|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$468.74
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$82.64 |
| Max. Negotiated Rate |
$421.87 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: Aetna Medicare |
$121.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.48
|
| Rate for Payer: BCBS Complete |
$86.76
|
| Rate for Payer: BCBS MAPPO |
$117.19
|
| Rate for Payer: BCBS Trust/PPO |
$385.35
|
| Rate for Payer: BCN Commercial |
$385.35
|
| Rate for Payer: BCN Medicare Advantage |
$117.19
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.19
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.56
|
| Rate for Payer: Mclaren Medicaid |
$82.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.04
|
| Rate for Payer: Meridian Medicaid |
$86.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PACE Senior Care Partners |
$111.33
|
| Rate for Payer: PACE SWMI |
$117.19
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: PHP Medicare Advantage |
$117.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.80
|
| Rate for Payer: Priority Health Medicare |
$118.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.24
|
| Rate for Payer: Railroad Medicare Medicare |
$117.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.49
|
| Rate for Payer: UHC Core |
$391.40
|
| Rate for Payer: UHC Exchange |
$117.19
|
| Rate for Payer: UHC Medicaid |
$82.64
|
| Rate for Payer: UHC Medicare Advantage |
$117.19
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$117.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.56
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$468.74
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$326.24 |
| Max. Negotiated Rate |
$421.87 |
| Rate for Payer: Aetna Commercial |
$398.43
|
| Rate for Payer: BCBS Trust/PPO |
$387.13
|
| Rate for Payer: BCN Commercial |
$387.13
|
| Rate for Payer: Cash Price |
$374.99
|
| Rate for Payer: Cofinity Commercial |
$403.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.99
|
| Rate for Payer: Healthscope Commercial |
$421.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.43
|
| Rate for Payer: Nomi Health Commercial |
$384.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.56
|
| Rate for Payer: PHP Commercial |
$398.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$326.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.49
|
| Rate for Payer: UHC Core |
$391.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.56
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
OP
|
$221.09
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$198.98 |
| Rate for Payer: Aetna Commercial |
$187.93
|
| Rate for Payer: Aetna Commercial |
$281.89
|
| Rate for Payer: Aetna Medicare |
$86.22
|
| Rate for Payer: Aetna Medicare |
$57.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.63
|
| Rate for Payer: BCBS Complete |
$40.92
|
| Rate for Payer: BCBS Complete |
$61.38
|
| Rate for Payer: BCBS MAPPO |
$55.27
|
| Rate for Payer: BCBS MAPPO |
$82.91
|
| Rate for Payer: BCBS Trust/PPO |
$181.76
|
| Rate for Payer: BCBS Trust/PPO |
$272.63
|
| Rate for Payer: BCN Commercial |
$272.63
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: BCN Medicare Advantage |
$82.91
|
| Rate for Payer: BCN Medicare Advantage |
$55.27
|
| Rate for Payer: Cash Price |
$176.87
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cofinity Commercial |
$190.14
|
| Rate for Payer: Cofinity Commercial |
$285.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.27
|
| Rate for Payer: Healthscope Commercial |
$198.98
|
| Rate for Payer: Healthscope Commercial |
$298.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.72
|
| Rate for Payer: Mclaren Medicaid |
$58.47
|
| Rate for Payer: Mclaren Medicaid |
$38.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.04
|
| Rate for Payer: Meridian Medicaid |
$40.92
|
| Rate for Payer: Meridian Medicaid |
$61.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.93
|
| Rate for Payer: Nomi Health Commercial |
$271.94
|
| Rate for Payer: Nomi Health Commercial |
$181.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.72
|
| Rate for Payer: PACE Senior Care Partners |
$78.76
|
| Rate for Payer: PACE Senior Care Partners |
$52.51
|
| Rate for Payer: PACE SWMI |
$82.91
|
| Rate for Payer: PACE SWMI |
$55.27
|
| Rate for Payer: PHP Commercial |
$187.93
|
| Rate for Payer: PHP Commercial |
$281.89
|
| Rate for Payer: PHP Medicare Advantage |
$55.27
|
| Rate for Payer: PHP Medicare Advantage |
$82.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$288.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.35
|
| Rate for Payer: Priority Health Medicare |
$83.74
|
| Rate for Payer: Priority Health Medicare |
$55.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.81
|
| Rate for Payer: Railroad Medicare Medicare |
$55.27
|
| Rate for Payer: Railroad Medicare Medicare |
