|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
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
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
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 PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.49 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.19
|
| Rate for Payer: BCN Commercial |
$1,303.19
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.50 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$438.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$526.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$526.98
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$421.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.11
|
| Rate for Payer: BCN Commercial |
$1,311.11
|
| Rate for Payer: BCN Medicare Advantage |
$421.58
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$421.58
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$442.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$484.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PACE Senior Care Partners |
$400.50
|
| Rate for Payer: PACE SWMI |
$421.58
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: PHP Medicare Advantage |
$421.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,467.10
|
| Rate for Payer: Priority Health Medicare |
$421.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.49
|
| Rate for Payer: Railroad Medicare Medicare |
$421.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,483.96
|
| Rate for Payer: UHC Core |
$1,408.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$421.58
|
| Rate for Payer: UHC Medicare Advantage |
$434.23
|
| Rate for Payer: VA VA |
$421.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$382.38 |
| Max. Negotiated Rate |
$1,449.04 |
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: Aetna Medicare |
$418.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.14
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$402.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.81
|
| Rate for Payer: BCN Commercial |
$1,251.81
|
| Rate for Payer: BCN Medicare Advantage |
$402.51
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.51
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.53
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$422.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$462.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PACE Senior Care Partners |
$382.38
|
| Rate for Payer: PACE SWMI |
$402.51
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: PHP Medicare Advantage |
$402.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,400.73
|
| Rate for Payer: Priority Health Medicare |
$402.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.96
|
| Rate for Payer: Railroad Medicare Medicare |
$402.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.84
|
| Rate for Payer: UHC Core |
$1,344.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.51
|
| Rate for Payer: UHC Medicare Advantage |
$414.59
|
| Rate for Payer: VA VA |
$402.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.53
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$981.96 |
| Max. Negotiated Rate |
$1,449.04 |
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.24
|
| Rate for Payer: BCN Commercial |
$1,244.24
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,400.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.84
|
| Rate for Payer: UHC Core |
$1,344.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.53
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.58
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$382.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$393.98
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.38
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,156.46 |
| Max. Negotiated Rate |
$3,182.18 |
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,732.44
|
| Rate for Payer: BCN Commercial |
$2,732.44
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,651.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,076.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,111.47
|
| Rate for Payer: UHC Core |
$2,952.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,651.82
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$839.74 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: Aetna Medicare |
$919.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,104.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,104.92
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$883.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,749.05
|
| Rate for Payer: BCN Commercial |
$2,749.05
|
| Rate for Payer: BCN Medicare Advantage |
$883.94
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$883.94
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,651.82
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$928.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,016.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PACE Senior Care Partners |
$839.74
|
| Rate for Payer: PACE SWMI |
$883.94
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: PHP Medicare Advantage |
$883.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,076.11
|
| Rate for Payer: Priority Health Medicare |
$883.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.46
|
| Rate for Payer: Railroad Medicare Medicare |
$883.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,111.47
|
| Rate for Payer: UHC Core |
$2,952.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$883.94
|
| Rate for Payer: UHC Medicare Advantage |
$910.46
|
| Rate for Payer: VA VA |
$883.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,651.82
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,964.52 |
| Max. Negotiated Rate |
$2,898.95 |
| Rate for Payer: Aetna Commercial |
$2,737.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.24
|
| Rate for Payer: BCN Commercial |
$2,489.24
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$2,770.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.85
|
| Rate for Payer: Healthscope Commercial |
$2,898.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PHP Commercial |
