|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$490.51
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna Medicare |
$127.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.28
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$122.63
|
| Rate for Payer: BCBS Trust/PPO |
$381.37
|
| Rate for Payer: BCN Commercial |
$381.37
|
| Rate for Payer: BCN Medicare Advantage |
$122.63
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.63
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PACE Senior Care Partners |
$116.50
|
| Rate for Payer: PACE SWMI |
$122.63
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: PHP Medicare Advantage |
$122.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$426.74
|
| Rate for Payer: Priority Health Medicare |
$122.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.16
|
| Rate for Payer: Railroad Medicare Medicare |
$122.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.65
|
| Rate for Payer: UHC Core |
$409.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.63
|
| Rate for Payer: UHC Medicare Advantage |
$126.31
|
| Rate for Payer: VA VA |
$122.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.07 |
| Max. Negotiated Rate |
$373.45 |
| Rate for Payer: Aetna Commercial |
$352.70
|
| Rate for Payer: BCBS Trust/PPO |
$320.67
|
| Rate for Payer: BCN Commercial |
$320.67
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$356.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Healthscope Commercial |
$373.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: PHP Commercial |
$352.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$361.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.15
|
| Rate for Payer: UHC Core |
$346.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.20
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.55 |
| Max. Negotiated Rate |
$373.45 |
| Rate for Payer: Aetna Commercial |
$352.70
|
| Rate for Payer: Aetna Medicare |
$107.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.67
|
| Rate for Payer: BCBS Complete |
$220.97
|
| Rate for Payer: BCBS MAPPO |
$103.74
|
| Rate for Payer: BCBS Trust/PPO |
$322.62
|
| Rate for Payer: BCN Commercial |
$322.62
|
| Rate for Payer: BCN Medicare Advantage |
$103.74
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$356.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.74
|
| Rate for Payer: Healthscope Commercial |
$373.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.20
|
| Rate for Payer: Mclaren Medicaid |
$210.45
|
| Rate for Payer: Meridian Medicaid |
$220.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: PACE Senior Care Partners |
$98.55
|
| Rate for Payer: PACE SWMI |
$103.74
|
| Rate for Payer: PHP Commercial |
$352.70
|
| Rate for Payer: PHP Medicare Advantage |
$103.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$361.00
|
| Rate for Payer: Priority Health Medicare |
$103.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.07
|
| Rate for Payer: Railroad Medicare Medicare |
$103.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$365.15
|
| Rate for Payer: UHC Core |
$346.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.74
|
| Rate for Payer: UHC Medicare Advantage |
$106.85
|
| Rate for Payer: VA VA |
$103.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.20
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$134.19 |
| Max. Negotiated Rate |
$508.51 |
| Rate for Payer: Aetna Commercial |
$480.26
|
| Rate for Payer: Aetna Medicare |
$146.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.57
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$141.25
|
| Rate for Payer: BCBS Trust/PPO |
$439.30
|
| Rate for Payer: BCN Commercial |
$439.30
|
| Rate for Payer: BCN Medicare Advantage |
$141.25
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$485.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.25
|
| Rate for Payer: Healthscope Commercial |
$508.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.76
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.26
|
| Rate for Payer: PACE Senior Care Partners |
$134.19
|
| Rate for Payer: PACE SWMI |
$141.25
|
| Rate for Payer: PHP Commercial |
$480.26
|
| Rate for Payer: PHP Medicare Advantage |
$141.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.56
|
| Rate for Payer: Priority Health Medicare |
$141.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.60
|
| Rate for Payer: Railroad Medicare Medicare |
$141.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.21
|
| Rate for Payer: UHC Core |
$471.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.25
|
| Rate for Payer: UHC Medicare Advantage |
$145.49
|
| Rate for Payer: VA VA |
$141.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.76
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.60 |
| Max. Negotiated Rate |
$508.51 |
| Rate for Payer: Aetna Commercial |
$480.26
|
| Rate for Payer: BCBS Trust/PPO |
$436.64
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$485.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Healthscope Commercial |
$508.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.26
|
| Rate for Payer: PHP Commercial |
$480.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$497.21
|
| Rate for Payer: UHC Core |
$471.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.76
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.39 |
| Max. Negotiated Rate |
$175.81 |
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Medicare |
$50.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.04
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$48.84
|
| Rate for Payer: BCBS Trust/PPO |
$151.88
|
| Rate for Payer: BCN Commercial |
$151.88
|
| Rate for Payer: BCN Medicare Advantage |
$48.84