$82.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.83
|
| Rate for Payer: UHC Core |
$276.91
|
| Rate for Payer: UHC Core |
$184.61
|
| Rate for Payer: UHC Exchange |
$82.91
|
| Rate for Payer: UHC Exchange |
$55.27
|
| Rate for Payer: UHC Medicaid |
$58.47
|
| Rate for Payer: UHC Medicaid |
$38.98
|
| Rate for Payer: UHC Medicare Advantage |
$55.27
|
| Rate for Payer: UHC Medicare Advantage |
$82.91
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
| Rate for Payer: UHCCP Medicaid |
$58.47
|
| Rate for Payer: VA VA |
$55.27
|
| Rate for Payer: VA VA |
$82.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.82
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$221.09
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.88 |
| Max. Negotiated Rate |
$198.98 |
| Rate for Payer: Aetna Commercial |
$187.93
|
| Rate for Payer: Aetna Commercial |
$281.89
|
| Rate for Payer: BCBS Trust/PPO |
$182.60
|
| Rate for Payer: BCBS Trust/PPO |
$273.89
|
| Rate for Payer: BCN Commercial |
$182.60
|
| Rate for Payer: BCN Commercial |
$273.89
|
| Rate for Payer: Cash Price |
$176.87
|
| Rate for Payer: Cash Price |
$265.30
|
| Rate for Payer: Cofinity Commercial |
$285.20
|
| Rate for Payer: Cofinity Commercial |
$190.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.87
|
| Rate for Payer: Healthscope Commercial |
$198.98
|
| Rate for Payer: Healthscope Commercial |
$298.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.89
|
| Rate for Payer: Nomi Health Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$271.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.72
|
| Rate for Payer: PHP Commercial |
$281.89
|
| Rate for Payer: PHP Commercial |
$187.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$288.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.83
|
| Rate for Payer: UHC Core |
$184.61
|
| Rate for Payer: UHC Core |
$276.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.72
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$834.90 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: BCBS Trust/PPO |
$990.72
|
| Rate for Payer: BCN Commercial |
$990.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$311.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.87
|
| Rate for Payer: BCBS Complete |
$222.04
|
| Rate for Payer: BCBS MAPPO |
$299.89
|
| Rate for Payer: BCBS Trust/PPO |
$986.17
|
| Rate for Payer: BCN Commercial |
$986.17
|
| Rate for Payer: BCN Medicare Advantage |
$299.89
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.89
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$211.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.89
|
| Rate for Payer: Meridian Medicaid |
$222.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$329.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$983.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Senior Care Partners |
$284.90
|
| Rate for Payer: PACE SWMI |
$299.89
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$299.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,043.63
|
| Rate for Payer: Priority Health Medicare |
$302.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.90
|
| Rate for Payer: Railroad Medicare Medicare |
$299.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,055.62
|
| Rate for Payer: UHC Core |
$1,001.64
|
| Rate for Payer: UHC Exchange |
$299.89
|
| Rate for Payer: UHC Medicaid |
$211.48
|
| Rate for Payer: UHC Medicare Advantage |
$299.89
|
| Rate for Payer: UHCCP Medicaid |
$211.48
|
| Rate for Payer: VA VA |
$299.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$236.28
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$212.65 |
| Rate for Payer: Aetna Commercial |
$200.84
|
| Rate for Payer: Aetna Medicare |
$61.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.84
|
| Rate for Payer: BCBS Complete |
$43.74
|
| Rate for Payer: BCBS MAPPO |
$59.07
|
| Rate for Payer: BCBS Trust/PPO |
$194.25
|
| Rate for Payer: BCN Commercial |
$194.25
|
| Rate for Payer: BCN Medicare Advantage |
$59.07
|
| Rate for Payer: Cash Price |
$189.02
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.07
|
| Rate for Payer: Healthscope Commercial |
$212.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.21
|
| Rate for Payer: Mclaren Medicaid |
$41.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.02
|
| Rate for Payer: Meridian Medicaid |
$43.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.84
|
| Rate for Payer: Nomi Health Commercial |
$193.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.21
|
| Rate for Payer: PACE Senior Care Partners |
$56.12
|
| Rate for Payer: PACE SWMI |
$59.07
|
| Rate for Payer: PHP Commercial |
$200.84
|
| Rate for Payer: PHP Medicare Advantage |
$59.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$205.56
|
| Rate for Payer: Priority Health Medicare |
$59.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.45
