|
HC IMPELLA RP FLEX
|
Facility
|
OP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,509.38 |
| Max. Negotiated Rate |
$28,125.00 |
| Rate for Payer: Aetna Commercial |
$26,562.50
|
| Rate for Payer: Aetna Medicare |
$8,125.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,765.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,765.62
|
| Rate for Payer: BCBS Complete |
$5,784.38
|
| Rate for Payer: BCBS MAPPO |
$7,812.50
|
| Rate for Payer: BCBS Trust/PPO |
$25,690.62
|
| Rate for Payer: BCN Commercial |
$25,690.62
|
| Rate for Payer: BCN Medicare Advantage |
$7,812.50
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Commercial |
$26,875.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,812.50
|
| Rate for Payer: Healthscope Commercial |
$28,125.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,437.50
|
| Rate for Payer: Mclaren Medicaid |
$5,509.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,203.12
|
| Rate for Payer: Meridian Medicaid |
$5,784.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,984.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,593.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Nomi Health Commercial |
$25,625.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: PACE Senior Care Partners |
$7,421.88
|
| Rate for Payer: PACE SWMI |
$7,812.50
|
| Rate for Payer: PHP Commercial |
$26,562.50
|
| Rate for Payer: PHP Medicare Advantage |
$7,812.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,509.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27,187.50
|
| Rate for Payer: Priority Health Medicare |
$7,890.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,750.00
|
| Rate for Payer: Railroad Medicare Medicare |
$7,812.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,500.00
|
| Rate for Payer: UHC Core |
$26,093.75
|
| Rate for Payer: UHC Exchange |
$7,812.50
|
| Rate for Payer: UHC Medicaid |
$5,509.38
|
| Rate for Payer: UHC Medicare Advantage |
$7,812.50
|
| Rate for Payer: UHCCP Medicaid |
$5,509.38
|
| Rate for Payer: VA VA |
$7,812.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,437.50
|
|
|
HC IMPELLA RP FLEX
|
Facility
|
IP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,750.00 |
| Max. Negotiated Rate |
$28,125.00 |
| Rate for Payer: Aetna Commercial |
$26,562.50
|
| Rate for Payer: BCBS Trust/PPO |
$25,809.38
|
| Rate for Payer: BCN Commercial |
$25,809.38
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Commercial |
$26,875.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Healthscope Commercial |
$28,125.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,437.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Nomi Health Commercial |
$25,625.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: PHP Commercial |
$26,562.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27,187.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,750.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,500.00
|
| Rate for Payer: UHC Core |
$26,093.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,437.50
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,403.37 |
| Max. Negotiated Rate |
$5,694.01 |
| Rate for Payer: Aetna Commercial |
$5,377.68
|
| Rate for Payer: BCBS Trust/PPO |
$5,225.21
|
| Rate for Payer: BCN Commercial |
$5,225.21
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Commercial |
$5,440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Healthscope Commercial |
$5,694.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Nomi Health Commercial |
$5,187.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: PHP Commercial |
$5,377.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,504.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,403.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,567.48
|
| Rate for Payer: UHC Core |
$5,282.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.01
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,115.39 |
| Max. Negotiated Rate |
$5,694.01 |
| Rate for Payer: Aetna Commercial |
$5,377.68
|
| Rate for Payer: Aetna Medicare |
$1,644.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,977.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,977.09
|
| Rate for Payer: BCBS Complete |
$1,171.07
|
| Rate for Payer: BCBS MAPPO |
$1,581.67
|
| Rate for Payer: BCBS Trust/PPO |
$5,201.16
|
| Rate for Payer: BCN Commercial |
$5,201.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,581.67
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Commercial |
$5,440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,581.67
|
| Rate for Payer: Healthscope Commercial |
$5,694.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.01
|
| Rate for Payer: Mclaren Medicaid |
$1,115.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,660.75
|
| Rate for Payer: Meridian Medicaid |
$1,171.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,818.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,739.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Nomi Health Commercial |
$5,187.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: PACE Senior Care Partners |
$1,502.59
|
| Rate for Payer: PACE SWMI |
$1,581.67
|
| Rate for Payer: PHP Commercial |
