|
HC INSULIN ANTIBODIES
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicaid |
$12.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.47
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC INSULIN ANTIBODIES
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.43
|
| Rate for Payer: BCN Commercial |
$58.43
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
OP
|
$193.58
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$34.13 |
| Max. Negotiated Rate |
$174.22 |
| Rate for Payer: Aetna Commercial |
$164.54
|
| Rate for Payer: Aetna Medicare |
$50.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.49
|
| Rate for Payer: BCBS Complete |
$35.83
|
| Rate for Payer: BCBS MAPPO |
$48.40
|
| Rate for Payer: BCBS Trust/PPO |
$159.14
|
| Rate for Payer: BCN Commercial |
$159.14
|
| Rate for Payer: BCN Medicare Advantage |
$48.40
|
| Rate for Payer: Cash Price |
$154.86
|
| Rate for Payer: Cofinity Commercial |
$166.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.40
|
| Rate for Payer: Healthscope Commercial |
$174.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.19
|
| Rate for Payer: Mclaren Medicaid |
$34.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.81
|
| Rate for Payer: Meridian Medicaid |
$35.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.54
|
| Rate for Payer: Nomi Health Commercial |
$158.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.19
|
| Rate for Payer: PACE Senior Care Partners |
$45.98
|
| Rate for Payer: PACE SWMI |
$48.40
|
| Rate for Payer: PHP Commercial |
$164.54
|
| Rate for Payer: PHP Medicare Advantage |
$48.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$168.41
|
| Rate for Payer: Priority Health Medicare |
$48.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.73
|
| Rate for Payer: Railroad Medicare Medicare |
$48.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.35
|
| Rate for Payer: UHC Core |
$161.64
|
| Rate for Payer: UHC Exchange |
$48.40
|
| Rate for Payer: UHC Medicaid |
$34.13
|
| Rate for Payer: UHC Medicare Advantage |
$48.40
|
| Rate for Payer: UHCCP Medicaid |
$34.13
|
| Rate for Payer: VA VA |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.19
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
IP
|
$193.58
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$134.73 |
| Max. Negotiated Rate |
$174.22 |
| Rate for Payer: Aetna Commercial |
$164.54
|
| Rate for Payer: BCBS Trust/PPO |
$159.88
|
| Rate for Payer: BCN Commercial |
$159.88
|
| Rate for Payer: Cash Price |
$154.86
|
| Rate for Payer: Cofinity Commercial |
$166.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.86
|
| Rate for Payer: Healthscope Commercial |
$174.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.54
|
| Rate for Payer: Nomi Health Commercial |
$158.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.19
|
| Rate for Payer: PHP Commercial |
$164.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$168.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.35
|
| Rate for Payer: UHC Core |
$161.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.19
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
IP
|
$1,209.35
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$841.71 |
| Max. Negotiated Rate |
$1,088.41 |
| Rate for Payer: Aetna Commercial |
$1,027.95
|
| Rate for Payer: BCBS Trust/PPO |
$998.80
|
| Rate for Payer: BCN Commercial |
$998.80
|
| Rate for Payer: Cash Price |
$967.48
|
| Rate for Payer: Cofinity Commercial |
$1,040.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.48
|
| Rate for Payer: Healthscope Commercial |
$1,088.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.95
|
| Rate for Payer: Nomi Health Commercial |
$991.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.01
|
| Rate for Payer: PHP Commercial |
$1,027.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,052.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$841.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.23
|
| Rate for Payer: UHC Core |
$1,009.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.01
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
OP
|
$1,209.35
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.21 |
| Max. Negotiated Rate |
$1,088.41 |
| Rate for Payer: Aetna Commercial |
$1,027.95
|
| Rate for Payer: Aetna Medicare |
$314.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$377.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$377.92
|
| Rate for Payer: BCBS Complete |
$223.85
|
| Rate for Payer: BCBS MAPPO |
$302.34
|
| Rate for Payer: BCBS Trust/PPO |
$994.21
|
| Rate for Payer: BCN Commercial |
$994.21
|
| Rate for Payer: BCN Medicare Advantage |
$302.34
|
| Rate for Payer: Cash Price |
$967.48
|
| Rate for Payer: Cofinity Commercial |
$1,040.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.34
|
| Rate for Payer: Healthscope Commercial |
$1,088.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.01
|
| Rate for Payer: Mclaren Medicaid |
$213.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.45
|
| Rate for Payer: Meridian Medicaid |
$223.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.95
|
| Rate for Payer: Nomi Health Commercial |
$991.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.01
|
| Rate for Payer: PACE Senior Care Partners |
$287.22
|
| Rate for Payer: PACE SWMI |
$302.34
|
| Rate for Payer: PHP Commercial |
