|
HC INJ PROCHLORPERAZINE UP TO 10 MG
|
Facility
|
IP
|
$79.78
|
|
|
Service Code
|
HCPCS J0780
|
| Hospital Charge Code |
63600246
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.53 |
| Max. Negotiated Rate |
$71.80 |
| Rate for Payer: Aetna Commercial |
$67.81
|
| Rate for Payer: BCBS Trust/PPO |
$65.89
|
| Rate for Payer: BCN Commercial |
$65.89
|
| Rate for Payer: Cash Price |
$63.82
|
| Rate for Payer: Cofinity Commercial |
$68.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.82
|
| Rate for Payer: Healthscope Commercial |
$71.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.81
|
| Rate for Payer: Nomi Health Commercial |
$65.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.84
|
| Rate for Payer: PHP Commercial |
$67.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.21
|
| Rate for Payer: UHC Core |
$66.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.84
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
IP
|
$697.21
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$485.26 |
| Max. Negotiated Rate |
$627.49 |
| Rate for Payer: Aetna Commercial |
$592.63
|
| Rate for Payer: BCBS Trust/PPO |
$575.83
|
| Rate for Payer: BCN Commercial |
$575.83
|
| Rate for Payer: Cash Price |
$557.77
|
| Rate for Payer: Cofinity Commercial |
$599.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.77
|
| Rate for Payer: Healthscope Commercial |
$627.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$592.63
|
| Rate for Payer: Nomi Health Commercial |
$571.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$522.91
|
| Rate for Payer: PHP Commercial |
$592.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$606.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.54
|
| Rate for Payer: UHC Core |
$582.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.91
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
OP
|
$697.21
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$122.92 |
| Max. Negotiated Rate |
$627.49 |
| Rate for Payer: Aetna Commercial |
$592.63
|
| Rate for Payer: Aetna Medicare |
$181.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.88
|
| Rate for Payer: BCBS Complete |
$129.05
|
| Rate for Payer: BCBS MAPPO |
$174.30
|
| Rate for Payer: BCBS Trust/PPO |
$573.18
|
| Rate for Payer: BCN Commercial |
$573.18
|
| Rate for Payer: BCN Medicare Advantage |
$174.30
|
| Rate for Payer: Cash Price |
$557.77
|
| Rate for Payer: Cofinity Commercial |
$599.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.30
|
| Rate for Payer: Healthscope Commercial |
$627.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.91
|
| Rate for Payer: Mclaren Medicaid |
$122.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.02
|
| Rate for Payer: Meridian Medicaid |
$129.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$592.63
|
| Rate for Payer: Nomi Health Commercial |
$571.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$522.91
|
| Rate for Payer: PACE Senior Care Partners |
$165.59
|
| Rate for Payer: PACE SWMI |
$174.30
|
| Rate for Payer: PHP Commercial |
$592.63
|
| Rate for Payer: PHP Medicare Advantage |
$174.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$606.57
|
| Rate for Payer: Priority Health Medicare |
$176.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$485.26
|
| Rate for Payer: Railroad Medicare Medicare |
$174.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.54
|
| Rate for Payer: UHC Core |
$582.17
|
| Rate for Payer: UHC Exchange |
$174.30
|
| Rate for Payer: UHC Medicaid |
$122.92
|
| Rate for Payer: UHC Medicare Advantage |
$174.30
|
| Rate for Payer: UHCCP Medicaid |
$122.92
|
| Rate for Payer: VA VA |
$174.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.91
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$147.72 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.29
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.42 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$55.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.33
|
| Rate for Payer: BCBS Complete |
$39.29
|
| Rate for Payer: BCBS MAPPO |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$174.48
|
| Rate for Payer: BCN Commercial |
$174.48
|
| Rate for Payer: BCN Medicare Advantage |
$53.06
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.06
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Mclaren Medicaid |
$37.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.71
|
| Rate for Payer: Meridian Medicaid |
$39.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Senior Care Partners |
$50.41
|
| Rate for Payer: PACE SWMI |
$53.06
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$53.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Medicare |
$53.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: Railroad Medicare Medicare |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: UHC Exchange |
$53.06
|
| Rate for Payer: UHC Medicaid |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$53.06
|
| Rate for Payer: UHCCP Medicaid |
$37.42
|
| Rate for Payer: VA VA |
$53.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.61
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Aetna Commercial |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$8.76
|
| Rate for Payer: BCN Commercial |
$8.76
|
| Rate for Payer: Cash Price |
$8.49
|
| Rate for Payer: Cofinity Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.49
|
| Rate for Payer: Healthscope Commercial |
$9.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.02
|
| Rate for Payer: Nomi Health Commercial |
