|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
IP
|
$1,292.55
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.61 |
| Max. Negotiated Rate |
$1,163.30 |
| Rate for Payer: Aetna Commercial |
$1,098.67
|
| Rate for Payer: Aetna Commercial |
$1,648.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,601.29
|
| Rate for Payer: BCN Commercial |
$1,067.52
|
| Rate for Payer: BCN Commercial |
$1,601.29
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,551.07
|
| Rate for Payer: Cofinity Commercial |
$1,667.40
|
| Rate for Payer: Cofinity Commercial |
$1,111.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Healthscope Commercial |
$1,163.30
|
| Rate for Payer: Healthscope Commercial |
$1,744.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.01
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Nomi Health Commercial |
$1,589.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,454.13
|
| Rate for Payer: PHP Commercial |
$1,648.01
|
| Rate for Payer: PHP Commercial |
$1,098.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,686.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,349.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,706.18
|
| Rate for Payer: UHC Core |
$1,079.28
|
| Rate for Payer: UHC Core |
$1,618.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.13
|
|
|
HC INJ ANES MIDDLE OR LOWER SPINE SYMPATHETIC NERVES
|
Facility
|
OP
|
$1,292.55
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36100604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.88 |
| Max. Negotiated Rate |
$1,163.30 |
| Rate for Payer: Aetna Commercial |
$1,098.67
|
| Rate for Payer: Aetna Commercial |
$1,648.01
|
| Rate for Payer: Aetna Medicare |
$504.10
|
| Rate for Payer: Aetna Medicare |
$336.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$605.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$605.89
|
| Rate for Payer: BCBS Complete |
$239.25
|
| Rate for Payer: BCBS Complete |
$358.88
|
| Rate for Payer: BCBS MAPPO |
$323.14
|
| Rate for Payer: BCBS MAPPO |
$484.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,593.92
|
| Rate for Payer: BCN Commercial |
$1,593.92
|
| Rate for Payer: BCN Commercial |
$1,062.61
|
| Rate for Payer: BCN Medicare Advantage |
$484.71
|
| Rate for Payer: BCN Medicare Advantage |
$323.14
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cash Price |
$1,551.07
|
| Rate for Payer: Cofinity Commercial |
$1,111.59
|
| Rate for Payer: Cofinity Commercial |
$1,667.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$484.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.14
|
| Rate for Payer: Healthscope Commercial |
$1,163.30
|
| Rate for Payer: Healthscope Commercial |
$1,744.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.13
|
| Rate for Payer: Mclaren Medicaid |
$341.82
|
| Rate for Payer: Mclaren Medicaid |
$227.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.29
|
| Rate for Payer: Meridian Medicaid |
$239.25
|
| Rate for Payer: Meridian Medicaid |
$358.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$557.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$533.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,589.85
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,454.13
|
| Rate for Payer: PACE Senior Care Partners |
$460.47
|
| Rate for Payer: PACE Senior Care Partners |
$306.98
|
| Rate for Payer: PACE SWMI |
$484.71
|
| Rate for Payer: PACE SWMI |
$323.14
|
| Rate for Payer: PHP Commercial |
$1,098.67
|
| Rate for Payer: PHP Commercial |
$1,648.01
|
| Rate for Payer: PHP Medicare Advantage |
$323.14
|
| Rate for Payer: PHP Medicare Advantage |
$484.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,686.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.52
|
| Rate for Payer: Priority Health Medicare |
$489.56
|
| Rate for Payer: Priority Health Medicare |
$326.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,349.43
|
| Rate for Payer: Railroad Medicare Medicare |
$323.14
|
| Rate for Payer: Railroad Medicare Medicare |
$484.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,706.18
|
| Rate for Payer: UHC Core |
$1,618.93
|
| Rate for Payer: UHC Core |
$1,079.28
|
| Rate for Payer: UHC Exchange |
$484.71
|
| Rate for Payer: UHC Exchange |
$323.14
|
| Rate for Payer: UHC Medicaid |
$341.82
|
| Rate for Payer: UHC Medicaid |
$227.88
|
| Rate for Payer: UHC Medicare Advantage |
$323.14
|
| Rate for Payer: UHC Medicare Advantage |
$484.71
|
| Rate for Payer: UHCCP Medicaid |
$227.88
|
| Rate for Payer: UHCCP Medicaid |
$341.82
|
| Rate for Payer: VA VA |
$323.14
|
| Rate for Payer: VA VA |
$484.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.41
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
IP
|
$1,949.46
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,356.82 |
| Max. Negotiated Rate |
$1,754.51 |
| Rate for Payer: Aetna Commercial |
$1,657.04
|
| Rate for Payer: Aetna Commercial |
$2,485.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,415.10
|
| Rate for Payer: BCN Commercial |
$1,610.06
|
| Rate for Payer: BCN Commercial |
$2,415.10
|
| Rate for Payer: Cash Price |
$1,559.57
|
| Rate for Payer: Cash Price |
$2,339.36
|
| Rate for Payer: Cofinity Commercial |
$2,514.81
|
| Rate for Payer: Cofinity Commercial |
$1,676.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,339.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.57
|
| Rate for Payer: Healthscope Commercial |
$1,754.51
|
| Rate for Payer: Healthscope Commercial |
$2,631.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,193.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,657.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,485.57
|
| Rate for Payer: Nomi Health Commercial |
$1,598.56
|
| Rate for Payer: Nomi Health Commercial |
$2,397.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,193.15
|
| Rate for Payer: PHP Commercial |
$2,485.57
|
| Rate for Payer: PHP Commercial |
$1,657.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,544.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,696.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,715.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.30
|
| Rate for Payer: UHC Core |
$1,627.80
|
| Rate for Payer: UHC Core |
$2,441.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,193.15
|
|
|
HC INJ ANESTH AND/OR STEROID AXILLARY NERVE
|
Facility
|
OP
|
$1,949.46
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36100599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.69 |
| Max. Negotiated Rate |
$1,754.51 |
| Rate for Payer: Aetna Commercial |
$1,657.04
|
| Rate for Payer: Aetna Commercial |
$2,485.57
|
| Rate for Payer: Aetna Medicare |
$760.29
|
| Rate for Payer: Aetna Medicare |
