|
HC INSERTION VENTRICULAR ASSIST DEVICE RIGHT HEART
|
Facility
|
IP
|
$3,141.86
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
48100136
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,186.73 |
| Max. Negotiated Rate |
$2,827.67 |
| Rate for Payer: Aetna Commercial |
$2,670.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,594.86
|
| Rate for Payer: BCN Commercial |
$2,594.86
|
| Rate for Payer: Cash Price |
$2,513.49
|
| Rate for Payer: Cofinity Commercial |
$2,702.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,513.49
|
| Rate for Payer: Healthscope Commercial |
$2,827.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,356.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,670.58
|
| Rate for Payer: Nomi Health Commercial |
$2,576.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,356.39
|
| Rate for Payer: PHP Commercial |
$2,670.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,733.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,186.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,764.84
|
| Rate for Payer: UHC Core |
$2,623.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,356.39
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,293.98
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,596.61 |
| Max. Negotiated Rate |
$2,064.58 |
| Rate for Payer: Aetna Commercial |
$1,949.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.60
|
| Rate for Payer: BCN Commercial |
$1,894.60
|
| Rate for Payer: Cash Price |
$1,835.18
|
| Rate for Payer: Cofinity Commercial |
$1,972.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,835.18
|
| Rate for Payer: Healthscope Commercial |
$2,064.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,720.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,949.88
|
| Rate for Payer: Nomi Health Commercial |
$1,881.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,720.48
|
| Rate for Payer: PHP Commercial |
$1,949.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,995.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,596.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,018.70
|
| Rate for Payer: UHC Core |
$1,915.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,720.48
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,293.98
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$404.43 |
| Max. Negotiated Rate |
$2,064.58 |
| Rate for Payer: Aetna Commercial |
$1,949.88
|
| Rate for Payer: Aetna Medicare |
$596.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$716.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$716.87
|
| Rate for Payer: BCBS Complete |
$424.62
|
| Rate for Payer: BCBS MAPPO |
$573.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,885.88
|
| Rate for Payer: BCN Commercial |
$1,885.88
|
| Rate for Payer: BCN Medicare Advantage |
$573.50
|
| Rate for Payer: Cash Price |
$1,835.18
|
| Rate for Payer: Cofinity Commercial |
$1,972.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,835.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$573.50
|
| Rate for Payer: Healthscope Commercial |
$2,064.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,720.48
|
| Rate for Payer: Mclaren Medicaid |
$404.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$602.17
|
| Rate for Payer: Meridian Medicaid |
$424.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$659.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$630.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,949.88
|
| Rate for Payer: Nomi Health Commercial |
$1,881.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,720.48
|
| Rate for Payer: PACE Senior Care Partners |
$544.82
|
| Rate for Payer: PACE SWMI |
$573.50
|
| Rate for Payer: PHP Commercial |
$1,949.88
|
| Rate for Payer: PHP Medicare Advantage |
$573.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$404.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,995.76
|
| Rate for Payer: Priority Health Medicare |
$579.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,596.61
|
| Rate for Payer: Railroad Medicare Medicare |
$573.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,018.70
|
| Rate for Payer: UHC Core |
$1,915.47
|
| Rate for Payer: UHC Exchange |
$573.50
|
| Rate for Payer: UHC Medicaid |
$404.43
|
| Rate for Payer: UHC Medicare Advantage |
$573.50
|
| Rate for Payer: UHCCP Medicaid |
$404.43
|
| Rate for Payer: VA VA |
$573.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,720.48
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$2,025.84
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.16 |
| Max. Negotiated Rate |
$1,823.26 |
| Rate for Payer: Aetna Commercial |
$1,721.96
|
| Rate for Payer: Aetna Medicare |
$526.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$633.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$633.08
|
| Rate for Payer: BCBS Complete |
$374.98
|
| Rate for Payer: BCBS MAPPO |
$506.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,665.44
|
| Rate for Payer: BCN Commercial |
$1,665.44
|
| Rate for Payer: BCN Medicare Advantage |
$506.46
|
| Rate for Payer: Cash Price |
$1,620.67
|
| Rate for Payer: Cofinity Commercial |
