|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$303.68
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: Aetna Medicare |
$78.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.90
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$75.92
|
| Rate for Payer: BCBS Trust/PPO |
$236.11
|
| Rate for Payer: BCN Commercial |
$236.11
|
| Rate for Payer: BCN Medicare Advantage |
$75.92
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PACE Senior Care Partners |
$72.12
|
| Rate for Payer: PACE SWMI |
$75.92
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: PHP Medicare Advantage |
$75.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Medicare |
$75.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: Railroad Medicare Medicare |
$75.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.92
|
| Rate for Payer: UHC Medicare Advantage |
$78.20
|
| Rate for Payer: VA VA |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$303.68
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.21 |
| Max. Negotiated Rate |
$273.31 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: BCBS Trust/PPO |
$234.68
|
| Rate for Payer: BCN Commercial |
$234.68
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$488.86
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.16 |
| Max. Negotiated Rate |
$439.97 |
| Rate for Payer: Aetna Commercial |
$415.53
|
| Rate for Payer: BCBS Trust/PPO |
$377.79
|
| Rate for Payer: BCN Commercial |
$377.79
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$420.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Healthscope Commercial |
$439.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PHP Commercial |
$415.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
| Rate for Payer: UHC Core |
$408.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$488.86
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$439.97 |
| Rate for Payer: Aetna Commercial |
$415.53
|
| Rate for Payer: Aetna Medicare |
$127.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.77
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$380.09
|
| Rate for Payer: BCN Commercial |
$380.09
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$420.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$439.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PACE Senior Care Partners |
$116.10
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$415.53
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
| Rate for Payer: UHC Core |
$408.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Medicare Advantage |
$125.88
|
| Rate for Payer: VA VA |
$122.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$303.68
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: Aetna Medicare |
$78.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.90
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$75.92
|
| Rate for Payer: BCBS Trust/PPO |
$236.11
|
| Rate for Payer: BCN Commercial |
$236.11
|
| Rate for Payer: BCN Medicare Advantage |
$75.92
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PACE Senior Care Partners |
$72.12
|
| Rate for Payer: PACE SWMI |
$75.92
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: PHP Medicare Advantage |
$75.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Medicare |
$75.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: Railroad Medicare Medicare |
$75.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.92
|
| Rate for Payer: UHC Medicare Advantage |
$78.20
|
| Rate for Payer: VA VA |
$75.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$303.68
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.21 |
| Max. Negotiated Rate |
$273.31 |
| Rate for Payer: Aetna Commercial |
$258.13
|
| Rate for Payer: BCBS Trust/PPO |
$234.68
|
| Rate for Payer: BCN Commercial |
$234.68
|
| Rate for Payer: Cash Price |
$242.94
|
| Rate for Payer: Cofinity Commercial |
$261.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.94
|
| Rate for Payer: Healthscope Commercial |
$273.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.13
|
| Rate for Payer: PHP Commercial |
$258.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.24
|
| Rate for Payer: UHC Core |
$253.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.76
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$881.89
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.45 |
| Max. Negotiated Rate |
$793.70 |
| Rate for Payer: Aetna Commercial |
$749.61
|
| Rate for Payer: Aetna Medicare |
$229.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.59
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$220.47
|
| Rate for Payer: BCBS Trust/PPO |
$685.67
|
| Rate for Payer: BCN Commercial |
$685.67
|
| Rate for Payer: BCN Medicare Advantage |
$220.47
|
| Rate for Payer: Cash Price |
$705.51
|
| Rate for Payer: Cash Price |
$705.51
|
| Rate for Payer: Cofinity Commercial |
$758.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.47
|
| Rate for Payer: Healthscope Commercial |
$793.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.42
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$231.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$749.61
|
| Rate for Payer: PACE Senior Care Partners |
$209.45
|
| Rate for Payer: PACE SWMI |
$220.47
|
| Rate for Payer: PHP Commercial |
$749.61
|
| Rate for Payer: PHP Medicare Advantage |
$220.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$617.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$767.24
|
| Rate for Payer: Priority Health Medicare |
$220.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$537.86
|
| Rate for Payer: Railroad Medicare Medicare |
$220.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$776.06
|
| Rate for Payer: UHC Core |
$736.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.47
|
| Rate for Payer: UHC Medicare Advantage |
$227.09
|
| Rate for Payer: VA VA |
$220.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.42
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$881.89
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$537.86 |
| Max. Negotiated Rate |
$793.70 |
| Rate for Payer: Aetna Commercial |
$749.61
|