$506.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$913.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$609.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$609.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$913.81
|
| Rate for Payer: BCBS Complete |
$360.85
|
| Rate for Payer: BCBS Complete |
$541.27
|
| Rate for Payer: BCBS MAPPO |
$487.37
|
| Rate for Payer: BCBS MAPPO |
$731.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,602.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.98
|
| Rate for Payer: BCN Commercial |
$2,403.98
|
| Rate for Payer: BCN Commercial |
$1,602.65
|
| Rate for Payer: BCN Medicare Advantage |
$731.05
|
| Rate for Payer: BCN Medicare Advantage |
$487.37
|
| Rate for Payer: Cash Price |
$1,559.57
|
| Rate for Payer: Cash Price |
$2,339.36
|
| Rate for Payer: Cofinity Commercial |
$1,676.54
|
| Rate for Payer: Cofinity Commercial |
$2,514.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,339.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,559.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.37
|
| Rate for Payer: Healthscope Commercial |
$1,754.51
|
| Rate for Payer: Healthscope Commercial |
$2,631.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,193.15
|
| Rate for Payer: Mclaren Medicaid |
$515.54
|
| Rate for Payer: Mclaren Medicaid |
$343.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$511.73
|
| Rate for Payer: Meridian Medicaid |
$360.85
|
| Rate for Payer: Meridian Medicaid |
$541.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$840.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$560.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$804.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,485.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,657.04
|
| Rate for Payer: Nomi Health Commercial |
$2,397.84
|
| Rate for Payer: Nomi Health Commercial |
$1,598.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,462.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,193.15
|
| Rate for Payer: PACE Senior Care Partners |
$694.50
|
| Rate for Payer: PACE Senior Care Partners |
$463.00
|
| Rate for Payer: PACE SWMI |
$731.05
|
| Rate for Payer: PACE SWMI |
$487.37
|
| Rate for Payer: PHP Commercial |
$1,657.04
|
| Rate for Payer: PHP Commercial |
$2,485.57
|
| Rate for Payer: PHP Medicare Advantage |
$487.37
|
| Rate for Payer: PHP Medicare Advantage |
$731.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$515.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,544.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,696.03
|
| Rate for Payer: Priority Health Medicare |
$738.36
|
| Rate for Payer: Priority Health Medicare |
$492.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,356.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,035.24
|
| Rate for Payer: Railroad Medicare Medicare |
$487.37
|
| Rate for Payer: Railroad Medicare Medicare |
$731.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,715.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.30
|
| Rate for Payer: UHC Core |
$2,441.71
|
| Rate for Payer: UHC Core |
$1,627.80
|
| Rate for Payer: UHC Exchange |
$731.05
|
| Rate for Payer: UHC Exchange |
$487.37
|
| Rate for Payer: UHC Medicaid |
$515.54
|
| Rate for Payer: UHC Medicaid |
$343.69
|
| Rate for Payer: UHC Medicare Advantage |
$487.37
|
| Rate for Payer: UHC Medicare Advantage |
$731.05
|
| Rate for Payer: UHCCP Medicaid |
$343.69
|
| Rate for Payer: UHCCP Medicaid |
$515.54
|
| Rate for Payer: VA VA |
$487.37
|
| Rate for Payer: VA VA |
$731.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,193.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.10
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
OP
|
$3,235.56
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$570.43 |
| Max. Negotiated Rate |
$2,912.00 |
| Rate for Payer: Aetna Commercial |
$2,750.23
|
| Rate for Payer: Aetna Commercial |
$4,125.34
|
| Rate for Payer: Aetna Medicare |
$1,261.87
|
| Rate for Payer: Aetna Medicare |
$841.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,516.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,011.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,011.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,516.67
|
| Rate for Payer: BCBS Complete |
$598.90
|
| Rate for Payer: BCBS Complete |
$898.35
|
| Rate for Payer: BCBS MAPPO |
$808.89
|
| Rate for Payer: BCBS MAPPO |
$1,213.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,659.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.93
|
| Rate for Payer: BCN Commercial |
$3,989.93
|
| Rate for Payer: BCN Commercial |
$2,659.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.34
|
| Rate for Payer: BCN Medicare Advantage |
$808.89
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cofinity Commercial |
$2,782.58
|
| Rate for Payer: Cofinity Commercial |
$4,173.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.89
|
| Rate for Payer: Healthscope Commercial |
$2,912.00
|
| Rate for Payer: Healthscope Commercial |
$4,368.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,426.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,640.01
|
| Rate for Payer: Mclaren Medicaid |
$855.64
|
| Rate for Payer: Mclaren Medicaid |
$570.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,274.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.33
|
| Rate for Payer: Meridian Medicaid |
$598.90
|
| Rate for Payer: Meridian Medicaid |
$898.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,395.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$930.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,334.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$889.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: PACE Senior Care Partners |
$1,152.67
|
| Rate for Payer: PACE Senior Care Partners |
$768.45
|
| Rate for Payer: PACE SWMI |
$1,213.34
|
| Rate for Payer: PACE SWMI |
$808.89
|
| Rate for Payer: PHP Commercial |
$2,750.23
|
| Rate for Payer: PHP Commercial |
$4,125.34
|
| Rate for Payer: PHP Medicare Advantage |
$808.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,222.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,814.94
|
| Rate for Payer: Priority Health Medicare |
$1,225.47
|
| Rate for Payer: Priority Health Medicare |
$816.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,251.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,377.92
|
| Rate for Payer: Railroad Medicare Medicare |
$808.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,213.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,270.94
|
| Rate for Payer: UHC Core |
$4,052.54
|
| Rate for Payer: UHC Core |
$2,701.69
|
| Rate for Payer: UHC Exchange |