$2,737.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,802.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,964.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,834.53
|
| Rate for Payer: UHC Core |
$2,689.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.80
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$2,898.95 |
| Rate for Payer: Aetna Commercial |
$2,737.90
|
| Rate for Payer: Aetna Medicare |
$837.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,006.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,006.58
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$805.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,504.37
|
| Rate for Payer: BCN Commercial |
$2,504.37
|
| Rate for Payer: BCN Medicare Advantage |
$805.26
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$2,770.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.26
|
| Rate for Payer: Healthscope Commercial |
$2,898.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.80
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$845.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PACE Senior Care Partners |
$765.00
|
| Rate for Payer: PACE SWMI |
$805.26
|
| Rate for Payer: PHP Commercial |
$2,737.90
|
| Rate for Payer: PHP Medicare Advantage |
$805.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,802.32
|
| Rate for Payer: Priority Health Medicare |
$805.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,964.52
|
| Rate for Payer: Railroad Medicare Medicare |
$805.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,834.53
|
| Rate for Payer: UHC Core |
$2,689.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.26
|
| Rate for Payer: UHC Medicare Advantage |
$829.42
|
| Rate for Payer: VA VA |
$805.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.80
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$508.70 |
| Max. Negotiated Rate |
$1,927.71 |
| Rate for Payer: Aetna Commercial |
$1,820.62
|
| Rate for Payer: Aetna Medicare |
$556.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.34
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$535.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,665.33
|
| Rate for Payer: BCN Commercial |
$1,665.33
|
| Rate for Payer: BCN Medicare Advantage |
$535.48
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.48
|
| Rate for Payer: Healthscope Commercial |
$1,927.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.42
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$562.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: PACE Senior Care Partners |
$508.70
|
| Rate for Payer: PACE SWMI |
$535.48
|
| Rate for Payer: PHP Commercial |
$1,820.62
|
| Rate for Payer: PHP Medicare Advantage |
$535.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,863.45
|
| Rate for Payer: Priority Health Medicare |
$535.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,306.34
|
| Rate for Payer: Railroad Medicare Medicare |
$535.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.87
|
| Rate for Payer: UHC Core |
$1,788.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.48
|
| Rate for Payer: UHC Medicare Advantage |
$551.54
|
| Rate for Payer: VA VA |
$535.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.42
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,141.90
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,306.34 |
| Max. Negotiated Rate |
$1,927.71 |
| Rate for Payer: Aetna Commercial |
$1,820.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,655.26
|
| Rate for Payer: BCN Commercial |
$1,655.26
|
| Rate for Payer: Cash Price |
$1,713.52
|
| Rate for Payer: Cofinity Commercial |
$1,842.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.52
|
| Rate for Payer: Healthscope Commercial |
$1,927.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,820.62
|
| Rate for Payer: PHP Commercial |
$1,820.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,499.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,863.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,306.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.87
|
| Rate for Payer: UHC Core |
$1,788.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.42
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,947.18
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$412.10 |
| Max. Negotiated Rate |
$1,752.46 |
| Rate for Payer: Aetna Commercial |
$1,655.10
|
| Rate for Payer: Aetna Medicare |
$506.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$608.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$608.49
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$486.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,513.93
|
| Rate for Payer: BCN Commercial |
$1,513.93
|
| Rate for Payer: BCN Medicare Advantage |
$486.80
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cofinity Commercial |
$1,674.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$486.80
|
| Rate for Payer: Healthscope Commercial |
$1,752.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,460.38
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$511.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$559.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,655.10
|
| Rate for Payer: PACE Senior Care Partners |
$462.46
|
| Rate for Payer: PACE SWMI |
$486.80
|
| Rate for Payer: PHP Commercial |
$1,655.10
|
| Rate for Payer: PHP Medicare Advantage |
$486.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,694.05
|
| Rate for Payer: Priority Health Medicare |
$486.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,187.59
|
| Rate for Payer: Railroad Medicare Medicare |
$486.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,713.52
|
| Rate for Payer: UHC Core |
$1,625.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$486.80
|
| Rate for Payer: UHC Medicare Advantage |
$501.40
|
| Rate for Payer: VA VA |
$486.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,460.38
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
IP
|
$1,947.18
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,187.59 |
| Max. Negotiated Rate |
$1,752.46 |
| Rate for Payer: Aetna Commercial |
$1,655.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,504.78
|
| Rate for Payer: BCN Commercial |
$1,504.78
|
| Rate for Payer: Cash Price |
$1,557.74
|