|
| Rate for Payer: Railroad Medicare Medicare |
$59.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.93
|
| Rate for Payer: UHC Core |
$197.29
|
| Rate for Payer: UHC Exchange |
$59.07
|
| Rate for Payer: UHC Medicaid |
$41.66
|
| Rate for Payer: UHC Medicare Advantage |
$59.07
|
| Rate for Payer: UHCCP Medicaid |
$41.66
|
| Rate for Payer: VA VA |
$59.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.21
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$236.28
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.45 |
| Max. Negotiated Rate |
$212.65 |
| Rate for Payer: Aetna Commercial |
$200.84
|
| Rate for Payer: BCBS Trust/PPO |
$195.14
|
| Rate for Payer: BCN Commercial |
$195.14
|
| Rate for Payer: Cash Price |
$189.02
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.02
|
| Rate for Payer: Healthscope Commercial |
$212.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.84
|
| Rate for Payer: Nomi Health Commercial |
$193.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.21
|
| Rate for Payer: PHP Commercial |
$200.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$205.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.93
|
| Rate for Payer: UHC Core |
$197.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.21
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$4,091.87
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$721.40 |
| Max. Negotiated Rate |
$3,682.68 |
| Rate for Payer: Aetna Commercial |
$3,478.09
|
| Rate for Payer: Aetna Medicare |
$1,063.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,278.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,278.71
|
| Rate for Payer: BCBS Complete |
$757.41
|
| Rate for Payer: BCBS MAPPO |
$1,022.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,363.93
|
| Rate for Payer: BCN Commercial |
$3,363.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,022.97
|
| Rate for Payer: Cash Price |
$3,273.50
|
| Rate for Payer: Cofinity Commercial |
$3,519.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,273.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,022.97
|
| Rate for Payer: Healthscope Commercial |
$3,682.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,068.90
|
| Rate for Payer: Mclaren Medicaid |
$721.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.12
|
| Rate for Payer: Meridian Medicaid |
$757.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,176.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,125.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,478.09
|
| Rate for Payer: Nomi Health Commercial |
$3,355.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,068.90
|
| Rate for Payer: PACE Senior Care Partners |
$971.82
|
| Rate for Payer: PACE SWMI |
$1,022.97
|
| Rate for Payer: PHP Commercial |
$3,478.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,022.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,559.93
|
| Rate for Payer: Priority Health Medicare |
$1,033.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,847.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,022.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,600.85
|
| Rate for Payer: UHC Core |
$3,416.71
|
| Rate for Payer: UHC Exchange |
$1,022.97
|
| Rate for Payer: UHC Medicaid |
$721.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,022.97
|
| Rate for Payer: UHCCP Medicaid |
$721.40
|
| Rate for Payer: VA VA |
$1,022.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,068.90
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$4,091.87
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,847.94 |
| Max. Negotiated Rate |
$3,682.68 |
| Rate for Payer: Aetna Commercial |
$3,478.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.48
|
| Rate for Payer: BCN Commercial |
$3,379.48
|
| Rate for Payer: Cash Price |
$3,273.50
|
| Rate for Payer: Cofinity Commercial |
$3,519.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,273.50
|
| Rate for Payer: Healthscope Commercial |
$3,682.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,068.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,478.09
|
| Rate for Payer: Nomi Health Commercial |
$3,355.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,068.90
|
| Rate for Payer: PHP Commercial |
$3,478.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,559.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,847.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,600.85
|
| Rate for Payer: UHC Core |
$3,416.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,068.90
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
OP
|
$373.92
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.92 |
| Max. Negotiated Rate |
$336.53 |
| Rate for Payer: Aetna Commercial |
$317.83
|
| Rate for Payer: Aetna Medicare |
$97.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.85
|
