|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,433.21 |
| Max. Negotiated Rate |
$7,316.46 |
| Rate for Payer: Aetna Commercial |
$6,909.99
|
| Rate for Payer: Aetna Medicare |
$2,113.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,540.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,540.44
|
| Rate for Payer: BCBS Complete |
$1,504.75
|
| Rate for Payer: BCBS MAPPO |
$2,032.35
|
| Rate for Payer: BCBS Trust/PPO |
$6,683.18
|
| Rate for Payer: BCN Commercial |
$6,683.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,032.35
|
| 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: Health Alliance Plan Medicare Advantage |
$2,032.35
|
| Rate for Payer: Healthscope Commercial |
$7,316.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,097.05
|
| Rate for Payer: Mclaren Medicaid |
$1,433.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,133.97
|
| Rate for Payer: Meridian Medicaid |
$1,504.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,337.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,235.59
|
| 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: PACE Senior Care Partners |
$1,930.73
|
| Rate for Payer: PACE SWMI |
$2,032.35
|
| Rate for Payer: PHP Commercial |
$6,909.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,032.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,072.58
|
| Rate for Payer: Priority Health Medicare |
$2,052.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,658.06
|
| Rate for Payer: Railroad Medicare Medicare |
$2,032.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,153.87
|
| Rate for Payer: UHC Core |
$6,788.05
|
| Rate for Payer: UHC Exchange |
$2,032.35
|
| Rate for Payer: UHC Medicaid |
$1,433.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,032.35
|
| Rate for Payer: UHCCP Medicaid |
$1,433.21
|
| Rate for Payer: VA VA |
$2,032.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,097.05
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
IP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,135.24 |
| Max. Negotiated Rate |
$7,933.50 |
| Rate for Payer: Aetna Commercial |
$7,492.75
|
| Rate for Payer: BCBS Trust/PPO |
$7,280.31
|
| Rate for Payer: BCN Commercial |
$7,280.31
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Commercial |
$7,580.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$7,933.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,611.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Nomi Health Commercial |
$7,228.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: PHP Commercial |
$7,492.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,669.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,135.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,757.20
|
| Rate for Payer: UHC Core |
$7,360.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,611.25
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
OP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,554.08 |
| Max. Negotiated Rate |
$7,933.50 |
| Rate for Payer: Aetna Commercial |
$7,492.75
|
| Rate for Payer: Aetna Medicare |
$2,291.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,754.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,754.69
|
| Rate for Payer: BCBS Complete |
$1,631.66
|
| Rate for Payer: BCBS MAPPO |
$2,203.75
|
| Rate for Payer: BCBS Trust/PPO |
$7,246.81
|
| Rate for Payer: BCN Commercial |
$7,246.81
|
| Rate for Payer: BCN Medicare Advantage |
$2,203.75
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Commercial |
$7,580.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,203.75
|
| Rate for Payer: Healthscope Commercial |
$7,933.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,611.25
|
| Rate for Payer: Mclaren Medicaid |
$1,554.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,313.94
|
| Rate for Payer: Meridian Medicaid |
$1,631.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,534.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,424.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Nomi Health Commercial |
$7,228.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: PACE Senior Care Partners |
$2,093.56
|
| Rate for Payer: PACE SWMI |
$2,203.75
|
| Rate for Payer: PHP Commercial |
$7,492.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,203.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,554.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,669.05
|
| Rate for Payer: Priority Health Medicare |
$2,225.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,135.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,203.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,757.20
|
| Rate for Payer: UHC Core |
$7,360.52
|
| Rate for Payer: UHC Exchange |
$2,203.75
|
| Rate for Payer: UHC Medicaid |
$1,554.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,203.75
|
| Rate for Payer: UHCCP Medicaid |
$1,554.08
|
| Rate for Payer: VA VA |
$2,203.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,611.25
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.22 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna Medicare |
$175.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.33
|
| Rate for Payer: BCBS Complete |
$125.18
|
| Rate for Payer: BCBS MAPPO |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$555.95
|
| Rate for Payer: BCN Commercial |
$555.95
|
| Rate for Payer: BCN Medicare Advantage |