$8.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.96
|
| Rate for Payer: PHP Commercial |
$9.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.34
|
| Rate for Payer: UHC Core |
$8.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.96
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.61
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Aetna Commercial |
$9.02
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.32
|
| Rate for Payer: BCBS Complete |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$8.72
|
| Rate for Payer: BCN Commercial |
$8.72
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$8.49
|
| Rate for Payer: Cofinity Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Healthscope Commercial |
$9.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.96
|
| Rate for Payer: Mclaren Medicaid |
$1.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.79
|
| Rate for Payer: Meridian Medicaid |
$1.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.02
|
| Rate for Payer: Nomi Health Commercial |
$8.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.96
|
| Rate for Payer: PACE Senior Care Partners |
$2.52
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Commercial |
$9.02
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.23
|
| Rate for Payer: Priority Health Medicare |
$2.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.34
|
| Rate for Payer: UHC Core |
$8.86
|
| Rate for Payer: UHC Exchange |
$2.65
|
| Rate for Payer: UHC Medicaid |
$1.87
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: VA VA |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.96
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.30
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$4.77 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: BCBS Trust/PPO |
$4.38
|
| Rate for Payer: BCN Commercial |
$4.38
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.24
|
| Rate for Payer: Healthscope Commercial |
$4.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.50
|
| Rate for Payer: Nomi Health Commercial |
$4.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.98
|
| Rate for Payer: PHP Commercial |
$4.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.66
|
| Rate for Payer: UHC Core |
$4.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.98
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.30
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.77 |
| Rate for Payer: Aetna Commercial |
$4.50
|
| Rate for Payer: Aetna Medicare |
$1.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.66
|
| Rate for Payer: BCBS Complete |
$0.98
|
| Rate for Payer: BCBS MAPPO |
$1.32
|
| Rate for Payer: BCBS Trust/PPO |
$4.36
|
| Rate for Payer: BCN Commercial |
$4.36
|
| Rate for Payer: BCN Medicare Advantage |
$1.32
|
| Rate for Payer: Cash Price |
$4.24
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.32
|
| Rate for Payer: Healthscope Commercial |
$4.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.98
|
| Rate for Payer: Mclaren Medicaid |
$0.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.39
|
| Rate for Payer: Meridian Medicaid |
$0.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.50
|
| Rate for Payer: Nomi Health Commercial |
$4.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.98
|
| Rate for Payer: PACE Senior Care Partners |
$1.26
|
| Rate for Payer: PACE SWMI |
$1.32
|
| Rate for Payer: PHP Commercial |
$4.50
|
| Rate for Payer: PHP Medicare Advantage |
$1.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.61
|
| Rate for Payer: Priority Health Medicare |
$1.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.66
|
| Rate for Payer: UHC Core |
$4.43
|
| Rate for Payer: UHC Exchange |
$1.32
|
| Rate for Payer: UHC Medicaid |
$0.93
|
| Rate for Payer: UHC Medicare Advantage |
$1.32
|
| Rate for Payer: UHCCP Medicaid |
$0.93
|
| Rate for Payer: VA VA |
$1.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.98
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$510.33
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.97 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: Aetna Medicare |
$132.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.48
|
| Rate for Payer: BCBS Complete |
$94.46
|
| Rate for Payer: BCBS MAPPO |
$127.58
|
| Rate for Payer: BCBS Trust/PPO |
$419.54
|
| Rate for Payer: BCN Commercial |
$419.54
|
| Rate for Payer: BCN Medicare Advantage |
$127.58
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.58
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: Mclaren Medicaid |
$89.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.96
|
| Rate for Payer: Meridian Medicaid |
$94.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PACE Senior Care Partners |
$121.20
|
| Rate for Payer: PACE SWMI |
$127.58
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: PHP Medicare Advantage |
$127.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$443.99
|
| Rate for Payer: Priority Health Medicare |
$128.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$355.19
|
| Rate for Payer: Railroad Medicare Medicare |
$127.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.09
|
| Rate for Payer: UHC Core |
$426.13
|
| Rate for Payer: UHC Exchange |
$127.58
|
| Rate for Payer: UHC Medicaid |
$89.97
|
| Rate for Payer: UHC Medicare Advantage |
$127.58
|
| Rate for Payer: UHCCP Medicaid |
$89.97
|
| Rate for Payer: VA VA |
$127.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
IP
|
$510.33
