|
HC INJECTION PROC RETROGRAD CYSTOGRAPHY
|
Facility
|
OP
|
$874.10
|
|
|
Service Code
|
CPT 51610
|
| Hospital Charge Code |
36100252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.10 |
| Max. Negotiated Rate |
$786.69 |
| Rate for Payer: Aetna Commercial |
$742.99
|
| Rate for Payer: Aetna Medicare |
$227.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.16
|
| Rate for Payer: BCBS Complete |
$161.80
|
| Rate for Payer: BCBS MAPPO |
$218.53
|
| Rate for Payer: BCBS Trust/PPO |
$718.60
|
| Rate for Payer: BCN Commercial |
$718.60
|
| Rate for Payer: BCN Medicare Advantage |
$218.53
|
| Rate for Payer: Cash Price |
$699.28
|
| Rate for Payer: Cofinity Commercial |
$751.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.53
|
| Rate for Payer: Healthscope Commercial |
$786.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.58
|
| Rate for Payer: Mclaren Medicaid |
$154.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.45
|
| Rate for Payer: Meridian Medicaid |
$161.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$742.99
|
| Rate for Payer: Nomi Health Commercial |
$716.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$655.58
|
| Rate for Payer: PACE Senior Care Partners |
$207.60
|
| Rate for Payer: PACE SWMI |
$218.53
|
| Rate for Payer: PHP Commercial |
$742.99
|
| Rate for Payer: PHP Medicare Advantage |
$218.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$760.47
|
| Rate for Payer: Priority Health Medicare |
$220.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.37
|
| Rate for Payer: Railroad Medicare Medicare |
$218.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.21
|
| Rate for Payer: UHC Core |
$729.87
|
| Rate for Payer: UHC Exchange |
$218.53
|
| Rate for Payer: UHC Medicaid |
$154.10
|
| Rate for Payer: UHC Medicare Advantage |
$218.53
|
| Rate for Payer: UHCCP Medicaid |
$154.10
|
| Rate for Payer: VA VA |
$218.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.58
|
|
|
HC INJECTION, PROMETHAZINE HCL, UP TO 50 MG
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT J2550
|
| Hospital Charge Code |
63600100
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJECTION, PROMETHAZINE HCL, UP TO 50 MG
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT J2550
|
| Hospital Charge Code |
63600100
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJECTION PUDENDAL NERVE
|
Facility
|
OP
|
$1,217.48
|
|
|
Service Code
|
CPT 64430
|
| Hospital Charge Code |
36100570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.64 |
| Max. Negotiated Rate |
$1,095.73 |
| Rate for Payer: Aetna Commercial |
$1,034.86
|
| Rate for Payer: Aetna Medicare |
$316.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$380.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$380.46
|
| Rate for Payer: BCBS Complete |
$225.36
|
| Rate for Payer: BCBS MAPPO |
$304.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.89
|
| Rate for Payer: BCN Commercial |
$1,000.89
|
| Rate for Payer: BCN Medicare Advantage |
$304.37
|
| Rate for Payer: Cash Price |
$973.98
|
| Rate for Payer: Cofinity Commercial |
$1,047.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$973.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.37
|
| Rate for Payer: Healthscope Commercial |
$1,095.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$913.11
|
| Rate for Payer: Mclaren Medicaid |
$214.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.59
|
| Rate for Payer: Meridian Medicaid |
$225.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$334.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.86
|
| Rate for Payer: Nomi Health Commercial |
$998.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.11
|
| Rate for Payer: PACE Senior Care Partners |
$289.15
|
| Rate for Payer: PACE SWMI |
$304.37
|
| Rate for Payer: PHP Commercial |
$1,034.86
|
| Rate for Payer: PHP Medicare Advantage |
$304.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,059.21
|
| Rate for Payer: Priority Health Medicare |
$307.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.37
|
| Rate for Payer: Railroad Medicare Medicare |
$304.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,071.38
|
| Rate for Payer: UHC Core |
$1,016.60
|
| Rate for Payer: UHC Exchange |
$304.37
|
| Rate for Payer: UHC Medicaid |
$214.64
|
| Rate for Payer: UHC Medicare Advantage |
$304.37
|
| Rate for Payer: UHCCP Medicaid |
$214.64
|
| Rate for Payer: VA VA |