$169.06
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.06
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Mclaren Medicaid |
$119.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.52
|
| Rate for Payer: Meridian Medicaid |
$125.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PACE Senior Care Partners |
$160.61
|
| Rate for Payer: PACE SWMI |
$169.06
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: PHP Medicare Advantage |
$169.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Medicare |
$170.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.68
|
| Rate for Payer: Railroad Medicare Medicare |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: UHC Exchange |
$169.06
|
| Rate for Payer: UHC Medicaid |
$119.22
|
| Rate for Payer: UHC Medicare Advantage |
$169.06
|
| Rate for Payer: UHCCP Medicaid |
$119.22
|
| Rate for Payer: VA VA |
$169.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$470.68 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: BCBS Trust/PPO |
$558.52
|
| Rate for Payer: BCN Commercial |
$558.52
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,321.20 |
| Max. Negotiated Rate |
$1,708.44 |
| Rate for Payer: Aetna Commercial |
$1,613.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,567.78
|
| Rate for Payer: BCN Commercial |
$1,567.78
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Commercial |
$1,632.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Healthscope Commercial |
$1,708.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Nomi Health Commercial |
$1,556.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: PHP Commercial |
$1,613.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,651.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,321.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.48
|
| Rate for Payer: UHC Core |
$1,585.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.70
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.67 |
| Max. Negotiated Rate |
$1,708.44 |
| Rate for Payer: Aetna Commercial |
$1,613.53
|
| Rate for Payer: Aetna Medicare |
$493.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.21
|
| Rate for Payer: BCBS Complete |
$351.37
|
| Rate for Payer: BCBS MAPPO |
$474.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,560.57
|
| Rate for Payer: BCN Commercial |
$1,560.57
|
| Rate for Payer: BCN Medicare Advantage |
$474.57
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Commercial |
$1,632.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.57
|
| Rate for Payer: Healthscope Commercial |
$1,708.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.70
|
| Rate for Payer: Mclaren Medicaid |
$334.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.30
|
| Rate for Payer: Meridian Medicaid |
$351.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$545.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$522.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Nomi Health Commercial |
$1,556.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: PACE Senior Care Partners |
$450.84
|
| Rate for Payer: PACE SWMI |
$474.57
|
| Rate for Payer: PHP Commercial |
$1,613.53
|
| Rate for Payer: PHP Medicare Advantage |
$474.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,651.49
|
| Rate for Payer: Priority Health Medicare |
$479.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,321.20
|
| Rate for Payer: Railroad Medicare Medicare |
$474.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.48
|
| Rate for Payer: UHC Core |
$1,585.06
|
| Rate for Payer: UHC Exchange |
$474.57
|
| Rate for Payer: UHC Medicaid |
$334.67
|
| Rate for Payer: UHC Medicare Advantage |
$474.57
|
| Rate for Payer: UHCCP Medicaid |
$334.67
|
| Rate for Payer: VA VA |
$474.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.70
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$174.55 |
| Max. Negotiated Rate |
$891.09 |
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: Aetna Medicare |
$257.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.41
|
| Rate for Payer: BCBS Complete |
$183.27
|
| Rate for Payer: BCBS MAPPO |
$247.53
|
| Rate for Payer: BCBS Trust/PPO |
$813.96
|
| Rate for Payer: BCN Commercial |
$813.96
|
| Rate for Payer: BCN Medicare Advantage |
$247.53
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.53
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$742.58
|
| Rate for Payer: Mclaren Medicaid |
$174.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.90
|
| Rate for Payer: Meridian Medicaid |
$183.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$272.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$811.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: PACE Senior Care Partners |
$235.15
|
| Rate for Payer: PACE SWMI |
$247.53
|
| Rate for Payer: PHP Commercial |
$841.59
|
| Rate for Payer: PHP Medicare Advantage |
$247.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$861.39
|
| Rate for Payer: Priority Health Medicare |
$250.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.11
|
| Rate for Payer: Railroad Medicare Medicare |
$247.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.29
|
| Rate for Payer: UHC Core |
$826.73
|
| Rate for Payer: UHC Exchange |
$247.53
|
| Rate for Payer: UHC Medicaid |
$174.55
|
| Rate for Payer: UHC Medicare Advantage |
$247.53
|