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$355.19 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: BCBS Trust/PPO |
$421.48
|
| Rate for Payer: BCN Commercial |
$421.48
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$443.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$355.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.09
|
| Rate for Payer: UHC Core |
$426.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$431.70
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.46 |
| Max. Negotiated Rate |
$388.53 |
| Rate for Payer: Aetna Commercial |
$366.94
|
| Rate for Payer: BCBS Trust/PPO |
$356.54
|
| Rate for Payer: BCN Commercial |
$356.54
|
| Rate for Payer: Cash Price |
$345.36
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.36
|
| Rate for Payer: Healthscope Commercial |
$388.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.94
|
| Rate for Payer: Nomi Health Commercial |
$353.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.77
|
| Rate for Payer: PHP Commercial |
$366.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$375.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.90
|
| Rate for Payer: UHC Core |
$360.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.77
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$431.70
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.11 |
| Max. Negotiated Rate |
$388.53 |
| Rate for Payer: Aetna Commercial |
$366.94
|
| Rate for Payer: Aetna Medicare |
$112.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.91
|
| Rate for Payer: BCBS Complete |
$79.91
|
| Rate for Payer: BCBS MAPPO |
$107.92
|
| Rate for Payer: BCBS Trust/PPO |
$354.90
|
| Rate for Payer: BCN Commercial |
$354.90
|
| Rate for Payer: BCN Medicare Advantage |
$107.92
|
| Rate for Payer: Cash Price |
$345.36
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.92
|
| Rate for Payer: Healthscope Commercial |
$388.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.77
|
| Rate for Payer: Mclaren Medicaid |
$76.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.32
|
| Rate for Payer: Meridian Medicaid |
$79.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$366.94
|
| Rate for Payer: Nomi Health Commercial |
$353.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.77
|
| Rate for Payer: PACE Senior Care Partners |
$102.53
|
| Rate for Payer: PACE SWMI |
$107.92
|
| Rate for Payer: PHP Commercial |
$366.94
|
| Rate for Payer: PHP Medicare Advantage |
$107.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$375.58
|
| Rate for Payer: Priority Health Medicare |
$109.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.46
|
| Rate for Payer: Railroad Medicare Medicare |
$107.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.90
|
| Rate for Payer: UHC Core |
$360.47
|
| Rate for Payer: UHC Exchange |
$107.92
|
| Rate for Payer: UHC Medicaid |
$76.11
|
| Rate for Payer: UHC Medicare Advantage |
$107.92
|
| Rate for Payer: UHCCP Medicaid |
$76.11
|
| Rate for Payer: VA VA |
$107.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.77
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$587.84
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.64 |
| Max. Negotiated Rate |
$529.06 |
| Rate for Payer: Aetna Commercial |
$499.66
|
| Rate for Payer: Aetna Medicare |
$152.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.70
|
| Rate for Payer: BCBS Complete |
$108.81
|
| Rate for Payer: BCBS MAPPO |
$146.96
|
| Rate for Payer: BCBS Trust/PPO |
$483.26
|
| Rate for Payer: BCN Commercial |
$483.26
|
| Rate for Payer: BCN Medicare Advantage |
$146.96
|
| Rate for Payer: Cash Price |
$470.27
|
| Rate for Payer: Cofinity Commercial |
$505.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.96
|
| Rate for Payer: Healthscope Commercial |
$529.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.88
|
| Rate for Payer: Mclaren Medicaid |
$103.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.31
|
| Rate for Payer: Meridian Medicaid |
$108.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.66
|
| Rate for Payer: Nomi Health Commercial |
$482.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.88
|
| Rate for Payer: PACE Senior Care Partners |
$139.61
|
| Rate for Payer: PACE SWMI |
$146.96
|
| Rate for Payer: PHP Commercial |
$499.66
|
| Rate for Payer: PHP Medicare Advantage |
$146.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.42
|
| Rate for Payer: Priority Health Medicare |
$148.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.14
|
| Rate for Payer: Railroad Medicare Medicare |
$146.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.30
|
| Rate for Payer: UHC Core |
$490.85
|
| Rate for Payer: UHC Exchange |
$146.96
|
| Rate for Payer: UHC Medicaid |
$103.64
|
| Rate for Payer: UHC Medicare Advantage |
$146.96
|
| Rate for Payer: UHCCP Medicaid |
$103.64
|
| Rate for Payer: VA VA |
$146.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.88
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$587.84
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.14 |
| Max. Negotiated Rate |
$529.06 |
| Rate for Payer: Aetna Commercial |
$499.66
|
| Rate for Payer: BCBS Trust/PPO |
$485.50
|
| Rate for Payer: BCN Commercial |
$485.50
|
| Rate for Payer: Cash Price |
$470.27
|
| Rate for Payer: Cofinity Commercial |
$505.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.27
|
| Rate for Payer: Healthscope Commercial |
$529.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.66
|
| Rate for Payer: Nomi Health Commercial |
$482.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.88
|
