|
HC DOPPLER COLOR FLOW
|
Facility
|
OP
|
$440.60
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
48000007
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$104.64 |
| Max. Negotiated Rate |
$396.54 |
| Rate for Payer: Aetna Commercial |
$374.51
|
| Rate for Payer: Aetna Medicare |
$114.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.69
|
| Rate for Payer: BCBS Complete |
$176.24
|
| Rate for Payer: BCBS MAPPO |
$110.15
|
| Rate for Payer: BCBS Trust/PPO |
$362.22
|
| Rate for Payer: BCN Commercial |
$342.57
|
| Rate for Payer: BCN Medicare Advantage |
$110.15
|
| Rate for Payer: Cash Price |
$352.48
|
| Rate for Payer: Cofinity Commercial |
$378.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.15
|
| Rate for Payer: Healthscope Commercial |
$396.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.51
|
| Rate for Payer: Nomi Health Commercial |
$361.29
|
| Rate for Payer: PACE Senior Care Partners |
$104.64
|
| Rate for Payer: PACE SWMI |
$110.15
|
| Rate for Payer: PHP Commercial |
$374.51
|
| Rate for Payer: PHP Medicare Advantage |
$110.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.39
|
| Rate for Payer: Priority Health HMO/PPO |
$383.32
|
| Rate for Payer: Priority Health Medicare |
$111.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.20
|
| Rate for Payer: Railroad Medicare Medicare |
$110.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.73
|
| Rate for Payer: UHC Core |
$367.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.15
|
| Rate for Payer: UHC Exchange |
$110.15
|
| Rate for Payer: UHC Medicare Advantage |
$110.15
|
| Rate for Payer: VA VA |
$110.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.45
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
IP
|
$225.72
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.72 |
| Max. Negotiated Rate |
$203.15 |
| Rate for Payer: Aetna Commercial |
$191.86
|
| Rate for Payer: BCBS Trust/PPO |
$184.26
|
| Rate for Payer: BCN Commercial |
$174.44
|
| Rate for Payer: Cash Price |
$180.58
|
| Rate for Payer: Cofinity Commercial |
$194.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.58
|
| Rate for Payer: Healthscope Commercial |
$203.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.86
|
| Rate for Payer: Nomi Health Commercial |
$185.09
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.72
|
| Rate for Payer: Priority Health HMO/PPO |
$196.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.63
|
| Rate for Payer: UHC Core |
$188.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.29
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
OP
|
$225.72
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.61 |
| Max. Negotiated Rate |
$203.15 |
| Rate for Payer: Aetna Commercial |
$191.86
|
| Rate for Payer: Aetna Medicare |
$58.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.54
|
| Rate for Payer: BCBS Complete |
$90.29
|
| Rate for Payer: BCBS MAPPO |
$56.43
|
| Rate for Payer: BCBS Trust/PPO |
$185.56
|
| Rate for Payer: BCN Commercial |
$175.50
|
| Rate for Payer: BCN Medicare Advantage |
$56.43
|
| Rate for Payer: Cash Price |
$180.58
|
| Rate for Payer: Cofinity Commercial |
$194.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.43
|
| Rate for Payer: Healthscope Commercial |
$203.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.86
|
| Rate for Payer: Nomi Health Commercial |
$185.09
|
| Rate for Payer: PACE Senior Care Partners |
$53.61
|
| Rate for Payer: PACE SWMI |
$56.43
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicare Advantage |
$56.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.72
|
| Rate for Payer: Priority Health HMO/PPO |
$196.38
|
| Rate for Payer: Priority Health Medicare |
$56.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.23
|
| Rate for Payer: Railroad Medicare Medicare |
$56.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.63
|
| Rate for Payer: UHC Core |
$188.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.43
|
| Rate for Payer: UHC Exchange |
$56.43
|
| Rate for Payer: UHC Medicare Advantage |
$56.43
|
| Rate for Payer: VA VA |
$56.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.29
|
|
|
HC DPPX AB CBA, S
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$208.16
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC DPPX AB CBA, S
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: Aetna Medicare |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.69
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$209.64
|
| Rate for Payer: BCN Commercial |
$198.26
|
| Rate for Payer: BCN Medicare Advantage |
$63.75
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.75
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.94
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: PHP Medicare Advantage |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$221.85
|
| Rate for Payer: Priority Health Medicare |
$64.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.85
|
| Rate for Payer: Railroad Medicare Medicare |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.75
|
| Rate for Payer: UHC Exchange |
$63.75
|
| Rate for Payer: UHC Medicare Advantage |
$63.75
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$63.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC DPPX AB IFA, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DPPX AB IFA, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
OP
|
$371.00
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.11 |
| Max. Negotiated Rate |
$333.90 |
| Rate for Payer: Aetna Commercial |
$315.35
|
| Rate for Payer: Aetna Medicare |
$96.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.94
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$92.75
|
| Rate for Payer: BCBS Trust/PPO |
$305.00
|
| Rate for Payer: BCN Commercial |
$288.45
|
| Rate for Payer: BCN Medicare Advantage |
$92.75
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$319.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.75
|
| Rate for Payer: Healthscope Commercial |
$333.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.25
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.39
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.35
|
| Rate for Payer: Nomi Health Commercial |
$304.22
|
| Rate for Payer: PACE Senior Care Partners |
$88.11
|
| Rate for Payer: PACE SWMI |
$92.75
|
| Rate for Payer: PHP Commercial |
$315.35
|
| Rate for Payer: PHP Medicare Advantage |
$92.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health HMO/PPO |
$322.77
|
| Rate for Payer: Priority Health Medicare |
