|
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 |
$97.86
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.39
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$309.79
|
| 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 |
$93.19
|
| 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 |
$309.79
|
| 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 |
$16.07
|
| 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 |
$16.07
|
|
|
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 |
$16.07
|
| 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 |
$16.07
|
|
|
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
|
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 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 |
$72.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.67
|
| 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 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 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 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 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 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,124.21
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$338.13 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: BCBS Trust/PPO |
$424.64
|
| Rate for Payer: BCN Commercial |
$402.01
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health HMO/PPO |
$452.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.78
|
| Rate for Payer: UHC Core |
$434.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.55 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$135.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.56
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$130.05
|
| Rate for Payer: BCBS Trust/PPO |
$427.66
|
| Rate for Payer: BCN Commercial |
$404.46
|
| Rate for Payer: BCN Medicare Advantage |
$130.05
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.05
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.55
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: PACE Senior Care Partners |
$123.55
|
| Rate for Payer: PACE SWMI |
$130.05
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: PHP Medicare Advantage |
$130.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health HMO/PPO |
$452.57
|
| Rate for Payer: Priority Health Medicare |
$131.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.53
|
| Rate for Payer: Railroad Medicare Medicare |
$130.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.78
|
| Rate for Payer: UHC Core |
$434.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.05
|
| Rate for Payer: UHC Exchange |
$130.05
|
| Rate for Payer: UHC Medicare Advantage |
$130.05
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$130.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,361.41 |
| Max. Negotiated Rate |
$1,885.03 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.72
|
| Rate for Payer: BCN Commercial |
$1,618.61
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,570.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: Nomi Health Commercial |
$1,717.47
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,822.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,843.14
|
| Rate for Payer: UHC Core |
$1,748.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,570.86
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,094.48
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$497.44 |
| Max. Negotiated Rate |
$1,885.03 |
| Rate for Payer: Aetna Commercial |
$1,780.31
|
| Rate for Payer: Aetna Medicare |
$544.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$654.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$654.52
|
| Rate for Payer: BCBS Complete |
$837.79
|
| Rate for Payer: BCBS MAPPO |
$523.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,721.87
|
| Rate for Payer: BCN Commercial |
$1,628.46
|
| Rate for Payer: BCN Medicare Advantage |
$523.62
|
| Rate for Payer: Cash Price |
$1,675.58
|
| Rate for Payer: Cofinity Commercial |
$1,801.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,675.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$523.62
|
| Rate for Payer: Healthscope Commercial |
$1,885.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,570.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$549.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$602.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,780.31
|
| Rate for Payer: Nomi Health Commercial |
$1,717.47
|
| Rate for Payer: PACE Senior Care Partners |
$497.44
|
| Rate for Payer: PACE SWMI |
$523.62
|
| Rate for Payer: PHP Commercial |
$1,780.31
|
| Rate for Payer: PHP Medicare Advantage |
$523.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,361.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,822.20
|
| Rate for Payer: Priority Health Medicare |
$528.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,403.30
|
| Rate for Payer: Railroad Medicare Medicare |
$523.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,843.14
|
| Rate for Payer: UHC Core |
$1,748.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$523.62
|
| Rate for Payer: UHC Exchange |
$523.62
|
| Rate for Payer: UHC Medicare Advantage |
$523.62
|
| Rate for Payer: VA VA |
$523.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,570.86
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
OP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,013.09 |
| Max. Negotiated Rate |
$3,839.08 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: Aetna Medicare |
$1,109.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,333.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,333.01
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$1,066.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,506.78
|
| Rate for Payer: BCN Commercial |
$3,316.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,066.41
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,066.41
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,199.23
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,119.73
