HC INTRACAV APPL - I
|
Facility
|
OP
|
$562.02
|
|
Service Code
|
CPT 77762
|
Hospital Charge Code |
33300028
|
Hospital Revenue Code
|
333
|
Min. Negotiated Rate |
$133.48 |
Max. Negotiated Rate |
$505.82 |
Rate for Payer: Aetna Commercial |
$477.72
|
Rate for Payer: Aetna Commercial |
$680.85
|
Rate for Payer: Aetna Medicare |
$208.26
|
Rate for Payer: Aetna Medicare |
$146.13
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.31
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.63
|
Rate for Payer: Amish Plain Church Group Commercial |
$250.31
|
Rate for Payer: Amish Plain Church Group Commercial |
$175.63
|
Rate for Payer: BCBS Complete |
$405.47
|
Rate for Payer: BCBS Complete |
$405.47
|
Rate for Payer: BCBS MAPPO |
$200.25
|
Rate for Payer: BCBS MAPPO |
$140.50
|
Rate for Payer: BCBS Trust/PPO |
$622.78
|
Rate for Payer: BCBS Trust/PPO |
$436.97
|
Rate for Payer: BCN Commercial |
$622.78
|
Rate for Payer: BCN Commercial |
$436.97
|
Rate for Payer: BCN Medicare Advantage |
$140.50
|
Rate for Payer: BCN Medicare Advantage |
$200.25
|
Rate for Payer: Cash Price |
$640.80
|
Rate for Payer: Cash Price |
$640.80
|
Rate for Payer: Cash Price |
$449.62
|
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 |
$449.62
|
Rate for Payer: Encore Health Key Benefits Commercial |
$640.80
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.25
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.50
|
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: Mclaren Medicaid |
$386.16
|
Rate for Payer: Mclaren Medicaid |
$386.16
|
Rate for Payer: Meridian Medicaid |
$405.47
|
Rate for Payer: Meridian Medicaid |
$405.47
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.26
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.53
|
Rate for Payer: MI Amish Medical Board Commercial |
$161.58
|
Rate for Payer: MI Amish Medical Board Commercial |
$230.29
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$477.72
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.85
|
Rate for Payer: PACE Senior Care Partners |
$133.48
|
Rate for Payer: PACE Senior Care Partners |
$190.24
|
Rate for Payer: PACE SWMI |
$140.50
|
Rate for Payer: PACE SWMI |
$200.25
|
Rate for Payer: PHP Commercial |
$680.85
|
Rate for Payer: PHP Commercial |
$477.72
|
Rate for Payer: PHP Medicare Advantage |
$140.50
|
Rate for Payer: PHP Medicare Advantage |
$200.25
|
Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
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 Medicare |
$140.50
|
Rate for Payer: Priority Health Medicare |
$200.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$342.78
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$488.53
|
Rate for Payer: Railroad Medicare Medicare |
$200.25
|
Rate for Payer: Railroad Medicare Medicare |
$140.50
|
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: UHC Dual Complete DSNP |
$200.25
|
Rate for Payer: UHC Dual Complete DSNP |
$140.50
|
Rate for Payer: UHC Medicare Advantage |
$206.26
|
Rate for Payer: UHC Medicare Advantage |
$144.72
|
Rate for Payer: VA VA |
$200.25
|
Rate for Payer: VA VA |
$140.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.52
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.75
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$428.40
|
|
Service Code
|
CPT 77761
|
Hospital Charge Code |
33300027
|
Hospital Revenue Code
|
333
|
Min. Negotiated Rate |
$101.74 |
Max. Negotiated Rate |
$405.47 |
Rate for Payer: Aetna Commercial |
$364.14
|
Rate for Payer: Aetna Commercial |
$514.25
|
Rate for Payer: Aetna Medicare |
$157.30
|
Rate for Payer: Aetna Medicare |
$111.38
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.06
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.88
|
Rate for Payer: Amish Plain Church Group Commercial |
$133.88
|
Rate for Payer: Amish Plain Church Group Commercial |
$189.06
|
Rate for Payer: BCBS Complete |
$405.47
|
Rate for Payer: BCBS Complete |
$405.47
|
Rate for Payer: BCBS MAPPO |
$151.25
|
Rate for Payer: BCBS MAPPO |
$107.10
|
Rate for Payer: BCBS Trust/PPO |
$333.08
|
Rate for Payer: BCBS Trust/PPO |
$470.39
|
Rate for Payer: BCN Commercial |
$470.39
|
Rate for Payer: BCN Commercial |
$333.08
|
Rate for Payer: BCN Medicare Advantage |
$107.10
|
Rate for Payer: BCN Medicare Advantage |
$151.25
|
Rate for Payer: Cash Price |
$342.72
|
Rate for Payer: Cash Price |
$484.00
|
Rate for Payer: Cash Price |
$342.72
|
Rate for Payer: Cash Price |
$484.00
|
Rate for Payer: Cofinity Commercial |
$368.42
|
Rate for Payer: Cofinity Commercial |
$520.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$484.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$342.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.10
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.25
|
Rate for Payer: Healthscope Commercial |
$544.50
|
Rate for Payer: Healthscope Commercial |
