|
HC EXC TUMOR SOFT TISSUE,NECK/ANT THORAX, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 21555
|
| Hospital Charge Code |
76100264
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC EXC TUMOR SOFT TISSUE, NECK/ANT THORAX, SQ, 3CM OR >
|
Facility
|
OP
|
$3,690.88
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
76100291
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.70 |
| Max. Negotiated Rate |
$3,321.79 |
| Rate for Payer: Aetna Commercial |
$3,137.25
|
| Rate for Payer: Aetna Medicare |
$959.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,153.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,153.40
|
| Rate for Payer: BCBS Complete |
$683.18
|
| Rate for Payer: BCBS MAPPO |
$922.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,034.27
|
| Rate for Payer: BCN Commercial |
$3,034.27
|
| Rate for Payer: BCN Medicare Advantage |
$922.72
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cofinity Commercial |
$3,174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,952.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.72
|
| Rate for Payer: Healthscope Commercial |
$3,321.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.16
|
| Rate for Payer: Mclaren Medicaid |
$650.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.86
|
| Rate for Payer: Meridian Medicaid |
$683.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,014.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.25
|
| Rate for Payer: Nomi Health Commercial |
$3,026.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.16
|
| Rate for Payer: PACE Senior Care Partners |
$876.58
|
| Rate for Payer: PACE SWMI |
$922.72
|
| Rate for Payer: PHP Commercial |
$3,137.25
|
| Rate for Payer: PHP Medicare Advantage |
$922.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.07
|
| Rate for Payer: Priority Health Medicare |
$931.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,568.85
|
| Rate for Payer: Railroad Medicare Medicare |
$922.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,247.97
|
| Rate for Payer: UHC Core |
$3,081.88
|
| Rate for Payer: UHC Exchange |
$922.72
|
| Rate for Payer: UHC Medicaid |
$650.70
|
| Rate for Payer: UHC Medicare Advantage |
$922.72
|
| Rate for Payer: UHCCP Medicaid |
$650.70
|
| Rate for Payer: VA VA |
$922.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.16
|
|
|
HC EXC TUMOR SOFT TISSUE, NECK/ANT THORAX, SQ, 3CM OR >
|
Facility
|
IP
|
$3,690.88
|
|
|
Service Code
|
CPT 21552
|
| Hospital Charge Code |
76100291
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,568.85 |
| Max. Negotiated Rate |
$3,321.79 |
| Rate for Payer: Aetna Commercial |
$3,137.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,048.30
|
| Rate for Payer: BCN Commercial |
$3,048.30
|
| Rate for Payer: Cash Price |
$2,952.70
|
| Rate for Payer: Cofinity Commercial |
$3,174.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,952.70
|
| Rate for Payer: Healthscope Commercial |
$3,321.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.25
|
| Rate for Payer: Nomi Health Commercial |
$3,026.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.16
|
| Rate for Payer: PHP Commercial |
$3,137.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,568.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,247.97
|
| Rate for Payer: UHC Core |
$3,081.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.16
|
|
|
HC EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
76100284
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,569.11 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,048.60
|
| Rate for Payer: BCN Commercial |
$3,048.60
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBFASCIAL <5CM
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 21556
|
| Hospital Charge Code |
76100284
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.77 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$959.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,153.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,153.52
|
| Rate for Payer: BCBS Complete |
$683.25
|
| Rate for Payer: BCBS MAPPO |
$922.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,034.58
|
| Rate for Payer: BCN Commercial |
$3,034.58
|
| Rate for Payer: BCN Medicare Advantage |
$922.81
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.81
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Mclaren Medicaid |
$650.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.95
|
| Rate for Payer: Meridian Medicaid |
$683.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,015.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Senior Care Partners |
$876.67
|
| Rate for Payer: PACE SWMI |
$922.81
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$922.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Medicare |
$932.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: Railroad Medicare Medicare |
$922.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: UHC Exchange |
$922.81
|
| Rate for Payer: UHC Medicaid |
$650.77
|
| Rate for Payer: UHC Medicare Advantage |
$922.81
|
| Rate for Payer: UHCCP Medicaid |