| Rate for Payer: PHP Commercial |
$499.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$511.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$517.30
|
| Rate for Payer: UHC Core |
$490.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.88
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$203.24
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.83 |
| Max. Negotiated Rate |
$182.92 |
| Rate for Payer: Aetna Commercial |
$172.75
|
| Rate for Payer: Aetna Medicare |
$52.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.51
|
| Rate for Payer: BCBS Complete |
$37.62
|
| Rate for Payer: BCBS MAPPO |
$50.81
|
| Rate for Payer: BCBS Trust/PPO |
$167.08
|
| Rate for Payer: BCN Commercial |
$167.08
|
| Rate for Payer: BCN Medicare Advantage |
$50.81
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cofinity Commercial |
$174.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.81
|
| Rate for Payer: Healthscope Commercial |
$182.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.43
|
| Rate for Payer: Mclaren Medicaid |
$35.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.35
|
| Rate for Payer: Meridian Medicaid |
$37.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.75
|
| Rate for Payer: Nomi Health Commercial |
$166.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.43
|
| Rate for Payer: PACE Senior Care Partners |
$48.27
|
| Rate for Payer: PACE SWMI |
$50.81
|
| Rate for Payer: PHP Commercial |
$172.75
|
| Rate for Payer: PHP Medicare Advantage |
$50.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.82
|
| Rate for Payer: Priority Health Medicare |
$51.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.46
|
| Rate for Payer: Railroad Medicare Medicare |
$50.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.85
|
| Rate for Payer: UHC Core |
$169.71
|
| Rate for Payer: UHC Exchange |
$50.81
|
| Rate for Payer: UHC Medicaid |
$35.83
|
| Rate for Payer: UHC Medicare Advantage |
$50.81
|
| Rate for Payer: UHCCP Medicaid |
$35.83
|
| Rate for Payer: VA VA |
$50.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.43
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$203.24
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.46 |
| Max. Negotiated Rate |
$182.92 |
| Rate for Payer: Aetna Commercial |
$172.75
|
| Rate for Payer: BCBS Trust/PPO |
$167.86
|
| Rate for Payer: BCN Commercial |
$167.86
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cofinity Commercial |
$174.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.59
|
| Rate for Payer: Healthscope Commercial |
$182.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.75
|
| Rate for Payer: Nomi Health Commercial |
$166.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.43
|
| Rate for Payer: PHP Commercial |
$172.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$176.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.85
|
| Rate for Payer: UHC Core |
$169.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.43
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$193.03 |
| Max. Negotiated Rate |
$985.43 |
| Rate for Payer: Aetna Commercial |
$930.68
|
| Rate for Payer: Aetna Medicare |
$284.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.16
|
| Rate for Payer: BCBS Complete |
$202.67
|
| Rate for Payer: BCBS MAPPO |
$273.73
|
| Rate for Payer: BCBS Trust/PPO |
$900.13
|
| Rate for Payer: BCN Commercial |
$900.13
|
| Rate for Payer: BCN Medicare Advantage |
$273.73
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Commercial |
$941.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.73
|
| Rate for Payer: Healthscope Commercial |
$985.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$821.19
|
| Rate for Payer: Mclaren Medicaid |
$193.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.42
|
| Rate for Payer: Meridian Medicaid |
$202.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$301.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Nomi Health Commercial |
$897.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: PACE Senior Care Partners |
$260.04
|
| Rate for Payer: PACE SWMI |
$273.73
|
| Rate for Payer: PHP Commercial |
$930.68
|
| Rate for Payer: PHP Medicare Advantage |
$273.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.58
|
| Rate for Payer: Priority Health Medicare |
$276.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$762.06
|
| Rate for Payer: Railroad Medicare Medicare |
$273.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.53
|
| Rate for Payer: UHC Core |
$914.26
|
| Rate for Payer: UHC Exchange |
$273.73
|
| Rate for Payer: UHC Medicaid |
$193.03
|
| Rate for Payer: UHC Medicare Advantage |
$273.73
|
| Rate for Payer: UHCCP Medicaid |
$193.03
|
| Rate for Payer: VA VA |
$273.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$821.19
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$762.06 |
| Max. Negotiated Rate |
$985.43 |
| Rate for Payer: Aetna Commercial |
$930.68
|
| Rate for Payer: BCBS Trust/PPO |
$904.29
|
| Rate for Payer: BCN Commercial |
$904.29
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Commercial |
$941.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Healthscope Commercial |
$985.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$821.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Nomi Health Commercial |
$897.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: PHP Commercial |
$930.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$762.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.53
|
| Rate for Payer: UHC Core |