$385.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$453.75
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.30
|
Rate for Payer: Mclaren Medicaid |
$386.16
|
Rate for Payer: Mclaren Medicaid |
$386.16
|
Rate for Payer: Meridian Medicaid |
$405.47
|
Rate for Payer: Meridian Medicaid |
$405.47
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.46
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.81
|
Rate for Payer: MI Amish Medical Board Commercial |
$173.94
|
Rate for Payer: MI Amish Medical Board Commercial |
$123.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$514.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.14
|
Rate for Payer: PACE Senior Care Partners |
$143.69
|
Rate for Payer: PACE Senior Care Partners |
$101.74
|
Rate for Payer: PACE SWMI |
$151.25
|
Rate for Payer: PACE SWMI |
$107.10
|
Rate for Payer: PHP Commercial |
$364.14
|
Rate for Payer: PHP Commercial |
$514.25
|
Rate for Payer: PHP Medicare Advantage |
$107.10
|
Rate for Payer: PHP Medicare Advantage |
$151.25
|
Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$299.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$423.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.71
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$526.35
|
Rate for Payer: Priority Health Medicare |
$151.25
|
Rate for Payer: Priority Health Medicare |
$107.10
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$261.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$368.99
|
Rate for Payer: Railroad Medicare Medicare |
$151.25
|
Rate for Payer: Railroad Medicare Medicare |
$107.10
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$532.40
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$376.99
|
Rate for Payer: UHC Core |
$357.71
|
Rate for Payer: UHC Core |
$505.18
|
Rate for Payer: UHC Dual Complete DSNP |
$151.25
|
Rate for Payer: UHC Dual Complete DSNP |
$107.10
|
Rate for Payer: UHC Medicare Advantage |
$110.31
|
Rate for Payer: UHC Medicare Advantage |
$155.79
|
Rate for Payer: VA VA |
$107.10
|
Rate for Payer: VA VA |
$151.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$453.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.30
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$605.00
|
|
Service Code
|
CPT 77761
|
Hospital Charge Code |
33300027
|
Hospital Revenue Code
|
333
|
Min. Negotiated Rate |
$368.99 |
Max. Negotiated Rate |
$544.50 |
Rate for Payer: Aetna Commercial |
$514.25
|
Rate for Payer: Aetna Commercial |
$364.14
|
Rate for Payer: BCBS Trust/PPO |
$331.07
|
Rate for Payer: BCBS Trust/PPO |
$467.54
|
Rate for Payer: BCN Commercial |
$331.07
|
Rate for Payer: BCN Commercial |
$467.54
|
Rate for Payer: Cash Price |
$484.00
|
Rate for Payer: Cash Price |
$342.72
|
Rate for Payer: Cofinity Commercial |
$520.30
|
Rate for Payer: Cofinity Commercial |
$368.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$342.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$484.00
|
Rate for Payer: Healthscope Commercial |
$385.56
|
Rate for Payer: Healthscope Commercial |
$544.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$453.75
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$514.25
|
Rate for Payer: PHP Commercial |
$364.14
|
Rate for Payer: PHP Commercial |
$514.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$299.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$423.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.71
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$526.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$261.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$368.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$376.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$532.40
|
Rate for Payer: UHC Core |
$505.18
|
Rate for Payer: UHC Core |
$357.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$453.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.30
|
|
HC INTRAOCULAR LENS
|
Facility
|
IP
|
$648.37
|
|
Hospital Charge Code |
27600003
|
Hospital Revenue Code
|
276
|
Min. Negotiated Rate |
$395.44 |
Max. Negotiated Rate |
$583.53 |
Rate for Payer: Aetna Commercial |
$551.11
|
Rate for Payer: BCBS Trust/PPO |
$501.06
|
Rate for Payer: BCN Commercial |
$501.06
|
Rate for Payer: Cash Price |
$518.70
|
Rate for Payer: Cofinity Commercial |
$557.60
|
Rate for Payer: Encore Health Key Benefits Commercial |
$518.70
|
Rate for Payer: Healthscope Commercial |
$583.53
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$551.11
|
Rate for Payer: PHP Commercial |
$551.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$453.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.08
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$395.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$570.57
|
Rate for Payer: UHC Core |
$541.39
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.28
|
|
HC INTRAOCULAR LENS
|
Facility
|
OP
|
$648.37
|
|
