|
HC EVENT MONITOR
|
Facility
|
OP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$91.75 |
| Max. Negotiated Rate |
$468.40 |
| Rate for Payer: Aetna Commercial |
$442.37
|
| Rate for Payer: Aetna Medicare |
$135.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.64
|
| Rate for Payer: BCBS Complete |
$96.33
|
| Rate for Payer: BCBS MAPPO |
$130.11
|
| Rate for Payer: BCBS Trust/PPO |
$427.85
|
| Rate for Payer: BCN Commercial |
$427.85
|
| Rate for Payer: BCN Medicare Advantage |
$130.11
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Commercial |
$447.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.11
|
| Rate for Payer: Healthscope Commercial |
$468.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.33
|
| Rate for Payer: Mclaren Medicaid |
$91.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.62
|
| Rate for Payer: Meridian Medicaid |
$96.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Nomi Health Commercial |
$426.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: PACE Senior Care Partners |
$123.60
|
| Rate for Payer: PACE SWMI |
$130.11
|
| Rate for Payer: PHP Commercial |
$442.37
|
| Rate for Payer: PHP Medicare Advantage |
$130.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.78
|
| Rate for Payer: Priority Health Medicare |
$131.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.23
|
| Rate for Payer: Railroad Medicare Medicare |
$130.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.99
|
| Rate for Payer: UHC Core |
$434.57
|
| Rate for Payer: UHC Exchange |
$130.11
|
| Rate for Payer: UHC Medicaid |
$91.75
|
| Rate for Payer: UHC Medicare Advantage |
$130.11
|
| Rate for Payer: UHCCP Medicaid |
$91.75
|
| Rate for Payer: VA VA |
$130.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.33
|
|
|
HC EVENT MONITOR
|
Facility
|
IP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$362.23 |
| Max. Negotiated Rate |
$468.40 |
| Rate for Payer: Aetna Commercial |
$442.37
|
| Rate for Payer: BCBS Trust/PPO |
$429.83
|
| Rate for Payer: BCN Commercial |
$429.83
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Commercial |
$447.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Healthscope Commercial |
$468.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Nomi Health Commercial |
$426.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: PHP Commercial |
$442.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.99
|
| Rate for Payer: UHC Core |
$434.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.33
|
|
|
HC EVEROLIMUS
|
Facility
|
IP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.49 |
| Max. Negotiated Rate |
$63.99 |
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: BCBS Trust/PPO |
$58.72
|
| Rate for Payer: BCN Commercial |
$58.72
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.57
|
| Rate for Payer: UHC Core |
$59.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC EVEROLIMUS
|
Facility
|
OP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$63.99 |
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: Aetna Medicare |
$18.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.22
|
| Rate for Payer: BCBS Complete |
$13.16
|
| Rate for Payer: BCBS MAPPO |
$17.77
|
| Rate for Payer: BCBS Trust/PPO |
$58.45
|
| Rate for Payer: BCN Commercial |
$58.45
|
| Rate for Payer: BCN Medicare Advantage |
$17.77
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.77
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Mclaren Medicaid |
$12.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.66
|
| Rate for Payer: Meridian Medicaid |
$13.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$58.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PACE Senior Care Partners |
$16.89
|
| Rate for Payer: PACE SWMI |
$17.77
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: PHP Medicare Advantage |
$17.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.86
|
| Rate for Payer: Priority Health Medicare |
$17.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.49
|
| Rate for Payer: Railroad Medicare Medicare |
$17.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.57
|
| Rate for Payer: UHC Core |
$59.37
|
| Rate for Payer: UHC Exchange |
$17.77
|
| Rate for Payer: UHC Medicaid |
$12.53
|
| Rate for Payer: UHC Medicare Advantage |
$17.77
|
| Rate for Payer: UHCCP Medicaid |
$12.53
|
| Rate for Payer: VA VA |
$17.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$203.48 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: BCBS Trust/PPO |
$241.45
|
| Rate for Payer: BCN Commercial |
$241.45
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$254.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.27
|
| Rate for Payer: UHC Core |
$244.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$51.54 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna Medicare |
$76.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.36
|
| Rate for Payer: BCBS Complete |
$54.11
|
| Rate for Payer: BCBS MAPPO |
$73.09
|
| Rate for Payer: BCBS Trust/PPO |
$240.34
|
| Rate for Payer: BCN Commercial |
$240.34
|
| Rate for Payer: BCN Medicare Advantage |
$73.09
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.09
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Mclaren Medicaid |
$51.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.74
|
| Rate for Payer: Meridian Medicaid |
$54.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Senior Care Partners |
$69.43
|
| Rate for Payer: PACE SWMI |
$73.09
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: PHP Medicare Advantage |
$73.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$254.34
|
| Rate for Payer: Priority Health Medicare |
$73.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.48
|
| Rate for Payer: Railroad Medicare Medicare |
$73.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.27
|
| Rate for Payer: UHC Core |
$244.11
|
| Rate for Payer: UHC Exchange |
$73.09
|
| Rate for Payer: UHC Medicaid |
$51.54
|
| Rate for Payer: UHC Medicare Advantage |
$73.09
|
| Rate for Payer: UHCCP Medicaid |
$51.54
|
| Rate for Payer: VA VA |
$73.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$51.54 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna Medicare |
$76.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.36
