|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
OP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.35 |
| Max. Negotiated Rate |
$542.91 |
| Rate for Payer: Aetna Commercial |
$512.75
|
| Rate for Payer: Aetna Medicare |
$156.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.51
|
| Rate for Payer: BCBS Complete |
$111.66
|
| Rate for Payer: BCBS MAPPO |
$150.81
|
| Rate for Payer: BCBS Trust/PPO |
$495.92
|
| Rate for Payer: BCN Commercial |
$495.92
|
| Rate for Payer: BCN Medicare Advantage |
$150.81
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.81
|
| Rate for Payer: Healthscope Commercial |
$542.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.42
|
| Rate for Payer: Mclaren Medicaid |
$106.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.35
|
| Rate for Payer: Meridian Medicaid |
$111.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$165.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: PACE Senior Care Partners |
$143.27
|
| Rate for Payer: PACE SWMI |
$150.81
|
| Rate for Payer: PHP Commercial |
$512.75
|
| Rate for Payer: PHP Medicare Advantage |
$150.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$524.81
|
| Rate for Payer: Priority Health Medicare |
$152.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$419.85
|
| Rate for Payer: Railroad Medicare Medicare |
$150.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.84
|
| Rate for Payer: UHC Core |
$503.70
|
| Rate for Payer: UHC Exchange |
$150.81
|
| Rate for Payer: UHC Medicaid |
$106.35
|
| Rate for Payer: UHC Medicare Advantage |
$150.81
|
| Rate for Payer: UHCCP Medicaid |
$106.35
|
| Rate for Payer: VA VA |
$150.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.42
|
|
|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
IP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$419.85 |
| Max. Negotiated Rate |
$542.91 |
| Rate for Payer: Aetna Commercial |
$512.75
|
| Rate for Payer: BCBS Trust/PPO |
$498.21
|
| Rate for Payer: BCN Commercial |
$498.21
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Healthscope Commercial |
$542.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Nomi Health Commercial |
$494.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: PHP Commercial |
$512.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$524.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$419.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.84
|
| Rate for Payer: UHC Core |
$503.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.42
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$344.23 |
| Max. Negotiated Rate |
$445.13 |
| Rate for Payer: Aetna Commercial |
$420.40
|
| Rate for Payer: BCBS Trust/PPO |
$408.48
|
| Rate for Payer: BCN Commercial |
$408.48
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Commercial |
$425.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Healthscope Commercial |
$445.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.40
|
| Rate for Payer: Nomi Health Commercial |
$405.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| Rate for Payer: PHP Commercial |
$420.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.24
|
| Rate for Payer: UHC Core |
$412.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.94
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$445.13 |
| Rate for Payer: Aetna Commercial |
$420.40
|
| Rate for Payer: Aetna Medicare |
$128.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.56
|
| Rate for Payer: BCBS Complete |
$91.55
|
| Rate for Payer: BCBS MAPPO |
$123.65
|
| Rate for Payer: BCBS Trust/PPO |
$406.60
|
| Rate for Payer: BCN Commercial |
$406.60
|
| Rate for Payer: BCN Medicare Advantage |
$123.65
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Commercial |
$425.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.65
|
| Rate for Payer: Healthscope Commercial |
$445.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.94
|
| Rate for Payer: Mclaren Medicaid |
$87.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.83
|
| Rate for Payer: Meridian Medicaid |
$91.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.40
|
| Rate for Payer: Nomi Health Commercial |
$405.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| Rate for Payer: PACE Senior Care Partners |
$117.47
|
| Rate for Payer: PACE SWMI |
$123.65
|
| Rate for Payer: PHP Commercial |
$420.40
|
| Rate for Payer: PHP Medicare Advantage |
$123.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.29
|
| Rate for Payer: Priority Health Medicare |
$124.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.23
|
| Rate for Payer: Railroad Medicare Medicare |
$123.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.24
|
| Rate for Payer: UHC Core |
$412.98
|
| Rate for Payer: UHC Exchange |
$123.65
|
| Rate for Payer: UHC Medicaid |
$87.20
|
| Rate for Payer: UHC Medicare Advantage |
$123.65
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$123.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.94