$1,742.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,620.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.46
|
| Rate for Payer: Healthscope Commercial |
$1,823.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,519.38
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$531.78
|
| Rate for Payer: Meridian Medicaid |
$374.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$582.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$557.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,721.96
|
| Rate for Payer: Nomi Health Commercial |
$1,661.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,519.38
|
| Rate for Payer: PACE Senior Care Partners |
$481.14
|
| Rate for Payer: PACE SWMI |
$506.46
|
| Rate for Payer: PHP Commercial |
$1,721.96
|
| Rate for Payer: PHP Medicare Advantage |
$506.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,762.48
|
| Rate for Payer: Priority Health Medicare |
$511.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,409.98
|
| Rate for Payer: Railroad Medicare Medicare |
$506.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,782.74
|
| Rate for Payer: UHC Core |
$1,691.58
|
| Rate for Payer: UHC Exchange |
$506.46
|
| Rate for Payer: UHC Medicaid |
$357.16
|
| Rate for Payer: UHC Medicare Advantage |
$506.46
|
| Rate for Payer: UHCCP Medicaid |
$357.16
|
| Rate for Payer: VA VA |
$506.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,519.38
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
IP
|
$2,025.84
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.98 |
| Max. Negotiated Rate |
$1,823.26 |
| Rate for Payer: Aetna Commercial |
$1,721.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.14
|
| Rate for Payer: BCN Commercial |
$1,673.14
|
| Rate for Payer: Cash Price |
$1,620.67
|
| Rate for Payer: Cofinity Commercial |
$1,742.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,620.67
|
| Rate for Payer: Healthscope Commercial |
$1,823.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,519.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,721.96
|
| Rate for Payer: Nomi Health Commercial |
$1,661.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,519.38
|
| Rate for Payer: PHP Commercial |
$1,721.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,762.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,409.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,782.74
|
| Rate for Payer: UHC Core |
$1,691.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,519.38
|
|
|
HC INSERT/REPLACE ICD W/SUBSTERNAL ELECTRODES
|
Facility
|
IP
|
$72,138.55
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
48100134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$50,208.43 |
| Max. Negotiated Rate |
$64,924.69 |
| Rate for Payer: Aetna Commercial |
$61,317.77
|
| Rate for Payer: BCBS Trust/PPO |
$59,579.23
|
| Rate for Payer: BCN Commercial |
$59,579.23
|
| Rate for Payer: Cash Price |
$57,710.84
|
| Rate for Payer: Cofinity Commercial |
$62,039.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,710.84
|
| Rate for Payer: Healthscope Commercial |
$64,924.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,103.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,317.77
|
| Rate for Payer: Nomi Health Commercial |
$59,153.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54,103.91
|
| Rate for Payer: PHP Commercial |
$61,317.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62,760.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50,208.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,481.92
|
| Rate for Payer: UHC Core |
$60,235.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,103.91
|
|
|
HC INSERT/REPLACE ICD W/SUBSTERNAL ELECTRODES
|
Facility
|
OP
|
$72,138.55
|
|
|
Service Code
|
CPT 0571T
|
| Hospital Charge Code |
48100134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,718.03 |
| Max. Negotiated Rate |
$64,924.69 |
| Rate for Payer: Aetna Commercial |
$61,317.77
|
| Rate for Payer: Aetna Medicare |
$18,756.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,543.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,543.30
|
| Rate for Payer: BCBS Complete |
$13,352.85
|
| Rate for Payer: BCBS MAPPO |
$18,034.64
|
| Rate for Payer: BCBS Trust/PPO |
$59,305.10
|
| Rate for Payer: BCN Commercial |
$59,305.10
|
| Rate for Payer: BCN Medicare Advantage |
$18,034.64
|
| Rate for Payer: Cash Price |
$57,710.84
|
| Rate for Payer: Cofinity Commercial |
$62,039.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,710.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,034.64
|
| Rate for Payer: Healthscope Commercial |
$64,924.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,103.91
|
| Rate for Payer: Mclaren Medicaid |
$12,718.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,936.37
|
| Rate for Payer: Meridian Medicaid |
$13,352.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,739.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$19,838.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,317.77
|
| Rate for Payer: Nomi Health Commercial |
$59,153.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54,103.91
|
| Rate for Payer: PACE Senior Care Partners |
$17,132.91
|
| Rate for Payer: PACE SWMI |
$18,034.64
|