$650.77
|
| Rate for Payer: VA VA |
$922.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC EXC TUMOR SOFT TISSUE SHOULDER, 3CM OR >
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 23071
|
| Hospital Charge Code |
76100251
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC EXC TUMOR SOFT TISSUE SHOULDER, 3CM OR >
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 23071
|
| Hospital Charge Code |
76100251
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.20 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$568.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.79
|
| Rate for Payer: BCBS Complete |
$404.43
|
| Rate for Payer: BCBS MAPPO |
$546.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.22
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$546.23
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Mclaren Medicaid |
$385.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.54
|
| Rate for Payer: Meridian Medicaid |
$404.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Senior Care Partners |
$518.92
|
| Rate for Payer: PACE SWMI |
$546.23
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$546.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Medicare |
$551.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: Railroad Medicare Medicare |
$546.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: UHC Exchange |
$546.23
|
| Rate for Payer: UHC Medicaid |
$385.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.23
|
| Rate for Payer: UHCCP Medicaid |
$385.20
|
| Rate for Payer: VA VA |
$546.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ <3CM
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
76100248
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.20 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$568.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.79
|
| Rate for Payer: BCBS Complete |
$404.43
|
| Rate for Payer: BCBS MAPPO |
$546.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.22
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$546.23
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Mclaren Medicaid |
$385.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.54
|
| Rate for Payer: Meridian Medicaid |
$404.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Senior Care Partners |
$518.92
|
| Rate for Payer: PACE SWMI |
$546.23
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$546.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Medicare |
$551.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: Railroad Medicare Medicare |
$546.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: UHC Exchange |
$546.23
|
| Rate for Payer: UHC Medicaid |
$385.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.23
|
| Rate for Payer: UHCCP Medicaid |
$385.20
|
| Rate for Payer: VA VA |
$546.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ <3CM
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 27327
|
| Hospital Charge Code |
76100248
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ 3CM OR >
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
76100249
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.77 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$959.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,153.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,153.52
|
| Rate for Payer: BCBS Complete |
$683.25
|
| Rate for Payer: BCBS MAPPO |
$922.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,034.58
|
| Rate for Payer: BCN Commercial |
$3,034.58
|
| Rate for Payer: BCN Medicare Advantage |
$922.81
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.81
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Mclaren Medicaid |
$650.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.95
|
| Rate for Payer: Meridian Medicaid |
$683.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,015.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Senior Care Partners |
$876.67
|
| Rate for Payer: PACE SWMI |
$922.81
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$922.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Medicare |
$932.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: Railroad Medicare Medicare |
$922.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: UHC Exchange |
$922.81
|
| Rate for Payer: UHC Medicaid |
$650.77
|
| Rate for Payer: UHC Medicare Advantage |
$922.81
|
| Rate for Payer: UHCCP Medicaid |
$650.77
|
| Rate for Payer: VA VA |
$922.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC EXC TUMOR SOFT TISSUE THIGH/KNEE, SQ 3CM OR >
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
76100249
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,569.11 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,048.60
|
| Rate for Payer: BCN Commercial |
$3,048.60
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
IP
|
$4,111.63
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
76100324
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,861.69 |
| Max. Negotiated Rate |
$3,700.47 |
| Rate for Payer: Aetna Commercial |