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,226.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: Nomi Health Commercial |
$3,497.82
|
| Rate for Payer: PACE Senior Care Partners |
$1,013.09
|
| Rate for Payer: PACE SWMI |
$1,066.41
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,066.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health HMO/PPO |
$3,711.11
|
| Rate for Payer: Priority Health Medicare |
$1,077.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,857.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,066.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,753.76
|
| Rate for Payer: UHC Core |
$3,561.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,066.41
|
| Rate for Payer: UHC Exchange |
$1,066.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,066.41
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$1,066.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,199.23
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL PERCUTANEOUS
|
Facility
|
IP
|
$4,265.64
|
|
|
Service Code
|
CPT 49406
|
| Hospital Charge Code |
36100433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,772.67 |
| Max. Negotiated Rate |
$3,839.08 |
| Rate for Payer: Aetna Commercial |
$3,625.79
|
| Rate for Payer: BCBS Trust/PPO |
$3,482.04
|
| Rate for Payer: BCN Commercial |
$3,296.49
|
| Rate for Payer: Cash Price |
$3,412.51
|
| Rate for Payer: Cofinity Commercial |
$3,668.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.51
|
| Rate for Payer: Healthscope Commercial |
$3,839.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,199.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,625.79
|
| Rate for Payer: Nomi Health Commercial |
$3,497.82
|
| Rate for Payer: PHP Commercial |
$3,625.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,772.67
|
| Rate for Payer: Priority Health HMO/PPO |
$3,711.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,857.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,753.76
|
| Rate for Payer: UHC Core |
$3,561.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,199.23
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
OP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$748.98 |
| Max. Negotiated Rate |
$2,838.24 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: Aetna Medicare |
$819.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$985.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$985.50
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$788.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,592.57
|
| Rate for Payer: BCN Commercial |
$2,451.92
|
| Rate for Payer: BCN Medicare Advantage |
$788.40
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$788.40
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,365.20
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$827.82
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$906.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: Nomi Health Commercial |
$2,585.95
|
| Rate for Payer: PACE Senior Care Partners |
$748.98
|
| Rate for Payer: PACE SWMI |
$788.40
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: PHP Medicare Advantage |
$788.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health HMO/PPO |
$2,743.63
|
| Rate for Payer: Priority Health Medicare |
$796.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,112.91
|
| Rate for Payer: Railroad Medicare Medicare |
$788.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,775.17
|
| Rate for Payer: UHC Core |
$2,633.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$788.40
|
| Rate for Payer: UHC Exchange |
$788.40
|
| Rate for Payer: UHC Medicare Advantage |
$788.40
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$788.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,365.20
|
|
|
HC DRAINAGE PERITONEAL OR RETROPERITONEAL TRANSVAG OR TRANSRECTAL
|
Facility
|
IP
|
$3,153.60
|
|
|
Service Code
|
CPT 49407
|
| Hospital Charge Code |
36100434
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,049.84 |
| Max. Negotiated Rate |
$2,838.24 |
| Rate for Payer: Aetna Commercial |
$2,680.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,574.28
|
| Rate for Payer: BCN Commercial |
$2,437.10
|
| Rate for Payer: Cash Price |
$2,522.88
|
| Rate for Payer: Cofinity Commercial |
$2,712.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,522.88
|
| Rate for Payer: Healthscope Commercial |
$2,838.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,365.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,680.56
|
| Rate for Payer: Nomi Health Commercial |
$2,585.95
|
| Rate for Payer: PHP Commercial |
$2,680.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,049.84
|
| Rate for Payer: Priority Health HMO/PPO |
$2,743.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,112.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,775.17
|
| Rate for Payer: UHC Core |
$2,633.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,365.20
|
|
|
HC DRAINAGE SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
76100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.74 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$556.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.40
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$535.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.00
|
| Rate for Payer: BCN Commercial |
$1,665.47
|
| Rate for Payer: BCN Medicare Advantage |
$535.52
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.52
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.30
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Senior Care Partners |
$508.74
|
| Rate for Payer: PACE SWMI |
$535.52
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$535.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Medicare |
$540.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.52
|
| Rate for Payer: UHC Exchange |
$535.52
|
| Rate for Payer: UHC Medicare Advantage |
$535.52
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$535.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