Hospital Charge Code |
27600003
|
Hospital Revenue Code
|
276
|
Min. Negotiated Rate |
$153.99 |
Max. Negotiated Rate |
$583.53 |
Rate for Payer: Aetna Commercial |
$551.11
|
Rate for Payer: Aetna Medicare |
$168.58
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.62
|
Rate for Payer: Amish Plain Church Group Commercial |
$202.62
|
Rate for Payer: BCBS Complete |
$259.35
|
Rate for Payer: BCBS MAPPO |
$162.09
|
Rate for Payer: BCBS Trust/PPO |
$504.11
|
Rate for Payer: BCN Commercial |
$504.11
|
Rate for Payer: BCN Medicare Advantage |
$162.09
|
Rate for Payer: Cash Price |
$518.70
|
Rate for Payer: Cofinity Commercial |
$557.60
|
Rate for Payer: Encore Health Key Benefits Commercial |
$518.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.09
|
Rate for Payer: Healthscope Commercial |
$583.53
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.28
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$170.20
|
Rate for Payer: MI Amish Medical Board Commercial |
$186.41
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$551.11
|
Rate for Payer: PACE Senior Care Partners |
$153.99
|
Rate for Payer: PACE SWMI |
$162.09
|
Rate for Payer: PHP Commercial |
$551.11
|
Rate for Payer: PHP Medicare Advantage |
$162.09
|
Rate for Payer: Priority Health Cigna Priority Health |
$453.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.08
|
Rate for Payer: Priority Health Medicare |
$162.09
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$395.44
|
Rate for Payer: Railroad Medicare Medicare |
$162.09
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$570.57
|
Rate for Payer: UHC Core |
$541.39
|
Rate for Payer: UHC Dual Complete DSNP |
$162.09
|
Rate for Payer: UHC Medicare Advantage |
$166.96
|
Rate for Payer: VA VA |
$162.09
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.28
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$475.38
|
|
Service Code
|
CPT 36680
|
Hospital Charge Code |
45000080
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$112.90 |
Max. Negotiated Rate |
$427.84 |
Rate for Payer: Aetna Commercial |
$404.07
|
Rate for Payer: Aetna Medicare |
$123.60
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.56
|
Rate for Payer: Amish Plain Church Group Commercial |
$148.56
|
Rate for Payer: BCBS Complete |
$274.44
|
Rate for Payer: BCBS MAPPO |
$118.84
|
Rate for Payer: BCBS Trust/PPO |
$369.61
|
Rate for Payer: BCN Commercial |
$369.61
|
Rate for Payer: BCN Medicare Advantage |
$118.84
|
Rate for Payer: Cash Price |
$380.30
|
Rate for Payer: Cash Price |
$380.30
|
Rate for Payer: Cofinity Commercial |
$408.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$380.30
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.84
|
Rate for Payer: Healthscope Commercial |
$427.84
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.54
|
Rate for Payer: Mclaren Medicaid |
$261.37
|
Rate for Payer: Meridian Medicaid |
$274.44
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$136.67
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.07
|
Rate for Payer: PACE Senior Care Partners |
$112.90
|
Rate for Payer: PACE SWMI |
$118.84
|
Rate for Payer: PHP Commercial |
$404.07
|
Rate for Payer: PHP Medicare Advantage |
$118.84
|
Rate for Payer: Priority Health Choice Medicaid |
$261.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$332.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.58
|
Rate for Payer: Priority Health Medicare |
$118.84
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$289.93
|
Rate for Payer: Railroad Medicare Medicare |
$118.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$418.33
|
Rate for Payer: UHC Core |
$396.94
|
Rate for Payer: UHC Dual Complete DSNP |
$118.84
|
Rate for Payer: UHC Medicare Advantage |
$122.41
|
Rate for Payer: VA VA |
$118.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.54
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$475.38
|
|
Service Code
|
CPT 36680
|
Hospital Charge Code |
45000080
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$289.93 |
Max. Negotiated Rate |
$427.84 |
Rate for Payer: Aetna Commercial |
$404.07
|
Rate for Payer: BCBS Trust/PPO |
$367.37
|
Rate for Payer: BCN Commercial |
$367.37
|
Rate for Payer: Cash Price |
$380.30
|
Rate for Payer: Cofinity Commercial |
$408.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$380.30
|
Rate for Payer: Healthscope Commercial |
$427.84
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.54
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.07
|
Rate for Payer: PHP Commercial |
$404.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$332.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.58
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$289.93
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$418.33
|
Rate for Payer: UHC Core |
$396.94
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.54