$914.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$821.19
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,043.69 |
| Max. Negotiated Rate |
$1,349.60 |
| Rate for Payer: Aetna Commercial |
$1,274.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.48
|
| Rate for Payer: BCN Commercial |
$1,238.48
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Commercial |
$1,289.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Healthscope Commercial |
$1,349.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Nomi Health Commercial |
$1,229.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: PHP Commercial |
$1,274.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,304.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.60
|
| Rate for Payer: UHC Core |
$1,252.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.66
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.37 |
| Max. Negotiated Rate |
$1,349.60 |
| Rate for Payer: Aetna Commercial |
$1,274.62
|
| Rate for Payer: Aetna Medicare |
$389.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$468.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$468.61
|
| Rate for Payer: BCBS Complete |
$277.57
|
| Rate for Payer: BCBS MAPPO |
$374.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.78
|
| Rate for Payer: BCN Commercial |
$1,232.78
|
| Rate for Payer: BCN Medicare Advantage |
$374.89
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Commercial |
$1,289.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.89
|
| Rate for Payer: Healthscope Commercial |
$1,349.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.66
|
| Rate for Payer: Mclaren Medicaid |
$264.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.63
|
| Rate for Payer: Meridian Medicaid |
$277.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$412.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Nomi Health Commercial |
$1,229.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: PACE Senior Care Partners |
$356.14
|
| Rate for Payer: PACE SWMI |
$374.89
|
| Rate for Payer: PHP Commercial |
$1,274.62
|
| Rate for Payer: PHP Medicare Advantage |
$374.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,304.61
|
| Rate for Payer: Priority Health Medicare |
$378.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.69
|
| Rate for Payer: Railroad Medicare Medicare |
$374.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.60
|
| Rate for Payer: UHC Core |
$1,252.12
|
| Rate for Payer: UHC Exchange |
$374.89
|
| Rate for Payer: UHC Medicaid |
$264.37
|
| Rate for Payer: UHC Medicare Advantage |
$374.89
|
| Rate for Payer: UHCCP Medicaid |
$264.37
|
| Rate for Payer: VA VA |
$374.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.66
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,080.04 |
| Max. Negotiated Rate |
$1,396.60 |
| Rate for Payer: Aetna Commercial |
$1,319.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.62
|
| Rate for Payer: BCN Commercial |
$1,281.62
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Commercial |
$1,334.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Healthscope Commercial |
$1,396.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Nomi Health Commercial |
$1,272.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: PHP Commercial |
$1,319.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,350.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,080.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.57
|
| Rate for Payer: UHC Core |
$1,295.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.84
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$273.58 |
| Max. Negotiated Rate |
$1,396.60 |
| Rate for Payer: Aetna Commercial |
$1,319.01
|
| Rate for Payer: Aetna Medicare |
$403.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$484.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$484.93
|
| Rate for Payer: BCBS Complete |
$287.23
|
| Rate for Payer: BCBS MAPPO |
$387.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.72
|
| Rate for Payer: BCN Commercial |
$1,275.72
|
| Rate for Payer: BCN Medicare Advantage |
$387.94
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Commercial |
$1,334.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.94
|
| Rate for Payer: Healthscope Commercial |
$1,396.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.84
|
| Rate for Payer: Mclaren Medicaid |
$273.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$407.34
|
| Rate for Payer: Meridian Medicaid |
$287.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$446.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$426.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Nomi Health Commercial |
$1,272.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: PACE Senior Care Partners |
$368.55
|
| Rate for Payer: PACE SWMI |
$387.94
|
| Rate for Payer: PHP Commercial |
$1,319.01
|
| Rate for Payer: PHP Medicare Advantage |
$387.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,350.05
|
| Rate for Payer: Priority Health Medicare |
$391.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,080.04
|
| Rate for Payer: Railroad Medicare Medicare |
$387.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,365.57
|
| Rate for Payer: UHC Core |
$1,295.74
|
| Rate for Payer: UHC Exchange |
$387.94
|
| Rate for Payer: UHC Medicaid |
$273.58
|
| Rate for Payer: UHC Medicare Advantage |
$387.94
|
| Rate for Payer: UHCCP Medicaid |
$273.58
|
| Rate for Payer: VA VA |
$387.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.84
|
|