| Rate for Payer: UHCCP Medicaid |
$174.55
|
| Rate for Payer: VA VA |
$247.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$742.58
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$689.11 |
| Max. Negotiated Rate |
$891.09 |
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: BCBS Trust/PPO |
$817.72
|
| Rate for Payer: BCN Commercial |
$817.72
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$742.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$811.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: PHP Commercial |
$841.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$861.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$871.29
|
| Rate for Payer: UHC Core |
$826.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$742.58
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.58 |
| Max. Negotiated Rate |
$273.50 |
| Rate for Payer: Aetna Commercial |
$258.31
|
| Rate for Payer: Aetna Medicare |
$79.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.97
|
| Rate for Payer: BCBS Complete |
$56.25
|
| Rate for Payer: BCBS MAPPO |
$75.97
|
| Rate for Payer: BCBS Trust/PPO |
$249.83
|
| Rate for Payer: BCN Commercial |
$249.83
|
| Rate for Payer: BCN Medicare Advantage |
$75.97
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Commercial |
$261.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.97
|
| Rate for Payer: Healthscope Commercial |
$273.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.92
|
| Rate for Payer: Mclaren Medicaid |
$53.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.77
|
| Rate for Payer: Meridian Medicaid |
$56.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$249.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: PACE Senior Care Partners |
$72.17
|
| Rate for Payer: PACE SWMI |
$75.97
|
| Rate for Payer: PHP Commercial |
$258.31
|
| Rate for Payer: PHP Medicare Advantage |
$75.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$264.38
|
| Rate for Payer: Priority Health Medicare |
$76.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.51
|
| Rate for Payer: Railroad Medicare Medicare |
$75.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.42
|
| Rate for Payer: UHC Core |
$253.75
|
| Rate for Payer: UHC Exchange |
$75.97
|
| Rate for Payer: UHC Medicaid |
$53.58
|
| Rate for Payer: UHC Medicare Advantage |
$75.97
|
| Rate for Payer: UHCCP Medicaid |
$53.58
|
| Rate for Payer: VA VA |
$75.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.92
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.51 |
| Max. Negotiated Rate |
$273.50 |
| Rate for Payer: Aetna Commercial |
$258.31
|
| Rate for Payer: BCBS Trust/PPO |
$250.98
|
| Rate for Payer: BCN Commercial |
$250.98
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Commercial |
$261.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Healthscope Commercial |
$273.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$249.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: PHP Commercial |
$258.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$264.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.42
|
| Rate for Payer: UHC Core |
$253.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.92
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$977.56 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.01
|
| Rate for Payer: BCN Commercial |
$1,160.01
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,221.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$977.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.00
|
| Rate for Payer: UHC Core |
$1,172.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.62 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna Medicare |
$365.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.92
|
| Rate for Payer: BCBS Complete |
$259.98
|
| Rate for Payer: BCBS MAPPO |
$351.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,154.67
|
| Rate for Payer: BCN Commercial |
$1,154.67
|
| Rate for Payer: BCN Medicare Advantage |
$351.13
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.13
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Mclaren Medicaid |
$247.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.69
|
| Rate for Payer: Meridian Medicaid |
$259.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$386.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Senior Care Partners |
$333.58
|
| Rate for Payer: PACE SWMI |
$351.13
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: PHP Medicare Advantage |
$351.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,221.95
|
| Rate for Payer: Priority Health Medicare |
$354.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$977.56
|
| Rate for Payer: Railroad Medicare Medicare |
$351.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.00
|
| Rate for Payer: UHC Core |
$1,172.79
|
| Rate for Payer: UHC Exchange |
$351.13
|
| Rate for Payer: UHC Medicaid |
$247.62
|
| Rate for Payer: UHC Medicare Advantage |
$351.13
|
| Rate for Payer: UHCCP Medicaid |
$247.62
|
| Rate for Payer: VA VA |
$351.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$503.09 |
| Max. Negotiated Rate |
$2,568.23 |
| Rate for Payer: Aetna Commercial |
$2,425.55
|
| Rate for Payer: Aetna Medicare |
$741.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$891.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$891.75