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$287.00
|
|
Service Code
|
HCPCS C1755
|
Hospital Charge Code |
27200248
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$175.04 |
Max. Negotiated Rate |
$258.30 |
Rate for Payer: Aetna Commercial |
$243.95
|
Rate for Payer: BCBS Trust/PPO |
$221.79
|
Rate for Payer: BCN Commercial |
$221.79
|
Rate for Payer: Cash Price |
$229.60
|
Rate for Payer: Cofinity Commercial |
$246.82
|
Rate for Payer: Encore Health Key Benefits Commercial |
$229.60
|
Rate for Payer: Healthscope Commercial |
$258.30
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.95
|
Rate for Payer: PHP Commercial |
$243.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$200.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.69
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$175.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$252.56
|
Rate for Payer: UHC Core |
$239.64
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.25
|
|
HC INTRASPINAL CATHETER
|
Facility
|
OP
|
$287.00
|
|
Service Code
|
HCPCS C1755
|
Hospital Charge Code |
27200248
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$68.16 |
Max. Negotiated Rate |
$258.30 |
Rate for Payer: Aetna Commercial |
$243.95
|
Rate for Payer: Aetna Medicare |
$74.62
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.69
|
Rate for Payer: Amish Plain Church Group Commercial |
$89.69
|
Rate for Payer: BCBS Complete |
$114.80
|
Rate for Payer: BCBS MAPPO |
$71.75
|
Rate for Payer: BCBS Trust/PPO |
$223.14
|
Rate for Payer: BCN Commercial |
$223.14
|
Rate for Payer: BCN Medicare Advantage |
$71.75
|
Rate for Payer: Cash Price |
$229.60
|
Rate for Payer: Cofinity Commercial |
$246.82
|
Rate for Payer: Encore Health Key Benefits Commercial |
$229.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.75
|
Rate for Payer: Healthscope Commercial |
$258.30
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.34
|
Rate for Payer: MI Amish Medical Board Commercial |
$82.51
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.95
|
Rate for Payer: PACE Senior Care Partners |
$68.16
|
Rate for Payer: PACE SWMI |
$71.75
|
Rate for Payer: PHP Commercial |
$243.95
|
Rate for Payer: PHP Medicare Advantage |
$71.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$200.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.69
|
Rate for Payer: Priority Health Medicare |
$71.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$175.04
|
Rate for Payer: Railroad Medicare Medicare |
$71.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$252.56
|
Rate for Payer: UHC Core |
$239.64
|
Rate for Payer: UHC Dual Complete DSNP |
$71.75
|
Rate for Payer: UHC Medicare Advantage |
$73.90
|
Rate for Payer: VA VA |
$71.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.25
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,730.82
|
|
Service Code
|
HCPCS J7300
|
Hospital Charge Code |
63600119
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$411.07 |
Max. Negotiated Rate |
$1,557.74 |
Rate for Payer: Aetna Commercial |
$1,471.20
|
Rate for Payer: Aetna Medicare |
$450.01
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$540.88
|
Rate for Payer: Amish Plain Church Group Commercial |
$540.88
|
Rate for Payer: BCBS Complete |
$692.33
|
Rate for Payer: BCBS MAPPO |
$432.70
|
Rate for Payer: BCBS Trust/PPO |
$1,345.71
|
Rate for Payer: BCN Commercial |
$1,345.71
|
Rate for Payer: BCN Medicare Advantage |
$432.70
|
Rate for Payer: Cash Price |
$1,384.66
|
Rate for Payer: Cofinity Commercial |
$1,488.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,384.66
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.70
|
Rate for Payer: Healthscope Commercial |
$1,557.74
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,298.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$454.34
|
Rate for Payer: MI Amish Medical Board Commercial |
$497.61
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.20
|
Rate for Payer: PACE Senior Care Partners |
$411.07
|
Rate for Payer: PACE SWMI |
$432.70
|
Rate for Payer: PHP Commercial |
$1,471.20
|
Rate for Payer: PHP Medicare Advantage |
$432.70
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,211.57
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,505.81
|
Rate for Payer: Priority Health Medicare |
$432.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,055.63
|
Rate for Payer: Railroad Medicare Medicare |
$432.70
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,523.12
|
Rate for Payer: UHC Core |
$1,445.23
|
Rate for Payer: UHC Dual Complete DSNP |
$432.70
|
Rate for Payer: UHC Medicare Advantage |
$445.69
|
Rate for Payer: VA VA |
$432.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,298.12
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,730.82
|
|
Service Code
|
HCPCS J7300
|
Hospital Charge Code |
63600119
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1,055.63 |