$1,027.95
|
| Rate for Payer: PHP Medicare Advantage |
$302.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,052.13
|
| Rate for Payer: Priority Health Medicare |
$305.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$841.71
|
| Rate for Payer: Railroad Medicare Medicare |
$302.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.23
|
| Rate for Payer: UHC Core |
$1,009.81
|
| Rate for Payer: UHC Exchange |
$302.34
|
| Rate for Payer: UHC Medicaid |
$213.21
|
| Rate for Payer: UHC Medicare Advantage |
$302.34
|
| Rate for Payer: UHCCP Medicaid |
$213.21
|
| Rate for Payer: VA VA |
$302.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.01
|
|
|
HC INTERFACE CABLE LEVEL 7
|
Facility
|
OP
|
$1,985.00
|
|
| Hospital Charge Code |
27000721
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$1,786.50 |
| Rate for Payer: Aetna Commercial |
$1,687.25
|
| Rate for Payer: Aetna Medicare |
$516.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.31
|
| Rate for Payer: BCBS Complete |
$367.42
|
| Rate for Payer: BCBS MAPPO |
$496.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.87
|
| Rate for Payer: BCN Commercial |
$1,631.87
|
| Rate for Payer: BCN Medicare Advantage |
$496.25
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,707.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.25
|
| Rate for Payer: Healthscope Commercial |
$1,786.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,488.75
|
| Rate for Payer: Mclaren Medicaid |
$349.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.06
|
| Rate for Payer: Meridian Medicaid |
$367.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$570.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$545.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,687.25
|
| Rate for Payer: Nomi Health Commercial |
$1,627.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,488.75
|
| Rate for Payer: PACE Senior Care Partners |
$471.44
|
| Rate for Payer: PACE SWMI |
$496.25
|
| Rate for Payer: PHP Commercial |
$1,687.25
|
| Rate for Payer: PHP Medicare Advantage |
$496.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,726.95
|
| Rate for Payer: Priority Health Medicare |
$501.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,381.56
|
| Rate for Payer: Railroad Medicare Medicare |
$496.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,746.80
|
| Rate for Payer: UHC Core |
$1,657.47
|
| Rate for Payer: UHC Exchange |
$496.25
|
| Rate for Payer: UHC Medicaid |
$349.96
|
| Rate for Payer: UHC Medicare Advantage |
$496.25
|
| Rate for Payer: UHCCP Medicaid |
$349.96
|
| Rate for Payer: VA VA |
$496.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,488.75
|
|
|
HC INTERFACE CABLE LEVEL 7
|
Facility
|
IP
|
$1,985.00
|
|
| Hospital Charge Code |
27000721
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,381.56 |
| Max. Negotiated Rate |
$1,786.50 |
| Rate for Payer: Aetna Commercial |
$1,687.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.41
|
| Rate for Payer: BCN Commercial |
$1,639.41
|
| Rate for Payer: Cash Price |
$1,588.00
|
| Rate for Payer: Cofinity Commercial |
$1,707.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.00
|
| Rate for Payer: Healthscope Commercial |
$1,786.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,488.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,687.25
|
| Rate for Payer: Nomi Health Commercial |
$1,627.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,488.75
|
| Rate for Payer: PHP Commercial |
$1,687.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,726.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,381.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,746.80
|
| Rate for Payer: UHC Core |
$1,657.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,488.75
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
OP
|
$134.21
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Aetna Commercial |
$114.08
|
| Rate for Payer: Aetna Medicare |
$34.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.94
|
| Rate for Payer: BCBS Complete |
$24.84
|
| Rate for Payer: BCBS MAPPO |
$33.55
|
| Rate for Payer: BCBS Trust/PPO |
$110.33
|
| Rate for Payer: BCN Commercial |
$110.33
|
| Rate for Payer: BCN Medicare Advantage |
$33.55
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.55
|
| Rate for Payer: Healthscope Commercial |
$120.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.66
|
| Rate for Payer: Mclaren Medicaid |
$23.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.23
|
| Rate for Payer: Meridian Medicaid |
$24.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.08
|
| Rate for Payer: Nomi Health Commercial |
$110.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.66
|
| Rate for Payer: PACE Senior Care Partners |
$31.87
|
| Rate for Payer: PACE SWMI |
$33.55
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicare Advantage |
$33.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.76
|
| Rate for Payer: Priority Health Medicare |
$33.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: Railroad Medicare Medicare |
$33.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.10
|
| Rate for Payer: UHC Core |
$112.07
|
| Rate for Payer: UHC Exchange |
$33.55
|
| Rate for Payer: UHC Medicaid |
$23.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.55
|
| Rate for Payer: UHCCP Medicaid |
$23.66