| Rate for Payer: PHP Commercial |
$61,317.77
|
| Rate for Payer: PHP Medicare Advantage |
$18,034.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,718.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62,760.54
|
| Rate for Payer: Priority Health Medicare |
$18,214.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50,208.43
|
| Rate for Payer: Railroad Medicare Medicare |
$18,034.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,481.92
|
| Rate for Payer: UHC Core |
$60,235.69
|
| Rate for Payer: UHC Exchange |
$18,034.64
|
| Rate for Payer: UHC Medicaid |
$12,718.03
|
| Rate for Payer: UHC Medicare Advantage |
$18,034.64
|
| Rate for Payer: UHCCP Medicaid |
$12,718.03
|
| Rate for Payer: VA VA |
$18,034.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,103.91
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$86,596.51
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,266.96 |
| Max. Negotiated Rate |
$77,936.86 |
| Rate for Payer: Aetna Commercial |
$73,607.03
|
| Rate for Payer: Aetna Medicare |
$22,515.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,061.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,061.41
|
| Rate for Payer: BCBS Complete |
$16,029.01
|
| Rate for Payer: BCBS MAPPO |
$21,649.13
|
| Rate for Payer: BCBS Trust/PPO |
$71,190.99
|
| Rate for Payer: BCN Commercial |
$71,190.99
|
| Rate for Payer: BCN Medicare Advantage |
$21,649.13
|
| Rate for Payer: Cash Price |
$69,277.21
|
| Rate for Payer: Cofinity Commercial |
$74,473.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69,277.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,649.13
|
| Rate for Payer: Healthscope Commercial |
$77,936.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64,947.38
|
| Rate for Payer: Mclaren Medicaid |
$15,266.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,731.58
|
| Rate for Payer: Meridian Medicaid |
$16,029.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,896.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$23,814.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,607.03
|
| Rate for Payer: Nomi Health Commercial |
$71,009.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64,947.38
|
| Rate for Payer: PACE Senior Care Partners |
$20,566.67
|
| Rate for Payer: PACE SWMI |
$21,649.13
|
| Rate for Payer: PHP Commercial |
$73,607.03
|
| Rate for Payer: PHP Medicare Advantage |
$21,649.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,266.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75,338.96
|
| Rate for Payer: Priority Health Medicare |
$21,865.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60,271.17
|
| Rate for Payer: Railroad Medicare Medicare |
$21,649.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76,204.93
|
| Rate for Payer: UHC Core |
$72,308.09
|
| Rate for Payer: UHC Exchange |
$21,649.13
|
| Rate for Payer: UHC Medicaid |
$15,266.96
|
| Rate for Payer: UHC Medicare Advantage |
$21,649.13
|
| Rate for Payer: UHCCP Medicaid |
$15,266.96
|
| Rate for Payer: VA VA |
$21,649.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64,947.38
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$86,596.51
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$60,271.17 |
| Max. Negotiated Rate |
$77,936.86 |
| Rate for Payer: Aetna Commercial |
$73,607.03
|
| Rate for Payer: BCBS Trust/PPO |
$71,520.06
|
| Rate for Payer: BCN Commercial |
$71,520.06
|
| Rate for Payer: Cash Price |
$69,277.21
|
| Rate for Payer: Cofinity Commercial |
$74,473.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69,277.21
|
| Rate for Payer: Healthscope Commercial |
$77,936.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64,947.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73,607.03
|
| Rate for Payer: Nomi Health Commercial |
$71,009.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64,947.38
|
| Rate for Payer: PHP Commercial |
$73,607.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75,338.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60,271.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76,204.93
|
| Rate for Payer: UHC Core |
$72,308.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64,947.38
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$189.01
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$170.11 |
| Rate for Payer: Aetna Commercial |
$160.66
|
| Rate for Payer: BCBS Trust/PPO |
$156.10
|
| Rate for Payer: BCN Commercial |
$156.10
|
| Rate for Payer: Cash Price |
$151.21
|
| Rate for Payer: Cofinity Commercial |
$162.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.21
|
| Rate for Payer: Healthscope Commercial |
$170.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.66
|
| Rate for Payer: Nomi Health Commercial |
$154.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.76
|
| Rate for Payer: PHP Commercial |
$160.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$164.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.33
|
| Rate for Payer: UHC Core |
$157.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.76
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$189.01
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.32 |
| Max. Negotiated Rate |
$170.11 |