$5,377.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,581.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,115.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,504.21
|
| Rate for Payer: Priority Health Medicare |
$1,597.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,403.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,581.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,567.48
|
| Rate for Payer: UHC Core |
$5,282.78
|
| Rate for Payer: UHC Exchange |
$1,581.67
|
| Rate for Payer: UHC Medicaid |
$1,115.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,581.67
|
| Rate for Payer: UHCCP Medicaid |
$1,115.39
|
| Rate for Payer: VA VA |
$1,581.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.01
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,972.63 |
| Max. Negotiated Rate |
$66,224.42 |
| Rate for Payer: Aetna Commercial |
$62,545.29
|
| Rate for Payer: Aetna Medicare |
$19,131.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,994.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,994.59
|
| Rate for Payer: BCBS Complete |
$13,620.16
|
| Rate for Payer: BCBS MAPPO |
$18,395.67
|
| Rate for Payer: BCBS Trust/PPO |
$60,492.33
|
| Rate for Payer: BCN Commercial |
$60,492.33
|
| Rate for Payer: BCN Medicare Advantage |
$18,395.67
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Commercial |
$63,281.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,395.67
|
| Rate for Payer: Healthscope Commercial |
$66,224.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55,187.02
|
| Rate for Payer: Mclaren Medicaid |
$12,972.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,315.46
|
| Rate for Payer: Meridian Medicaid |
$13,620.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,155.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,235.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Nomi Health Commercial |
$60,337.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: PACE Senior Care Partners |
$17,475.89
|
| Rate for Payer: PACE SWMI |
$18,395.67
|
| Rate for Payer: PHP Commercial |
$62,545.29
|
| Rate for Payer: PHP Medicare Advantage |
$18,395.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,972.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64,016.94
|
| Rate for Payer: Priority Health Medicare |
$18,579.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51,213.55
|
| Rate for Payer: Railroad Medicare Medicare |
$18,395.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64,752.77
|
| Rate for Payer: UHC Core |
$61,441.55
|
| Rate for Payer: UHC Exchange |
$18,395.67
|
| Rate for Payer: UHC Medicaid |
$12,972.63
|
| Rate for Payer: UHC Medicare Advantage |
$18,395.67
|
| Rate for Payer: UHCCP Medicaid |
$12,972.63
|
| Rate for Payer: VA VA |
$18,395.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55,187.02
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51,213.55 |
| Max. Negotiated Rate |
$66,224.42 |
| Rate for Payer: Aetna Commercial |
$62,545.29
|
| Rate for Payer: BCBS Trust/PPO |
$60,771.94
|
| Rate for Payer: BCN Commercial |
$60,771.94
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Commercial |
$63,281.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Healthscope Commercial |
$66,224.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55,187.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Nomi Health Commercial |
$60,337.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: PHP Commercial |
$62,545.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64,016.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51,213.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64,752.77
|
| Rate for Payer: UHC Core |
$61,441.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55,187.02
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.72 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: BCBS Trust/PPO |
$457.71
|
| Rate for Payer: BCN Commercial |
$457.71
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$482.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.70
|
| Rate for Payer: UHC Core |
$462.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.71 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna Medicare |
$144.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.19
|
| Rate for Payer: BCBS Complete |
$102.58
|
| Rate for Payer: BCBS MAPPO |
$138.55
|
| Rate for Payer: BCBS Trust/PPO |
$455.61
|
| Rate for Payer: BCN Commercial |
$455.61
|
| Rate for Payer: BCN Medicare Advantage |
$138.55
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.55
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Mclaren Medicaid |
$97.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.48
|
| Rate for Payer: Meridian Medicaid |
$102.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PACE Senior Care Partners |
$131.62
|
| Rate for Payer: PACE SWMI |
$138.55
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: PHP Medicare Advantage |
$138.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$482.15
|
| Rate for Payer: Priority Health Medicare |
$139.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.72
|
| Rate for Payer: Railroad Medicare Medicare |
$138.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.70
|
| Rate for Payer: UHC Core |
$462.76
|
| Rate for Payer: UHC Exchange |