|
| Rate for Payer: BCBS Complete |
$54.11
|
| Rate for Payer: BCBS MAPPO |
$73.09
|
| Rate for Payer: BCBS Trust/PPO |
$240.34
|
| Rate for Payer: BCN Commercial |
$240.34
|
| Rate for Payer: BCN Medicare Advantage |
$73.09
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.09
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Mclaren Medicaid |
$51.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.74
|
| Rate for Payer: Meridian Medicaid |
$54.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Senior Care Partners |
$69.43
|
| Rate for Payer: PACE SWMI |
$73.09
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: PHP Medicare Advantage |
$73.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$254.34
|
| Rate for Payer: Priority Health Medicare |
$73.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.48
|
| Rate for Payer: Railroad Medicare Medicare |
$73.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.27
|
| Rate for Payer: UHC Core |
$244.11
|
| Rate for Payer: UHC Exchange |
$73.09
|
| Rate for Payer: UHC Medicaid |
$51.54
|
| Rate for Payer: UHC Medicare Advantage |
$73.09
|
| Rate for Payer: UHCCP Medicaid |
$51.54
|
| Rate for Payer: VA VA |
$73.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$203.48 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: BCBS Trust/PPO |
$241.45
|
| Rate for Payer: BCN Commercial |
$241.45
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$239.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$254.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.27
|
| Rate for Payer: UHC Core |
$244.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.24 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna Commercial |
$680.94
|
| Rate for Payer: Aetna Medicare |
$208.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.35
|
| Rate for Payer: BCBS Complete |
$148.29
|
| Rate for Payer: BCBS MAPPO |
$200.28
|
| Rate for Payer: BCBS Trust/PPO |
$658.59
|
| Rate for Payer: BCN Commercial |
$658.59
|
| Rate for Payer: BCN Medicare Advantage |
$200.28
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Commercial |
$688.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.28
|
| Rate for Payer: Healthscope Commercial |
$721.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.83
|
| Rate for Payer: Mclaren Medicaid |
$141.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.29
|
| Rate for Payer: Meridian Medicaid |
$148.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Nomi Health Commercial |
$656.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: PACE Senior Care Partners |
$190.26
|
| Rate for Payer: PACE SWMI |
$200.28
|
| Rate for Payer: PHP Commercial |
$680.94
|
| Rate for Payer: PHP Medicare Advantage |
$200.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$696.97
|
| Rate for Payer: Priority Health Medicare |
$202.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.57
|
| Rate for Payer: Railroad Medicare Medicare |
$200.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.98
|
| Rate for Payer: UHC Core |
$668.93
|
| Rate for Payer: UHC Exchange |
$200.28
|
| Rate for Payer: UHC Medicaid |
$141.24
|
| Rate for Payer: UHC Medicare Advantage |
$200.28
|
| Rate for Payer: UHCCP Medicaid |
$141.24
|
| Rate for Payer: VA VA |
$200.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.83
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$557.57 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna Commercial |
$680.94
|
| Rate for Payer: BCBS Trust/PPO |
$661.64
|
| Rate for Payer: BCN Commercial |
$661.64
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Commercial |
$688.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Healthscope Commercial |
$721.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Nomi Health Commercial |
$656.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: PHP Commercial |
$680.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$696.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.98
|
| Rate for Payer: UHC Core |
$668.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.83
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$60.06 |
| Rate for Payer: Aetna Commercial |
$56.72
|
| Rate for Payer: Aetna Medicare |
$17.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.85
|
| Rate for Payer: BCBS Complete |
$12.35
|
| Rate for Payer: BCBS MAPPO |
$16.68
|
| Rate for Payer: BCBS Trust/PPO |
$54.86
|
| Rate for Payer: BCN Commercial |
$54.86
|
| Rate for Payer: BCN Medicare Advantage |
$16.68
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$57.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.68
|
| Rate for Payer: Healthscope Commercial |
$60.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.05
|
| Rate for Payer: Mclaren Medicaid |
$11.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.52
|
| Rate for Payer: Meridian Medicaid |
$12.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Nomi Health Commercial |
$54.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: PACE Senior Care Partners |
$15.85
|
| Rate for Payer: PACE SWMI |
$16.68
|
| Rate for Payer: PHP Commercial |
$56.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.06
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.72
|
| Rate for Payer: UHC Core |
$55.72
|
| Rate for Payer: UHC Exchange |
$16.68
|
| Rate for Payer: UHC Medicaid |
$11.76
|
| Rate for Payer: UHC Medicare Advantage |
$16.68
|
| Rate for Payer: UHCCP Medicaid |
$11.76
|
| Rate for Payer: VA VA |
$16.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.05
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.44 |
| Max. Negotiated Rate |
$60.06 |
| Rate for Payer: Aetna Commercial |
$56.72
|
| Rate for Payer: BCBS Trust/PPO |
$55.11
|
| Rate for Payer: BCN Commercial |
$55.11
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$57.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Healthscope Commercial |
$60.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Nomi Health Commercial |
$54.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: PHP Commercial |
$56.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.72
|
| Rate for Payer: UHC Core |
$55.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.05
