACE SWMI |
$345.80
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: PHP Medicare Advantage |
$345.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health HMO/PPO |
$1,203.40
|
| Rate for Payer: Priority Health Medicare |
$349.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.76
|
| Rate for Payer: Railroad Medicare Medicare |
$345.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.23
|
| Rate for Payer: UHC Core |
$1,154.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.80
|
| Rate for Payer: UHC Exchange |
$345.80
|
| Rate for Payer: UHC Medicare Advantage |
$345.80
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$345.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT SOFT TISS NECK WO CON
|
Facility
|
IP
|
$1,383.22
|
|
|
Service Code
|
CPT 70490
|
| Hospital Charge Code |
35000001
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$899.09 |
| Max. Negotiated Rate |
$1,244.90 |
| Rate for Payer: Aetna Commercial |
$1,175.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,129.12
|
| Rate for Payer: BCN Commercial |
$1,068.95
|
| Rate for Payer: Cash Price |
$1,106.58
|
| Rate for Payer: Cofinity Commercial |
$1,189.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,106.58
|
| Rate for Payer: Healthscope Commercial |
$1,244.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,037.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,175.74
|
| Rate for Payer: Nomi Health Commercial |
$1,134.24
|
| Rate for Payer: PHP Commercial |
$1,175.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.09
|
| Rate for Payer: Priority Health HMO/PPO |
$1,203.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,217.23
|
| Rate for Payer: UHC Core |
$1,154.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,037.42
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
OP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: Aetna Medicare |
$489.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$587.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$587.96
|
| Rate for Payer: BCBS Complete |
$132.42
|
| Rate for Payer: BCBS MAPPO |
$470.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.75
|
| Rate for Payer: BCN Commercial |
$1,462.84
|
| Rate for Payer: BCN Medicare Advantage |
$470.36
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.36
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| Rate for Payer: Mclaren Medicaid |
$126.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$493.88
|
| Rate for Payer: Meridian Medicaid |
$132.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: Nomi Health Commercial |
$1,542.80
|
| Rate for Payer: PACE Senior Care Partners |
$446.85
|
| Rate for Payer: PACE SWMI |
$470.36
|
| Rate for Payer: PHP Commercial |
$1,599.24
|
| Rate for Payer: PHP Medicare Advantage |
$470.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,636.87
|
| Rate for Payer: Priority Health Medicare |
$475.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.58
|
| Rate for Payer: Railroad Medicare Medicare |
$470.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,655.68
|
| Rate for Payer: UHC Core |
$1,571.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$470.36
|
| Rate for Payer: UHC Exchange |
$470.36
|
| Rate for Payer: UHC Medicare Advantage |
$470.36
|
| Rate for Payer: UHCCP Medicaid |
$126.11
|
| Rate for Payer: VA VA |
$470.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SOFT TISS NECK WO W CON
|
Facility
|
IP
|
$1,881.46
|
|
|
Service Code
|
CPT 70492
|
| Hospital Charge Code |
35000003
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$1,222.95 |
| Max. Negotiated Rate |
$1,693.31 |
| Rate for Payer: Aetna Commercial |
$1,599.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.84
|
| Rate for Payer: BCN Commercial |
$1,453.99
|
| Rate for Payer: Cash Price |
$1,505.17
|
| Rate for Payer: Cofinity Commercial |
$1,618.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,505.17
|
| Rate for Payer: Healthscope Commercial |
$1,693.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,411.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,599.24
|
| Rate for Payer: Nomi Health Commercial |
$1,542.80
|
| Rate for Payer: PHP Commercial |
$1,599.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,222.95
|
| Rate for Payer: Priority Health HMO/PPO |
$1,636.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,655.68
|
| Rate for Payer: UHC Core |
$1,571.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,411.10
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
OP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: Aetna Medicare |
$504.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$605.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$605.82
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$484.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,593.73
|
| Rate for Payer: BCN Commercial |
$1,507.27
|
| Rate for Payer: BCN Medicare Advantage |
$484.65
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.65
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.89
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: Nomi Health Commercial |
$1,589.66
|
| Rate for Payer: PACE Senior Care Partners |
$460.42
|
| Rate for Payer: PACE SWMI |
$484.65
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: PHP Medicare Advantage |
$484.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,686.59
|
| Rate for Payer: Priority Health Medicare |
$489.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,298.87
|
| Rate for Payer: Railroad Medicare Medicare |
$484.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.98
|
| Rate for Payer: UHC Core |
$1,618.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$484.65
|
| Rate for Payer: UHC Exchange |
$484.65
|
| Rate for Payer: UHC Medicare Advantage |
$484.65
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$484.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL W CON
|
Facility
|
IP
|
$1,938.61
|
|
|
Service Code
|
CPT 72126
|
| Hospital Charge Code |
35200004
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,260.10 |
| Max. Negotiated Rate |
$1,744.75 |
| Rate for Payer: Aetna Commercial |
$1,647.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,582.49
|
| Rate for Payer: BCN Commercial |
$1,498.16
|
| Rate for Payer: Cash Price |
$1,550.89
|
| Rate for Payer: Cofinity Commercial |
$1,667.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,550.89
|
| Rate for Payer: Healthscope Commercial |
$1,744.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,453.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,647.82
|
| Rate for Payer: Nomi Health Commercial |
$1,589.66
|
| Rate for Payer: PHP Commercial |
$1,647.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.10
|
| Rate for Payer: Priority Health HMO/PPO |
$1,686.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,298.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,705.98
|
| Rate for Payer: UHC Core |
$1,618.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,453.96
|
|
|
HC CT SPINE CERVICAL WO CON
|
Facility
|
IP
|
$1,617.92
|
|
|
Service Code
|
CPT 72125
|
| Hospital Charge Code |
35200003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,051.65 |
| Max. Negotiated Rate |
$1,456.13 |
| Rate for Payer: Aetna Commercial |
$1,375.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.71
|
| Rate for Payer: BCN Commercial |
$1,250.33
|
| Rate for Payer: Cash Price |
$1,294.34
|
| Rate for Payer: Cofinity Commercial |
$1,391.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.34
|
| Rate for Payer: Healthscope Commercial |
$1,456.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.23
|
| Rate for Payer: Nomi Health Commercial |
$1,326.69
|
| Rate for Payer: PHP Commercial |
$1,375.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,407.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,084.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,423.77
|
| Rate for Payer: UHC Core |
$1,350.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.44
|
|
