|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: Aetna Medicare |
$74.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.57
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$71.66
|
| Rate for Payer: BCBS Trust/PPO |
$235.63
|
| Rate for Payer: BCN Commercial |
$222.85
|
| Rate for Payer: BCN Medicare Advantage |
$71.66
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.96
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.24
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PACE Senior Care Partners |
$68.07
|
| Rate for Payer: PACE SWMI |
$71.66
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: PHP Medicare Advantage |
$71.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO |
$249.36
|
| Rate for Payer: Priority Health Medicare |
$72.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.04
|
| Rate for Payer: Railroad Medicare Medicare |
$71.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.23
|
| Rate for Payer: UHC Core |
$239.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.66
|
| Rate for Payer: UHC Exchange |
$71.66
|
| Rate for Payer: UHC Medicare Advantage |
$71.66
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$71.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.96
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: BCBS Trust/PPO |
$233.97
|
| Rate for Payer: BCN Commercial |
$221.50
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO |
$249.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.23
|
| Rate for Payer: UHC Core |
$239.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.96
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$785.40
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$510.51 |
| Max. Negotiated Rate |
$706.86 |
| Rate for Payer: Aetna Commercial |
$667.59
|
| Rate for Payer: BCBS Trust/PPO |
$641.12
|
| Rate for Payer: BCN Commercial |
$606.96
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$675.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Healthscope Commercial |
$706.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.59
|
| Rate for Payer: Nomi Health Commercial |
$644.03
|
| Rate for Payer: PHP Commercial |
$667.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.51
|
| Rate for Payer: Priority Health HMO/PPO |
$683.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.15
|
| Rate for Payer: UHC Core |
$655.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.05
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$785.40
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.53 |
| Max. Negotiated Rate |
$706.86 |
| Rate for Payer: Aetna Commercial |
$667.59
|
| Rate for Payer: Aetna Medicare |
$204.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.44
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$196.35
|
| Rate for Payer: BCBS Trust/PPO |
$645.68
|
| Rate for Payer: BCN Commercial |
$610.65
|
| Rate for Payer: BCN Medicare Advantage |
$196.35
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cash Price |
$628.32
|
| Rate for Payer: Cofinity Commercial |
$675.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.35
|
| Rate for Payer: Healthscope Commercial |
$706.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.05
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.17
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.59
|
| Rate for Payer: Nomi Health Commercial |
$644.03
|
| Rate for Payer: PACE Senior Care Partners |
$186.53
|
| Rate for Payer: PACE SWMI |
$196.35
|
| Rate for Payer: PHP Commercial |
$667.59
|
| Rate for Payer: PHP Medicare Advantage |
$196.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.51
|
| Rate for Payer: Priority Health HMO/PPO |
$683.30
|
| Rate for Payer: Priority Health Medicare |
$198.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.22
|
| Rate for Payer: Railroad Medicare Medicare |
$196.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.15
|
| Rate for Payer: UHC Core |
$655.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.35
|
| Rate for Payer: UHC Exchange |
$196.35
|
| Rate for Payer: UHC Medicare Advantage |
$196.35
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$196.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.05
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.07 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$51.09
|
| Rate for Payer: BCBS Trust/PPO |
$49.07
|
| Rate for Payer: BCN Commercial |
$46.45
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$51.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: Nomi Health Commercial |
$49.29
|
| Rate for Payer: PHP Commercial |
$51.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: Priority Health HMO/PPO |
$52.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.90
|
| Rate for Payer: UHC Core |
$50.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.08
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna Commercial |
$51.09
|
| Rate for Payer: Aetna Medicare |
$15.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.78
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$15.03
|
| Rate for Payer: BCBS Trust/PPO |
$49.42
|
| Rate for Payer: BCN Commercial |
$46.74
|
| Rate for Payer: BCN Medicare Advantage |
$15.03
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$51.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.03
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.08
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.78
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: Nomi Health Commercial |
$49.29
|
| Rate for Payer: PACE Senior Care Partners |
$14.28
|
| Rate for Payer: PACE SWMI |
$15.03
|
| Rate for Payer: PHP Commercial |
$51.09
|
| Rate for Payer: PHP Medicare Advantage |
$15.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: Priority Health HMO/PPO |
$52.30
|
| Rate for Payer: Priority Health Medicare |
$15.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.27
|
| Rate for Payer: Railroad Medicare Medicare |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.90
|
| Rate for Payer: UHC Core |
$50.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.03
|
| Rate for Payer: UHC Exchange |
$15.03
|
| Rate for Payer: UHC Medicare Advantage |
$15.03