$304.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$913.11
|
|
|
HC INJECTION PUDENDAL NERVE
|
Facility
|
IP
|
$1,217.48
|
|
|
Service Code
|
CPT 64430
|
| Hospital Charge Code |
36100570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$847.37 |
| Max. Negotiated Rate |
$1,095.73 |
| Rate for Payer: Aetna Commercial |
$1,034.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,005.52
|
| Rate for Payer: BCN Commercial |
$1,005.52
|
| Rate for Payer: Cash Price |
$973.98
|
| Rate for Payer: Cofinity Commercial |
$1,047.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$973.98
|
| Rate for Payer: Healthscope Commercial |
$1,095.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$913.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,034.86
|
| Rate for Payer: Nomi Health Commercial |
$998.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.11
|
| Rate for Payer: PHP Commercial |
$1,034.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,059.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,071.38
|
| Rate for Payer: UHC Core |
$1,016.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$913.11
|
|
|
HC INJECTION SCLEROSING SOL MULTIPLE
|
Facility
|
OP
|
$335.88
|
|
|
Service Code
|
CPT 36471
|
| Hospital Charge Code |
36100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.22 |
| Max. Negotiated Rate |
$302.29 |
| Rate for Payer: Aetna Commercial |
$285.50
|
| Rate for Payer: Aetna Medicare |
$87.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.96
|
| Rate for Payer: BCBS Complete |
$62.17
|
| Rate for Payer: BCBS MAPPO |
$83.97
|
| Rate for Payer: BCBS Trust/PPO |
$276.13
|
| Rate for Payer: BCN Commercial |
$276.13
|
| Rate for Payer: BCN Medicare Advantage |
$83.97
|
| Rate for Payer: Cash Price |
$268.70
|
| Rate for Payer: Cofinity Commercial |
$288.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.97
|
| Rate for Payer: Healthscope Commercial |
$302.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.91
|
| Rate for Payer: Mclaren Medicaid |
$59.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.17
|
| Rate for Payer: Meridian Medicaid |
$62.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.50
|
| Rate for Payer: Nomi Health Commercial |
$275.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.91
|
| Rate for Payer: PACE Senior Care Partners |
$79.77
|
| Rate for Payer: PACE SWMI |
$83.97
|
| Rate for Payer: PHP Commercial |
$285.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.22
|
| Rate for Payer: Priority Health Medicare |
$84.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.77
|
| Rate for Payer: Railroad Medicare Medicare |
$83.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.57
|
| Rate for Payer: UHC Core |
$280.46
|
| Rate for Payer: UHC Exchange |
$83.97
|
| Rate for Payer: UHC Medicaid |
$59.22
|
| Rate for Payer: UHC Medicare Advantage |
$83.97
|
| Rate for Payer: UHCCP Medicaid |
$59.22
|
| Rate for Payer: VA VA |
$83.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.91
|
|
|
HC INJECTION SCLEROSING SOL MULTIPLE
|
Facility
|
IP
|
$335.88
|
|
|
Service Code
|
CPT 36471
|
| Hospital Charge Code |
36100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.77 |
| Max. Negotiated Rate |
$302.29 |
| Rate for Payer: Aetna Commercial |
$285.50
|
| Rate for Payer: BCBS Trust/PPO |
$277.40
|
| Rate for Payer: BCN Commercial |
$277.40
|
| Rate for Payer: Cash Price |
$268.70
|
| Rate for Payer: Cofinity Commercial |
$288.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.70
|
| Rate for Payer: Healthscope Commercial |
$302.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.50
|
| Rate for Payer: Nomi Health Commercial |
$275.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.91
|
| Rate for Payer: PHP Commercial |
$285.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.57
|
| Rate for Payer: UHC Core |
$280.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.91
|
|
|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
OP
|
$257.88
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$232.09 |
| Rate for Payer: Aetna Commercial |
$219.20
|
| Rate for Payer: Aetna Medicare |
$67.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.59
|
| Rate for Payer: BCBS Complete |
$47.73
|
| Rate for Payer: BCBS MAPPO |
$64.47
|
| Rate for Payer: BCBS Trust/PPO |
$212.00
|
| Rate for Payer: BCN Commercial |
$212.00
|
| Rate for Payer: BCN Medicare Advantage |
$64.47
|