$1,213.34
|
| Rate for Payer: UHC Exchange |
$808.89
|
| Rate for Payer: UHC Medicaid |
$855.64
|
| Rate for Payer: UHC Medicaid |
$570.43
|
| Rate for Payer: UHC Medicare Advantage |
$808.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,213.34
|
| Rate for Payer: UHCCP Medicaid |
$570.43
|
| Rate for Payer: UHCCP Medicaid |
$855.64
|
| Rate for Payer: VA VA |
$808.89
|
| Rate for Payer: VA VA |
$1,213.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,640.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,426.67
|
|
|
HC INJ ANESTH AND/OR STEROID BRACHIAL PLEXUS
|
Facility
|
IP
|
$3,235.56
|
|
|
Service Code
|
CPT 64415
|
| Hospital Charge Code |
37100005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,251.95 |
| Max. Negotiated Rate |
$2,912.00 |
| Rate for Payer: Aetna Commercial |
$2,750.23
|
| Rate for Payer: Aetna Commercial |
$4,125.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,008.37
|
| Rate for Payer: BCN Commercial |
$2,672.25
|
| Rate for Payer: BCN Commercial |
$4,008.37
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cofinity Commercial |
$4,173.87
|
| Rate for Payer: Cofinity Commercial |
$2,782.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Healthscope Commercial |
$2,912.00
|
| Rate for Payer: Healthscope Commercial |
$4,368.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,426.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,640.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: PHP Commercial |
$4,125.34
|
| Rate for Payer: PHP Commercial |
$2,750.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,222.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,814.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,251.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,377.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,270.94
|
| Rate for Payer: UHC Core |
$2,701.69
|
| Rate for Payer: UHC Core |
$4,052.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,426.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,640.01
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
OP
|
$2,600.63
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$458.49 |
| Max. Negotiated Rate |
$2,340.57 |
| Rate for Payer: Aetna Commercial |
$2,210.54
|
| Rate for Payer: Aetna Commercial |
$3,315.81
|
| Rate for Payer: Aetna Medicare |
$1,014.25
|
| Rate for Payer: Aetna Medicare |
$676.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,219.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$812.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$812.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,219.05
|
| Rate for Payer: BCBS Complete |
$481.38
|
| Rate for Payer: BCBS Complete |
$722.07
|
| Rate for Payer: BCBS MAPPO |
$650.16
|
| Rate for Payer: BCBS MAPPO |
$975.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,137.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,206.97
|
| Rate for Payer: BCN Commercial |
$3,206.97
|
| Rate for Payer: BCN Commercial |
$2,137.98
|
| Rate for Payer: BCN Medicare Advantage |
$975.24
|
| Rate for Payer: BCN Medicare Advantage |
$650.16
|
| Rate for Payer: Cash Price |
$2,080.50
|
| Rate for Payer: Cash Price |
$3,120.76
|
| Rate for Payer: Cofinity Commercial |
$2,236.54
|
| Rate for Payer: Cofinity Commercial |
$3,354.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,080.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$975.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.16
|
| Rate for Payer: Healthscope Commercial |
$2,340.57
|
| Rate for Payer: Healthscope Commercial |
$3,510.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,950.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,925.71
|
| Rate for Payer: Mclaren Medicaid |
$687.74
|
| Rate for Payer: Mclaren Medicaid |
$458.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,024.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$682.67
|
| Rate for Payer: Meridian Medicaid |
$481.38
|
| Rate for Payer: Meridian Medicaid |
$722.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,121.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$747.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,072.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$715.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,315.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,210.54
|
| Rate for Payer: Nomi Health Commercial |
$3,198.78
|
| Rate for Payer: Nomi Health Commercial |
$2,132.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,925.71
|
| Rate for Payer: PACE Senior Care Partners |
$926.48
|
| Rate for Payer: PACE Senior Care Partners |
$617.65
|
| Rate for Payer: PACE SWMI |
$975.24
|
| Rate for Payer: PACE SWMI |
$650.16
|
| Rate for Payer: PHP Commercial |
$2,210.54
|
| Rate for Payer: PHP Commercial |
$3,315.81
|
| Rate for Payer: PHP Medicare Advantage |
$650.16
|
| Rate for Payer: PHP Medicare Advantage |
$975.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$687.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,393.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,262.55
|
| Rate for Payer: Priority Health Medicare |
$984.99
|
| Rate for Payer: Priority Health Medicare |
$656.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,715.06
|
| Rate for Payer: Railroad Medicare Medicare |
$650.16
|
| Rate for Payer: Railroad Medicare Medicare |
$975.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,288.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,432.84
|
| Rate for Payer: UHC Core |
$3,257.29
|
| Rate for Payer: UHC Core |
$2,171.53
|
| Rate for Payer: UHC Exchange |
$975.24
|
| Rate for Payer: UHC Exchange |
$650.16
|
| Rate for Payer: UHC Medicaid |
$687.74
|
| Rate for Payer: UHC Medicaid |
$458.49
|
| Rate for Payer: UHC Medicare Advantage |
$650.16
|
| Rate for Payer: UHC Medicare Advantage |
$975.24
|
| Rate for Payer: UHCCP Medicaid |
$458.49
|
| Rate for Payer: UHCCP Medicaid |
$687.74
|
| Rate for Payer: VA VA |
$650.16
|
| Rate for Payer: VA VA |
$975.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,925.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,950.47
|
|
|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
IP
|
$2,600.63
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,810.04 |
| Max. Negotiated Rate |
$2,340.57 |
| Rate for Payer: Aetna Commercial |
$2,210.54
|
| Rate for Payer: Aetna Commercial |
$3,315.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,147.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,221.79
|
| Rate for Payer: BCN Commercial |
$2,147.86
|
| Rate for Payer: BCN Commercial |
$3,221.79
|
| Rate for Payer: Cash Price |
$2,080.50
|
| Rate for Payer: Cash Price |