Max. Negotiated Rate |
$1,557.74 |
Rate for Payer: Aetna Commercial |
$1,471.20
|
Rate for Payer: BCBS Trust/PPO |
$1,337.58
|
Rate for Payer: BCN Commercial |
$1,337.58
|
Rate for Payer: Cash Price |
$1,384.66
|
Rate for Payer: Cofinity Commercial |
$1,488.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,384.66
|
Rate for Payer: Healthscope Commercial |
$1,557.74
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,298.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,471.20
|
Rate for Payer: PHP Commercial |
$1,471.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,211.57
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,505.81
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,055.63
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$1,523.12
|
Rate for Payer: UHC Core |
$1,445.23
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,298.12
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,693.37
|
|
Service Code
|
CPT 93612
|
Hospital Charge Code |
48100034
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$877.18 |
Max. Negotiated Rate |
$5,144.02 |
Rate for Payer: Aetna Commercial |
$3,139.36
|
Rate for Payer: Aetna Medicare |
$960.28
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,154.18
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,154.18
|
Rate for Payer: BCBS Complete |
$5,144.02
|
Rate for Payer: BCBS MAPPO |
$923.34
|
Rate for Payer: BCBS Trust/PPO |
$2,871.60
|
Rate for Payer: BCN Commercial |
$2,871.60
|
Rate for Payer: BCN Medicare Advantage |
$923.34
|
Rate for Payer: Cash Price |
$2,954.70
|
Rate for Payer: Cash Price |
$2,954.70
|
Rate for Payer: Cofinity Commercial |
$3,176.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.34
|
Rate for Payer: Healthscope Commercial |
$3,324.03
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
Rate for Payer: Mclaren Medicaid |
$4,899.07
|
Rate for Payer: Meridian Medicaid |
$5,144.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$969.51
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,061.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
Rate for Payer: PACE Senior Care Partners |
$877.18
|
Rate for Payer: PACE SWMI |
$923.34
|
Rate for Payer: PHP Commercial |
$3,139.36
|
Rate for Payer: PHP Medicare Advantage |
$923.34
|
Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,213.23
|
Rate for Payer: Priority Health Medicare |
$923.34
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,252.59
|
Rate for Payer: Railroad Medicare Medicare |
$923.34
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.17
|
Rate for Payer: UHC Core |
$3,083.96
|
Rate for Payer: UHC Dual Complete DSNP |
$923.34
|
Rate for Payer: UHC Medicare Advantage |
$951.04
|
Rate for Payer: VA VA |
$923.34
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,693.37
|
|
Service Code
|
CPT 93612
|
Hospital Charge Code |
48100034
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$2,252.59 |
Max. Negotiated Rate |
$3,324.03 |
Rate for Payer: Aetna Commercial |
$3,139.36
|
Rate for Payer: BCBS Trust/PPO |
$2,854.24
|
Rate for Payer: BCN Commercial |
$2,854.24
|
Rate for Payer: Cash Price |
$2,954.70
|
Rate for Payer: Cofinity Commercial |
$3,176.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
Rate for Payer: Healthscope Commercial |
$3,324.03
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
Rate for Payer: PHP Commercial |
$3,139.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,213.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,252.59
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.17
|
Rate for Payer: UHC Core |
$3,083.96
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$48.00
|
|
Service Code
|
CPT 86340
|
Hospital Charge Code |
30200200
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$11.13 |
Max. Negotiated Rate |
$43.20 |
Rate for Payer: Aetna Commercial |
$40.80
|
Rate for Payer: Aetna Medicare |
$12.48
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
Rate for Payer: BCBS Complete |
$11.69
|
Rate for Payer: BCBS MAPPO |
$12.00
|
Rate for Payer: BCBS Trust/PPO |
$37.32
|
Rate for Payer: BCN Commercial |
$37.32
|
Rate for Payer: BCN Medicare Advantage |
$12.00
|
Rate for Payer: Cash Price |
$38.40
|
Rate for Payer: Cash Price |
$38.40
|
Rate for Payer: Cofinity Commercial |
$41.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
Rate for Payer: Healthscope Commercial |
$43.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
Rate for Payer: Mclaren Medicaid |
$11.13
|
Rate for Payer: Meridian Medicaid |
$11.69
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.60
|
Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
Rate for Payer: PACE Senior Care Partners |
$11.40
|
Rate for Payer: PACE SWMI |
$12.00
|
Rate for Payer: PHP Commercial |
$40.80
|
Rate for Payer: PHP Medicare Advantage |
$12.00
|
Rate for Payer: Priority Health Choice Medicaid |
$11.13