| Rate for Payer: BCBS Trust/PPO |
$681.52
|
| Rate for Payer: BCN Commercial |
$681.52
|
| Rate for Payer: Cash Price |
$705.51
|
| Rate for Payer: Cofinity Commercial |
$758.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.51
|
| Rate for Payer: Healthscope Commercial |
$793.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$749.61
|
| Rate for Payer: PHP Commercial |
$749.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$617.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$767.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$537.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$776.06
|
| Rate for Payer: UHC Core |
$736.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.42
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,162.55
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,318.94 |
| Max. Negotiated Rate |
$1,946.30 |
| Rate for Payer: Aetna Commercial |
$1,838.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,671.22
|
| Rate for Payer: BCN Commercial |
$1,671.22
|
| Rate for Payer: Cash Price |
$1,730.04
|
| Rate for Payer: Cofinity Commercial |
$1,859.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,730.04
|
| Rate for Payer: Healthscope Commercial |
$1,946.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,838.17
|
| Rate for Payer: PHP Commercial |
$1,838.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,318.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,903.04
|
| Rate for Payer: UHC Core |
$1,805.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.91
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,162.55
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$513.61 |
| Max. Negotiated Rate |
$1,946.30 |
| Rate for Payer: Aetna Commercial |
$1,838.17
|
| Rate for Payer: Aetna Medicare |
$562.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$675.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$675.80
|
| Rate for Payer: BCBS Complete |
$865.02
|
| Rate for Payer: BCBS MAPPO |
$540.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.38
|
| Rate for Payer: BCN Commercial |
$1,681.38
|
| Rate for Payer: BCN Medicare Advantage |
$540.64
|
| Rate for Payer: Cash Price |
$1,730.04
|
| Rate for Payer: Cofinity Commercial |
$1,859.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,730.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.64
|
| Rate for Payer: Healthscope Commercial |
$1,946.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,621.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$567.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$621.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,838.17
|
| Rate for Payer: PACE Senior Care Partners |
$513.61
|
| Rate for Payer: PACE SWMI |
$540.64
|
| Rate for Payer: PHP Commercial |
$1,838.17
|
| Rate for Payer: PHP Medicare Advantage |
$540.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,881.42
|
| Rate for Payer: Priority Health Medicare |
$540.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,318.94
|
| Rate for Payer: Railroad Medicare Medicare |
$540.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,903.04
|
| Rate for Payer: UHC Core |
$1,805.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$540.64
|
| Rate for Payer: UHC Medicare Advantage |
$556.86
|
| Rate for Payer: VA VA |
$540.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,621.91
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,313.96
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$801.38 |
| Max. Negotiated Rate |
$1,182.56 |
| Rate for Payer: Aetna Commercial |
$1,116.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.43
|
| Rate for Payer: BCN Commercial |
$1,015.43
|
| Rate for Payer: Cash Price |
$1,051.17
|
| Rate for Payer: Cofinity Commercial |
$1,130.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,051.17
|
| Rate for Payer: Healthscope Commercial |
$1,182.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$985.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,116.87
|
| Rate for Payer: PHP Commercial |
$1,116.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,156.28
|
| Rate for Payer: UHC Core |
$1,097.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$985.47
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,313.96
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$312.07 |
| Max. Negotiated Rate |
$1,182.56 |
| Rate for Payer: Aetna Commercial |
$1,116.87
|
| Rate for Payer: Aetna Medicare |
$341.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.61
|
| Rate for Payer: BCBS Complete |
$525.58
|
| Rate for Payer: BCBS MAPPO |
$328.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.60
|
| Rate for Payer: BCN Commercial |
$1,021.60
|
| Rate for Payer: BCN Medicare Advantage |
$328.49
|
| Rate for Payer: Cash Price |
$1,051.17
|
| Rate for Payer: Cofinity Commercial |
$1,130.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,051.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.49
|
| Rate for Payer: Healthscope Commercial |
$1,182.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$985.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,116.87
|
| Rate for Payer: PACE Senior Care Partners |
$312.07
|
| Rate for Payer: PACE SWMI |
$328.49
|
| Rate for Payer: PHP Commercial |
$1,116.87
|
| Rate for Payer: PHP Medicare Advantage |
$328.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,143.15
|
| Rate for Payer: Priority Health Medicare |
$328.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$801.38
|
| Rate for Payer: Railroad Medicare Medicare |
$328.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,156.28
|
| Rate for Payer: UHC Core |
$1,097.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.49
|
| Rate for Payer: UHC Medicare Advantage |
$338.34
|
| Rate for Payer: VA VA |
$328.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$985.47
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,052.08
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$163.20 |
| Max. Negotiated Rate |
$946.87 |
| Rate for Payer: Aetna Commercial |
$894.27
|
| Rate for Payer: Aetna Medicare |
$273.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.78
|