$138.55
|
| Rate for Payer: UHC Medicaid |
$97.71
|
| Rate for Payer: UHC Medicare Advantage |
$138.55
|
| Rate for Payer: UHCCP Medicaid |
$97.71
|
| Rate for Payer: VA VA |
$138.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,281.39 |
| Max. Negotiated Rate |
$6,541.39 |
| Rate for Payer: Aetna Commercial |
$6,177.98
|
| Rate for Payer: Aetna Medicare |
$1,889.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,271.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,271.32
|
| Rate for Payer: BCBS Complete |
$1,345.35
|
| Rate for Payer: BCBS MAPPO |
$1,817.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,975.20
|
| Rate for Payer: BCN Commercial |
$5,975.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,817.05
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Commercial |
$6,250.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,817.05
|
| Rate for Payer: Healthscope Commercial |
$6,541.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,451.16
|
| Rate for Payer: Mclaren Medicaid |
$1,281.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,907.91
|
| Rate for Payer: Meridian Medicaid |
$1,345.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,089.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,998.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Nomi Health Commercial |
$5,959.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,726.20
|
| Rate for Payer: PACE SWMI |
$1,817.05
|
| Rate for Payer: PHP Commercial |
$6,177.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,817.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,281.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,323.34
|
| Rate for Payer: Priority Health Medicare |
$1,835.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,058.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,817.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,396.02
|
| Rate for Payer: UHC Core |
$6,068.96
|
| Rate for Payer: UHC Exchange |
$1,817.05
|
| Rate for Payer: UHC Medicaid |
$1,281.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,817.05
|
| Rate for Payer: UHCCP Medicaid |
$1,281.39
|
| Rate for Payer: VA VA |
$1,817.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,451.16
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$5,058.67 |
| Max. Negotiated Rate |
$6,541.39 |
| Rate for Payer: Aetna Commercial |
$6,177.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,002.81
|
| Rate for Payer: BCN Commercial |
$6,002.81
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Commercial |
$6,250.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Healthscope Commercial |
$6,541.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,451.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Nomi Health Commercial |
$5,959.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: PHP Commercial |
$6,177.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,323.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,058.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,396.02
|
| Rate for Payer: UHC Core |
$6,068.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,451.16
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$728.30 |
| Max. Negotiated Rate |
$3,717.90 |
| Rate for Payer: Aetna Commercial |
$3,511.35
|
| Rate for Payer: Aetna Medicare |
$1,074.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,290.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,290.94
|
| Rate for Payer: BCBS Complete |
$764.65
|
| Rate for Payer: BCBS MAPPO |
$1,032.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,396.10
|
| Rate for Payer: BCN Commercial |
$3,396.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,032.75
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Commercial |
$3,552.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,032.75
|
| Rate for Payer: Healthscope Commercial |
$3,717.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,098.25
|
| Rate for Payer: Mclaren Medicaid |
$728.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,084.39
|
| Rate for Payer: Meridian Medicaid |
$764.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,187.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,136.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Nomi Health Commercial |
$3,387.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: PACE Senior Care Partners |
$981.11
|
| Rate for Payer: PACE SWMI |
$1,032.75
|
| Rate for Payer: PHP Commercial |
$3,511.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,032.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$728.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,593.97
|
| Rate for Payer: Priority Health Medicare |
$1,043.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,032.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,635.28
|
| Rate for Payer: UHC Core |
$3,449.39
|
| Rate for Payer: UHC Exchange |
$1,032.75
|
| Rate for Payer: UHC Medicaid |
$728.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,032.75
|
| Rate for Payer: UHCCP Medicaid |
$728.30
|
| Rate for Payer: VA VA |
$1,032.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,098.25
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,875.18 |
| Max. Negotiated Rate |
$3,717.90 |