$3,120.76
|
| Rate for Payer: Cofinity Commercial |
$3,354.82
|
| Rate for Payer: Cofinity Commercial |
$2,236.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,120.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,080.50
|
| Rate for Payer: Healthscope Commercial |
$2,340.57
|
| Rate for Payer: Healthscope Commercial |
$3,510.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,950.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,925.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,210.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,315.81
|
| Rate for Payer: Nomi Health Commercial |
$2,132.52
|
| Rate for Payer: Nomi Health Commercial |
$3,198.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,950.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,925.71
|
| Rate for Payer: PHP Commercial |
$3,315.81
|
| Rate for Payer: PHP Commercial |
$2,210.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,393.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,262.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,810.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,715.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,288.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,432.84
|
| Rate for Payer: UHC Core |
$2,171.53
|
| Rate for Payer: UHC Core |
$3,257.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,950.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,925.71
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
IP
|
$1,492.45
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,038.75 |
| Max. Negotiated Rate |
$1,343.20 |
| Rate for Payer: Aetna Commercial |
$1,268.58
|
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.61
|
| Rate for Payer: BCBS Trust/PPO |
$821.75
|
| Rate for Payer: BCN Commercial |
$1,232.61
|
| Rate for Payer: BCN Commercial |
$821.75
|
| Rate for Payer: Cash Price |
$1,193.96
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Cofinity Commercial |
$1,283.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.96
|
| Rate for Payer: Healthscope Commercial |
$1,343.20
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Nomi Health Commercial |
$1,223.81
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: PHP Commercial |
$1,268.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.57
|
| Rate for Payer: UHC Core |
$1,246.20
|
| Rate for Payer: UHC Core |
$830.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
OP
|
$1,492.45
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$263.12 |
| Max. Negotiated Rate |
$1,343.20 |
| Rate for Payer: Aetna Commercial |
$1,268.58
|
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: Aetna Medicare |
$258.69
|
| Rate for Payer: Aetna Medicare |
$388.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.93
|
| Rate for Payer: BCBS Complete |
$276.25
|
| Rate for Payer: BCBS Complete |
$184.17
|
| Rate for Payer: BCBS MAPPO |
$373.11
|
| Rate for Payer: BCBS MAPPO |
$248.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.94
|
| Rate for Payer: BCBS Trust/PPO |
$817.96
|
| Rate for Payer: BCN Commercial |
$817.96
|
| Rate for Payer: BCN Commercial |
$1,226.94
|
| Rate for Payer: BCN Medicare Advantage |
$248.74
|
| Rate for Payer: BCN Medicare Advantage |
$373.11
|
| Rate for Payer: Cash Price |
$1,193.96
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Commercial |
$1,283.51
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.11
|
| Rate for Payer: Healthscope Commercial |
$1,343.20
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Mclaren Medicaid |
$175.41
|
| Rate for Payer: Mclaren Medicaid |
$263.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.77
|
| Rate for Payer: Meridian Medicaid |
$276.25
|
| Rate for Payer: Meridian Medicaid |
$184.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.58
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Nomi Health Commercial |
$1,223.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PACE Senior Care Partners |
$236.31
|
| Rate for Payer: PACE Senior Care Partners |
$354.46
|
| Rate for Payer: PACE SWMI |
$248.74
|
| Rate for Payer: PACE SWMI |
$373.11
|
| Rate for Payer: PHP Commercial |
$1,268.58
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: PHP Medicare Advantage |
$373.11
|
| Rate for Payer: PHP Medicare Advantage |
$248.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$263.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,298.43
|
| Rate for Payer: Priority Health Medicare |
$251.23
|
| Rate for Payer: Priority Health Medicare |
$376.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,038.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.50
|
| Rate for Payer: Railroad Medicare Medicare |
$373.11
|
| Rate for Payer: Railroad Medicare Medicare |
$248.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.57
|
| Rate for Payer: UHC Core |
$830.80
|
| Rate for Payer: UHC Core |
$1,246.20
|
| Rate for Payer: UHC Exchange |
$248.74
|
| Rate for Payer: UHC Exchange |
$373.11
|
| Rate for Payer: UHC Medicaid |
$175.41
|
| Rate for Payer: UHC Medicaid |
$263.12
|
| Rate for Payer: UHC Medicare Advantage |
$373.11
|
| Rate for Payer: UHC Medicare Advantage |
$248.74
|
| Rate for Payer: UHCCP Medicaid |
$263.12
|
| Rate for Payer: UHCCP Medicaid |
$175.41
|
| Rate for Payer: VA VA |
$373.11
|
| Rate for Payer: VA VA |
$248.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.34
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
OP
|
$1,564.96
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$275.90 |
| Max. Negotiated Rate |
$1,408.46 |
| Rate for Payer: Aetna Commercial |
$1,330.22
|
| Rate for Payer: Aetna Commercial |
$1,995.32
|
| Rate for Payer: Aetna Medicare |
$610.33
|
| Rate for Payer: Aetna Medicare |
$406.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$733.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$733.58
|
| Rate for Payer: BCBS Complete |
$289.67
|
| Rate for Payer: BCBS Complete |
$434.51
|
| Rate for Payer: BCBS MAPPO |
$391.24
|
| Rate for Payer: BCBS MAPPO |
$586.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.83
|
| Rate for Payer: BCN Commercial |
$1,929.83
|
| Rate for Payer: BCN Commercial |
$1,286.55
|
| Rate for Payer: BCN Medicare Advantage |
$586.86
|
| Rate for Payer: BCN Medicare Advantage |
$391.24
|
| Rate for Payer: Cash Price |
$1,251.97
|
| Rate for Payer: Cash Price |
$1,877.95
|
| Rate for Payer: Cofinity Commercial |
$1,345.87
|
| Rate for Payer: Cofinity Commercial |
$2,018.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,877.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.24
|
| Rate for Payer: Healthscope Commercial |
$1,408.46
|
| Rate for Payer: Healthscope Commercial |