| Rate for Payer: Cash Price |
$206.30
|
| Rate for Payer: Cofinity Commercial |
$221.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.47
|
| Rate for Payer: Healthscope Commercial |
$232.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.41
|
| Rate for Payer: Mclaren Medicaid |
$45.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.69
|
| Rate for Payer: Meridian Medicaid |
$47.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.20
|
| Rate for Payer: Nomi Health Commercial |
$211.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.41
|
| Rate for Payer: PACE Senior Care Partners |
$61.25
|
| Rate for Payer: PACE SWMI |
$64.47
|
| Rate for Payer: PHP Commercial |
$219.20
|
| Rate for Payer: PHP Medicare Advantage |
$64.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.36
|
| Rate for Payer: Priority Health Medicare |
$65.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.48
|
| Rate for Payer: Railroad Medicare Medicare |
$64.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.93
|
| Rate for Payer: UHC Core |
$215.33
|
| Rate for Payer: UHC Exchange |
$64.47
|
| Rate for Payer: UHC Medicaid |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$64.47
|
| Rate for Payer: UHCCP Medicaid |
$45.46
|
| Rate for Payer: VA VA |
$64.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.41
|
|
|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
IP
|
$257.88
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.48 |
| Max. Negotiated Rate |
$232.09 |
| Rate for Payer: Aetna Commercial |
$219.20
|
| Rate for Payer: BCBS Trust/PPO |
$212.98
|
| Rate for Payer: BCN Commercial |
$212.98
|
| Rate for Payer: Cash Price |
$206.30
|
| Rate for Payer: Cofinity Commercial |
$221.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.30
|
| Rate for Payer: Healthscope Commercial |
$232.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.20
|
| Rate for Payer: Nomi Health Commercial |
$211.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.41
|
| Rate for Payer: PHP Commercial |
$219.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.93
|
| Rate for Payer: UHC Core |
$215.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.41
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
IP
|
$880.72
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.98 |
| Max. Negotiated Rate |
$792.65 |
| Rate for Payer: Aetna Commercial |
$748.61
|
| Rate for Payer: BCBS Trust/PPO |
$727.39
|
| Rate for Payer: BCN Commercial |
$727.39
|
| Rate for Payer: Cash Price |
$704.58
|
| Rate for Payer: Cofinity Commercial |
$757.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.58
|
| Rate for Payer: Healthscope Commercial |
$792.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$748.61
|
| Rate for Payer: Nomi Health Commercial |
$722.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.54
|
| Rate for Payer: PHP Commercial |
$748.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$766.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$612.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.03
|
| Rate for Payer: UHC Core |
$735.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.54
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
OP
|
$880.72
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.27 |
| Max. Negotiated Rate |
$792.65 |
| Rate for Payer: Aetna Commercial |
$748.61
|
| Rate for Payer: Aetna Medicare |
$228.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.23
|
| Rate for Payer: BCBS Complete |
$163.02
|
| Rate for Payer: BCBS MAPPO |
$220.18
|
| Rate for Payer: BCBS Trust/PPO |
$724.04
|
| Rate for Payer: BCN Commercial |
$724.04
|
| Rate for Payer: BCN Medicare Advantage |
$220.18
|
| Rate for Payer: Cash Price |
$704.58
|
| Rate for Payer: Cofinity Commercial |
$757.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.18
|
| Rate for Payer: Healthscope Commercial |
$792.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.54
|
| Rate for Payer: Mclaren Medicaid |
$155.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.19
|
| Rate for Payer: Meridian Medicaid |
$163.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$748.61
|
| Rate for Payer: Nomi Health Commercial |
$722.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.54
|
| Rate for Payer: PACE Senior Care Partners |
$209.17
|
| Rate for Payer: PACE SWMI |
$220.18
|
| Rate for Payer: PHP Commercial |
$748.61
|
| Rate for Payer: PHP Medicare Advantage |