| Rate for Payer: Aetna Commercial |
$3,511.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,411.79
|
| Rate for Payer: BCN Commercial |
$3,411.79
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Commercial |
$3,552.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Healthscope Commercial |
$3,717.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,098.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Nomi Health Commercial |
$3,387.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: PHP Commercial |
$3,511.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,593.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,635.28
|
| Rate for Payer: UHC Core |
$3,449.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,098.25
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,841.75 |
| Max. Negotiated Rate |
$4,967.78 |
| Rate for Payer: Aetna Commercial |
$4,691.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,558.77
|
| Rate for Payer: BCN Commercial |
$4,558.77
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Commercial |
$4,746.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Healthscope Commercial |
$4,967.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,139.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Nomi Health Commercial |
$4,526.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: PHP Commercial |
$4,691.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,802.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,841.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,857.39
|
| Rate for Payer: UHC Core |
$4,609.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,139.82
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$973.13 |
| Max. Negotiated Rate |
$4,967.78 |
| Rate for Payer: Aetna Commercial |
$4,691.80
|
| Rate for Payer: Aetna Medicare |
$1,435.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,724.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,724.92
|
| Rate for Payer: BCBS Complete |
$1,021.71
|
| Rate for Payer: BCBS MAPPO |
$1,379.94
|
| Rate for Payer: BCBS Trust/PPO |
$4,537.79
|
| Rate for Payer: BCN Commercial |
$4,537.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.94
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Commercial |
$4,746.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.94
|
| Rate for Payer: Healthscope Commercial |
$4,967.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,139.82
|
| Rate for Payer: Mclaren Medicaid |
$973.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.94
|
| Rate for Payer: Meridian Medicaid |
$1,021.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Nomi Health Commercial |
$4,526.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: PACE Senior Care Partners |
$1,310.94
|
| Rate for Payer: PACE SWMI |
$1,379.94
|
| Rate for Payer: PHP Commercial |
$4,691.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$973.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,802.19
|
| Rate for Payer: Priority Health Medicare |
$1,393.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,841.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,857.39
|
| Rate for Payer: UHC Core |
$4,609.00
|
| Rate for Payer: UHC Exchange |
$1,379.94
|
| Rate for Payer: UHC Medicaid |
$973.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,379.94
|
| Rate for Payer: UHCCP Medicaid |
$973.13
|
| Rate for Payer: VA VA |
$1,379.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,139.82
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$992.16 |
| Max. Negotiated Rate |
$5,064.91 |
| Rate for Payer: Aetna Commercial |
$4,783.53
|
| Rate for Payer: Aetna Medicare |
$1,463.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,758.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,758.65
|
| Rate for Payer: BCBS Complete |
$1,041.68
|
| Rate for Payer: BCBS MAPPO |
$1,406.92
|
| Rate for Payer: BCBS Trust/PPO |
$4,626.52
|
| Rate for Payer: BCN Commercial |
$4,626.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,406.92
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Commercial |
$4,839.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,406.92
|
| Rate for Payer: Healthscope Commercial |
$5,064.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,220.76
|
| Rate for Payer: Mclaren Medicaid |
$992.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,477.27
|
| Rate for Payer: Meridian Medicaid |
$1,041.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,617.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,547.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Nomi Health Commercial |
$4,614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,336.57
|
| Rate for Payer: PACE SWMI |
$1,406.92
|
| Rate for Payer: PHP Commercial |
$4,783.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,406.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$992.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,896.08
|
| Rate for Payer: Priority Health Medicare |
$1,420.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,916.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,406.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,952.36
|
| Rate for Payer: UHC Core |
$4,699.11
|
| Rate for Payer: UHC Exchange |
$1,406.92