| Rate for Payer: Aetna Commercial |
$160.66
|
| Rate for Payer: Aetna Medicare |
$49.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.07
|
| Rate for Payer: BCBS Complete |
$34.99
|
| Rate for Payer: BCBS MAPPO |
$47.25
|
| Rate for Payer: BCBS Trust/PPO |
$155.39
|
| Rate for Payer: BCN Commercial |
$155.39
|
| Rate for Payer: BCN Medicare Advantage |
$47.25
|
| Rate for Payer: Cash Price |
$151.21
|
| Rate for Payer: Cofinity Commercial |
$162.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.25
|
| Rate for Payer: Healthscope Commercial |
$170.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.76
|
| Rate for Payer: Mclaren Medicaid |
$33.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.62
|
| Rate for Payer: Meridian Medicaid |
$34.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.66
|
| Rate for Payer: Nomi Health Commercial |
$154.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.76
|
| Rate for Payer: PACE Senior Care Partners |
$44.89
|
| Rate for Payer: PACE SWMI |
$47.25
|
| Rate for Payer: PHP Commercial |
$160.66
|
| Rate for Payer: PHP Medicare Advantage |
$47.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$164.44
|
| Rate for Payer: Priority Health Medicare |
$47.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.55
|
| Rate for Payer: Railroad Medicare Medicare |
$47.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.33
|
| Rate for Payer: UHC Core |
$157.82
|
| Rate for Payer: UHC Exchange |
$47.25
|
| Rate for Payer: UHC Medicaid |
$33.32
|
| Rate for Payer: UHC Medicare Advantage |
$47.25
|
| Rate for Payer: UHCCP Medicaid |
$33.32
|
| Rate for Payer: VA VA |
$47.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.76
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,280.84
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,979.46 |
| Max. Negotiated Rate |
$3,852.76 |
| Rate for Payer: Aetna Commercial |
$3,638.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,535.55
|
| Rate for Payer: BCN Commercial |
$3,535.55
|
| Rate for Payer: Cash Price |
$3,424.67
|
| Rate for Payer: Cofinity Commercial |
$3,681.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,424.67
|
| Rate for Payer: Healthscope Commercial |
$3,852.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,210.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,638.71
|
| Rate for Payer: Nomi Health Commercial |
$3,510.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,210.63
|
| Rate for Payer: PHP Commercial |
$3,638.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,724.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,979.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,767.14
|
| Rate for Payer: UHC Core |
$3,574.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,210.63
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,280.84
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$754.71 |
| Max. Negotiated Rate |
$3,852.76 |
| Rate for Payer: Aetna Commercial |
$3,638.71
|
| Rate for Payer: Aetna Medicare |
$1,113.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,337.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,337.76
|
| Rate for Payer: BCBS Complete |
$792.38
|
| Rate for Payer: BCBS MAPPO |
$1,070.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,519.28
|
| Rate for Payer: BCN Commercial |
$3,519.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.21
|
| Rate for Payer: Cash Price |
$3,424.67
|
| Rate for Payer: Cofinity Commercial |
$3,681.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,424.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.21
|
| Rate for Payer: Healthscope Commercial |
$3,852.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,210.63
|
| Rate for Payer: Mclaren Medicaid |
$754.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.72
|
| Rate for Payer: Meridian Medicaid |
$792.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,230.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,177.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,638.71
|
| Rate for Payer: Nomi Health Commercial |
$3,510.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,210.63
|
| Rate for Payer: PACE Senior Care Partners |
$1,016.70
|
| Rate for Payer: PACE SWMI |
$1,070.21
|
| Rate for Payer: PHP Commercial |
$3,638.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$754.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,724.33
|
| Rate for Payer: Priority Health Medicare |
$1,080.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,979.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,070.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,767.14
|
| Rate for Payer: UHC Core |
$3,574.50
|
| Rate for Payer: UHC Exchange |
$1,070.21
|
| Rate for Payer: UHC Medicaid |
$754.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.21
|
| Rate for Payer: UHCCP Medicaid |
$754.71
|
| Rate for Payer: VA VA |
$1,070.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,210.63
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,222.35
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,938.76 |
| Max. Negotiated Rate |
$3,800.11 |
| Rate for Payer: Aetna Commercial |
$3,589.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,487.24