| Rate for Payer: Cofinity Commercial |
$1,674.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,557.74
|
| Rate for Payer: Healthscope Commercial |
$1,752.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,460.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,655.10
|
| Rate for Payer: PHP Commercial |
$1,655.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,363.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,694.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,187.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,713.52
|
| Rate for Payer: UHC Core |
$1,625.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,460.38
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$83,233.86
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,768.04 |
| Max. Negotiated Rate |
$74,910.47 |
| Rate for Payer: Aetna Commercial |
$70,748.78
|
| Rate for Payer: Aetna Medicare |
$21,640.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,010.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,010.58
|
| Rate for Payer: BCBS Complete |
$22,660.63
|
| Rate for Payer: BCBS MAPPO |
$20,808.46
|
| Rate for Payer: BCBS Trust/PPO |
$64,714.33
|
| Rate for Payer: BCN Commercial |
$64,714.33
|
| Rate for Payer: BCN Medicare Advantage |
$20,808.46
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cofinity Commercial |
$71,581.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66,587.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20,808.46
|
| Rate for Payer: Healthscope Commercial |
$74,910.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62,425.40
|
| Rate for Payer: Mclaren Medicaid |
$21,581.55
|
| Rate for Payer: Meridian Medicaid |
$22,660.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21,848.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23,929.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70,748.78
|
| Rate for Payer: PACE Senior Care Partners |
$19,768.04
|
| Rate for Payer: PACE SWMI |
$20,808.46
|
| Rate for Payer: PHP Commercial |
$70,748.78
|
| Rate for Payer: PHP Medicare Advantage |
$20,808.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,581.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58,263.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72,413.46
|
| Rate for Payer: Priority Health Medicare |
$20,808.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50,764.33
|
| Rate for Payer: Railroad Medicare Medicare |
$20,808.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73,245.80
|
| Rate for Payer: UHC Core |
$69,500.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$20,808.46
|
| Rate for Payer: UHC Medicare Advantage |
$21,432.72
|
| Rate for Payer: VA VA |
$20,808.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62,425.40
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$83,233.86
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$50,764.33 |
| Max. Negotiated Rate |
$74,910.47 |
| Rate for Payer: Aetna Commercial |
$70,748.78
|
| Rate for Payer: BCBS Trust/PPO |
$64,323.13
|
| Rate for Payer: BCN Commercial |
$64,323.13
|
| Rate for Payer: Cash Price |
$66,587.09
|
| Rate for Payer: Cofinity Commercial |
$71,581.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66,587.09
|
| Rate for Payer: Healthscope Commercial |
$74,910.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62,425.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70,748.78
|
| Rate for Payer: PHP Commercial |
$70,748.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58,263.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72,413.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50,764.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73,245.80
|
| Rate for Payer: UHC Core |
$69,500.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62,425.40
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$181.67
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.15 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$154.42
|
| Rate for Payer: Aetna Medicare |
$47.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.77
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$141.25
|
| Rate for Payer: BCN Commercial |
$141.25
|
| Rate for Payer: BCN Medicare Advantage |
$45.42
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.42
|
| Rate for Payer: Healthscope Commercial |
$163.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.25
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.42
|
| Rate for Payer: PACE Senior Care Partners |
$43.15
|
| Rate for Payer: PACE SWMI |
$45.42
|
| Rate for Payer: PHP Commercial |
$154.42
|
| Rate for Payer: PHP Medicare Advantage |
$45.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.05
|
| Rate for Payer: Priority Health Medicare |
$45.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.80
|
| Rate for Payer: Railroad Medicare Medicare |
$45.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.87
|
| Rate for Payer: UHC Core |
$151.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.42
|
| Rate for Payer: UHC Medicare Advantage |
$46.78
|
| Rate for Payer: VA VA |
$45.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.25
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$181.67
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.80 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$154.42
|
| Rate for Payer: BCBS Trust/PPO |
$140.39
|
| Rate for Payer: BCN Commercial |
$140.39
|
| Rate for Payer: Cash Price |
$145.34
|
| Rate for Payer: Cofinity Commercial |
$156.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.34
|
| Rate for Payer: Healthscope Commercial |
$163.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$154.42
|
| Rate for Payer: PHP Commercial |
$154.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.87
|
| Rate for Payer: UHC Core |
$151.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.25
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$3,997.05
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,437.80 |
| Max. Negotiated Rate |
$3,597.34 |
| Rate for Payer: Aetna Commercial |
$3,397.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,088.92
|
| Rate for Payer: BCN Commercial |
$3,088.92
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cofinity Commercial |