|
| Rate for Payer: VA VA |
$33.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.66
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
IP
|
$134.21
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.41 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Aetna Commercial |
$114.08
|
| Rate for Payer: BCBS Trust/PPO |
$110.84
|
| Rate for Payer: BCN Commercial |
$110.84
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.37
|
| Rate for Payer: Healthscope Commercial |
$120.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.08
|
| Rate for Payer: Nomi Health Commercial |
$110.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.66
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.10
|
| Rate for Payer: UHC Core |
$112.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.66
|
|
|
HC INTERMEDIATE CARE R & B
|
Facility
|
IP
|
$4,994.01
|
|
| Hospital Charge Code |
20600001
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$4,494.61 |
| Rate for Payer: Aetna Commercial |
$4,244.91
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,124.55
|
| Rate for Payer: BCN Commercial |
$4,124.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$3,995.21
|
| Rate for Payer: Cash Price |
$3,995.21
|
| Rate for Payer: Cofinity Commercial |
$4,294.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,995.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$4,494.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,745.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,244.91
|
| Rate for Payer: Nomi Health Commercial |
$4,095.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,745.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$4,244.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,344.79
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,475.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,394.73
|
| Rate for Payer: UHC Core |
$4,170.00
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,745.51
|
|
|
HC INTERMEDIATE NURSERY CARE
|
Facility
|
IP
|
$3,024.95
|
|
| Hospital Charge Code |
17100001
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$2,722.45 |
| Rate for Payer: Aetna Commercial |
$2,571.21
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,498.31
|
| Rate for Payer: BCN Commercial |
$2,498.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$2,419.96
|
| Rate for Payer: Cash Price |
$2,419.96
|
| Rate for Payer: Cofinity Commercial |
$2,601.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,419.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$2,722.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,268.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,571.21
|
| Rate for Payer: Nomi Health Commercial |
$2,480.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,268.71
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,571.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,631.71
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,105.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,661.96
|
| Rate for Payer: UHC Core |
$2,525.83
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,268.71
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
IP
|
$547.59
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$381.12 |
| Max. Negotiated Rate |
$492.83 |
| Rate for Payer: Aetna Commercial |
$465.45
|
| Rate for Payer: BCBS Trust/PPO |
$452.25
|
| Rate for Payer: BCN Commercial |
$452.25
|
| Rate for Payer: Cash Price |
$438.07
|
| Rate for Payer: Cofinity Commercial |
$470.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.07
|
| Rate for Payer: Healthscope Commercial |
$492.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$410.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.45
|
| Rate for Payer: Nomi Health Commercial |
$449.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$410.69
|
| Rate for Payer: PHP Commercial |
$465.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$476.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.88
|
| Rate for Payer: UHC Core |
$457.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$410.69
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
OP
|
$547.59
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.54 |
| Max. Negotiated Rate |
$492.83 |
| Rate for Payer: Aetna Commercial |
$465.45
|
| Rate for Payer: Aetna Medicare |
$142.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.12
|
| Rate for Payer: BCBS Complete |
$101.36
|
| Rate for Payer: BCBS MAPPO |
$136.90
|
| Rate for Payer: BCBS Trust/PPO |
$450.17
|
| Rate for Payer: BCN Commercial |
$450.17
|
| Rate for Payer: BCN Medicare Advantage |
$136.90
|
| Rate for Payer: Cash Price |
$438.07
|
| Rate for Payer: Cofinity Commercial |
$470.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.90
|
| Rate for Payer: Healthscope Commercial |
$492.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$410.69
|
| Rate for Payer: Mclaren Medicaid |
$96.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.74
|
| Rate for Payer: Meridian Medicaid |
$101.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.45
|
| Rate for Payer: Nomi Health Commercial |
$449.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$410.69
|
| Rate for Payer: PACE Senior Care Partners |
$130.05
|
| Rate for Payer: PACE SWMI |
$136.90
|
| Rate for Payer: PHP Commercial |
$465.45
|