| Rate for Payer: BCBS Complete |
$69.21
|
| Rate for Payer: BCBS MAPPO |
$93.48
|
| Rate for Payer: BCBS Trust/PPO |
$307.40
|
| Rate for Payer: BCN Commercial |
$307.40
|
| Rate for Payer: BCN Medicare Advantage |
$93.48
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$321.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.48
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.44
|
| Rate for Payer: Mclaren Medicaid |
$65.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.15
|
| Rate for Payer: Meridian Medicaid |
$69.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: PACE Senior Care Partners |
$88.81
|
| Rate for Payer: PACE SWMI |
$93.48
|
| Rate for Payer: PHP Commercial |
$317.83
|
| Rate for Payer: PHP Medicare Advantage |
$93.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.31
|
| Rate for Payer: Priority Health Medicare |
$94.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.25
|
| Rate for Payer: Railroad Medicare Medicare |
$93.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.05
|
| Rate for Payer: UHC Core |
$312.22
|
| Rate for Payer: UHC Exchange |
$93.48
|
| Rate for Payer: UHC Medicaid |
$65.92
|
| Rate for Payer: UHC Medicare Advantage |
$93.48
|
| Rate for Payer: UHCCP Medicaid |
$65.92
|
| Rate for Payer: VA VA |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.44
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$373.92
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.25 |
| Max. Negotiated Rate |
$336.53 |
| Rate for Payer: Aetna Commercial |
$317.83
|
| Rate for Payer: BCBS Trust/PPO |
$308.82
|
| Rate for Payer: BCN Commercial |
$308.82
|
| Rate for Payer: Cash Price |
$299.14
|
| Rate for Payer: Cofinity Commercial |
$321.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.14
|
| Rate for Payer: Healthscope Commercial |
$336.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.83
|
| Rate for Payer: Nomi Health Commercial |
$306.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.44
|
| Rate for Payer: PHP Commercial |
$317.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.05
|
| Rate for Payer: UHC Core |
$312.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.44
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$24.61
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$22.15 |
| Rate for Payer: Aetna Commercial |
$20.92
|
| Rate for Payer: BCBS Trust/PPO |
$20.33
|
| Rate for Payer: BCN Commercial |
$20.33
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$21.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Healthscope Commercial |
$22.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.92
|
| Rate for Payer: Nomi Health Commercial |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.46
|
| Rate for Payer: PHP Commercial |
$20.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.46
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$24.61
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.34 |
| Max. Negotiated Rate |
$22.15 |
| Rate for Payer: Aetna Commercial |
$20.92
|
| Rate for Payer: Aetna Medicare |
$6.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.69
|
| Rate for Payer: BCBS Complete |
$4.56
|
| Rate for Payer: BCBS MAPPO |
$6.15
|
| Rate for Payer: BCBS Trust/PPO |
$20.23
|
| Rate for Payer: BCN Commercial |
$20.23
|
| Rate for Payer: BCN Medicare Advantage |
$6.15
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$21.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.15
|
| Rate for Payer: Healthscope Commercial |
$22.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.46
|
| Rate for Payer: Mclaren Medicaid |
$4.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.46
|
| Rate for Payer: Meridian Medicaid |
$4.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.92
|
| Rate for Payer: Nomi Health Commercial |
$20.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.46
|
| Rate for Payer: PACE Senior Care Partners |
$5.84
|
| Rate for Payer: PACE SWMI |
$6.15
|
| Rate for Payer: PHP Commercial |
$20.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.41
|
| Rate for Payer: Priority Health Medicare |
$6.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$20.55
|
| Rate for Payer: UHC Exchange |
$6.15
|
| Rate for Payer: UHC Medicaid |
$4.34
|
| Rate for Payer: UHC Medicare Advantage |
$6.15
|
| Rate for Payer: UHCCP Medicaid |
$4.34
|
| Rate for Payer: VA VA |
$6.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.46
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$29.66
|
| Rate for Payer: BCN Commercial |
$29.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Senior Care Partners |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicaid |
$6.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.02
|
| Rate for Payer: UHCCP Medicaid |
$6.36
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.11 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.80