| Rate for Payer: BCBS Complete |
$171.36
|
| Rate for Payer: BCBS MAPPO |
$263.02
|
| Rate for Payer: BCBS Trust/PPO |
$817.99
|
| Rate for Payer: BCN Commercial |
$817.99
|
| Rate for Payer: BCN Medicare Advantage |
$263.02
|
| Rate for Payer: Cash Price |
$841.66
|
| Rate for Payer: Cash Price |
$841.66
|
| Rate for Payer: Cofinity Commercial |
$904.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.02
|
| Rate for Payer: Healthscope Commercial |
$946.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.06
|
| Rate for Payer: Mclaren Medicaid |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$171.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.27
|
| Rate for Payer: PACE Senior Care Partners |
$249.87
|
| Rate for Payer: PACE SWMI |
$263.02
|
| Rate for Payer: PHP Commercial |
$894.27
|
| Rate for Payer: PHP Medicare Advantage |
$263.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.31
|
| Rate for Payer: Priority Health Medicare |
$263.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.66
|
| Rate for Payer: Railroad Medicare Medicare |
$263.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.83
|
| Rate for Payer: UHC Core |
$878.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.02
|
| Rate for Payer: UHC Medicare Advantage |
$270.91
|
| Rate for Payer: VA VA |
$263.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.06
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,052.08
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$641.66 |
| Max. Negotiated Rate |
$946.87 |
| Rate for Payer: Aetna Commercial |
$894.27
|
| Rate for Payer: BCBS Trust/PPO |
$813.05
|
| Rate for Payer: BCN Commercial |
$813.05
|
| Rate for Payer: Cash Price |
$841.66
|
| Rate for Payer: Cofinity Commercial |
$904.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.66
|
| Rate for Payer: Healthscope Commercial |
$946.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.27
|
| Rate for Payer: PHP Commercial |
$894.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$915.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$641.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.83
|
| Rate for Payer: UHC Core |
$878.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.06
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,086.75
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$733.10 |
| Max. Negotiated Rate |
$5,144.02 |
| Rate for Payer: Aetna Commercial |
$2,623.74
|
| Rate for Payer: Aetna Medicare |
$802.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$964.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$964.61
|
| Rate for Payer: BCBS Complete |
$5,144.02
|
| Rate for Payer: BCBS MAPPO |
$771.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,399.95
|
| Rate for Payer: BCN Commercial |
$2,399.95
|
| Rate for Payer: BCN Medicare Advantage |
$771.69
|
| Rate for Payer: Cash Price |
$2,469.40
|
| Rate for Payer: Cash Price |
$2,469.40
|
| Rate for Payer: Cofinity Commercial |
$2,654.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,469.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$771.69
|
| Rate for Payer: Healthscope Commercial |
$2,778.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,315.06
|
| Rate for Payer: Mclaren Medicaid |
$4,899.07
|
| Rate for Payer: Meridian Medicaid |
$5,144.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$810.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$887.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,623.74
|
| Rate for Payer: PACE Senior Care Partners |
$733.10
|
| Rate for Payer: PACE SWMI |
$771.69
|
| Rate for Payer: PHP Commercial |
$2,623.74
|
| Rate for Payer: PHP Medicare Advantage |
$771.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,160.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,685.47
|
| Rate for Payer: Priority Health Medicare |
$771.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,882.61
|
| Rate for Payer: Railroad Medicare Medicare |
$771.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,716.34
|
| Rate for Payer: UHC Core |
$2,577.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$771.69
|
| Rate for Payer: UHC Medicare Advantage |
$794.84
|
| Rate for Payer: VA VA |
$771.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,315.06
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,086.75
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,882.61 |
| Max. Negotiated Rate |
$2,778.08 |
| Rate for Payer: Aetna Commercial |
$2,623.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,385.44
|
| Rate for Payer: BCN Commercial |
$2,385.44
|
| Rate for Payer: Cash Price |
$2,469.40
|
| Rate for Payer: Cofinity Commercial |
$2,654.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,469.40
|
| Rate for Payer: Healthscope Commercial |
$2,778.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,315.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,623.74
|
| Rate for Payer: PHP Commercial |
$2,623.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,160.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,685.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,882.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,716.34
|
| Rate for Payer: UHC Core |
$2,577.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,315.06
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$2,978.40
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$707.37 |
| Max. Negotiated Rate |
$5,144.02 |
| Rate for Payer: Aetna Commercial |
$2,531.64
|
| Rate for Payer: Aetna Medicare |
$774.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$930.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$930.75
|
| Rate for Payer: BCBS Complete |
$5,144.02
|
| Rate for Payer: BCBS MAPPO |
$744.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,315.71
|
| Rate for Payer: BCN Commercial |
$2,315.71
|
| Rate for Payer: BCN Medicare Advantage |
$744.60
|
| Rate for Payer: Cash Price |
$2,382.72
|
| Rate for Payer: Cash Price |
$2,382.72
|
| Rate for Payer: Cofinity Commercial |
$2,561.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,382.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.60
|