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.01 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: BCBS Trust/PPO |
$505.52
|
| Rate for Payer: BCN Commercial |
$505.52
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$159.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.28
|
| Rate for Payer: BCBS Complete |
$113.30
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCBS Trust/PPO |
$503.19
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$107.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Meridian Medicaid |
$113.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$145.37
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Medicare |
$154.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHC Medicaid |
$107.91
|
| Rate for Payer: UHC Medicare Advantage |
$153.02
|
| Rate for Payer: UHCCP Medicaid |
$107.91
|
| Rate for Payer: VA VA |
$153.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.91 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$159.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.28
|
| Rate for Payer: BCBS Complete |
$113.30
|
| Rate for Payer: BCBS MAPPO |
$153.02
|
| Rate for Payer: BCBS Trust/PPO |
$503.19
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: BCN Medicare Advantage |
$153.02
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.02
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$107.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.67
|
| Rate for Payer: Meridian Medicaid |
$113.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Senior Care Partners |
$145.37
|
| Rate for Payer: PACE SWMI |
$153.02
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Medicare |
$154.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: Railroad Medicare Medicare |
$153.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: UHC Exchange |
$153.02
|
| Rate for Payer: UHC Medicaid |
$107.91
|
| Rate for Payer: UHC Medicare Advantage |
$153.02
|
| Rate for Payer: UHCCP Medicaid |
$107.91
|
| Rate for Payer: VA VA |
$153.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$426.01 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: BCBS Trust/PPO |
$505.52
|
| Rate for Payer: BCN Commercial |
$505.52
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$501.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$532.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.63
|
| Rate for Payer: UHC Core |
$511.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$311.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.87
|
| Rate for Payer: BCBS Complete |
$222.04
|
| Rate for Payer: BCBS MAPPO |
$299.89
|
| Rate for Payer: BCBS Trust/PPO |
$986.17
|
| Rate for Payer: BCN Commercial |
$986.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.89
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.89
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$211.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.89
|
| Rate for Payer: Meridian Medicaid |
$222.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Senior Care Partners |
$284.90
|
| Rate for Payer: PACE SWMI |
$299.89
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$299.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Medicare |
$302.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: Railroad Medicare Medicare |
$299.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: UHC Exchange |
$299.89
|
| Rate for Payer: UHC Medicaid |
$211.48
|
| Rate for Payer: UHC Medicare Advantage |
$299.89
|
| Rate for Payer: UHCCP Medicaid |
$211.48
|
| Rate for Payer: VA VA |
$299.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$834.90 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: BCBS Trust/PPO |
$990.72
|
| Rate for Payer: BCN Commercial |
$990.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,329.73
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,013.49 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,575.92
|
| Rate for Payer: BCN Commercial |
$3,575.92
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$3,550.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,766.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,013.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,810.16
|
| Rate for Payer: UHC Core |
$3,615.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,329.73
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$763.33 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna Medicare |
$1,125.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,353.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,353.04
|
| Rate for Payer: BCBS Complete |
$801.43
|
| Rate for Payer: BCBS MAPPO |
$1,082.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,559.47
|
| Rate for Payer: BCN Commercial |
$3,559.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,082.43
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,082.43
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Mclaren Medicaid |
$763.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,136.55
|
| Rate for Payer: Meridian Medicaid |
$801.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,244.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,190.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$3,550.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,028.31
|
| Rate for Payer: PACE SWMI |
$1,082.43
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,082.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,766.87
|
| Rate for Payer: Priority Health Medicare |
$1,093.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,013.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,082.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,810.16
|
| Rate for Payer: UHC Core |
$3,615.32
|
| Rate for Payer: UHC Exchange |
$1,082.43
|
| Rate for Payer: UHC Medicaid |
$763.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,082.43
|
| Rate for Payer: UHCCP Medicaid |
$763.33
|
| Rate for Payer: VA VA |
$1,082.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,329.73
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$763.33 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna Medicare |
$1,125.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,353.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,353.04
|