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
IP
|
$704.42
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$490.28 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: BCBS Trust/PPO |
$581.78
|
| Rate for Payer: BCN Commercial |
$581.78
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
OP
|
$704.42
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$124.19 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna Medicare |
$183.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.13
|
| Rate for Payer: BCBS Complete |
$130.39
|
| Rate for Payer: BCBS MAPPO |
$176.10
|
| Rate for Payer: BCBS Trust/PPO |
$579.10
|
| Rate for Payer: BCN Commercial |
$579.10
|
| Rate for Payer: BCN Medicare Advantage |
$176.10
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.10
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Mclaren Medicaid |
$124.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.91
|
| Rate for Payer: Meridian Medicaid |
$130.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PACE Senior Care Partners |
$167.30
|
| Rate for Payer: PACE SWMI |
$176.10
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: PHP Medicare Advantage |
$176.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Medicare |
$177.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: Railroad Medicare Medicare |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: UHC Exchange |
$176.10
|
| Rate for Payer: UHC Medicaid |
$124.19
|
| Rate for Payer: UHC Medicare Advantage |
$176.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$176.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
IP
|
$3,102.33
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,159.22 |
| Max. Negotiated Rate |
$2,792.10 |
| Rate for Payer: Aetna Commercial |
$2,636.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,562.21
|
| Rate for Payer: BCN Commercial |
$2,562.21
|
| Rate for Payer: Cash Price |
$2,481.86
|
| Rate for Payer: Cofinity Commercial |
$2,668.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.86
|
| Rate for Payer: Healthscope Commercial |
$2,792.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.98
|
| Rate for Payer: Nomi Health Commercial |
$2,543.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,326.75
|
| Rate for Payer: PHP Commercial |
$2,636.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,699.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,159.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,730.05
|
| Rate for Payer: UHC Core |
$2,590.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.75
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
OP
|
$3,102.33
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$2,792.10 |
| Rate for Payer: Aetna Commercial |
$2,636.98
|
| Rate for Payer: Aetna Medicare |
$806.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.48
|
| Rate for Payer: BCBS Complete |
$574.24
|
| Rate for Payer: BCBS MAPPO |
$775.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,550.43
|
| Rate for Payer: BCN Commercial |
$2,550.43
|
| Rate for Payer: BCN Medicare Advantage |
$775.58
|
| Rate for Payer: Cash Price |
$2,481.86
|
| Rate for Payer: Cash Price |
$2,481.86
|
| Rate for Payer: Cofinity Commercial |
$2,668.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.58
|
| Rate for Payer: Healthscope Commercial |
$2,792.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.75
|
| Rate for Payer: Mclaren Medicaid |
$546.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.36
|
| Rate for Payer: Meridian Medicaid |
$574.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$853.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.98
|
| Rate for Payer: Nomi Health Commercial |
$2,543.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,326.75
|
| Rate for Payer: PACE Senior Care Partners |
$736.80
|
| Rate for Payer: PACE SWMI |
$775.58
|
| Rate for Payer: PHP Commercial |
$2,636.98
|
| Rate for Payer: PHP Medicare Advantage |
$775.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$546.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,699.03
|
| Rate for Payer: Priority Health Medicare |
$783.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,159.22
|
| Rate for Payer: Railroad Medicare Medicare |
$775.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,730.05
|
| Rate for Payer: UHC Core |
$2,590.45
|
| Rate for Payer: UHC Exchange |
$775.58
|
| Rate for Payer: UHC Medicaid |
$546.94
|
| Rate for Payer: UHC Medicare Advantage |
$775.58
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$775.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.75
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
OP
|
$447.37
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.87 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$380.26
|
| Rate for Payer: Aetna Medicare |