|
| Rate for Payer: BCN Commercial |
$3,487.24
|
| Rate for Payer: Cash Price |
$3,377.88
|
| Rate for Payer: Cofinity Commercial |
$3,631.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,377.88
|
| Rate for Payer: Healthscope Commercial |
$3,800.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,166.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,589.00
|
| Rate for Payer: Nomi Health Commercial |
$3,462.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,166.76
|
| Rate for Payer: PHP Commercial |
$3,589.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,673.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,938.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,715.67
|
| Rate for Payer: UHC Core |
$3,525.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,166.76
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,222.35
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$744.40 |
| Max. Negotiated Rate |
$3,800.11 |
| Rate for Payer: Aetna Commercial |
$3,589.00
|
| Rate for Payer: Aetna Medicare |
$1,097.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,319.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,319.48
|
| Rate for Payer: BCBS Complete |
$781.56
|
| Rate for Payer: BCBS MAPPO |
$1,055.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,471.19
|
| Rate for Payer: BCN Commercial |
$3,471.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,055.59
|
| Rate for Payer: Cash Price |
$3,377.88
|
| Rate for Payer: Cofinity Commercial |
$3,631.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,377.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,055.59
|
| Rate for Payer: Healthscope Commercial |
$3,800.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,166.76
|
| Rate for Payer: Mclaren Medicaid |
$744.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,108.37
|
| Rate for Payer: Meridian Medicaid |
$781.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,213.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,161.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,589.00
|
| Rate for Payer: Nomi Health Commercial |
$3,462.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,166.76
|
| Rate for Payer: PACE Senior Care Partners |
$1,002.81
|
| Rate for Payer: PACE SWMI |
$1,055.59
|
| Rate for Payer: PHP Commercial |
$3,589.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,055.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$744.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,673.44
|
| Rate for Payer: Priority Health Medicare |
$1,066.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,938.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,055.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,715.67
|
| Rate for Payer: UHC Core |
$3,525.66
|
| Rate for Payer: UHC Exchange |
$1,055.59
|
| Rate for Payer: UHC Medicaid |
$744.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,055.59
|
| Rate for Payer: UHCCP Medicaid |
$744.40
|
| Rate for Payer: VA VA |
$1,055.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,166.76
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$275.53
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.58 |
| Max. Negotiated Rate |
$247.98 |
| Rate for Payer: Aetna Commercial |
$234.20
|
| Rate for Payer: Aetna Medicare |
$71.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.10
|
| Rate for Payer: BCBS Complete |
$51.00
|
| Rate for Payer: BCBS MAPPO |
$68.88
|
| Rate for Payer: BCBS Trust/PPO |
$226.51
|
| Rate for Payer: BCCCP Commercial |
$119.98
|
| Rate for Payer: BCN Commercial |
$226.51
|
| Rate for Payer: BCN Medicare Advantage |
$68.88
|
| Rate for Payer: Cash Price |
$220.42
|
| Rate for Payer: Cash Price |
$220.42
|
| Rate for Payer: Cofinity Commercial |
$236.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.88
|
| Rate for Payer: Healthscope Commercial |
$247.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.65
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.33
|
| Rate for Payer: Meridian Medicaid |
$51.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.20
|
| Rate for Payer: Nomi Health Commercial |
$225.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.65
|
| Rate for Payer: PACE Senior Care Partners |
$65.44
|
| Rate for Payer: PACE SWMI |
$68.88
|
| Rate for Payer: PHP Commercial |
$234.20
|
| Rate for Payer: PHP Medicare Advantage |
$68.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.71
|
| Rate for Payer: Priority Health Medicare |
$69.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.77
|
| Rate for Payer: Railroad Medicare Medicare |
$68.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.47
|
| Rate for Payer: UHC Core |
$230.07
|
| Rate for Payer: UHC Exchange |
$68.88
|
| Rate for Payer: UHC Medicaid |
$48.58
|
| Rate for Payer: UHC Medicare Advantage |
$68.88
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: VA VA |
$68.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.65
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$275.53
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.77 |
| Max. Negotiated Rate |
$247.98 |
| Rate for Payer: Aetna Commercial |
$234.20
|
| Rate for Payer: BCBS Trust/PPO |