| Rate for Payer: BCBS Complete |
$801.43
|
| Rate for Payer: BCBS MAPPO |
$1,082.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,559.47
|
| Rate for Payer: BCN Commercial |
$3,559.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,082.43
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,082.43
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Mclaren Medicaid |
$763.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,136.55
|
| Rate for Payer: Meridian Medicaid |
$801.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,244.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,190.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$3,550.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,028.31
|
| Rate for Payer: PACE SWMI |
$1,082.43
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,082.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,766.87
|
| Rate for Payer: Priority Health Medicare |
$1,093.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,013.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,082.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,810.16
|
| Rate for Payer: UHC Core |
$3,615.32
|
| Rate for Payer: UHC Exchange |
$1,082.43
|
| Rate for Payer: UHC Medicaid |
$763.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,082.43
|
| Rate for Payer: UHCCP Medicaid |
$763.33
|
| Rate for Payer: VA VA |
$1,082.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,329.73
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,013.49 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,575.92
|
| Rate for Payer: BCN Commercial |
$3,575.92
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$3,550.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,766.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,013.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,810.16
|
| Rate for Payer: UHC Core |
$3,615.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,293.68
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,076.40 |
| Max. Negotiated Rate |
$6,564.31 |
| Rate for Payer: Aetna Commercial |
$6,199.63
|
| Rate for Payer: BCBS Trust/PPO |
$6,023.85
|
| Rate for Payer: BCN Commercial |
$6,023.85
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cofinity Commercial |
$6,272.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,834.94
|
| Rate for Payer: Healthscope Commercial |
$6,564.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,470.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,199.63
|
| Rate for Payer: Nomi Health Commercial |
$5,980.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,470.26
|
| Rate for Payer: PHP Commercial |
$6,199.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,345.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,076.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,418.44
|
| Rate for Payer: UHC Core |
$6,090.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,470.26
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,293.68
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,285.88 |
| Max. Negotiated Rate |
$6,564.31 |
| Rate for Payer: Aetna Commercial |
$6,199.63
|
| Rate for Payer: Aetna Medicare |
$1,896.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,279.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,279.28
|
| Rate for Payer: BCBS Complete |
$1,350.06
|
| Rate for Payer: BCBS MAPPO |
$1,823.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,996.13
|
| Rate for Payer: BCN Commercial |
$5,996.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,823.42
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cofinity Commercial |
$6,272.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,834.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,823.42
|
| Rate for Payer: Healthscope Commercial |
$6,564.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,470.26
|
| Rate for Payer: Mclaren Medicaid |
$1,285.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,914.59
|
| Rate for Payer: Meridian Medicaid |
$1,350.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,096.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,005.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,199.63
|
| Rate for Payer: Nomi Health Commercial |
$5,980.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,470.26
|
| Rate for Payer: PACE Senior Care Partners |
$1,732.25
|
| Rate for Payer: PACE SWMI |
$1,823.42
|
| Rate for Payer: PHP Commercial |
$6,199.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,823.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,285.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,345.50
|
| Rate for Payer: Priority Health Medicare |
$1,841.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,076.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,823.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,418.44
|
| Rate for Payer: UHC Core |
$6,090.22
|
| Rate for Payer: UHC Exchange |
$1,823.42
|
| Rate for Payer: UHC Medicaid |
$1,285.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,823.42
|
| Rate for Payer: UHCCP Medicaid |
$1,285.88
|
| Rate for Payer: VA VA |
$1,823.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,470.26
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,614.20
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,819.48 |
| Max. Negotiated Rate |
$2,352.78 |
| Rate for Payer: Aetna Commercial |
$2,222.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.07
|
| Rate for Payer: BCN Commercial |
$2,159.07
|
| Rate for Payer: Cash Price |
$2,091.36
|
| Rate for Payer: Cofinity Commercial |
$2,248.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,091.36
|
| Rate for Payer: Healthscope Commercial |
$2,352.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,960.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,222.07
|
| Rate for Payer: Nomi Health Commercial |
$2,143.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,960.65
|
| Rate for Payer: PHP Commercial |
$2,222.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,274.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,819.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,300.50
|
| Rate for Payer: UHC Core |
$2,182.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,960.65
|
|