$2,112.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,760.58
|
| Rate for Payer: Mclaren Medicaid |
$413.85
|
| Rate for Payer: Mclaren Medicaid |
$275.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$616.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.80
|
| Rate for Payer: Meridian Medicaid |
$289.67
|
| Rate for Payer: Meridian Medicaid |
$434.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$674.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$645.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$430.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,995.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,330.22
|
| Rate for Payer: Nomi Health Commercial |
$1,924.90
|
| Rate for Payer: Nomi Health Commercial |
$1,283.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,760.58
|
| Rate for Payer: PACE Senior Care Partners |
$557.52
|
| Rate for Payer: PACE Senior Care Partners |
$371.68
|
| Rate for Payer: PACE SWMI |
$586.86
|
| Rate for Payer: PACE SWMI |
$391.24
|
| Rate for Payer: PHP Commercial |
$1,330.22
|
| Rate for Payer: PHP Commercial |
$1,995.32
|
| Rate for Payer: PHP Medicare Advantage |
$391.24
|
| Rate for Payer: PHP Medicare Advantage |
$586.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,042.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,361.52
|
| Rate for Payer: Priority Health Medicare |
$592.73
|
| Rate for Payer: Priority Health Medicare |
$395.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,089.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,633.82
|
| Rate for Payer: Railroad Medicare Medicare |
$391.24
|
| Rate for Payer: Railroad Medicare Medicare |
$586.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,377.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,065.75
|
| Rate for Payer: UHC Core |
$1,960.11
|
| Rate for Payer: UHC Core |
$1,306.74
|
| Rate for Payer: UHC Exchange |
$586.86
|
| Rate for Payer: UHC Exchange |
$391.24
|
| Rate for Payer: UHC Medicaid |
$413.85
|
| Rate for Payer: UHC Medicaid |
$275.90
|
| Rate for Payer: UHC Medicare Advantage |
$391.24
|
| Rate for Payer: UHC Medicare Advantage |
$586.86
|
| Rate for Payer: UHCCP Medicaid |
$275.90
|
| Rate for Payer: UHCCP Medicaid |
$413.85
|
| Rate for Payer: VA VA |
$391.24
|
| Rate for Payer: VA VA |
$586.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,760.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.72
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
IP
|
$1,564.96
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,089.21 |
| Max. Negotiated Rate |
$1,408.46 |
| Rate for Payer: Aetna Commercial |
$1,330.22
|
| Rate for Payer: Aetna Commercial |
$1,995.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,292.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,938.75
|
| Rate for Payer: BCN Commercial |
$1,292.50
|
| Rate for Payer: BCN Commercial |
$1,938.75
|
| Rate for Payer: Cash Price |
$1,251.97
|
| Rate for Payer: Cash Price |
$1,877.95
|
| Rate for Payer: Cofinity Commercial |
$2,018.80
|
| Rate for Payer: Cofinity Commercial |
$1,345.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,877.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,251.97
|
| Rate for Payer: Healthscope Commercial |
$1,408.46
|
| Rate for Payer: Healthscope Commercial |
$2,112.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,173.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,760.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,330.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,995.32
|
| Rate for Payer: Nomi Health Commercial |
$1,283.27
|
| Rate for Payer: Nomi Health Commercial |
$1,924.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,173.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,760.58
|
| Rate for Payer: PHP Commercial |
$1,995.32
|
| Rate for Payer: PHP Commercial |
$1,330.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,042.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,361.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,089.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,633.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,377.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,065.75
|
| Rate for Payer: UHC Core |
$1,306.74
|
| Rate for Payer: UHC Core |
$1,960.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,173.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,760.58
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
IP
|
$1,362.21
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$948.10 |
| Max. Negotiated Rate |
$1,225.99 |
| Rate for Payer: Aetna Commercial |
$1,157.88
|
| Rate for Payer: Aetna Commercial |
$771.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.05
|
| Rate for Payer: BCBS Trust/PPO |
$750.03
|
| Rate for Payer: BCN Commercial |
$1,125.05
|
| Rate for Payer: BCN Commercial |
$750.03
|
| Rate for Payer: Cash Price |
$1,089.77
|
| Rate for Payer: Cash Price |
$726.51
|
| Rate for Payer: Cofinity Commercial |
$781.00
|
| Rate for Payer: Cofinity Commercial |
$1,171.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.77
|
| Rate for Payer: Healthscope Commercial |
$1,225.99
|
| Rate for Payer: Healthscope Commercial |
$817.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,021.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.92
|
| Rate for Payer: Nomi Health Commercial |
$1,117.01
|
| Rate for Payer: Nomi Health Commercial |
$744.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.11
|
| Rate for Payer: PHP Commercial |
$771.92
|
| Rate for Payer: PHP Commercial |
$1,157.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$790.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,185.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$948.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.16
|
| Rate for Payer: UHC Core |
$1,137.45
|
| Rate for Payer: UHC Core |
$758.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,021.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.11
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
OP
|
$1,362.21
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.16 |
| Max. Negotiated Rate |
$1,225.99 |
| Rate for Payer: Aetna Commercial |
$1,157.88
|
| Rate for Payer: Aetna Commercial |
$771.92
|
| Rate for Payer: Aetna Medicare |
$236.12
|
| Rate for Payer: Aetna Medicare |
$354.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$425.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$425.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.79
|
| Rate for Payer: BCBS Complete |
$252.15
|
| Rate for Payer: BCBS Complete |
$168.10
|
| Rate for Payer: BCBS MAPPO |
$340.55
|
| Rate for Payer: BCBS MAPPO |