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.08
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: BCBS Trust/PPO |
$489.85
|
| Rate for Payer: BCN Commercial |
$463.74
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.52 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$156.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.52
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$150.02
|
| Rate for Payer: BCBS Trust/PPO |
$493.33
|
| Rate for Payer: BCN Commercial |
$466.56
|
| Rate for Payer: BCN Medicare Advantage |
$150.02
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.02
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Senior Care Partners |
$142.52
|
| Rate for Payer: PACE SWMI |
$150.02
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$150.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Medicare |
$151.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: Railroad Medicare Medicare |
$150.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.02
|
| Rate for Payer: UHC Exchange |
$150.02
|
| Rate for Payer: UHC Medicare Advantage |
$150.02
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$390.05 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: BCBS Trust/PPO |
$489.85
|
| Rate for Payer: BCN Commercial |
$463.74
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.52 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$156.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.52
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$150.02
|
| Rate for Payer: BCBS Trust/PPO |
$493.33
|
| Rate for Payer: BCN Commercial |
$466.56
|
| Rate for Payer: BCN Medicare Advantage |
$150.02
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.02
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.52
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: Nomi Health Commercial |
$492.07
|
| Rate for Payer: PACE Senior Care Partners |
$142.52
|
| Rate for Payer: PACE SWMI |
$150.02
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$150.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health HMO/PPO |
$522.07
|
| Rate for Payer: Priority Health Medicare |
$151.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.05
|
| Rate for Payer: Railroad Medicare Medicare |
$150.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.07
|
| Rate for Payer: UHC Core |
$501.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.02
|
| Rate for Payer: UHC Exchange |
$150.02
|
| Rate for Payer: UHC Medicare Advantage |
$150.02
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$150.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,759.14 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,465.05
|
| Rate for Payer: BCN Commercial |
$3,280.40
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,693.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,844.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,735.45
|
| Rate for Payer: UHC Core |
$3,544.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,008.15 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna Medicare |
$1,103.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,326.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,326.51
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$1,061.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,489.67
|
| Rate for Payer: BCN Commercial |
$3,300.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.21
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.21
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.27
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,220.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,008.15
|
| Rate for Payer: PACE SWMI |
$1,061.21
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,693.00
|
| Rate for Payer: Priority Health Medicare |
$1,071.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,844.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,061.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,735.45
|
| Rate for Payer: UHC Core |
$3,544.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.21
|
| Rate for Payer: UHC Exchange |
$1,061.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.21
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$1,061.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,759.14 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,465.05
|
| Rate for Payer: BCN Commercial |
$3,280.40
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,693.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,844.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,735.45
|
| Rate for Payer: UHC Core |
$3,544.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,008.15 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna Medicare |
$1,103.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,326.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,326.51
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$1,061.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,489.67
|
| Rate for Payer: BCN Commercial |
$3,300.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,061.21
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,061.21
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,114.27
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,220.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: Nomi Health Commercial |
$3,480.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,008.15
|
| Rate for Payer: PACE SWMI |
$1,061.21
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,061.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,693.00
|
| Rate for Payer: Priority Health Medicare |
$1,071.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,844.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,061.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,735.45
|
| Rate for Payer: UHC Core |
$3,544.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,061.21
|
| Rate for Payer: UHC Exchange |
$1,061.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,061.21
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$1,061.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,698.28 |
| Max. Negotiated Rate |
$6,435.60 |
| Rate for Payer: Aetna Commercial |