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
Rate for Payer: Priority Health Medicare |
$12.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
Rate for Payer: Railroad Medicare Medicare |
$12.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
Rate for Payer: UHC Core |
$40.08
|
Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
Rate for Payer: UHC Medicare Advantage |
$12.36
|
Rate for Payer: VA VA |
$12.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$48.00
|
|
Service Code
|
CPT 86340
|
Hospital Charge Code |
30200200
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$29.28 |
Max. Negotiated Rate |
$43.20 |
Rate for Payer: Aetna Commercial |
$40.80
|
Rate for Payer: BCBS Trust/PPO |
$37.09
|
Rate for Payer: BCN Commercial |
$37.09
|
Rate for Payer: Cash Price |
$38.40
|
Rate for Payer: Cofinity Commercial |
$41.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
Rate for Payer: Healthscope Commercial |
$43.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
Rate for Payer: PHP Commercial |
$40.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
Rate for Payer: UHC Core |
$40.08
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,672.00
|
|
Service Code
|
CPT 36160
|
Hospital Charge Code |
36100621
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$872.10 |
Max. Negotiated Rate |
$3,304.80 |
Rate for Payer: Aetna Commercial |
$3,121.20
|
Rate for Payer: Aetna Medicare |
$954.72
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.50
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,147.50
|
Rate for Payer: BCBS Complete |
$1,468.80
|
Rate for Payer: BCBS MAPPO |
$918.00
|
Rate for Payer: BCBS Trust/PPO |
$2,854.98
|
Rate for Payer: BCN Commercial |
$2,854.98
|
Rate for Payer: BCN Medicare Advantage |
$918.00
|
Rate for Payer: Cash Price |
$2,937.60
|
Rate for Payer: Cofinity Commercial |
$3,157.92
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.00
|
Rate for Payer: Healthscope Commercial |
$3,304.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$963.90
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,055.70
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,121.20
|
Rate for Payer: PACE Senior Care Partners |
$872.10
|
Rate for Payer: PACE SWMI |
$918.00
|
Rate for Payer: PHP Commercial |
$3,121.20
|
Rate for Payer: PHP Medicare Advantage |
$918.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,570.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,194.64
|
Rate for Payer: Priority Health Medicare |
$918.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,239.55
|
Rate for Payer: Railroad Medicare Medicare |
$918.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3,231.36
|
Rate for Payer: UHC Core |
$3,066.12
|
Rate for Payer: UHC Dual Complete DSNP |
$918.00
|
Rate for Payer: UHC Medicare Advantage |
$945.54
|
Rate for Payer: VA VA |
$918.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,672.00
|
|
Service Code
|
CPT 36160
|
Hospital Charge Code |
36100621
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,239.55 |
Max. Negotiated Rate |
$3,304.80 |
Rate for Payer: Aetna Commercial |
$3,121.20
|
Rate for Payer: BCBS Trust/PPO |
$2,837.72
|
Rate for Payer: BCN Commercial |
$2,837.72
|
Rate for Payer: Cash Price |
$2,937.60
|
Rate for Payer: Cofinity Commercial |
$3,157.92
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
Rate for Payer: Healthscope Commercial |
$3,304.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,121.20
|
Rate for Payer: PHP Commercial |
$3,121.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,570.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,194.64
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,239.55
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3,231.36
|
Rate for Payer: UHC Core |
$3,066.12
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
HC INTRODUCER
|
Facility
|
IP
|
$293.71
|
|
Service Code
|
HCPCS C1894
|
Hospital Charge Code |
27200049
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$179.13 |
Max. Negotiated Rate |
$264.34 |
Rate for Payer: Aetna Commercial |
$249.65
|
Rate for Payer: BCBS Trust/PPO |
$226.98
|
Rate for Payer: BCN Commercial |
$226.98
|
Rate for Payer: Cash Price |
$234.97
|
Rate for Payer: Cofinity Commercial |
$252.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$234.97
|
Rate for Payer: Healthscope Commercial |
$264.34
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.65
|
Rate for Payer: PHP Commercial |
$249.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$205.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.53
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$179.13
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$258.46
|
Rate for Payer: UHC Core |
$245.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.28
|
|
HC INTRODUCER
|
Facility
|
OP
|
$293.71
|
|
Service Code
|
HCPCS C1894
|
Hospital Charge Code |