$227.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,119.87
|
| Rate for Payer: BCBS Trust/PPO |
$746.58
|
| Rate for Payer: BCN Commercial |
$746.58
|
| Rate for Payer: BCN Commercial |
$1,119.87
|
| Rate for Payer: BCN Medicare Advantage |
$227.03
|
| Rate for Payer: BCN Medicare Advantage |
$340.55
|
| Rate for Payer: Cash Price |
$1,089.77
|
| Rate for Payer: Cash Price |
$726.51
|
| Rate for Payer: Cofinity Commercial |
$1,171.50
|
| Rate for Payer: Cofinity Commercial |
$781.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,089.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.55
|
| Rate for Payer: Healthscope Commercial |
$1,225.99
|
| Rate for Payer: Healthscope Commercial |
$817.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,021.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.11
|
| Rate for Payer: Mclaren Medicaid |
$160.11
|
| Rate for Payer: Mclaren Medicaid |
$240.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$357.58
|
| Rate for Payer: Meridian Medicaid |
$252.15
|
| Rate for Payer: Meridian Medicaid |
$168.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$391.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$374.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,157.88
|
| Rate for Payer: Nomi Health Commercial |
$744.67
|
| Rate for Payer: Nomi Health Commercial |
$1,117.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,021.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$681.11
|
| Rate for Payer: PACE Senior Care Partners |
$215.68
|
| Rate for Payer: PACE Senior Care Partners |
$323.52
|
| Rate for Payer: PACE SWMI |
$227.03
|
| Rate for Payer: PACE SWMI |
$340.55
|
| Rate for Payer: PHP Commercial |
$1,157.88
|
| Rate for Payer: PHP Commercial |
$771.92
|
| Rate for Payer: PHP Medicare Advantage |
$340.55
|
| Rate for Payer: PHP Medicare Advantage |
$227.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$790.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,185.12
|
| Rate for Payer: Priority Health Medicare |
$229.31
|
| Rate for Payer: Priority Health Medicare |
$343.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$948.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$632.07
|
| Rate for Payer: Railroad Medicare Medicare |
$340.55
|
| Rate for Payer: Railroad Medicare Medicare |
$227.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,198.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.16
|
| Rate for Payer: UHC Core |
$758.30
|
| Rate for Payer: UHC Core |
$1,137.45
|
| Rate for Payer: UHC Exchange |
$227.03
|
| Rate for Payer: UHC Exchange |
$340.55
|
| Rate for Payer: UHC Medicaid |
$160.11
|
| Rate for Payer: UHC Medicaid |
$240.16
|
| Rate for Payer: UHC Medicare Advantage |
$340.55
|
| Rate for Payer: UHC Medicare Advantage |
$227.03
|
| Rate for Payer: UHCCP Medicaid |
$240.16
|
| Rate for Payer: UHCCP Medicaid |
$160.11
|
| Rate for Payer: VA VA |
$340.55
|
| Rate for Payer: VA VA |
$227.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,021.66
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
OP
|
$3,235.56
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$570.43 |
| Max. Negotiated Rate |
$2,912.00 |
| Rate for Payer: Aetna Commercial |
$2,750.23
|
| Rate for Payer: Aetna Commercial |
$4,125.34
|
| Rate for Payer: Aetna Medicare |
$1,261.87
|
| Rate for Payer: Aetna Medicare |
$841.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,516.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,011.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,011.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,516.67
|
| Rate for Payer: BCBS Complete |
$598.90
|
| Rate for Payer: BCBS Complete |
$898.35
|
| Rate for Payer: BCBS MAPPO |
$808.89
|
| Rate for Payer: BCBS MAPPO |
$1,213.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,659.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.93
|
| Rate for Payer: BCN Commercial |
$3,989.93
|
| Rate for Payer: BCN Commercial |
$2,659.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.34
|
| Rate for Payer: BCN Medicare Advantage |
$808.89
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cofinity Commercial |
$2,782.58
|
| Rate for Payer: Cofinity Commercial |
$4,173.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$808.89
|
| Rate for Payer: Healthscope Commercial |
$2,912.00
|
| Rate for Payer: Healthscope Commercial |
$4,368.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,426.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,640.01
|
| Rate for Payer: Mclaren Medicaid |
$855.64
|
| Rate for Payer: Mclaren Medicaid |
$570.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,274.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.33
|
| Rate for Payer: Meridian Medicaid |
$598.90
|
| Rate for Payer: Meridian Medicaid |
$898.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,395.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$930.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,334.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$889.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: PACE Senior Care Partners |
$1,152.67
|
| Rate for Payer: PACE Senior Care Partners |
$768.45
|
| Rate for Payer: PACE SWMI |
$1,213.34
|
| Rate for Payer: PACE SWMI |
$808.89
|
| Rate for Payer: PHP Commercial |
$2,750.23
|
| Rate for Payer: PHP Commercial |
$4,125.34
|
| Rate for Payer: PHP Medicare Advantage |
$808.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$570.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,222.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,814.94
|
| Rate for Payer: Priority Health Medicare |
$1,225.47
|
| Rate for Payer: Priority Health Medicare |
$816.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,251.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,377.92
|
| Rate for Payer: Railroad Medicare Medicare |
$808.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,213.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,270.94
|
| Rate for Payer: UHC Core |
$4,052.54
|
| Rate for Payer: UHC Core |
$2,701.69
|
| Rate for Payer: UHC Exchange |
$1,213.34
|
| Rate for Payer: UHC Exchange |
$808.89
|
| Rate for Payer: UHC Medicaid |
$855.64
|
| Rate for Payer: UHC Medicaid |
$570.43
|
| Rate for Payer: UHC Medicare Advantage |
$808.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,213.34
|
| Rate for Payer: UHCCP Medicaid |
$570.43
|
| Rate for Payer: UHCCP Medicaid |
$855.64
|
| Rate for Payer: VA VA |
$808.89
|
| Rate for Payer: VA VA |
$1,213.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,640.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,426.67
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
IP
|
$3,235.56