$220.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$766.23
|
| Rate for Payer: Priority Health Medicare |
$222.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$612.98
|
| Rate for Payer: Railroad Medicare Medicare |
$220.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.03
|
| Rate for Payer: UHC Core |
$735.40
|
| Rate for Payer: UHC Exchange |
$220.18
|
| Rate for Payer: UHC Medicaid |
$155.27
|
| Rate for Payer: UHC Medicare Advantage |
$220.18
|
| Rate for Payer: UHCCP Medicaid |
$155.27
|
| Rate for Payer: VA VA |
$220.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.54
|
|
|
HC INJECTION SHUNTOGRAM
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC INJECTION SHUNTOGRAM
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.85
|
| Rate for Payer: BCN Commercial |
$245.85
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$52.48 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$77.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.03
|
| Rate for Payer: BCBS Complete |
$55.10
|
| Rate for Payer: BCBS MAPPO |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.72
|
| Rate for Payer: BCN Commercial |
$244.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.42
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.42
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$52.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Medicaid |
$55.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Senior Care Partners |
$70.70
|
| Rate for Payer: PACE SWMI |
$74.42
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Medicare |
$75.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: Railroad Medicare Medicare |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: UHC Exchange |
$74.42
|
| Rate for Payer: UHC Medicaid |
$52.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.42
|
| Rate for Payer: UHCCP Medicaid |
$52.48
|
| Rate for Payer: VA VA |
$74.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,031.48
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$717.91 |
| Max. Negotiated Rate |
$928.33 |
| Rate for Payer: Aetna Commercial |
$876.76
|
| Rate for Payer: BCBS Trust/PPO |
$851.90
|
| Rate for Payer: BCN Commercial |
$851.90
|
| Rate for Payer: Cash Price |
$825.18
|
| Rate for Payer: Cofinity Commercial |
$887.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.18
|
| Rate for Payer: Healthscope Commercial |
$928.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.76
|
| Rate for Payer: Nomi Health Commercial |
$845.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.61
|
| Rate for Payer: PHP Commercial |
$876.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$717.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.70
|
| Rate for Payer: UHC Core |
$861.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.61
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
OP
|
$1,031.48
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.85 |
| Max. Negotiated Rate |
$928.33 |
| Rate for Payer: Aetna Commercial |
$876.76
|
| Rate for Payer: Aetna Medicare |
$268.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.34
|
| Rate for Payer: BCBS Complete |
$190.93
|
| Rate for Payer: BCBS MAPPO |
$257.87
|
| Rate for Payer: BCBS Trust/PPO |
$847.98
|
| Rate for Payer: BCN Commercial |
$847.98
|
| Rate for Payer: BCN Medicare Advantage |
$257.87
|
| Rate for Payer: Cash Price |
$825.18
|
| Rate for Payer: Cofinity Commercial |
$887.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.87
|
| Rate for Payer: Healthscope Commercial |
$928.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.61
|
| Rate for Payer: Mclaren Medicaid |
$181.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.76
|
| Rate for Payer: Meridian Medicaid |
$190.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.76
|
| Rate for Payer: Nomi Health Commercial |
$845.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.61
|
| Rate for Payer: PACE Senior Care Partners |
$244.98
|
| Rate for Payer: PACE SWMI |
$257.87
|
| Rate for Payer: PHP Commercial |
$876.76
|
| Rate for Payer: PHP Medicare Advantage |
$257.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.39
|
| Rate for Payer: Priority Health Medicare |
$260.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$717.91
|
| Rate for Payer: Railroad Medicare Medicare |
$257.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.70
|
| Rate for Payer: UHC Core |