$6,078.07
|
| Rate for Payer: Aetna Medicare |
$1,859.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,234.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,234.58
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$1,787.67
|
| Rate for Payer: BCBS Trust/PPO |
$5,878.57
|
| Rate for Payer: BCN Commercial |
$5,559.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,787.67
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$6,149.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,787.67
|
| Rate for Payer: Healthscope Commercial |
$6,435.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,363.00
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,877.05
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,055.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: Nomi Health Commercial |
$5,863.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,698.28
|
| Rate for Payer: PACE SWMI |
$1,787.67
|
| Rate for Payer: PHP Commercial |
$6,078.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,787.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: Priority Health HMO/PPO |
$6,221.08
|
| Rate for Payer: Priority Health Medicare |
$1,805.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,790.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,787.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,292.59
|
| Rate for Payer: UHC Core |
$5,970.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,787.67
|
| Rate for Payer: UHC Exchange |
$1,787.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,787.67
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$1,787.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,363.00
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,647.94 |
| Max. Negotiated Rate |
$6,435.60 |
| Rate for Payer: Aetna Commercial |
$6,078.07
|
| Rate for Payer: BCBS Trust/PPO |
$5,837.09
|
| Rate for Payer: BCN Commercial |
$5,526.04
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$6,149.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Healthscope Commercial |
$6,435.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,363.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: Nomi Health Commercial |
$5,863.55
|
| Rate for Payer: PHP Commercial |
$6,078.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: Priority Health HMO/PPO |
$6,221.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,790.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,292.59
|
| Rate for Payer: UHC Core |
$5,970.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,363.00
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,665.91 |
| Max. Negotiated Rate |
$2,306.65 |
| Rate for Payer: Aetna Commercial |
$2,178.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.13
|
| Rate for Payer: BCN Commercial |
$1,980.64
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$2,204.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Healthscope Commercial |
$2,306.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,922.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: Nomi Health Commercial |
$2,101.61
|
| Rate for Payer: PHP Commercial |
$2,178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health HMO/PPO |
$2,229.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,717.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,255.39
|
| Rate for Payer: UHC Core |
$2,140.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,922.20
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$608.70 |
| Max. Negotiated Rate |
$2,306.65 |
| Rate for Payer: Aetna Commercial |
$2,178.50
|
| Rate for Payer: Aetna Medicare |
$666.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$800.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$800.92
|
| Rate for Payer: BCBS Complete |
$1,411.07
|
| Rate for Payer: BCBS MAPPO |
$640.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.99
|
| Rate for Payer: BCN Commercial |
$1,992.69
|
| Rate for Payer: BCN Medicare Advantage |
$640.74
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$2,204.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.74
|
| Rate for Payer: Healthscope Commercial |
$2,306.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,922.20
|
| Rate for Payer: Mclaren Medicaid |
$1,343.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.77
|
| Rate for Payer: Meridian Medicaid |
$1,411.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$736.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: Nomi Health Commercial |
$2,101.61
|
| Rate for Payer: PACE Senior Care Partners |
$608.70
|
| Rate for Payer: PACE SWMI |
$640.74
|
| Rate for Payer: PHP Commercial |
$2,178.50
|
| Rate for Payer: PHP Medicare Advantage |
$640.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,343.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health HMO/PPO |
$2,229.76
|
| Rate for Payer: Priority Health Medicare |
$647.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,717.17
|
| Rate for Payer: Railroad Medicare Medicare |
$640.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,255.39
|
| Rate for Payer: UHC Core |
$2,140.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.74
|
| Rate for Payer: UHC Exchange |
$640.74
|
| Rate for Payer: UHC Medicare Advantage |
$640.74
|
| Rate for Payer: UHCCP Medicaid |
$1,343.79
|
| Rate for Payer: VA VA |
$640.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,922.20
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,816.97 |
| Max. Negotiated Rate |
$3,900.42 |
| Rate for Payer: Aetna Commercial |
$3,683.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,537.68
|
| Rate for Payer: BCN Commercial |
$3,349.16
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$3,727.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Healthscope Commercial |
$3,900.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: PHP Commercial |
$3,683.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health HMO/PPO |
$3,770.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,903.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,813.74
|
| Rate for Payer: UHC Core |
$3,618.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.35