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,251.95 |
| Max. Negotiated Rate |
$2,912.00 |
| Rate for Payer: Aetna Commercial |
$2,750.23
|
| Rate for Payer: Aetna Commercial |
$4,125.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,008.37
|
| Rate for Payer: BCN Commercial |
$2,672.25
|
| Rate for Payer: BCN Commercial |
$4,008.37
|
| Rate for Payer: Cash Price |
$2,588.45
|
| Rate for Payer: Cash Price |
$3,882.67
|
| Rate for Payer: Cofinity Commercial |
$4,173.87
|
| Rate for Payer: Cofinity Commercial |
$2,782.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,882.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,588.45
|
| Rate for Payer: Healthscope Commercial |
$2,912.00
|
| Rate for Payer: Healthscope Commercial |
$4,368.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,426.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,640.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,750.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,125.34
|
| Rate for Payer: Nomi Health Commercial |
$2,653.16
|
| Rate for Payer: Nomi Health Commercial |
$3,979.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,426.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,640.01
|
| Rate for Payer: PHP Commercial |
$4,125.34
|
| Rate for Payer: PHP Commercial |
$2,750.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,222.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,814.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,251.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,377.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,847.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,270.94
|
| Rate for Payer: UHC Core |
$2,701.69
|
| Rate for Payer: UHC Core |
$4,052.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,426.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,640.01
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
IP
|
$3,244.17
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2,257.94 |
| Max. Negotiated Rate |
$2,919.75 |
| Rate for Payer: Aetna Commercial |
$2,757.54
|
| Rate for Payer: Aetna Commercial |
$4,136.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,679.36
|
| Rate for Payer: BCBS Trust/PPO |
$4,019.04
|
| Rate for Payer: BCN Commercial |
$2,679.36
|
| Rate for Payer: BCN Commercial |
$4,019.04
|
| Rate for Payer: Cash Price |
$2,595.34
|
| Rate for Payer: Cash Price |
$3,893.01
|
| Rate for Payer: Cofinity Commercial |
$4,184.98
|
| Rate for Payer: Cofinity Commercial |
$2,789.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,893.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,595.34
|
| Rate for Payer: Healthscope Commercial |
$2,919.75
|
| Rate for Payer: Healthscope Commercial |
$4,379.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,433.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,757.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.32
|
| Rate for Payer: Nomi Health Commercial |
$2,660.22
|
| Rate for Payer: Nomi Health Commercial |
$3,990.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,433.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,649.70
|
| Rate for Payer: PHP Commercial |
$4,136.32
|
| Rate for Payer: PHP Commercial |
$2,757.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,233.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,822.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,257.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,386.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,854.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,282.31
|
| Rate for Payer: UHC Core |
$2,708.88
|
| Rate for Payer: UHC Core |
$4,063.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,433.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.70
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
OP
|
$3,244.17
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$571.95 |
| Max. Negotiated Rate |
$2,919.75 |
| Rate for Payer: Aetna Commercial |
$2,757.54
|
| Rate for Payer: Aetna Commercial |
$4,136.32
|
| Rate for Payer: Aetna Medicare |
$1,265.23
|
| Rate for Payer: Aetna Medicare |
$843.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,520.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,013.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,013.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,520.71
|
| Rate for Payer: BCBS Complete |
$600.50
|
| Rate for Payer: BCBS Complete |
$900.74
|
| Rate for Payer: BCBS MAPPO |
$811.04
|
| Rate for Payer: BCBS MAPPO |
$1,216.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,667.03
|
| Rate for Payer: BCBS Trust/PPO |
$4,000.55
|
| Rate for Payer: BCN Commercial |
$4,000.55
|
| Rate for Payer: BCN Commercial |
$2,667.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,216.57
|
| Rate for Payer: BCN Medicare Advantage |
$811.04
|
| Rate for Payer: Cash Price |
$2,595.34
|
| Rate for Payer: Cash Price |
$3,893.01
|
| Rate for Payer: Cofinity Commercial |
$2,789.99
|
| Rate for Payer: Cofinity Commercial |
$4,184.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,893.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,595.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,216.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$811.04
|
| Rate for Payer: Healthscope Commercial |
$2,919.75
|
| Rate for Payer: Healthscope Commercial |
$4,379.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,433.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,649.70
|
| Rate for Payer: Mclaren Medicaid |
$857.92
|
| Rate for Payer: Mclaren Medicaid |
$571.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,277.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$851.59
|
| Rate for Payer: Meridian Medicaid |
$600.50
|
| Rate for Payer: Meridian Medicaid |
$900.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,399.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$932.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,338.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$892.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,136.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,757.54
|
| Rate for Payer: Nomi Health Commercial |
$3,990.33
|
| Rate for Payer: Nomi Health Commercial |
$2,660.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,433.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,649.70
|
| Rate for Payer: PACE Senior Care Partners |
$1,155.74
|
| Rate for Payer: PACE Senior Care Partners |
$770.49
|
| Rate for Payer: PACE SWMI |
$1,216.57
|
| Rate for Payer: PACE SWMI |
$811.04
|
| Rate for Payer: PHP Commercial |
$2,757.54
|
| Rate for Payer: PHP Commercial |
$4,136.32
|
| Rate for Payer: PHP Medicare Advantage |