| Rate for Payer: PHP Medicare Advantage |
$136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$476.40
|
| Rate for Payer: Priority Health Medicare |
$138.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.12
|
| Rate for Payer: Railroad Medicare Medicare |
$136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$481.88
|
| Rate for Payer: UHC Core |
$457.24
|
| Rate for Payer: UHC Exchange |
$136.90
|
| Rate for Payer: UHC Medicaid |
$96.54
|
| Rate for Payer: UHC Medicare Advantage |
$136.90
|
| Rate for Payer: UHCCP Medicaid |
$96.54
|
| Rate for Payer: VA VA |
$136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$410.69
|
|
|
HC INTERMEDIATE REPAIR WOUND N/H/F/XTRNL GENT 7.6 TO 12.5 CM
|
Facility
|
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
76100544
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$332.50 |
| Max. Negotiated Rate |
$1,697.40 |
| Rate for Payer: Aetna Commercial |
$1,603.10
|
| Rate for Payer: Aetna Medicare |
$490.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$589.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$589.38
|
| Rate for Payer: BCBS Complete |
$349.10
|
| Rate for Payer: BCBS MAPPO |
$471.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,550.48
|
| Rate for Payer: BCN Commercial |
$1,550.48
|
| Rate for Payer: BCN Medicare Advantage |
$471.50
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,621.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.50
|
| Rate for Payer: Healthscope Commercial |
$1,697.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.50
|
| Rate for Payer: Mclaren Medicaid |
$332.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.07
|
| Rate for Payer: Meridian Medicaid |
$349.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$542.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$518.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.10
|
| Rate for Payer: Nomi Health Commercial |
$1,546.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.50
|
| Rate for Payer: PACE Senior Care Partners |
$447.93
|
| Rate for Payer: PACE SWMI |
$471.50
|
| Rate for Payer: PHP Commercial |
$1,603.10
|
| Rate for Payer: PHP Medicare Advantage |
$471.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,640.82
|
| Rate for Payer: Priority Health Medicare |
$476.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.66
|
| Rate for Payer: Railroad Medicare Medicare |
$471.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.68
|
| Rate for Payer: UHC Core |
$1,574.81
|
| Rate for Payer: UHC Exchange |
$471.50
|
| Rate for Payer: UHC Medicaid |
$332.50
|
| Rate for Payer: UHC Medicare Advantage |
$471.50
|
| Rate for Payer: UHCCP Medicaid |
$332.50
|
| Rate for Payer: VA VA |
$471.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.50
|
|
|
HC INTERMEDIATE REPAIR WOUND N/H/F/XTRNL GENT 7.6 TO 12.5 CM
|
Facility
|
IP
|
$1,886.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
76100544
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,312.66 |
| Max. Negotiated Rate |
$1,697.40 |
| Rate for Payer: Aetna Commercial |
$1,603.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,557.65
|
| Rate for Payer: BCN Commercial |
$1,557.65
|
| Rate for Payer: Cash Price |
$1,508.80
|
| Rate for Payer: Cofinity Commercial |
$1,621.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.80
|
| Rate for Payer: Healthscope Commercial |
$1,697.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.10
|
| Rate for Payer: Nomi Health Commercial |
$1,546.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.50
|
| Rate for Payer: PHP Commercial |
$1,603.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,640.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.68
|
| Rate for Payer: UHC Core |
$1,574.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.50
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
IP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,340.61 |
| Max. Negotiated Rate |
$1,733.54 |
| Rate for Payer: Aetna Commercial |
$1,637.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,590.82
|
| Rate for Payer: BCN Commercial |
$1,590.82
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Commercial |
$1,656.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Healthscope Commercial |
$1,733.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Nomi Health Commercial |
$1,579.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: PHP Commercial |
$1,637.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,675.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,340.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,695.02
|
| Rate for Payer: UHC Core |
$1,608.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.62
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$339.58 |
| Max. Negotiated Rate |
$1,733.54 |
| Rate for Payer: Aetna Commercial |
$1,637.24
|
| Rate for Payer: Aetna Medicare |
$500.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.92
|
| Rate for Payer: BCBS Complete |
$356.53
|
| Rate for Payer: BCBS MAPPO |
$481.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,583.50
|
| Rate for Payer: BCN Commercial |
$1,583.50
|
| Rate for Payer: BCN Medicare Advantage |
$481.54
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Commercial |
$1,656.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.54
|
| Rate for Payer: Healthscope Commercial |