|
| Rate for Payer: BCBS Complete |
$528.20
|
| Rate for Payer: BCBS MAPPO |
$713.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.94
|
| Rate for Payer: BCN Commercial |
$2,345.94
|
| Rate for Payer: BCN Medicare Advantage |
$713.40
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Commercial |
$2,454.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.40
|
| Rate for Payer: Healthscope Commercial |
$2,568.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,140.19
|
| Rate for Payer: Mclaren Medicaid |
$503.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$749.07
|
| Rate for Payer: Meridian Medicaid |
$528.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$784.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Nomi Health Commercial |
$2,339.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: PACE Senior Care Partners |
$677.73
|
| Rate for Payer: PACE SWMI |
$713.40
|
| Rate for Payer: PHP Commercial |
$2,425.55
|
| Rate for Payer: PHP Medicare Advantage |
$713.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$503.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,482.62
|
| Rate for Payer: Priority Health Medicare |
$720.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,986.10
|
| Rate for Payer: Railroad Medicare Medicare |
$713.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,511.16
|
| Rate for Payer: UHC Core |
$2,382.75
|
| Rate for Payer: UHC Exchange |
$713.40
|
| Rate for Payer: UHC Medicaid |
$503.09
|
| Rate for Payer: UHC Medicare Advantage |
$713.40
|
| Rate for Payer: UHCCP Medicaid |
$503.09
|
| Rate for Payer: VA VA |
$713.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,140.19
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,986.10 |
| Max. Negotiated Rate |
$2,568.23 |
| Rate for Payer: Aetna Commercial |
$2,425.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,356.78
|
| Rate for Payer: BCN Commercial |
$2,356.78
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Commercial |
$2,454.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Healthscope Commercial |
$2,568.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,140.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Nomi Health Commercial |
$2,339.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: PHP Commercial |
$2,425.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,482.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,986.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,511.16
|
| Rate for Payer: UHC Core |
$2,382.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,140.19
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,189.62
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$827.98 |
| Max. Negotiated Rate |
$1,070.66 |
| Rate for Payer: Aetna Commercial |
$1,011.18
|
| Rate for Payer: BCBS Trust/PPO |
$982.51
|
| Rate for Payer: BCN Commercial |
$982.51
|
| Rate for Payer: Cash Price |
$951.70
|
| Rate for Payer: Cofinity Commercial |
$1,023.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$951.70
|
| Rate for Payer: Healthscope Commercial |
$1,070.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.18
|
| Rate for Payer: Nomi Health Commercial |
$975.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.22
|
| Rate for Payer: PHP Commercial |
$1,011.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,034.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,046.87
|
| Rate for Payer: UHC Core |
$993.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.22
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,189.62
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$209.73 |
| Max. Negotiated Rate |
$1,070.66 |
| Rate for Payer: Aetna Commercial |
$1,011.18
|
| Rate for Payer: Aetna Medicare |
$309.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$371.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$371.76
|
| Rate for Payer: BCBS Complete |
$220.20
|
| Rate for Payer: BCBS MAPPO |
$297.40
|
| Rate for Payer: BCBS Trust/PPO |
$977.99
|
| Rate for Payer: BCN Commercial |
$977.99
|
| Rate for Payer: BCN Medicare Advantage |
$297.40
|
| Rate for Payer: Cash Price |
$951.70
|
| Rate for Payer: Cofinity Commercial |
$1,023.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$951.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.40
|
| Rate for Payer: Healthscope Commercial |
$1,070.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.22
|
| Rate for Payer: Mclaren Medicaid |
$209.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.28
|
| Rate for Payer: Meridian Medicaid |
$220.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$327.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.18
|
| Rate for Payer: Nomi Health Commercial |
$975.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.22
|
| Rate for Payer: PACE Senior Care Partners |
$282.53
|
| Rate for Payer: PACE SWMI |
$297.40
|
| Rate for Payer: PHP Commercial |
$1,011.18
|
| Rate for Payer: PHP Medicare Advantage |
$297.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,034.97
|
| Rate for Payer: Priority Health Medicare |
$300.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.98
|
| Rate for Payer: Railroad Medicare Medicare |
$297.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,046.87
|
| Rate for Payer: UHC Core |
$993.33
|
| Rate for Payer: UHC Exchange |
$297.40
|
| Rate for Payer: UHC Medicaid |