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,029.28 |
| Max. Negotiated Rate |
$3,900.42 |
| Rate for Payer: Aetna Commercial |
$3,683.73
|
| Rate for Payer: Aetna Medicare |
$1,126.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,354.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,354.31
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$1,083.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,562.82
|
| Rate for Payer: BCN Commercial |
$3,369.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.45
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$3,727.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.45
|
| Rate for Payer: Healthscope Commercial |
$3,900.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.35
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.62
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,245.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: Nomi Health Commercial |
$3,553.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,029.28
|
| Rate for Payer: PACE SWMI |
$1,083.45
|
| Rate for Payer: PHP Commercial |
$3,683.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health HMO/PPO |
$3,770.41
|
| Rate for Payer: Priority Health Medicare |
$1,094.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,903.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,083.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,813.74
|
| Rate for Payer: UHC Core |
$3,618.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.45
|
| Rate for Payer: UHC Exchange |
$1,083.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.45
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$1,083.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.35
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$841.30 |
| Max. Negotiated Rate |
$3,188.10 |
| Rate for Payer: Aetna Commercial |
$3,010.98
|
| Rate for Payer: Aetna Medicare |
$921.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,106.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,106.98
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$885.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,912.15
|
| Rate for Payer: BCN Commercial |
$2,754.16
|
| Rate for Payer: BCN Medicare Advantage |
$885.58
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,046.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$885.58
|
| Rate for Payer: Healthscope Commercial |
$3,188.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,656.75
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$929.86
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,018.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: PACE Senior Care Partners |
$841.30
|
| Rate for Payer: PACE SWMI |
$885.58
|
| Rate for Payer: PHP Commercial |
$3,010.98
|
| Rate for Payer: PHP Medicare Advantage |
$885.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health HMO/PPO |
$3,081.83
|
| Rate for Payer: Priority Health Medicare |
$894.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,373.36
|
| Rate for Payer: Railroad Medicare Medicare |
$885.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,117.25
|
| Rate for Payer: UHC Core |
$2,957.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$885.58
|
| Rate for Payer: UHC Exchange |
$885.58
|
| Rate for Payer: UHC Medicare Advantage |
$885.58
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$885.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,656.75
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,302.51 |
| Max. Negotiated Rate |
$3,188.10 |
| Rate for Payer: Aetna Commercial |
$3,010.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,891.60
|
| Rate for Payer: BCN Commercial |
$2,737.51
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,046.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Healthscope Commercial |
$3,188.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,656.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: Nomi Health Commercial |
$2,904.71
|
| Rate for Payer: PHP Commercial |
$3,010.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health HMO/PPO |
$3,081.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,373.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,117.25
|
| Rate for Payer: UHC Core |
$2,957.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,656.75
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$309.69 |
| Max. Negotiated Rate |
$1,371.64 |
| Rate for Payer: Aetna Commercial |
$1,295.44
|
| Rate for Payer: Aetna Medicare |
$396.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$476.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$476.27
|
| Rate for Payer: BCBS Complete |
$325.20
|
| Rate for Payer: BCBS MAPPO |
$381.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,252.92
|
| Rate for Payer: BCN Commercial |
$1,184.95
|
| Rate for Payer: BCN Medicare Advantage |
$381.01
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,310.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.01
|
| Rate for Payer: Healthscope Commercial |
$1,371.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,143.04
|
| Rate for Payer: Mclaren Medicaid |
$309.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.06
|
| Rate for Payer: Meridian Medicaid |
$325.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: Nomi Health Commercial |
$1,249.72
|
| Rate for Payer: PACE Senior Care Partners |
$361.96
|
| Rate for Payer: PACE SWMI |
$381.01
|
| Rate for Payer: PHP Commercial |
$1,295.44
|
| Rate for Payer: PHP Medicare Advantage |
$381.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$309.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,325.92
|
| Rate for Payer: Priority Health Medicare |
$384.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,021.11
|
| Rate for Payer: Railroad Medicare Medicare |
$381.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,341.16
|
| Rate for Payer: UHC Core |
$1,272.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.01
|
| Rate for Payer: UHC Exchange |
$381.01
|
| Rate for Payer: UHC Medicare Advantage |
$381.01
|
| Rate for Payer: UHCCP Medicaid |
$309.69
|
| Rate for Payer: VA VA |
$381.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,143.04
|
|