$93.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.57
|
| Rate for Payer: Railroad Medicare Medicare |
$92.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.48
|
| Rate for Payer: UHC Core |
$309.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.75
|
| Rate for Payer: UHC Exchange |
$92.75
|
| Rate for Payer: UHC Medicare Advantage |
$92.75
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$92.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.25
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
IP
|
$371.00
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.15 |
| Max. Negotiated Rate |
$333.90 |
| Rate for Payer: Aetna Commercial |
$315.35
|
| Rate for Payer: BCBS Trust/PPO |
$302.85
|
| Rate for Payer: BCN Commercial |
$286.71
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$319.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.80
|
| Rate for Payer: Healthscope Commercial |
$333.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.35
|
| Rate for Payer: Nomi Health Commercial |
$304.22
|
| Rate for Payer: PHP Commercial |
$315.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.15
|
| Rate for Payer: Priority Health HMO/PPO |
$322.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.48
|
| Rate for Payer: UHC Core |
$309.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.25
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$8.57
|
| Rate for Payer: BCBS MAPPO |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$17.61
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$5.36
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: PACE Senior Care Partners |
$5.09
|
| Rate for Payer: PACE SWMI |
$5.36
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.36
|
| Rate for Payer: UHC Exchange |
$5.36
|
| Rate for Payer: UHC Medicare Advantage |
$5.36
|
| Rate for Payer: VA VA |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$17.49
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$377.62 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: Aetna Medicare |
$413.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$496.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$496.88
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS MAPPO |
$397.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,307.14
|
| Rate for Payer: BCN Commercial |
$1,236.22
|
| Rate for Payer: BCN Medicare Advantage |
$397.50
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.50
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$457.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: PACE Senior Care Partners |
$377.62
|
| Rate for Payer: PACE SWMI |
$397.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: PHP Medicare Advantage |
$397.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,383.30
|
| Rate for Payer: Priority Health Medicare |
$401.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,065.30
|
| Rate for Payer: Railroad Medicare Medicare |
$397.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.20
|
| Rate for Payer: UHC Core |
$1,327.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.50
|
| Rate for Payer: UHC Exchange |
$397.50
|
| Rate for Payer: UHC Medicare Advantage |
$397.50
|
| Rate for Payer: VA VA |
$397.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,033.50 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,297.92
|
| Rate for Payer: BCN Commercial |
$1,228.75
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Nomi Health Commercial |
$1,303.80
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,033.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,383.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,065.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.20
|
| Rate for Payer: UHC Core |
$1,327.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.23 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna Medicare |
$60.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.68
|
| Rate for Payer: BCBS Complete |
$93.02
|
| Rate for Payer: BCBS MAPPO |
$58.14
|
| Rate for Payer: BCBS Trust/PPO |
$191.19
|
| Rate for Payer: BCN Commercial |
$180.82
|
| Rate for Payer: BCN Medicare Advantage |
$58.14
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.14
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: PACE Senior Care Partners |
$55.23
|
| Rate for Payer: PACE SWMI |
$58.14
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: PHP Medicare Advantage |
$58.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.16
|
| Rate for Payer: Priority Health HMO/PPO |
$202.33
|
| Rate for Payer: Priority Health Medicare |
$58.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.82
|
| Rate for Payer: Railroad Medicare Medicare |
$58.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.65
|
| Rate for Payer: UHC Core |
$194.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.14
|
| Rate for Payer: UHC Exchange |
$58.14
|
| Rate for Payer: UHC Medicare Advantage |
$58.14
|
| Rate for Payer: VA VA |
$58.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$151.16 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: BCBS Trust/PPO |
$189.84
|
| Rate for Payer: BCN Commercial |
$179.72
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Nomi Health Commercial |
$190.70
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.16
|
| Rate for Payer: Priority Health HMO/PPO |
$202.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.65
|
| Rate for Payer: UHC Core |
$194.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.57 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna Medicare |
$100.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.49
|
| Rate for Payer: BCBS Complete |
$154.22
|
| Rate for Payer: BCBS MAPPO |
$96.39
|
| Rate for Payer: BCBS Trust/PPO |
$316.97
|
| Rate for Payer: BCN Commercial |
$299.77
|
| Rate for Payer: BCN Medicare Advantage |
$96.39
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.39
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: PACE Senior Care Partners |
$91.57
|
| Rate for Payer: PACE SWMI |
$96.39
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: PHP Medicare Advantage |
$96.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO |
$335.44
|
| Rate for Payer: Priority Health Medicare |
$97.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.33
|
| Rate for Payer: Railroad Medicare Medicare |
$96.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.29
|
| Rate for Payer: UHC Core |
$321.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.39
|
| Rate for Payer: UHC Exchange |
$96.39
|
| Rate for Payer: UHC Medicare Advantage |