$209.73
|
| Rate for Payer: UHC Medicare Advantage |
$297.40
|
| Rate for Payer: UHCCP Medicaid |
$209.73
|
| Rate for Payer: VA VA |
$297.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.22
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$104.89 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.92
|
| Rate for Payer: BCBS Complete |
$110.13
|
| Rate for Payer: BCBS MAPPO |
$148.74
|
| Rate for Payer: BCBS Trust/PPO |
$489.11
|
| Rate for Payer: BCN Commercial |
$489.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.74
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.74
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Mclaren Medicaid |
$104.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.17
|
| Rate for Payer: Meridian Medicaid |
$110.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Senior Care Partners |
$141.30
|
| Rate for Payer: PACE SWMI |
$148.74
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$148.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Medicare |
$150.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: Railroad Medicare Medicare |
$148.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: UHC Exchange |
$148.74
|
| Rate for Payer: UHC Medicaid |
$104.89
|
| Rate for Payer: UHC Medicare Advantage |
$148.74
|
| Rate for Payer: UHCCP Medicaid |
$104.89
|
| Rate for Payer: VA VA |
$148.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$414.09 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: BCBS Trust/PPO |
$491.37
|
| Rate for Payer: BCN Commercial |
$491.37
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,714.36
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,889.19 |
| Max. Negotiated Rate |
$2,442.92 |
| Rate for Payer: Aetna Commercial |
$2,307.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,241.79
|
| Rate for Payer: BCN Commercial |
$2,241.79
|
| Rate for Payer: Cash Price |
$2,171.49
|
| Rate for Payer: Cofinity Commercial |
$2,334.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,171.49
|
| Rate for Payer: Healthscope Commercial |
$2,442.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,035.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.21
|
| Rate for Payer: Nomi Health Commercial |
$2,225.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,035.77
|
| Rate for Payer: PHP Commercial |
$2,307.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,361.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,889.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,388.64
|
| Rate for Payer: UHC Core |
$2,266.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,035.77
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
OP
|
$2,714.36
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$478.54 |
| Max. Negotiated Rate |
$2,442.92 |
| Rate for Payer: Aetna Commercial |
$2,307.21
|
| Rate for Payer: Aetna Medicare |
$705.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.24
|
| Rate for Payer: BCBS Complete |
$502.43
|
| Rate for Payer: BCBS MAPPO |
$678.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,231.48
|
| Rate for Payer: BCN Commercial |
$2,231.48
|
| Rate for Payer: BCN Medicare Advantage |
$678.59
|
| Rate for Payer: Cash Price |
$2,171.49
|
| Rate for Payer: Cofinity Commercial |
$2,334.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,171.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.59
|
| Rate for Payer: Healthscope Commercial |
$2,442.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,035.77
|
| Rate for Payer: Mclaren Medicaid |
$478.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.52
|
| Rate for Payer: Meridian Medicaid |
$502.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$746.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.21
|
| Rate for Payer: Nomi Health Commercial |
$2,225.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,035.77
|
| Rate for Payer: PACE Senior Care Partners |
$644.66
|
| Rate for Payer: PACE SWMI |
$678.59
|
| Rate for Payer: PHP Commercial |
$2,307.21
|
| Rate for Payer: PHP Medicare Advantage |
$678.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,361.49
|
| Rate for Payer: Priority Health Medicare |
$685.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,889.19
|
| Rate for Payer: Railroad Medicare Medicare |
$678.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,388.64
|
| Rate for Payer: UHC Core |
$2,266.49
|
| Rate for Payer: UHC Exchange |
$678.59
|
| Rate for Payer: UHC Medicaid |
$478.54
|
| Rate for Payer: UHC Medicare Advantage |
$678.59
|
| Rate for Payer: UHCCP Medicaid |
$478.54
|
| Rate for Payer: VA VA |
$678.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,035.77
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
OP
|
$168.05
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$29.63 |
| Max. Negotiated Rate |
$151.25 |
| Rate for Payer: Aetna Commercial |
$142.84
|
| Rate for Payer: Aetna Medicare |
$43.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.52
|
| Rate for Payer: BCBS Complete |
$31.11
|
| Rate for Payer: BCBS MAPPO |
$42.01
|
| Rate for Payer: BCBS Trust/PPO |
$138.15
|
| Rate for Payer: BCN Commercial |
$138.15
|
| Rate for Payer: BCN Medicare Advantage |
$42.01
|
| Rate for Payer: Cash Price |
$134.44
|
| Rate for Payer: Cofinity Commercial |
$144.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.01