27200049
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$69.76 |
Max. Negotiated Rate |
$264.34 |
Rate for Payer: Aetna Commercial |
$249.65
|
Rate for Payer: Aetna Medicare |
$76.36
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$91.78
|
Rate for Payer: BCBS Complete |
$117.48
|
Rate for Payer: BCBS MAPPO |
$73.43
|
Rate for Payer: BCBS Trust/PPO |
$228.36
|
Rate for Payer: BCN Commercial |
$228.36
|
Rate for Payer: BCN Medicare Advantage |
$73.43
|
Rate for Payer: Cash Price |
$234.97
|
Rate for Payer: Cofinity Commercial |
$252.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$234.97
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.43
|
Rate for Payer: Healthscope Commercial |
$264.34
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.28
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.10
|
Rate for Payer: MI Amish Medical Board Commercial |
$84.44
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.65
|
Rate for Payer: PACE Senior Care Partners |
$69.76
|
Rate for Payer: PACE SWMI |
$73.43
|
Rate for Payer: PHP Commercial |
$249.65
|
Rate for Payer: PHP Medicare Advantage |
$73.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$205.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$255.53
|
Rate for Payer: Priority Health Medicare |
$73.43
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$179.13
|
Rate for Payer: Railroad Medicare Medicare |
$73.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$258.46
|
Rate for Payer: UHC Core |
$245.25
|
Rate for Payer: UHC Dual Complete DSNP |
$73.43
|
Rate for Payer: UHC Medicare Advantage |
$75.63
|
Rate for Payer: VA VA |
$73.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.28
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$249.93
|
|
Service Code
|
HCPCS C1894
|
Hospital Charge Code |
27200050
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$59.36 |
Max. Negotiated Rate |
$224.94 |
Rate for Payer: Aetna Commercial |
$212.44
|
Rate for Payer: Aetna Medicare |
$64.98
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.10
|
Rate for Payer: Amish Plain Church Group Commercial |
$78.10
|
Rate for Payer: BCBS Complete |
$99.97
|
Rate for Payer: BCBS MAPPO |
$62.48
|
Rate for Payer: BCBS Trust/PPO |
$194.32
|
Rate for Payer: BCN Commercial |
$194.32
|
Rate for Payer: BCN Medicare Advantage |
$62.48
|
Rate for Payer: Cash Price |
$199.94
|
Rate for Payer: Cofinity Commercial |
$214.94
|
Rate for Payer: Encore Health Key Benefits Commercial |
$199.94
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
Rate for Payer: Healthscope Commercial |
$224.94
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.45
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.61
|
Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.44
|
Rate for Payer: PACE Senior Care Partners |
$59.36
|
Rate for Payer: PACE SWMI |
$62.48
|
Rate for Payer: PHP Commercial |
$212.44
|
Rate for Payer: PHP Medicare Advantage |
$62.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$174.95
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.44
|
Rate for Payer: Priority Health Medicare |
$62.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$152.43
|
Rate for Payer: Railroad Medicare Medicare |
$62.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$219.94
|
Rate for Payer: UHC Core |
$208.69
|
Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
Rate for Payer: UHC Medicare Advantage |
$64.36
|
Rate for Payer: VA VA |
$62.48
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.45
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$249.93
|
|
Service Code
|
HCPCS C1894
|
Hospital Charge Code |
27200050
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$152.43 |
Max. Negotiated Rate |
$224.94 |
Rate for Payer: Aetna Commercial |
$212.44
|
Rate for Payer: BCBS Trust/PPO |
$193.15
|
Rate for Payer: BCN Commercial |
$193.15
|
Rate for Payer: Cash Price |
$199.94
|
Rate for Payer: Cofinity Commercial |
$214.94
|
Rate for Payer: Encore Health Key Benefits Commercial |
$199.94
|
Rate for Payer: Healthscope Commercial |
$224.94
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.45
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.44
|
Rate for Payer: PHP Commercial |
$212.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$174.95
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.44
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$152.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$219.94
|
Rate for Payer: UHC Core |
$208.69
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.45
|
|
HC INTRODUCER REGULAR
|
Facility
|
IP
|
$92.82
|
|
Service Code
|
HCPCS C1893
|
Hospital Charge Code |
27200051
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$56.61 |
Max. Negotiated Rate |
$83.54 |
Rate for Payer: Aetna Commercial |
$78.90
|
Rate for Payer: BCBS Trust/PPO |
$71.73
|
Rate for Payer: BCN Commercial |