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.84
|
| Rate for Payer: Healthscope Commercial |
$175.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.50
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: PACE Senior Care Partners |
$46.39
|
| Rate for Payer: PACE SWMI |
$48.84
|
| Rate for Payer: PHP Commercial |
$166.04
|
| Rate for Payer: PHP Medicare Advantage |
$48.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.95
|
| Rate for Payer: Priority Health Medicare |
$48.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.14
|
| Rate for Payer: Railroad Medicare Medicare |
$48.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.90
|
| Rate for Payer: UHC Core |
$163.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.84
|
| Rate for Payer: UHC Medicare Advantage |
$50.30
|
| Rate for Payer: VA VA |
$48.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.50
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$175.81 |
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: BCBS Trust/PPO |
$150.96
|
| Rate for Payer: BCN Commercial |
$150.96
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Healthscope Commercial |
$175.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: PHP Commercial |
$166.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.90
|
| Rate for Payer: UHC Core |
$163.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.50
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$249.94 |
| Max. Negotiated Rate |
$947.16 |
| Rate for Payer: Aetna Commercial |
$894.54
|
| Rate for Payer: Aetna Medicare |
$273.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.88
|
| Rate for Payer: BCBS Complete |
$420.96
|
| Rate for Payer: BCBS MAPPO |
$263.10
|
| Rate for Payer: BCBS Trust/PPO |
$818.24
|
| Rate for Payer: BCN Commercial |
$818.24
|
| Rate for Payer: BCN Medicare Advantage |
$263.10
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$905.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.10
|
| Rate for Payer: Healthscope Commercial |
$947.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: PACE Senior Care Partners |
$249.94
|
| Rate for Payer: PACE SWMI |
$263.10
|
| Rate for Payer: PHP Commercial |
$894.54
|
| Rate for Payer: PHP Medicare Advantage |
$263.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.59
|
| Rate for Payer: Priority Health Medicare |
$263.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.86
|
| Rate for Payer: Railroad Medicare Medicare |
$263.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$926.11
|
| Rate for Payer: UHC Core |
$878.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.10
|
| Rate for Payer: UHC Medicare Advantage |
$270.99
|
| Rate for Payer: VA VA |
$263.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.30
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$641.86 |
| Max. Negotiated Rate |
$947.16 |
| Rate for Payer: Aetna Commercial |
$894.54
|
| Rate for Payer: BCBS Trust/PPO |
$813.29
|
| Rate for Payer: BCN Commercial |
$813.29
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$905.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Healthscope Commercial |
$947.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: PHP Commercial |
$894.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$926.11
|
| Rate for Payer: UHC Core |
$878.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.30
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.31 |
| Max. Negotiated Rate |
$1,297.19 |
| Rate for Payer: Aetna Commercial |
$1,225.12
|
| Rate for Payer: Aetna Medicare |
$374.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$450.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$450.41
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$360.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,120.63
|
| Rate for Payer: BCN Commercial |
$1,120.63
|
| Rate for Payer: BCN Medicare Advantage |
$360.33
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,239.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.33
|
| Rate for Payer: Healthscope Commercial |
$1,297.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.99
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$378.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: PACE Senior Care Partners |
$342.31
|
| Rate for Payer: PACE SWMI |
$360.33
|
| Rate for Payer: PHP Commercial |
$1,225.12
|
| Rate for Payer: PHP Medicare Advantage |
$360.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,253.95
|
| Rate for Payer: Priority Health Medicare |
$360.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.06
|
| Rate for Payer: Railroad Medicare Medicare |
$360.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.36
|
| Rate for Payer: UHC Core |
$1,203.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$360.33
|
| Rate for Payer: UHC Medicare Advantage |
$371.14
|
| Rate for Payer: VA VA |
$360.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.99
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$879.06 |
| Max. Negotiated Rate |
$1,297.19 |
| Rate for Payer: Aetna Commercial |
$1,225.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.85
|
| Rate for Payer: BCN Commercial |
$1,113.85
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,239.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Healthscope Commercial |
$1,297.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: PHP Commercial |
$1,225.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,253.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.36
|
| Rate for Payer: UHC Core |
$1,203.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.99
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.24 |
| Max. Negotiated Rate |
$1,342.37 |
| Rate for Payer: Aetna Commercial |
$1,267.79
|