|
| Rate for Payer: UHC Medicaid |
$992.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,406.92
|
| Rate for Payer: UHCCP Medicaid |
$992.16
|
| Rate for Payer: VA VA |
$1,406.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,220.76
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,916.87 |
| Max. Negotiated Rate |
$5,064.91 |
| Rate for Payer: Aetna Commercial |
$4,783.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,647.90
|
| Rate for Payer: BCN Commercial |
$4,647.90
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Commercial |
$4,839.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Healthscope Commercial |
$5,064.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,220.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Nomi Health Commercial |
$4,614.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: PHP Commercial |
$4,783.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,896.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,916.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,952.36
|
| Rate for Payer: UHC Core |
$4,699.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,220.76
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.03 |
| Max. Negotiated Rate |
$102.19 |
| Rate for Payer: Aetna Commercial |
$96.52
|
| Rate for Payer: BCBS Trust/PPO |
$93.78
|
| Rate for Payer: BCN Commercial |
$93.78
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Nomi Health Commercial |
$93.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: PHP Commercial |
$96.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$98.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.92
|
| Rate for Payer: UHC Core |
$94.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.16
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$102.19 |
| Rate for Payer: Aetna Commercial |
$96.52
|
| Rate for Payer: Aetna Medicare |
$29.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.48
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$28.39
|
| Rate for Payer: BCBS Trust/PPO |
$93.35
|
| Rate for Payer: BCN Commercial |
$93.35
|
| Rate for Payer: BCN Medicare Advantage |
$28.39
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.39
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.16
|
| Rate for Payer: Mclaren Medicaid |
$20.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.81
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Nomi Health Commercial |
$93.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: PACE Senior Care Partners |
$26.97
|
| Rate for Payer: PACE SWMI |
$28.39
|
| Rate for Payer: PHP Commercial |
$96.52
|
| Rate for Payer: PHP Medicare Advantage |
$28.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$98.79
|
| Rate for Payer: Priority Health Medicare |
$28.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.03
|
| Rate for Payer: Railroad Medicare Medicare |
$28.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.92
|
| Rate for Payer: UHC Core |
$94.81
|
| Rate for Payer: UHC Exchange |
$28.39
|
| Rate for Payer: UHC Medicaid |
$20.02
|
| Rate for Payer: UHC Medicare Advantage |
$28.39
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
| Rate for Payer: VA VA |
$28.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.16
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$347.88 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: BCBS Trust/PPO |
$412.81
|
| Rate for Payer: BCN Commercial |
$412.81
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.85
|
| Rate for Payer: UHC Core |
$417.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.12 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna Medicare |
$129.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.20
|
| Rate for Payer: BCBS Complete |
$92.52
|
| Rate for Payer: BCBS MAPPO |
$124.96
|
| Rate for Payer: BCBS Trust/PPO |
$410.91
|
| Rate for Payer: BCN Commercial |
$410.91
|
| Rate for Payer: BCN Medicare Advantage |
$124.96
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.96
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Mclaren Medicaid |
$88.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.21
|
| Rate for Payer: Meridian Medicaid |
$92.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$409.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PACE Senior Care Partners |
$118.71
|
| Rate for Payer: PACE SWMI |
$124.96
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: PHP Medicare Advantage |
$124.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.85
|
| Rate for Payer: Priority Health Medicare |
$126.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.88
|
| Rate for Payer: Railroad Medicare Medicare |
$124.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.85
|
| Rate for Payer: UHC Core |
$417.36
|
| Rate for Payer: UHC Exchange |
$124.96
|
| Rate for Payer: UHC Medicaid |
$88.12
|
| Rate for Payer: UHC Medicare Advantage |
$124.96
|
| Rate for Payer: UHCCP Medicaid |
$88.12
|
| Rate for Payer: VA VA |
$124.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$360.39 |
| Max. Negotiated Rate |
$1,839.78 |
| Rate for Payer: Aetna Commercial |
$1,737.57
|
| Rate for Payer: Aetna Medicare |
$531.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$638.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$638.81