$116.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.80
|
| Rate for Payer: BCBS Complete |
$82.81
|
| Rate for Payer: BCBS MAPPO |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$367.78
|
| Rate for Payer: BCN Commercial |
$367.78
|
| Rate for Payer: BCN Medicare Advantage |
$111.84
|
| Rate for Payer: Cash Price |
$357.90
|
| Rate for Payer: Cofinity Commercial |
$384.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.84
|
| Rate for Payer: Healthscope Commercial |
$402.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.53
|
| Rate for Payer: Mclaren Medicaid |
$78.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.43
|
| Rate for Payer: Meridian Medicaid |
$82.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.26
|
| Rate for Payer: Nomi Health Commercial |
$366.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.53
|
| Rate for Payer: PACE Senior Care Partners |
$106.25
|
| Rate for Payer: PACE SWMI |
$111.84
|
| Rate for Payer: PHP Commercial |
$380.26
|
| Rate for Payer: PHP Medicare Advantage |
$111.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.21
|
| Rate for Payer: Priority Health Medicare |
$112.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.37
|
| Rate for Payer: Railroad Medicare Medicare |
$111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.69
|
| Rate for Payer: UHC Core |
$373.55
|
| Rate for Payer: UHC Exchange |
$111.84
|
| Rate for Payer: UHC Medicaid |
$78.87
|
| Rate for Payer: UHC Medicare Advantage |
$111.84
|
| Rate for Payer: UHCCP Medicaid |
$78.87
|
| Rate for Payer: VA VA |
$111.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.53
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
IP
|
$447.37
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$311.37 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$380.26
|
| Rate for Payer: BCBS Trust/PPO |
$369.48
|
| Rate for Payer: BCN Commercial |
$369.48
|
| Rate for Payer: Cash Price |
$357.90
|
| Rate for Payer: Cofinity Commercial |
$384.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.90
|
| Rate for Payer: Healthscope Commercial |
$402.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.26
|
| Rate for Payer: Nomi Health Commercial |
$366.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.53
|
| Rate for Payer: PHP Commercial |
$380.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.69
|
| Rate for Payer: UHC Core |
$373.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.53
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
OP
|
$262.18
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$235.96 |
| Rate for Payer: Aetna Commercial |
$222.85
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.93
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$65.55
|
| Rate for Payer: BCBS Trust/PPO |
$215.54
|
| Rate for Payer: BCN Commercial |
$215.54
|
| Rate for Payer: BCN Medicare Advantage |
$65.55
|
| Rate for Payer: Cash Price |
$209.74
|
| Rate for Payer: Cofinity Commercial |
$225.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.55
|
| Rate for Payer: Healthscope Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.63
|
| Rate for Payer: Mclaren Medicaid |
$46.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.82
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.85
|
| Rate for Payer: Nomi Health Commercial |
$214.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.63
|
| Rate for Payer: PACE Senior Care Partners |
$62.27
|
| Rate for Payer: PACE SWMI |
$65.55
|
| Rate for Payer: PHP Commercial |
$222.85
|
| Rate for Payer: PHP Medicare Advantage |
$65.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.10
|
| Rate for Payer: Priority Health Medicare |
$66.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.72
|
| Rate for Payer: UHC Core |
$218.92
|
| Rate for Payer: UHC Exchange |
$65.55
|
| Rate for Payer: UHC Medicaid |
$46.22
|
| Rate for Payer: UHC Medicare Advantage |
$65.55
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: VA VA |
$65.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.63
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
IP
|
$262.18
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$182.48 |
| Max. Negotiated Rate |
$235.96 |
| Rate for Payer: Aetna Commercial |
$222.85
|
| Rate for Payer: BCBS Trust/PPO |
$216.53
|
| Rate for Payer: BCN Commercial |
$216.53
|
| Rate for Payer: Cash Price |
$209.74
|
| Rate for Payer: Cofinity Commercial |
$225.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.74
|
| Rate for Payer: Healthscope Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.85
|
| Rate for Payer: Nomi Health Commercial |
$214.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.63
|
| Rate for Payer: PHP Commercial |
$222.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.72
|
| Rate for Payer: UHC Core |
$218.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.63
|
|