| Rate for Payer: Healthscope Commercial |
$2,680.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,233.80
|
| Rate for Payer: Mclaren Medicaid |
$4,899.07
|
| Rate for Payer: Meridian Medicaid |
$5,144.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$781.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$856.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,531.64
|
| Rate for Payer: PACE Senior Care Partners |
$707.37
|
| Rate for Payer: PACE SWMI |
$744.60
|
| Rate for Payer: PHP Commercial |
$2,531.64
|
| Rate for Payer: PHP Medicare Advantage |
$744.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,084.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,591.21
|
| Rate for Payer: Priority Health Medicare |
$744.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,816.53
|
| Rate for Payer: Railroad Medicare Medicare |
$744.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,620.99
|
| Rate for Payer: UHC Core |
$2,486.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$744.60
|
| Rate for Payer: UHC Medicare Advantage |
$766.94
|
| Rate for Payer: VA VA |
$744.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,233.80
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$2,978.40
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,816.53 |
| Max. Negotiated Rate |
$2,680.56 |
| Rate for Payer: Aetna Commercial |
$2,531.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,301.71
|
| Rate for Payer: BCN Commercial |
$2,301.71
|
| Rate for Payer: Cash Price |
$2,382.72
|
| Rate for Payer: Cofinity Commercial |
$2,561.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,382.72
|
| Rate for Payer: Healthscope Commercial |
$2,680.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,233.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,531.64
|
| Rate for Payer: PHP Commercial |
$2,531.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,084.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,591.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,816.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,620.99
|
| Rate for Payer: UHC Core |
$2,486.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,233.80
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,403.31
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,295.48 |
| Max. Negotiated Rate |
$4,862.98 |
| Rate for Payer: Aetna Commercial |
$4,592.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,175.68
|
| Rate for Payer: BCN Commercial |
$4,175.68
|
| Rate for Payer: Cash Price |
$4,322.65
|
| Rate for Payer: Cofinity Commercial |
$4,646.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,322.65
|
| Rate for Payer: Healthscope Commercial |
$4,862.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,052.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,592.81
|
| Rate for Payer: PHP Commercial |
$4,592.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,700.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,295.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,754.91
|
| Rate for Payer: UHC Core |
$4,511.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,052.48
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,403.31
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,283.29 |
| Max. Negotiated Rate |
$4,862.98 |
| Rate for Payer: Aetna Commercial |
$4,592.81
|
| Rate for Payer: Aetna Medicare |
$1,404.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,688.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,688.53
|
| Rate for Payer: BCBS Complete |
$2,161.32
|
| Rate for Payer: BCBS MAPPO |
$1,350.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,201.07
|
| Rate for Payer: BCN Commercial |
$4,201.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,350.83
|
| Rate for Payer: Cash Price |
$4,322.65
|
| Rate for Payer: Cofinity Commercial |
$4,646.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,322.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,350.83
|
| Rate for Payer: Healthscope Commercial |
$4,862.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,052.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,418.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,553.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,592.81
|
| Rate for Payer: PACE Senior Care Partners |
$1,283.29
|
| Rate for Payer: PACE SWMI |
$1,350.83
|
| Rate for Payer: PHP Commercial |
$4,592.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,350.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,782.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,700.88
|
| Rate for Payer: Priority Health Medicare |
$1,350.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,295.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,754.91
|
| Rate for Payer: UHC Core |
$4,511.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,350.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,391.35
|
| Rate for Payer: VA VA |
$1,350.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,052.48
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$801.00
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$488.53 |
| Max. Negotiated Rate |
$720.90 |
| Rate for Payer: Aetna Commercial |
$680.85
|
| Rate for Payer: Aetna Commercial |
$477.72
|
| Rate for Payer: BCBS Trust/PPO |
$619.01
|
| Rate for Payer: BCBS Trust/PPO |
$434.33
|
| Rate for Payer: BCN Commercial |
$434.33
|
| Rate for Payer: BCN Commercial |
$619.01
|
| Rate for Payer: Cash Price |
$640.80
|
| Rate for Payer: Cash Price |
$449.62
|
| Rate for Payer: Cofinity Commercial |
$688.86
|
| Rate for Payer: Cofinity Commercial |
$483.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.62
|
| Rate for Payer: Healthscope Commercial |
$720.90
|
| Rate for Payer: Healthscope Commercial |
$505.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$477.72
|
| Rate for Payer: PHP Commercial |
$477.72
|
| Rate for Payer: PHP Commercial |
$680.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$488.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.58
|
| Rate for Payer: UHC Core |
$469.29
|
| Rate for Payer: UHC Core |
$668.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.52
|
|