|
| Rate for Payer: Healthscope Commercial |
$151.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.04
|
| Rate for Payer: Mclaren Medicaid |
$29.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.11
|
| Rate for Payer: Meridian Medicaid |
$31.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.84
|
| Rate for Payer: Nomi Health Commercial |
$137.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.04
|
| Rate for Payer: PACE Senior Care Partners |
$39.91
|
| Rate for Payer: PACE SWMI |
$42.01
|
| Rate for Payer: PHP Commercial |
$142.84
|
| Rate for Payer: PHP Medicare Advantage |
$42.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$146.20
|
| Rate for Payer: Priority Health Medicare |
$42.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.96
|
| Rate for Payer: Railroad Medicare Medicare |
$42.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.88
|
| Rate for Payer: UHC Core |
$140.32
|
| Rate for Payer: UHC Exchange |
$42.01
|
| Rate for Payer: UHC Medicaid |
$29.63
|
| Rate for Payer: UHC Medicare Advantage |
$42.01
|
| Rate for Payer: UHCCP Medicaid |
$29.63
|
| Rate for Payer: VA VA |
$42.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.04
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
IP
|
$168.05
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$116.96 |
| Max. Negotiated Rate |
$151.25 |
| Rate for Payer: Aetna Commercial |
$142.84
|
| Rate for Payer: BCBS Trust/PPO |
$138.79
|
| Rate for Payer: BCN Commercial |
$138.79
|
| Rate for Payer: Cash Price |
$134.44
|
| Rate for Payer: Cofinity Commercial |
$144.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.44
|
| Rate for Payer: Healthscope Commercial |
$151.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.84
|
| Rate for Payer: Nomi Health Commercial |
$137.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.04
|
| Rate for Payer: PHP Commercial |
$142.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$146.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.88
|
| Rate for Payer: UHC Core |
$140.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.04
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
IP
|
$3,828.30
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,664.50 |
| Max. Negotiated Rate |
$3,445.47 |
| Rate for Payer: Aetna Commercial |
$3,254.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,161.79
|
| Rate for Payer: BCN Commercial |
$3,161.79
|
| Rate for Payer: Cash Price |
$3,062.64
|
| Rate for Payer: Cofinity Commercial |
$3,292.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,062.64
|
| Rate for Payer: Healthscope Commercial |
$3,445.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,871.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,254.05
|
| Rate for Payer: Nomi Health Commercial |
$3,139.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,871.22
|
| Rate for Payer: PHP Commercial |
$3,254.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,330.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,664.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.90
|
| Rate for Payer: UHC Core |
$3,196.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,871.22
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
OP
|
$3,828.30
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$674.93 |
| Max. Negotiated Rate |
$3,445.47 |
| Rate for Payer: Aetna Commercial |
$3,254.05
|
| Rate for Payer: Aetna Medicare |
$995.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,196.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,196.34
|
| Rate for Payer: BCBS Complete |
$708.62
|
| Rate for Payer: BCBS MAPPO |
$957.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,147.25
|
| Rate for Payer: BCN Commercial |
$3,147.25
|
| Rate for Payer: BCN Medicare Advantage |
$957.08
|
| Rate for Payer: Cash Price |
$3,062.64
|
| Rate for Payer: Cofinity Commercial |
$3,292.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,062.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$957.08
|
| Rate for Payer: Healthscope Commercial |
$3,445.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,871.22
|
| Rate for Payer: Mclaren Medicaid |
$674.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.93
|
| Rate for Payer: Meridian Medicaid |
$708.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,100.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,052.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,254.05
|
| Rate for Payer: Nomi Health Commercial |
$3,139.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,871.22
|
| Rate for Payer: PACE Senior Care Partners |
$909.22
|
| Rate for Payer: PACE SWMI |
$957.08
|
| Rate for Payer: PHP Commercial |
$3,254.05
|
| Rate for Payer: PHP Medicare Advantage |
$957.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,330.62
|
| Rate for Payer: Priority Health Medicare |
$966.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,664.50
|
| Rate for Payer: Railroad Medicare Medicare |
$957.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.90
|
| Rate for Payer: UHC Core |
$3,196.63
|
| Rate for Payer: UHC Exchange |
$957.08
|
| Rate for Payer: UHC Medicaid |
$674.93
|
| Rate for Payer: UHC Medicare Advantage |
$957.08
|
| Rate for Payer: UHCCP Medicaid |
$674.93
|
| Rate for Payer: VA VA |
$957.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,871.22
|
|