$3,494.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,395.80
|
| Rate for Payer: BCN Commercial |
$3,395.80
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cofinity Commercial |
$3,536.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,289.30
|
| Rate for Payer: Healthscope Commercial |
$3,700.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,083.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,494.89
|
| Rate for Payer: Nomi Health Commercial |
$3,371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,083.72
|
| Rate for Payer: PHP Commercial |
$3,494.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,577.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,861.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,618.23
|
| Rate for Payer: UHC Core |
$3,433.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,083.72
|
|
|
HC EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$4,111.63
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
76100324
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$724.88 |
| Max. Negotiated Rate |
$3,700.47 |
| Rate for Payer: Aetna Commercial |
$3,494.89
|
| Rate for Payer: Aetna Medicare |
$1,069.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,284.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,284.88
|
| Rate for Payer: BCBS Complete |
$761.06
|
| Rate for Payer: BCBS MAPPO |
$1,027.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,380.17
|
| Rate for Payer: BCN Commercial |
$3,380.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,027.91
|
| Rate for Payer: Cash Price |
$3,289.30
|
| Rate for Payer: Cofinity Commercial |
$3,536.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,289.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,027.91
|
| Rate for Payer: Healthscope Commercial |
$3,700.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,083.72
|
| Rate for Payer: Mclaren Medicaid |
$724.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,079.30
|
| Rate for Payer: Meridian Medicaid |
$761.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,182.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,130.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,494.89
|
| Rate for Payer: Nomi Health Commercial |
$3,371.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,083.72
|
| Rate for Payer: PACE Senior Care Partners |
$976.51
|
| Rate for Payer: PACE SWMI |
$1,027.91
|
| Rate for Payer: PHP Commercial |
$3,494.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,027.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$724.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,577.12
|
| Rate for Payer: Priority Health Medicare |
$1,038.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,861.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,027.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,618.23
|
| Rate for Payer: UHC Core |
$3,433.21
|
| Rate for Payer: UHC Exchange |
$1,027.91
|
| Rate for Payer: UHC Medicaid |
$724.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,027.91
|
| Rate for Payer: UHCCP Medicaid |
$724.88
|
| Rate for Payer: VA VA |
$1,027.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,083.72
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$8,119.20
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,431.41 |
| Max. Negotiated Rate |
$7,307.28 |
| Rate for Payer: Aetna Commercial |
$6,901.32
|
| Rate for Payer: Aetna Medicare |
$2,110.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,537.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,537.25
|
| Rate for Payer: BCBS Complete |
$1,502.86
|
| Rate for Payer: BCBS MAPPO |
$2,029.80
|
| Rate for Payer: BCBS Trust/PPO |
$6,674.79
|
| Rate for Payer: BCN Commercial |
$6,674.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,029.80
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cofinity Commercial |
$6,982.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,495.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,029.80
|
| Rate for Payer: Healthscope Commercial |
$7,307.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,089.40
|
| Rate for Payer: Mclaren Medicaid |
$1,431.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,131.29
|
| Rate for Payer: Meridian Medicaid |
$1,502.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,334.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,232.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,901.32
|
| Rate for Payer: Nomi Health Commercial |
$6,657.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,089.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,928.31
|
| Rate for Payer: PACE SWMI |
$2,029.80
|
| Rate for Payer: PHP Commercial |
$6,901.32
|
| Rate for Payer: PHP Medicare Advantage |
$2,029.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,431.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,063.70
|
| Rate for Payer: Priority Health Medicare |
$2,050.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,650.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,029.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,144.90