$71.73
|
Rate for Payer: Cash Price |
$74.26
|
Rate for Payer: Cofinity Commercial |
$79.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
Rate for Payer: Healthscope Commercial |
$83.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
Rate for Payer: PHP Commercial |
$78.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
Rate for Payer: UHC Core |
$77.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
HC INTRODUCER REGULAR
|
Facility
|
OP
|
$92.82
|
|
Service Code
|
HCPCS C1893
|
Hospital Charge Code |
27200051
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$22.04 |
Max. Negotiated Rate |
$83.54 |
Rate for Payer: Aetna Commercial |
$78.90
|
Rate for Payer: Aetna Medicare |
$24.13
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.01
|
Rate for Payer: Amish Plain Church Group Commercial |
$29.01
|
Rate for Payer: BCBS Complete |
$37.13
|
Rate for Payer: BCBS MAPPO |
$23.20
|
Rate for Payer: BCBS Trust/PPO |
$72.17
|
Rate for Payer: BCN Commercial |
$72.17
|
Rate for Payer: BCN Medicare Advantage |
$23.20
|
Rate for Payer: Cash Price |
$74.26
|
Rate for Payer: Cofinity Commercial |
$79.83
|
Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.20
|
Rate for Payer: Healthscope Commercial |
$83.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.37
|
Rate for Payer: MI Amish Medical Board Commercial |
$26.69
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
Rate for Payer: PACE Senior Care Partners |
$22.04
|
Rate for Payer: PACE SWMI |
$23.20
|
Rate for Payer: PHP Commercial |
$78.90
|
Rate for Payer: PHP Medicare Advantage |
$23.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
Rate for Payer: Priority Health Medicare |
$23.20
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
Rate for Payer: Railroad Medicare Medicare |
$23.20
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
Rate for Payer: UHC Core |
$77.50
|
Rate for Payer: UHC Dual Complete DSNP |
$23.20
|
Rate for Payer: UHC Medicare Advantage |
$23.90
|
Rate for Payer: VA VA |
$23.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
OP
|
$3,389.80
|
|
Service Code
|
CPT 50553
|
Hospital Charge Code |
36100246
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$805.08 |
Max. Negotiated Rate |
$3,564.05 |
Rate for Payer: Aetna Commercial |
$2,881.33
|
Rate for Payer: Aetna Medicare |
$881.35
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,059.31
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,059.31
|
Rate for Payer: BCBS Complete |
$3,564.05
|
Rate for Payer: BCBS MAPPO |
$847.45
|
Rate for Payer: BCBS Trust/PPO |
$2,635.57
|
Rate for Payer: BCN Commercial |
$2,635.57
|
Rate for Payer: BCN Medicare Advantage |
$847.45
|
Rate for Payer: Cash Price |
$2,711.84
|
Rate for Payer: Cash Price |
$2,711.84
|
Rate for Payer: Cofinity Commercial |
$2,915.23
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$847.45
|
Rate for Payer: Healthscope Commercial |
$3,050.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
Rate for Payer: Mclaren Medicaid |
$3,394.34
|
Rate for Payer: Meridian Medicaid |
$3,564.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$889.82
|
Rate for Payer: MI Amish Medical Board Commercial |
$974.57
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
Rate for Payer: PACE Senior Care Partners |
$805.08
|
Rate for Payer: PACE SWMI |
$847.45
|
Rate for Payer: PHP Commercial |
$2,881.33
|
Rate for Payer: PHP Medicare Advantage |
$847.45
|
Rate for Payer: Priority Health Choice Medicaid |
$3,394.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,949.13
|
Rate for Payer: Priority Health Medicare |
$847.45
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.44
|
Rate for Payer: Railroad Medicare Medicare |
$847.45
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,983.02
|
Rate for Payer: UHC Core |
$2,830.48
|
Rate for Payer: UHC Dual Complete DSNP |
$847.45
|
Rate for Payer: UHC Medicare Advantage |
$872.87
|
Rate for Payer: VA VA |
$847.45
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
IP
|
$3,389.80
|
|
Service Code
|
CPT 50553
|
Hospital Charge Code |
36100246
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,067.44 |
Max. Negotiated Rate |
$3,050.82 |
Rate for Payer: Aetna Commercial |
$2,881.33
|
Rate for Payer: BCBS Trust/PPO |
$2,619.64
|
Rate for Payer: BCN Commercial |
$2,619.64
|
Rate for Payer: Cash Price |
$2,711.84
|
Rate for Payer: Cofinity Commercial |
$2,915.23
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
Rate for Payer: Healthscope Commercial |
$3,050.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
Rate for Payer: PHP Commercial |
$2,881.33
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,949.13
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,067.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,983.02
|
Rate for Payer: UHC Core |
$2,830.48
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|