$861.29
|
| Rate for Payer: UHC Exchange |
$257.87
|
| Rate for Payer: UHC Medicaid |
$181.85
|
| Rate for Payer: UHC Medicare Advantage |
$257.87
|
| Rate for Payer: UHCCP Medicaid |
$181.85
|
| Rate for Payer: VA VA |
$257.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.61
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
OP
|
$1,068.81
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.43 |
| Max. Negotiated Rate |
$961.93 |
| Rate for Payer: Aetna Commercial |
$908.49
|
| Rate for Payer: Aetna Medicare |
$277.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.00
|
| Rate for Payer: BCBS Complete |
$197.84
|
| Rate for Payer: BCBS MAPPO |
$267.20
|
| Rate for Payer: BCBS Trust/PPO |
$878.67
|
| Rate for Payer: BCN Commercial |
$878.67
|
| Rate for Payer: BCN Medicare Advantage |
$267.20
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cofinity Commercial |
$919.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.20
|
| Rate for Payer: Healthscope Commercial |
$961.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.61
|
| Rate for Payer: Mclaren Medicaid |
$188.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.56
|
| Rate for Payer: Meridian Medicaid |
$197.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.49
|
| Rate for Payer: Nomi Health Commercial |
$876.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.61
|
| Rate for Payer: PACE Senior Care Partners |
$253.84
|
| Rate for Payer: PACE SWMI |
$267.20
|
| Rate for Payer: PHP Commercial |
$908.49
|
| Rate for Payer: PHP Medicare Advantage |
$267.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$929.86
|
| Rate for Payer: Priority Health Medicare |
$269.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$743.89
|
| Rate for Payer: Railroad Medicare Medicare |
$267.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.55
|
| Rate for Payer: UHC Core |
$892.46
|
| Rate for Payer: UHC Exchange |
$267.20
|
| Rate for Payer: UHC Medicaid |
$188.43
|
| Rate for Payer: UHC Medicare Advantage |
$267.20
|
| Rate for Payer: UHCCP Medicaid |
$188.43
|
| Rate for Payer: VA VA |
$267.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.61
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,068.81
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$743.89 |
| Max. Negotiated Rate |
$961.93 |
| Rate for Payer: Aetna Commercial |
$908.49
|
| Rate for Payer: BCBS Trust/PPO |
$882.73
|
| Rate for Payer: BCN Commercial |
$882.73
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cofinity Commercial |
$919.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.05
|
| Rate for Payer: Healthscope Commercial |
$961.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.49
|
| Rate for Payer: Nomi Health Commercial |
$876.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.61
|
| Rate for Payer: PHP Commercial |
$908.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$929.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$743.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.55
|
| Rate for Payer: UHC Core |
$892.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.61
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
IP
|
$284.95
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.33 |
| Max. Negotiated Rate |
$256.45 |
| Rate for Payer: Aetna Commercial |
$242.21
|
| Rate for Payer: BCBS Trust/PPO |
$235.34
|
| Rate for Payer: BCN Commercial |
$235.34
|
| Rate for Payer: Cash Price |
$227.96
|
| Rate for Payer: Cofinity Commercial |
$245.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.96
|
| Rate for Payer: Healthscope Commercial |
$256.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.21
|
| Rate for Payer: Nomi Health Commercial |
$233.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.71
|
| Rate for Payer: PHP Commercial |
$242.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.76
|
| Rate for Payer: UHC Core |
$237.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.71
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
OP
|
$284.95
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.24 |
| Max. Negotiated Rate |
$256.45 |
| Rate for Payer: Aetna Commercial |
$242.21
|
| Rate for Payer: Aetna Medicare |
$74.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.05
|
| Rate for Payer: BCBS Complete |
$52.74
|
| Rate for Payer: BCBS MAPPO |
$71.24
|
| Rate for Payer: BCBS Trust/PPO |
$234.26
|
| Rate for Payer: BCN Commercial |