$96.39
|
| Rate for Payer: VA VA |
$96.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$250.61 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: BCBS Trust/PPO |
$314.73
|
| Rate for Payer: BCN Commercial |
$297.96
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Nomi Health Commercial |
$316.16
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.61
|
| Rate for Payer: Priority Health HMO/PPO |
$335.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.29
|
| Rate for Payer: UHC Core |
$321.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.91 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna Medicare |
$140.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.30
|
| Rate for Payer: BCBS Complete |
$215.42
|
| Rate for Payer: BCBS MAPPO |
$134.64
|
| Rate for Payer: BCBS Trust/PPO |
$442.75
|
| Rate for Payer: BCN Commercial |
$418.73
|
| Rate for Payer: BCN Medicare Advantage |
$134.64
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: PACE Senior Care Partners |
$127.91
|
| Rate for Payer: PACE SWMI |
$134.64
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: PHP Medicare Advantage |
$134.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: Priority Health HMO/PPO |
$468.55
|
| Rate for Payer: Priority Health Medicare |
$135.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.84
|
| Rate for Payer: Railroad Medicare Medicare |
$134.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.93
|
| Rate for Payer: UHC Core |
$449.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.64
|
| Rate for Payer: UHC Exchange |
$134.64
|
| Rate for Payer: UHC Medicare Advantage |
$134.64
|
| Rate for Payer: VA VA |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$350.06 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: BCBS Trust/PPO |
$439.63
|
| Rate for Payer: BCN Commercial |
$416.20
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Nomi Health Commercial |
$441.62
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.06
|
| Rate for Payer: Priority Health HMO/PPO |
$468.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.93
|
| Rate for Payer: UHC Core |
$449.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$218.29 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna Medicare |
$238.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.23
|
| Rate for Payer: BCBS Complete |
$367.65
|
| Rate for Payer: BCBS MAPPO |
$229.78
|
| Rate for Payer: BCBS Trust/PPO |
$755.62
|
| Rate for Payer: BCN Commercial |
$714.62
|
| Rate for Payer: BCN Medicare Advantage |
$229.78
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: PACE Senior Care Partners |
$218.29
|
| Rate for Payer: PACE SWMI |
$229.78
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: PHP Medicare Advantage |
$229.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: Priority Health HMO/PPO |
$799.64
|
| Rate for Payer: Priority Health Medicare |
$232.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.82
|
| Rate for Payer: Railroad Medicare Medicare |
$229.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.83
|
| Rate for Payer: UHC Core |
$767.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.78
|
| Rate for Payer: UHC Exchange |
$229.78
|
| Rate for Payer: UHC Medicare Advantage |
$229.78
|
| Rate for Payer: VA VA |
$229.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$597.43 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: BCBS Trust/PPO |
$750.29
|
| Rate for Payer: BCN Commercial |
$710.30
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Nomi Health Commercial |
$753.69
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.43
|
| Rate for Payer: Priority Health HMO/PPO |
$799.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.83
|
| Rate for Payer: UHC Core |
$767.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,017.14 |
| Max. Negotiated Rate |
$3,854.44 |
| Rate for Payer: Aetna Commercial |
$3,640.30
|
| Rate for Payer: Aetna Medicare |
$1,113.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,338.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,338.35
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$1,070.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,520.82
|
| Rate for Payer: BCN Commercial |
$3,329.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.68
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$3,683.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.68
|
| Rate for Payer: Healthscope Commercial |
$3,854.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,212.03
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.21
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,231.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: Nomi Health Commercial |
$3,511.82
|
| Rate for Payer: PACE Senior Care Partners |
$1,017.14
|
| Rate for Payer: PACE SWMI |
$1,070.68
|
| Rate for Payer: PHP Commercial |
$3,640.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3,725.96
|
| Rate for Payer: Priority Health Medicare |
$1,081.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,869.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,070.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,768.78
|
| Rate for Payer: UHC Core |
$3,576.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,070.68
|
| Rate for Payer: UHC Exchange |
$1,070.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.68
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$1,070.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,212.03
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,282.71
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,783.76 |
| Max. Negotiated Rate |
$3,854.44 |
| Rate for Payer: Aetna Commercial |
$3,640.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,495.98
|
| Rate for Payer: BCN Commercial |
$3,309.68
|
| Rate for Payer: Cash Price |
$3,426.17
|
| Rate for Payer: Cofinity Commercial |
$3,683.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,426.17
|
| Rate for Payer: Healthscope Commercial |
$3,854.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,212.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,640.30
|
| Rate for Payer: Nomi Health Commercial |
$3,511.82
|
| Rate for Payer: PHP Commercial |
$3,640.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,783.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3,725.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,869.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,768.78
|
| Rate for Payer: UHC Core |
$3,576.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,212.03
|
|