$811.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,216.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$857.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,233.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,822.43
|
| Rate for Payer: Priority Health Medicare |
$1,228.73
|
| Rate for Payer: Priority Health Medicare |
$819.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,257.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,386.92
|
| Rate for Payer: Railroad Medicare Medicare |
$811.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,216.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,854.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,282.31
|
| Rate for Payer: UHC Core |
$4,063.33
|
| Rate for Payer: UHC Core |
$2,708.88
|
| Rate for Payer: UHC Exchange |
$1,216.57
|
| Rate for Payer: UHC Exchange |
$811.04
|
| Rate for Payer: UHC Medicaid |
$857.92
|
| Rate for Payer: UHC Medicaid |
$571.95
|
| Rate for Payer: UHC Medicare Advantage |
$811.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,216.57
|
| Rate for Payer: UHCCP Medicaid |
$571.95
|
| Rate for Payer: UHCCP Medicaid |
$857.92
|
| Rate for Payer: VA VA |
$811.04
|
| Rate for Payer: VA VA |
$1,216.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,649.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,433.13
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
OP
|
$994.97
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$175.41 |
| Max. Negotiated Rate |
$895.47 |
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: Aetna Medicare |
$258.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.93
|
| Rate for Payer: BCBS Complete |
$184.17
|
| Rate for Payer: BCBS MAPPO |
$248.74
|
| Rate for Payer: BCBS Trust/PPO |
$817.96
|
| Rate for Payer: BCN Commercial |
$817.96
|
| Rate for Payer: BCN Medicare Advantage |
$248.74
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.74
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Mclaren Medicaid |
$175.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.18
|
| Rate for Payer: Meridian Medicaid |
$184.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PACE Senior Care Partners |
$236.31
|
| Rate for Payer: PACE SWMI |
$248.74
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: PHP Medicare Advantage |
$248.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.62
|
| Rate for Payer: Priority Health Medicare |
$251.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.50
|
| Rate for Payer: Railroad Medicare Medicare |
$248.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.57
|
| Rate for Payer: UHC Core |
$830.80
|
| Rate for Payer: UHC Exchange |
$248.74
|
| Rate for Payer: UHC Medicaid |
$175.41
|
| Rate for Payer: UHC Medicare Advantage |
$248.74
|
| Rate for Payer: UHCCP Medicaid |
$175.41
|
| Rate for Payer: VA VA |
$248.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
IP
|
$994.97
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$692.50 |
| Max. Negotiated Rate |
$895.47 |
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: BCBS Trust/PPO |
$821.75
|
| Rate for Payer: BCN Commercial |
$821.75
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Nomi Health Commercial |
$815.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$865.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.57
|
| Rate for Payer: UHC Core |
$830.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
IP
|
$494.70
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$344.31 |
| Max. Negotiated Rate |
$445.23 |
| Rate for Payer: Aetna Commercial |
$420.50
|
| Rate for Payer: BCBS Trust/PPO |
$408.57
|
| Rate for Payer: BCN Commercial |
$408.57
|
| Rate for Payer: Cash Price |
$395.76
|
| Rate for Payer: Cofinity Commercial |
$425.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.76
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.50
|
| Rate for Payer: Nomi Health Commercial |
$405.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.02
|
| Rate for Payer: PHP Commercial |
$420.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.34
|
| Rate for Payer: UHC Core |
$413.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.02
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
OP
|
$494.70
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$87.22 |
| Max. Negotiated Rate |
$445.23 |
| Rate for Payer: Aetna Commercial |
$420.50
|
| Rate for Payer: Aetna Medicare |
$128.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.59
|
| Rate for Payer: BCBS Complete |
$91.57
|
| Rate for Payer: BCBS MAPPO |
$123.67
|
| Rate for Payer: BCBS Trust/PPO |
$406.69
|
| Rate for Payer: BCN Commercial |
$406.69
|
| Rate for Payer: BCN Medicare Advantage |
$123.67
|
| Rate for Payer: Cash Price |
$395.76
|
| Rate for Payer: Cofinity Commercial |
$425.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.67
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.02
|
| Rate for Payer: Mclaren Medicaid |
$87.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.86
|
| Rate for Payer: Meridian Medicaid |
$91.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.50
|
| Rate for Payer: Nomi Health Commercial |
$405.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.02
|
| Rate for Payer: PACE Senior Care Partners |
$117.49
|
| Rate for Payer: PACE SWMI |
$123.67
|
| Rate for Payer: PHP Commercial |
$420.50
|
| Rate for Payer: PHP Medicare Advantage |
$123.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.39
|
| Rate for Payer: Priority Health Medicare |
$124.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.31
|
| Rate for Payer: Railroad Medicare Medicare |
$123.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.34
|
| Rate for Payer: UHC Core |
$413.07
|
| Rate for Payer: UHC Exchange |
$123.67
|
| Rate for Payer: UHC Medicaid |
$87.22
|
| Rate for Payer: UHC Medicare Advantage |
$123.67
|
| Rate for Payer: UHCCP Medicaid |
$87.22
|
| Rate for Payer: VA VA |
$123.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.02
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC W IMAGIG GUID
|
Facility
|
IP
|
$1,125.53
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36100540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.37 |
| Max. Negotiated Rate |
$1,012.98 |
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: BCBS Trust/PPO |
$929.58
|
| Rate for Payer: BCN Commercial |
$929.58
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Nomi Health Commercial |
$922.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$979.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.47
|
| Rate for Payer: UHC Core |
$939.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