| Rate for Payer: Aetna Medicare |
$387.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.10
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$372.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.66
|
| Rate for Payer: BCN Commercial |
$1,159.66
|
| Rate for Payer: BCN Medicare Advantage |
$372.88
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,282.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.88
|
| Rate for Payer: Healthscope Commercial |
$1,342.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.64
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$428.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: PACE Senior Care Partners |
$354.24
|
| Rate for Payer: PACE SWMI |
$372.88
|
| Rate for Payer: PHP Commercial |
$1,267.79
|
| Rate for Payer: PHP Medicare Advantage |
$372.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,297.62
|
| Rate for Payer: Priority Health Medicare |
$372.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$909.68
|
| Rate for Payer: Railroad Medicare Medicare |
$372.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.54
|
| Rate for Payer: UHC Core |
$1,245.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.88
|
| Rate for Payer: UHC Medicare Advantage |
$384.07
|
| Rate for Payer: VA VA |
$372.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.64
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$909.68 |
| Max. Negotiated Rate |
$1,342.37 |
| Rate for Payer: Aetna Commercial |
$1,267.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,152.65
|
| Rate for Payer: BCN Commercial |
$1,152.65
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,282.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Healthscope Commercial |
$1,342.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: PHP Commercial |
$1,267.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,297.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$909.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.54
|
| Rate for Payer: UHC Core |
$1,245.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.64
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.37 |
| Max. Negotiated Rate |
$146.64 |
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: BCBS Trust/PPO |
$125.91
|
| Rate for Payer: BCN Commercial |
$125.91
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$140.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Healthscope Commercial |
$146.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.38
|
| Rate for Payer: UHC Core |
$136.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.20
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.70 |
| Max. Negotiated Rate |
$146.64 |
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: Aetna Medicare |
$42.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.92
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$40.73
|
| Rate for Payer: BCBS Trust/PPO |
$126.68
|
| Rate for Payer: BCN Commercial |
$126.68
|
| Rate for Payer: BCN Medicare Advantage |
$40.73
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$140.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.73
|
| Rate for Payer: Healthscope Commercial |
$146.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.20
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PACE Senior Care Partners |
$38.70
|
| Rate for Payer: PACE SWMI |
$40.73
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: PHP Medicare Advantage |
$40.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.75
|
| Rate for Payer: Priority Health Medicare |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.37
|
| Rate for Payer: Railroad Medicare Medicare |
$40.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.38
|
| Rate for Payer: UHC Core |
$136.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.73
|
| Rate for Payer: UHC Medicare Advantage |
$41.95
|
| Rate for Payer: VA VA |
$40.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.20
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$864.39 |
| Max. Negotiated Rate |
$1,275.54 |
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.27
|
| Rate for Payer: BCN Commercial |
$1,095.27
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,062.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$864.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.20
|
| Rate for Payer: UHC Core |
$1,183.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,062.95
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: Aetna Medicare |
$368.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.90
|
| Rate for Payer: BCBS Complete |
$1,310.64
|
| Rate for Payer: BCBS MAPPO |
$354.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.93
|
| Rate for Payer: BCN Commercial |
$1,101.93
|
| Rate for Payer: BCN Medicare Advantage |
$354.32
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.32
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,062.95
|
| Rate for Payer: Mclaren Medicaid |
$1,248.23
|
| Rate for Payer: Meridian Medicaid |
$1,310.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PACE Senior Care Partners |
$336.60
|
| Rate for Payer: PACE SWMI |
$354.32
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: PHP Medicare Advantage |
$354.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,248.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,233.02
|
| Rate for Payer: Priority Health Medicare |
$354.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$864.39
|
| Rate for Payer: Railroad Medicare Medicare |
$354.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,247.20
|
| Rate for Payer: UHC Core |
$1,183.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.32
|
| Rate for Payer: UHC Medicare Advantage |
$364.95
|