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
OP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.64 |
| Max. Negotiated Rate |
$268.73 |
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: Aetna Medicare |
$77.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.31
|
| Rate for Payer: BCBS Complete |
$55.27
|
| Rate for Payer: BCBS MAPPO |
$74.65
|
| Rate for Payer: BCBS Trust/PPO |
$245.47
|
| Rate for Payer: BCN Commercial |
$245.47
|
| Rate for Payer: BCN Medicare Advantage |
$74.65
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Commercial |
$256.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.65
|
| Rate for Payer: Healthscope Commercial |
$268.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.94
|
| Rate for Payer: Mclaren Medicaid |
$52.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.38
|
| Rate for Payer: Meridian Medicaid |
$55.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: PACE Senior Care Partners |
$70.92
|
| Rate for Payer: PACE SWMI |
$74.65
|
| Rate for Payer: PHP Commercial |
$253.80
|
| Rate for Payer: PHP Medicare Advantage |
$74.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$259.77
|
| Rate for Payer: Priority Health Medicare |
$75.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.82
|
| Rate for Payer: Railroad Medicare Medicare |
$74.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.76
|
| Rate for Payer: UHC Core |
$249.32
|
| Rate for Payer: UHC Exchange |
$74.65
|
| Rate for Payer: UHC Medicaid |
$52.64
|
| Rate for Payer: UHC Medicare Advantage |
$74.65
|
| Rate for Payer: UHCCP Medicaid |
$52.64
|
| Rate for Payer: VA VA |
$74.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.94
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$207.82 |
| Max. Negotiated Rate |
$268.73 |
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: BCBS Trust/PPO |
$246.61
|
| Rate for Payer: BCN Commercial |
$246.61
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Commercial |
$256.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Healthscope Commercial |
$268.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Nomi Health Commercial |
$244.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: PHP Commercial |
$253.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$259.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.76
|
| Rate for Payer: UHC Core |
$249.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.94
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,253.32 |
| Max. Negotiated Rate |
$1,620.67 |
| Rate for Payer: Aetna Commercial |
$1,530.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.24
|
| Rate for Payer: BCN Commercial |
$1,487.24
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Commercial |
$1,548.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Healthscope Commercial |
$1,620.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Nomi Health Commercial |
$1,476.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: PHP Commercial |
$1,530.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,566.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,253.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,584.66
|
| Rate for Payer: UHC Core |
$1,503.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.56
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$317.47 |
| Max. Negotiated Rate |
$1,620.67 |
| Rate for Payer: Aetna Commercial |
$1,530.64
|
| Rate for Payer: Aetna Medicare |
$468.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$562.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$562.73
|
| Rate for Payer: BCBS Complete |
$333.32
|
| Rate for Payer: BCBS MAPPO |
$450.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,480.40
|
| Rate for Payer: BCN Commercial |
$1,480.40
|
| Rate for Payer: BCN Medicare Advantage |
$450.19
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Commercial |
$1,548.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$450.19
|
| Rate for Payer: Healthscope Commercial |
$1,620.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.56
|
| Rate for Payer: Mclaren Medicaid |
$317.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.70
|
| Rate for Payer: Meridian Medicaid |
$333.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$517.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$495.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Nomi Health Commercial |
$1,476.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: PACE Senior Care Partners |
$427.68
|
| Rate for Payer: PACE SWMI |
$450.19
|
| Rate for Payer: PHP Commercial |
$1,530.64
|
| Rate for Payer: PHP Medicare Advantage |
$450.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$317.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,566.65
|
| Rate for Payer: Priority Health Medicare |
$454.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,253.32
|
| Rate for Payer: Railroad Medicare Medicare |
$450.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,584.66
|
| Rate for Payer: UHC Core |
$1,503.63