|
| Rate for Payer: BCBS Complete |
$378.38
|
| Rate for Payer: BCBS MAPPO |
$511.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,680.54
|
| Rate for Payer: BCN Commercial |
$1,680.54
|
| Rate for Payer: BCN Medicare Advantage |
$511.05
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Commercial |
$1,758.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.05
|
| Rate for Payer: Healthscope Commercial |
$1,839.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.15
|
| Rate for Payer: Mclaren Medicaid |
$360.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.60
|
| Rate for Payer: Meridian Medicaid |
$378.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$587.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$562.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Nomi Health Commercial |
$1,676.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: PACE Senior Care Partners |
$485.50
|
| Rate for Payer: PACE SWMI |
$511.05
|
| Rate for Payer: PHP Commercial |
$1,737.57
|
| Rate for Payer: PHP Medicare Advantage |
$511.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,778.45
|
| Rate for Payer: Priority Health Medicare |
$516.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.76
|
| Rate for Payer: Railroad Medicare Medicare |
$511.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,798.90
|
| Rate for Payer: UHC Core |
$1,706.91
|
| Rate for Payer: UHC Exchange |
$511.05
|
| Rate for Payer: UHC Medicaid |
$360.39
|
| Rate for Payer: UHC Medicare Advantage |
$511.05
|
| Rate for Payer: UHCCP Medicaid |
$360.39
|
| Rate for Payer: VA VA |
$511.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.15
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,422.76 |
| Max. Negotiated Rate |
$1,839.78 |
| Rate for Payer: Aetna Commercial |
$1,737.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,688.30
|
| Rate for Payer: BCN Commercial |
$1,688.30
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Commercial |
$1,758.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Healthscope Commercial |
$1,839.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Nomi Health Commercial |
$1,676.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: PHP Commercial |
$1,737.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,778.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,422.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,798.90
|
| Rate for Payer: UHC Core |
$1,706.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.15
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.99 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Medicare |
$166.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.28
|
| Rate for Payer: BCBS Complete |
$118.63
|
| Rate for Payer: BCBS MAPPO |
$160.22
|
| Rate for Payer: BCBS Trust/PPO |
$526.88
|
| Rate for Payer: BCN Commercial |
$526.88
|
| Rate for Payer: BCN Medicare Advantage |
$160.22
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.22
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Mclaren Medicaid |
$112.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.23
|
| Rate for Payer: Meridian Medicaid |
$118.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PACE Senior Care Partners |
$152.21
|
| Rate for Payer: PACE SWMI |
$160.22
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: PHP Medicare Advantage |
$160.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$557.57
|
| Rate for Payer: Priority Health Medicare |
$161.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.06
|
| Rate for Payer: Railroad Medicare Medicare |
$160.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.98
|
| Rate for Payer: UHC Core |
$535.14
|
| Rate for Payer: UHC Exchange |
$160.22
|
| Rate for Payer: UHC Medicaid |
$112.99
|
| Rate for Payer: UHC Medicare Advantage |
$160.22
|
| Rate for Payer: UHCCP Medicaid |
$112.99
|
| Rate for Payer: VA VA |
$160.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$446.06 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: BCBS Trust/PPO |
$529.31
|
| Rate for Payer: BCN Commercial |
$529.31
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$557.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.98
|
| Rate for Payer: UHC Core |
$535.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,658.06 |
| Max. Negotiated Rate |
$7,316.46 |
| Rate for Payer: Aetna Commercial |
$6,909.99
|
| Rate for Payer: BCBS Trust/PPO |
$6,714.07
|
| Rate for Payer: BCN Commercial |
$6,714.07
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cofinity Commercial |
$6,991.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,503.52
|
| Rate for Payer: Healthscope Commercial |
$7,316.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,097.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,909.99
|
| Rate for Payer: Nomi Health Commercial |
$6,666.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,097.05
|
| Rate for Payer: PHP Commercial |
$6,909.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,072.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,658.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,153.87
|
| Rate for Payer: UHC Core |
$6,788.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,097.05
|
|