|
| Rate for Payer: UHC Core |
$6,779.53
|
| Rate for Payer: UHC Exchange |
$2,029.80
|
| Rate for Payer: UHC Medicaid |
$1,431.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,029.80
|
| Rate for Payer: UHCCP Medicaid |
$1,431.41
|
| Rate for Payer: VA VA |
$2,029.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,089.40
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$8,119.20
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,650.96 |
| Max. Negotiated Rate |
$7,307.28 |
| Rate for Payer: Aetna Commercial |
$6,901.32
|
| Rate for Payer: BCBS Trust/PPO |
$6,705.65
|
| Rate for Payer: BCN Commercial |
$6,705.65
|
| Rate for Payer: Cash Price |
$6,495.36
|
| Rate for Payer: Cofinity Commercial |
$6,982.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,495.36
|
| Rate for Payer: Healthscope Commercial |
$7,307.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,089.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,901.32
|
| Rate for Payer: Nomi Health Commercial |
$6,657.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,089.40
|
| Rate for Payer: PHP Commercial |
$6,901.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,063.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,650.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,144.90
|
| Rate for Payer: UHC Core |
$6,779.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,089.40
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$2,986.24
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,078.42 |
| Max. Negotiated Rate |
$2,687.62 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,466.34
|
| Rate for Payer: BCN Commercial |
$2,466.34
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,239.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,598.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,078.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,627.89
|
| Rate for Payer: UHC Core |
$2,493.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,239.68
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$2,986.24
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$526.47 |
| Max. Negotiated Rate |
$2,687.62 |
| Rate for Payer: Aetna Commercial |
$2,538.30
|
| Rate for Payer: Aetna Medicare |
$776.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$933.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$933.20
|
| Rate for Payer: BCBS Complete |
$552.75
|
| Rate for Payer: BCBS MAPPO |
$746.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,454.99
|
| Rate for Payer: BCN Commercial |
$2,454.99
|
| Rate for Payer: BCN Medicare Advantage |
$746.56
|
| Rate for Payer: Cash Price |
$2,388.99
|
| Rate for Payer: Cofinity Commercial |
$2,568.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,388.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.56
|
| Rate for Payer: Healthscope Commercial |
$2,687.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,239.68
|
| Rate for Payer: Mclaren Medicaid |
$526.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.89
|
| Rate for Payer: Meridian Medicaid |
$552.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$821.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,538.30
|
| Rate for Payer: Nomi Health Commercial |
$2,448.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,239.68
|
| Rate for Payer: PACE Senior Care Partners |
$709.23
|
| Rate for Payer: PACE SWMI |
$746.56
|
| Rate for Payer: PHP Commercial |
$2,538.30
|
| Rate for Payer: PHP Medicare Advantage |
$746.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,598.03
|
| Rate for Payer: Priority Health Medicare |
$754.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,078.42
|
| Rate for Payer: Railroad Medicare Medicare |
$746.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,627.89
|
| Rate for Payer: UHC Core |
$2,493.51
|
| Rate for Payer: UHC Exchange |
$746.56
|
| Rate for Payer: UHC Medicaid |
$526.47
|
| Rate for Payer: UHC Medicare Advantage |
$746.56
|
| Rate for Payer: UHCCP Medicaid |
$526.47
|
| Rate for Payer: VA VA |
$746.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,239.68
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
OP
|
$1,040.64
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$183.46 |
| Max. Negotiated Rate |
$936.58 |
| Rate for Payer: Aetna Commercial |
$884.54
|
| Rate for Payer: Aetna Medicare |
$270.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.20
|
| Rate for Payer: BCBS Complete |
$192.62
|
| Rate for Payer: BCBS MAPPO |
$260.16
|
| Rate for Payer: BCBS Trust/PPO |
$855.51
|
| Rate for Payer: BCN Commercial |
$855.51
|
| Rate for Payer: BCN Medicare Advantage |
$260.16
|
| Rate for Payer: Cash Price |
$832.51
|
| Rate for Payer: Cofinity Commercial |
$894.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.16
|
| Rate for Payer: Healthscope Commercial |
$936.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.48
|
| Rate for Payer: Mclaren Medicaid |
$183.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.17
|
| Rate for Payer: Meridian Medicaid |
$192.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.54
|