$234.26
|
| Rate for Payer: BCN Medicare Advantage |
$71.24
|
| Rate for Payer: Cash Price |
$227.96
|
| Rate for Payer: Cofinity Commercial |
$245.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.24
|
| Rate for Payer: Healthscope Commercial |
$256.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.71
|
| Rate for Payer: Mclaren Medicaid |
$50.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.80
|
| Rate for Payer: Meridian Medicaid |
$52.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.21
|
| Rate for Payer: Nomi Health Commercial |
$233.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.71
|
| Rate for Payer: PACE Senior Care Partners |
$67.68
|
| Rate for Payer: PACE SWMI |
$71.24
|
| Rate for Payer: PHP Commercial |
$242.21
|
| Rate for Payer: PHP Medicare Advantage |
$71.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.91
|
| Rate for Payer: Priority Health Medicare |
$71.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.33
|
| Rate for Payer: Railroad Medicare Medicare |
$71.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.76
|
| Rate for Payer: UHC Core |
$237.93
|
| Rate for Payer: UHC Exchange |
$71.24
|
| Rate for Payer: UHC Medicaid |
$50.24
|
| Rate for Payer: UHC Medicare Advantage |
$71.24
|
| Rate for Payer: UHCCP Medicaid |
$50.24
|
| Rate for Payer: VA VA |
$71.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.71
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
IP
|
$1,106.99
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$770.47 |
| Max. Negotiated Rate |
$996.29 |
| Rate for Payer: Aetna Commercial |
$940.94
|
| Rate for Payer: BCBS Trust/PPO |
$914.26
|
| Rate for Payer: BCN Commercial |
$914.26
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cofinity Commercial |
$952.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.59
|
| Rate for Payer: Healthscope Commercial |
$996.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.94
|
| Rate for Payer: Nomi Health Commercial |
$907.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.24
|
| Rate for Payer: PHP Commercial |
$940.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$963.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$770.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.15
|
| Rate for Payer: UHC Core |
$924.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.24
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
OP
|
$1,106.99
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.16 |
| Max. Negotiated Rate |
$996.29 |
| Rate for Payer: Aetna Commercial |
$940.94
|
| Rate for Payer: Aetna Medicare |
$287.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$345.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$345.93
|
| Rate for Payer: BCBS Complete |
$204.90
|
| Rate for Payer: BCBS MAPPO |
$276.75
|
| Rate for Payer: BCBS Trust/PPO |
$910.06
|
| Rate for Payer: BCN Commercial |
$910.06
|
| Rate for Payer: BCN Medicare Advantage |
$276.75
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cofinity Commercial |
$952.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$276.75
|
| Rate for Payer: Healthscope Commercial |
$996.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.24
|
| Rate for Payer: Mclaren Medicaid |
$195.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$290.58
|
| Rate for Payer: Meridian Medicaid |
$204.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$318.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$304.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.94
|
| Rate for Payer: Nomi Health Commercial |
$907.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.24
|
| Rate for Payer: PACE Senior Care Partners |
$262.91
|
| Rate for Payer: PACE SWMI |
$276.75
|
| Rate for Payer: PHP Commercial |
$940.94
|
| Rate for Payer: PHP Medicare Advantage |
$276.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$963.08
|
| Rate for Payer: Priority Health Medicare |
$279.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$770.47
|
| Rate for Payer: Railroad Medicare Medicare |
$276.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.15
|
| Rate for Payer: UHC Core |
$924.34
|
| Rate for Payer: UHC Exchange |
$276.75
|
| Rate for Payer: UHC Medicaid |
$195.16
|
| Rate for Payer: UHC Medicare Advantage |
$276.75
|
| Rate for Payer: UHCCP Medicaid |
$195.16
|
| Rate for Payer: VA VA |
$276.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.24
|
|