| Rate for Payer: VA VA |
$354.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,062.95
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.18 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: BCBS Trust/PPO |
$287.85
|
| Rate for Payer: BCN Commercial |
$287.85
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.78
|
| Rate for Payer: UHC Core |
$311.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.46 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna Medicare |
$96.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.40
|
| Rate for Payer: BCBS Complete |
$148.99
|
| Rate for Payer: BCBS MAPPO |
$93.12
|
| Rate for Payer: BCBS Trust/PPO |
$289.60
|
| Rate for Payer: BCN Commercial |
$289.60
|
| Rate for Payer: BCN Medicare Advantage |
$93.12
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.12
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PACE Senior Care Partners |
$88.46
|
| Rate for Payer: PACE SWMI |
$93.12
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: PHP Medicare Advantage |
$93.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$324.06
|
| Rate for Payer: Priority Health Medicare |
$93.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.18
|
| Rate for Payer: Railroad Medicare Medicare |
$93.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.78
|
| Rate for Payer: UHC Core |
$311.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.12
|
| Rate for Payer: UHC Medicare Advantage |
$95.91
|
| Rate for Payer: VA VA |
$93.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,522.08 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.62
|
| Rate for Payer: BCN Commercial |
$1,928.62
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$592.71 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$648.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$779.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$779.88
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$623.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.35
|
| Rate for Payer: BCN Commercial |
$1,940.35
|
| Rate for Payer: BCN Medicare Advantage |
$623.91
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.91
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$655.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$717.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Senior Care Partners |
$592.71
|
| Rate for Payer: PACE SWMI |
$623.91
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$623.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Medicare |
$623.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: Railroad Medicare Medicare |
$623.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.91
|
| Rate for Payer: UHC Medicare Advantage |
$642.62
|
| Rate for Payer: VA VA |
$623.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.71 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$648.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$779.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$779.88
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$623.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.35
|
| Rate for Payer: BCN Commercial |
$1,940.35
|
| Rate for Payer: BCN Medicare Advantage |
$623.91
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.91
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$655.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$717.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Senior Care Partners |
$592.71
|
| Rate for Payer: PACE SWMI |
$623.91
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$623.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Medicare |
$623.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: Railroad Medicare Medicare |
$623.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.91
|
| Rate for Payer: UHC Medicare Advantage |
$642.62
|
| Rate for Payer: VA VA |
$623.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,522.08 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.62
|
| Rate for Payer: BCN Commercial |
$1,928.62
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.81 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$755.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$907.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$907.65
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$726.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,258.23
|
| Rate for Payer: BCN Commercial |
$2,258.23
|
| Rate for Payer: BCN Medicare Advantage |
$726.12
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.12
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$762.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$835.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Senior Care Partners |
$689.81
|
| Rate for Payer: PACE SWMI |
$726.12
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$726.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,526.90
|
| Rate for Payer: Priority Health Medicare |
$726.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,771.44
|
| Rate for Payer: Railroad Medicare Medicare |
$726.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,555.94
|
| Rate for Payer: UHC Core |
$2,425.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$726.12
|
| Rate for Payer: UHC Medicare Advantage |
$747.90
|
| Rate for Payer: VA VA |
$726.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,771.44 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.58
|
| Rate for Payer: BCN Commercial |
$2,244.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,526.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,771.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,555.94
|
| Rate for Payer: UHC Core |
$2,425.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