$3,437.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,197.64
|
| Rate for Payer: Healthscope Commercial |
$3,597.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,997.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,397.49
|
| Rate for Payer: PHP Commercial |
$3,397.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,477.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,437.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,517.40
|
| Rate for Payer: UHC Core |
$3,337.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,997.79
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$3,997.05
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$949.30 |
| Max. Negotiated Rate |
$3,597.34 |
| Rate for Payer: Aetna Commercial |
$3,397.49
|
| Rate for Payer: Aetna Medicare |
$1,039.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,249.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,249.08
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$999.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,107.71
|
| Rate for Payer: BCN Commercial |
$3,107.71
|
| Rate for Payer: BCN Medicare Advantage |
$999.26
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cash Price |
$3,197.64
|
| Rate for Payer: Cofinity Commercial |
$3,437.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,197.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$999.26
|
| Rate for Payer: Healthscope Commercial |
$3,597.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,997.79
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,049.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,149.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,397.49
|
| Rate for Payer: PACE Senior Care Partners |
$949.30
|
| Rate for Payer: PACE SWMI |
$999.26
|
| Rate for Payer: PHP Commercial |
$3,397.49
|
| Rate for Payer: PHP Medicare Advantage |
$999.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,797.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,477.43
|
| Rate for Payer: Priority Health Medicare |
$999.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,437.80
|
| Rate for Payer: Railroad Medicare Medicare |
$999.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,517.40
|
| Rate for Payer: UHC Core |
$3,337.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$999.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.24
|
| Rate for Payer: VA VA |
$999.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,997.79
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,058.39
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$963.87 |
| Max. Negotiated Rate |
$3,785.15 |
| Rate for Payer: Aetna Commercial |
$3,449.63
|
| Rate for Payer: Aetna Medicare |
$1,055.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,268.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,268.25
|
| Rate for Payer: BCBS Complete |
$3,785.15
|
| Rate for Payer: BCBS MAPPO |
$1,014.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,155.40
|
| Rate for Payer: BCN Commercial |
$3,155.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,014.60
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cofinity Commercial |
$3,490.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,014.60
|
| Rate for Payer: Healthscope Commercial |
$3,652.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,043.79
|
| Rate for Payer: Mclaren Medicaid |
$3,604.90
|
| Rate for Payer: Meridian Medicaid |
$3,785.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,065.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,166.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,449.63
|
| Rate for Payer: PACE Senior Care Partners |
$963.87
|
| Rate for Payer: PACE SWMI |
$1,014.60
|
| Rate for Payer: PHP Commercial |
$3,449.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,014.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,604.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,840.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,530.80
|
| Rate for Payer: Priority Health Medicare |
$1,014.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,475.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,014.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,571.38
|
| Rate for Payer: UHC Core |
$3,388.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,014.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,045.04
|
| Rate for Payer: VA VA |
$1,014.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,043.79
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,058.39
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,475.21 |
| Max. Negotiated Rate |
$3,652.55 |
| Rate for Payer: Aetna Commercial |
$3,449.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,136.32
|
| Rate for Payer: BCN Commercial |
$3,136.32
|
| Rate for Payer: Cash Price |
$3,246.71
|
| Rate for Payer: Cofinity Commercial |
$3,490.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,246.71
|
| Rate for Payer: Healthscope Commercial |
$3,652.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,043.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,449.63
|
| Rate for Payer: PHP Commercial |
$3,449.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,840.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,530.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,475.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,571.38
|
| Rate for Payer: UHC Core |
$3,388.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,043.79
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$259.90
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$158.51 |
| Max. Negotiated Rate |
$233.91 |
| Rate for Payer: Aetna Commercial |
$220.92
|
| Rate for Payer: BCBS Trust/PPO |
$200.85
|
| Rate for Payer: BCN Commercial |
$200.85
|
| Rate for Payer: Cash Price |
$207.92
|
| Rate for Payer: Cofinity Commercial |
$223.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.92
|
| Rate for Payer: Healthscope Commercial |
$233.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.92
|
| Rate for Payer: PHP Commercial |
$220.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.71
|
| Rate for Payer: UHC Core |
$217.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.92
|
|