| Rate for Payer: Nomi Health Commercial |
$853.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.48
|
| Rate for Payer: PACE Senior Care Partners |
$247.15
|
| Rate for Payer: PACE SWMI |
$260.16
|
| Rate for Payer: PHP Commercial |
$884.54
|
| Rate for Payer: PHP Medicare Advantage |
$260.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.36
|
| Rate for Payer: Priority Health Medicare |
$262.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.29
|
| Rate for Payer: Railroad Medicare Medicare |
$260.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.76
|
| Rate for Payer: UHC Core |
$868.93
|
| Rate for Payer: UHC Exchange |
$260.16
|
| Rate for Payer: UHC Medicaid |
$183.46
|
| Rate for Payer: UHC Medicare Advantage |
$260.16
|
| Rate for Payer: UHCCP Medicaid |
$183.46
|
| Rate for Payer: VA VA |
$260.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.48
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
IP
|
$1,040.64
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$724.29 |
| Max. Negotiated Rate |
$936.58 |
| Rate for Payer: Aetna Commercial |
$884.54
|
| Rate for Payer: BCBS Trust/PPO |
$859.46
|
| Rate for Payer: BCN Commercial |
$859.46
|
| Rate for Payer: Cash Price |
$832.51
|
| Rate for Payer: Cofinity Commercial |
$894.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.51
|
| Rate for Payer: Healthscope Commercial |
$936.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.54
|
| Rate for Payer: Nomi Health Commercial |
$853.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.48
|
| Rate for Payer: PHP Commercial |
$884.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.76
|
| Rate for Payer: UHC Core |
$868.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.48
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
IP
|
$349.77
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$243.44 |
| Max. Negotiated Rate |
$314.79 |
| Rate for Payer: Aetna Commercial |
$297.30
|
| Rate for Payer: BCBS Trust/PPO |
$288.88
|
| Rate for Payer: BCN Commercial |
$288.88
|
| Rate for Payer: Cash Price |
$279.82
|
| Rate for Payer: Cofinity Commercial |
$300.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.82
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.30
|
| Rate for Payer: Nomi Health Commercial |
$286.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.33
|
| Rate for Payer: PHP Commercial |
$297.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$304.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.80
|
| Rate for Payer: UHC Core |
$292.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.33
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
OP
|
$349.77
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$314.79 |
| Rate for Payer: Aetna Commercial |
$297.30
|
| Rate for Payer: Aetna Medicare |
$90.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.30
|
| Rate for Payer: BCBS Complete |
$64.74
|
| Rate for Payer: BCBS MAPPO |
$87.44
|
| Rate for Payer: BCBS Trust/PPO |
$287.55
|
| Rate for Payer: BCN Commercial |
$287.55
|
| Rate for Payer: BCN Medicare Advantage |
$87.44
|
| Rate for Payer: Cash Price |
$279.82
|
| Rate for Payer: Cofinity Commercial |
$300.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.44
|
| Rate for Payer: Healthscope Commercial |
$314.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.33
|
| Rate for Payer: Mclaren Medicaid |
$61.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.81
|
| Rate for Payer: Meridian Medicaid |
$64.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.30
|
| Rate for Payer: Nomi Health Commercial |
$286.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.33
|
| Rate for Payer: PACE Senior Care Partners |
$83.07
|
| Rate for Payer: PACE SWMI |
$87.44
|
| Rate for Payer: PHP Commercial |
$297.30
|
| Rate for Payer: PHP Medicare Advantage |
$87.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$304.30
|
| Rate for Payer: Priority Health Medicare |
$88.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.44
|
| Rate for Payer: Railroad Medicare Medicare |
$87.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.80
|
| Rate for Payer: UHC Core |
$292.06
|
| Rate for Payer: UHC Exchange |
$87.44
|
| Rate for Payer: UHC Medicaid |
$61.66
|
| Rate for Payer: UHC Medicare Advantage |
$87.44
|
| Rate for Payer: UHCCP Medicaid |
$61.66
|
| Rate for Payer: VA VA |
$87.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.33
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
OP
|
$138.98
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$125.08 |
| Rate for Payer: Aetna Commercial |
$118.13
|
| Rate for Payer: Aetna Medicare |
$36.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.43
|
| Rate for Payer: BCBS Complete |
$25.73
|
| Rate for Payer: BCBS MAPPO |
$34.74
|
| Rate for Payer: BCBS Trust/PPO |
$114.26
|
| Rate for Payer: BCN Commercial |
$114.26
|
| Rate for Payer: BCN Medicare Advantage |
$34.74
|
| Rate for Payer: Cash Price |
$111.18
|
| Rate for Payer: Cofinity Commercial |
$119.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.74
|
| Rate for Payer: Healthscope Commercial |