$1,733.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.62
|
| Rate for Payer: Mclaren Medicaid |
$339.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.62
|
| Rate for Payer: Meridian Medicaid |
$356.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$529.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Nomi Health Commercial |
$1,579.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: PACE Senior Care Partners |
$457.46
|
| Rate for Payer: PACE SWMI |
$481.54
|
| Rate for Payer: PHP Commercial |
$1,637.24
|
| Rate for Payer: PHP Medicare Advantage |
$481.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,675.76
|
| Rate for Payer: Priority Health Medicare |
$486.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,340.61
|
| Rate for Payer: Railroad Medicare Medicare |
$481.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,695.02
|
| Rate for Payer: UHC Core |
$1,608.34
|
| Rate for Payer: UHC Exchange |
$481.54
|
| Rate for Payer: UHC Medicaid |
$339.58
|
| Rate for Payer: UHC Medicare Advantage |
$481.54
|
| Rate for Payer: UHCCP Medicaid |
$339.58
|
| Rate for Payer: VA VA |
$481.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.62
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: BCBS Trust/PPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$237.21
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.64 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.76
|
| Rate for Payer: BCBS Complete |
$53.16
|
| Rate for Payer: BCBS MAPPO |
$71.81
|
| Rate for Payer: BCBS Trust/PPO |
$236.12
|
| Rate for Payer: BCN Commercial |
$236.12
|
| Rate for Payer: BCN Medicare Advantage |
$71.81
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$50.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.40
|
| Rate for Payer: Meridian Medicaid |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$235.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Senior Care Partners |
$68.21
|
| Rate for Payer: PACE SWMI |
$71.81
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$71.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$249.88
|
| Rate for Payer: Priority Health Medicare |
$72.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.91
|
| Rate for Payer: Railroad Medicare Medicare |
$71.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.75
|
| Rate for Payer: UHC Core |
$239.83
|
| Rate for Payer: UHC Exchange |
$71.81
|
| Rate for Payer: UHC Medicaid |
$50.64
|
| Rate for Payer: UHC Medicare Advantage |
$71.81
|
| Rate for Payer: UHCCP Medicaid |
$50.64
|
| Rate for Payer: VA VA |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.90 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: BCBS Trust/PPO |
$260.94
|
| Rate for Payer: BCN Commercial |
$260.94
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.70 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$82.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.73
|
| Rate for Payer: BCBS Complete |
$58.48
|
| Rate for Payer: BCBS MAPPO |
$78.99
|
| Rate for Payer: BCBS Trust/PPO |
$259.74
|
| Rate for Payer: BCN Commercial |
$259.74
|
| Rate for Payer: BCN Medicare Advantage |
$78.99
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Mclaren Medicaid |
$55.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.94
|
| Rate for Payer: Meridian Medicaid |
$58.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$259.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Senior Care Partners |
$75.04
|
| Rate for Payer: PACE SWMI |
$78.99
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: PHP Medicare Advantage |
$78.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.88
|
| Rate for Payer: Priority Health Medicare |
$79.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.90
|
| Rate for Payer: Railroad Medicare Medicare |
$78.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.04
|
| Rate for Payer: UHC Core |
$263.82
|
| Rate for Payer: UHC Exchange |
$78.99
|
| Rate for Payer: UHC Medicaid |
$55.70
|
| Rate for Payer: UHC Medicare Advantage |
$78.99
|
| Rate for Payer: UHCCP Medicaid |
$55.70
|
| Rate for Payer: VA VA |
$78.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$132.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.94
|
| Rate for Payer: BCBS Complete |
$94.14
|
| Rate for Payer: BCBS MAPPO |
$127.15
|
| Rate for Payer: BCBS Trust/PPO |
$418.13
|
| Rate for Payer: BCN Commercial |
$418.13
|
| Rate for Payer: BCN Medicare Advantage |
$127.15
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.15
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.51
|
| Rate for Payer: Meridian Medicaid |
$94.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Senior Care Partners |
$120.79
|
| Rate for Payer: PACE SWMI |
$127.15
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$127.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.49
|
| Rate for Payer: Priority Health Medicare |
$128.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.99
|
| Rate for Payer: Railroad Medicare Medicare |
$127.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.58
|
| Rate for Payer: UHC Core |
$424.69
|
| Rate for Payer: UHC Exchange |
$127.15
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHC Medicare Advantage |
$127.15
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
| Rate for Payer: VA VA |
$127.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