$227.56
|
| Rate for Payer: BCN Commercial |
$227.56
|
| Rate for Payer: Cash Price |
$220.42
|
| Rate for Payer: Cofinity Commercial |
$236.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.42
|
| Rate for Payer: Healthscope Commercial |
$247.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.20
|
| Rate for Payer: Nomi Health Commercial |
$225.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.65
|
| Rate for Payer: PHP Commercial |
$234.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.47
|
| Rate for Payer: UHC Core |
$230.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.65
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
IP
|
$668.56
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$465.32 |
| Max. Negotiated Rate |
$601.70 |
| Rate for Payer: Aetna Commercial |
$568.28
|
| Rate for Payer: BCBS Trust/PPO |
$552.16
|
| Rate for Payer: BCN Commercial |
$552.16
|
| Rate for Payer: Cash Price |
$534.85
|
| Rate for Payer: Cofinity Commercial |
$574.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$534.85
|
| Rate for Payer: Healthscope Commercial |
$601.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$501.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.28
|
| Rate for Payer: Nomi Health Commercial |
$548.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$501.42
|
| Rate for Payer: PHP Commercial |
$568.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$581.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$588.33
|
| Rate for Payer: UHC Core |
$558.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$501.42
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
OP
|
$668.56
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.87 |
| Max. Negotiated Rate |
$601.70 |
| Rate for Payer: Aetna Commercial |
$568.28
|
| Rate for Payer: Aetna Medicare |
$173.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.93
|
| Rate for Payer: BCBS Complete |
$123.75
|
| Rate for Payer: BCBS MAPPO |
$167.14
|
| Rate for Payer: BCBS Trust/PPO |
$549.62
|
| Rate for Payer: BCCCP Commercial |
$359.30
|
| Rate for Payer: BCN Commercial |
$549.62
|
| Rate for Payer: BCN Medicare Advantage |
$167.14
|
| Rate for Payer: Cash Price |
$534.85
|
| Rate for Payer: Cash Price |
$534.85
|
| Rate for Payer: Cofinity Commercial |
$574.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$534.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.14
|
| Rate for Payer: Healthscope Commercial |
$601.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$501.42
|
| Rate for Payer: Mclaren Medicaid |
$117.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.50
|
| Rate for Payer: Meridian Medicaid |
$123.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.28
|
| Rate for Payer: Nomi Health Commercial |
$548.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$501.42
|
| Rate for Payer: PACE Senior Care Partners |
$158.78
|
| Rate for Payer: PACE SWMI |
$167.14
|
| Rate for Payer: PHP Commercial |
$568.28
|
| Rate for Payer: PHP Medicare Advantage |
$167.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$581.65
|
| Rate for Payer: Priority Health Medicare |
$168.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.32
|
| Rate for Payer: Railroad Medicare Medicare |
$167.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$588.33
|
| Rate for Payer: UHC Core |
$558.25
|
| Rate for Payer: UHC Exchange |
$167.14
|
| Rate for Payer: UHC Medicaid |
$117.87
|
| Rate for Payer: UHC Medicare Advantage |
$167.14
|
| Rate for Payer: UHCCP Medicaid |
$117.87
|
| Rate for Payer: VA VA |
$167.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$501.42
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
IP
|
$761.46
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$529.98 |
| Max. Negotiated Rate |
$685.31 |
| Rate for Payer: Aetna Commercial |
$647.24
|
| Rate for Payer: BCBS Trust/PPO |
$628.89
|
| Rate for Payer: BCN Commercial |
$628.89
|
| Rate for Payer: Cash Price |
$609.17
|
| Rate for Payer: Cofinity Commercial |
$654.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.17
|
| Rate for Payer: Healthscope Commercial |
$685.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$647.24
|
| Rate for Payer: Nomi Health Commercial |
$624.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.10
|
| Rate for Payer: PHP Commercial |
$647.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$662.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.08
|
| Rate for Payer: UHC Core |
$635.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.10
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
OP
|
$761.46
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$134.25 |
| Max. Negotiated Rate |
$685.31 |
| Rate for Payer: Aetna Commercial |
$647.24
|
| Rate for Payer: Aetna Medicare |
$197.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.96
|
| Rate for Payer: BCBS Complete |
$140.95
|
| Rate for Payer: BCBS MAPPO |
$190.37
|
| Rate for Payer: BCBS Trust/PPO |
$626.00
|
| Rate for Payer: BCN Commercial |
$626.00
|
| Rate for Payer: BCN Medicare Advantage |
$190.37
|
| Rate for Payer: Cash Price |
$609.17
|
| Rate for Payer: Cofinity Commercial |