$125.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.23
|
| Rate for Payer: Mclaren Medicaid |
$24.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.48
|
| Rate for Payer: Meridian Medicaid |
$25.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.13
|
| Rate for Payer: Nomi Health Commercial |
$113.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.23
|
| Rate for Payer: PACE Senior Care Partners |
$33.01
|
| Rate for Payer: PACE SWMI |
$34.74
|
| Rate for Payer: PHP Commercial |
$118.13
|
| Rate for Payer: PHP Medicare Advantage |
$34.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.91
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.73
|
| Rate for Payer: Railroad Medicare Medicare |
$34.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.30
|
| Rate for Payer: UHC Core |
$116.05
|
| Rate for Payer: UHC Exchange |
$34.74
|
| Rate for Payer: UHC Medicaid |
$24.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.74
|
| Rate for Payer: UHCCP Medicaid |
$24.50
|
| Rate for Payer: VA VA |
$34.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.23
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
IP
|
$138.98
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$96.73 |
| Max. Negotiated Rate |
$125.08 |
| Rate for Payer: Aetna Commercial |
$118.13
|
| Rate for Payer: BCBS Trust/PPO |
$114.78
|
| Rate for Payer: BCN Commercial |
$114.78
|
| Rate for Payer: Cash Price |
$111.18
|
| Rate for Payer: Cofinity Commercial |
$119.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.18
|
| Rate for Payer: Healthscope Commercial |
$125.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.13
|
| Rate for Payer: Nomi Health Commercial |
$113.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.23
|
| Rate for Payer: PHP Commercial |
$118.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.30
|
| Rate for Payer: UHC Core |
$116.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.23
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
IP
|
$1,981.19
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,378.91 |
| Max. Negotiated Rate |
$1,783.07 |
| Rate for Payer: Aetna Commercial |
$1,684.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.26
|
| Rate for Payer: BCN Commercial |
$1,636.26
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cofinity Commercial |
$1,703.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.95
|
| Rate for Payer: Healthscope Commercial |
$1,783.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.01
|
| Rate for Payer: Nomi Health Commercial |
$1,624.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.89
|
| Rate for Payer: PHP Commercial |
$1,684.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,723.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,378.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,743.45
|
| Rate for Payer: UHC Core |
$1,654.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.89
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
OP
|
$1,981.19
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$349.28 |
| Max. Negotiated Rate |
$1,783.07 |
| Rate for Payer: Aetna Commercial |
$1,684.01
|
| Rate for Payer: Aetna Medicare |
$515.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$619.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$619.12
|
| Rate for Payer: BCBS Complete |
$366.72
|
| Rate for Payer: BCBS MAPPO |
$495.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.74
|
| Rate for Payer: BCN Commercial |
$1,628.74
|
| Rate for Payer: BCN Medicare Advantage |
$495.30
|
| Rate for Payer: Cash Price |
$1,584.95
|
| Rate for Payer: Cofinity Commercial |
$1,703.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,584.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.30
|
| Rate for Payer: Healthscope Commercial |
$1,783.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.89
|
| Rate for Payer: Mclaren Medicaid |
$349.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$520.06
|
| Rate for Payer: Meridian Medicaid |
$366.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$569.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$544.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.01
|
| Rate for Payer: Nomi Health Commercial |
$1,624.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.89
|
| Rate for Payer: PACE Senior Care Partners |
$470.53
|
| Rate for Payer: PACE SWMI |
$495.30
|
| Rate for Payer: PHP Commercial |
$1,684.01
|
| Rate for Payer: PHP Medicare Advantage |
$495.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,723.64
|
| Rate for Payer: Priority Health Medicare |
$500.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,378.91
|
| Rate for Payer: Railroad Medicare Medicare |
$495.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,743.45
|
| Rate for Payer: UHC Core |
$1,654.29
|
| Rate for Payer: UHC Exchange |
$495.30
|
| Rate for Payer: UHC Medicaid |
$349.28
|
| Rate for Payer: UHC Medicare Advantage |
$495.30
|
| Rate for Payer: UHCCP Medicaid |
$349.28
|
| Rate for Payer: VA VA |
$495.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.89
|
|