$654.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.37
|
| Rate for Payer: Healthscope Commercial |
$685.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.10
|
| Rate for Payer: Mclaren Medicaid |
$134.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.88
|
| Rate for Payer: Meridian Medicaid |
$140.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$647.24
|
| Rate for Payer: Nomi Health Commercial |
$624.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$571.10
|
| Rate for Payer: PACE Senior Care Partners |
$180.85
|
| Rate for Payer: PACE SWMI |
$190.37
|
| Rate for Payer: PHP Commercial |
$647.24
|
| Rate for Payer: PHP Medicare Advantage |
$190.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$662.47
|
| Rate for Payer: Priority Health Medicare |
$192.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.98
|
| Rate for Payer: Railroad Medicare Medicare |
$190.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.08
|
| Rate for Payer: UHC Core |
$635.82
|
| Rate for Payer: UHC Exchange |
$190.37
|
| Rate for Payer: UHC Medicaid |
$134.25
|
| Rate for Payer: UHC Medicare Advantage |
$190.37
|
| Rate for Payer: UHCCP Medicaid |
$134.25
|
| Rate for Payer: VA VA |
$190.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.10
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
IP
|
$680.24
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$473.45 |
| Max. Negotiated Rate |
$612.22 |
| Rate for Payer: Aetna Commercial |
$578.20
|
| Rate for Payer: BCBS Trust/PPO |
$561.81
|
| Rate for Payer: BCN Commercial |
$561.81
|
| Rate for Payer: Cash Price |
$544.19
|
| Rate for Payer: Cofinity Commercial |
$585.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.19
|
| Rate for Payer: Healthscope Commercial |
$612.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.20
|
| Rate for Payer: Nomi Health Commercial |
$557.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.18
|
| Rate for Payer: PHP Commercial |
$578.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$591.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.61
|
| Rate for Payer: UHC Core |
$568.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.18
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
OP
|
$680.24
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$119.93 |
| Max. Negotiated Rate |
$612.22 |
| Rate for Payer: Aetna Commercial |
$578.20
|
| Rate for Payer: Aetna Medicare |
$176.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.57
|
| Rate for Payer: BCBS Complete |
$125.91
|
| Rate for Payer: BCBS MAPPO |
$170.06
|
| Rate for Payer: BCBS Trust/PPO |
$559.23
|
| Rate for Payer: BCN Commercial |
$559.23
|
| Rate for Payer: BCN Medicare Advantage |
$170.06
|
| Rate for Payer: Cash Price |
$544.19
|
| Rate for Payer: Cofinity Commercial |
$585.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.06
|
| Rate for Payer: Healthscope Commercial |
$612.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.18
|
| Rate for Payer: Mclaren Medicaid |
$119.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.56
|
| Rate for Payer: Meridian Medicaid |
$125.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.20
|
| Rate for Payer: Nomi Health Commercial |
$557.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$510.18
|
| Rate for Payer: PACE Senior Care Partners |
$161.56
|
| Rate for Payer: PACE SWMI |
$170.06
|
| Rate for Payer: PHP Commercial |
$578.20
|
| Rate for Payer: PHP Medicare Advantage |
$170.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$591.81
|
| Rate for Payer: Priority Health Medicare |
$171.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$473.45
|
| Rate for Payer: Railroad Medicare Medicare |
$170.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.61
|
| Rate for Payer: UHC Core |
$568.00
|
| Rate for Payer: UHC Exchange |
$170.06
|
| Rate for Payer: UHC Medicaid |
$119.93
|
| Rate for Payer: UHC Medicare Advantage |
$170.06
|
| Rate for Payer: UHCCP Medicaid |
$119.93
|
| Rate for Payer: VA VA |
$170.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.18
|
|
|
HC INSULIN
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.96 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: BCBS Trust/PPO |
$84.21
|
| Rate for Payer: BCN Commercial |
$84.21
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC INSULIN
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.98 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$26.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.86
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: BCBS MAPPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$83.82
|
| Rate for Payer: BCN Commercial |
$83.82
|
| Rate for Payer: BCN Medicare Advantage |
$25.49
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.49
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.76
|
| Rate for Payer: Meridian Medicaid |
$18.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.49
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Medicare |
$25.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicaid |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: UHCCP Medicaid |
$17.98
|
| Rate for Payer: VA VA |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