|
| Rate for Payer: UHC Exchange |
$450.19
|
| Rate for Payer: UHC Medicaid |
$317.47
|
| Rate for Payer: UHC Medicare Advantage |
$450.19
|
| Rate for Payer: UHCCP Medicaid |
$317.47
|
| Rate for Payer: VA VA |
$450.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.56
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$677.45 |
| Max. Negotiated Rate |
$3,458.32 |
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: Aetna Medicare |
$999.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,200.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,200.81
|
| Rate for Payer: BCBS Complete |
$711.26
|
| Rate for Payer: BCBS MAPPO |
$960.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,158.99
|
| Rate for Payer: BCN Commercial |
$3,158.99
|
| Rate for Payer: BCN Medicare Advantage |
$960.64
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.64
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Mclaren Medicaid |
$677.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,008.68
|
| Rate for Payer: Meridian Medicaid |
$711.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,104.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,056.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PACE Senior Care Partners |
$912.61
|
| Rate for Payer: PACE SWMI |
$960.64
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: PHP Medicare Advantage |
$960.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,343.04
|
| Rate for Payer: Priority Health Medicare |
$970.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,674.44
|
| Rate for Payer: Railroad Medicare Medicare |
$960.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.47
|
| Rate for Payer: UHC Core |
$3,208.55
|
| Rate for Payer: UHC Exchange |
$960.64
|
| Rate for Payer: UHC Medicaid |
$677.45
|
| Rate for Payer: UHC Medicare Advantage |
$960.64
|
| Rate for Payer: UHCCP Medicaid |
$677.45
|
| Rate for Payer: VA VA |
$960.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,674.44 |
| Max. Negotiated Rate |
$3,458.32 |
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,173.59
|
| Rate for Payer: BCN Commercial |
$3,173.59
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,150.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,343.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,674.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.47
|
| Rate for Payer: UHC Core |
$3,208.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.61
|
| Rate for Payer: BCBS Complete |
$9.24
|
| Rate for Payer: BCBS MAPPO |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$41.06
|
| Rate for Payer: BCN Medicare Advantage |
$12.48
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.48
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$8.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.11
|
| Rate for Payer: Meridian Medicaid |
$9.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Senior Care Partners |
$11.86
|
| Rate for Payer: PACE SWMI |
$12.48
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Medicare |
$12.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: UHC Exchange |
$12.48
|
| Rate for Payer: UHC Medicaid |
$8.80
|
| Rate for Payer: UHC Medicare Advantage |
$12.48
|
| Rate for Payer: UHCCP Medicaid |
$8.80
|
| Rate for Payer: VA VA |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$673.53 |
| Max. Negotiated Rate |
$3,438.32 |
| Rate for Payer: Aetna Commercial |
$3,247.30
|
| Rate for Payer: Aetna Medicare |
$993.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,193.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,193.86
|
| Rate for Payer: BCBS Complete |
$707.15
|
| Rate for Payer: BCBS MAPPO |
$955.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,140.71
|
| Rate for Payer: BCN Commercial |
$3,140.71
|
| Rate for Payer: BCN Medicare Advantage |
$955.09
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Commercial |
$3,285.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$955.09
|
| Rate for Payer: Healthscope Commercial |
$3,438.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.26
|
| Rate for Payer: Mclaren Medicaid |
$673.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,002.84
|
| Rate for Payer: Meridian Medicaid |
$707.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,098.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,050.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Nomi Health Commercial |
$3,132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: PACE Senior Care Partners |
$907.33
|
| Rate for Payer: PACE SWMI |
$955.09
|
| Rate for Payer: PHP Commercial |
$3,247.30
|
| Rate for Payer: PHP Medicare Advantage |
$955.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,323.70
|
| Rate for Payer: Priority Health Medicare |
$964.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,658.96
|
| Rate for Payer: Railroad Medicare Medicare |
$955.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,361.91
|
| Rate for Payer: UHC Core |
$3,189.99
|
| Rate for Payer: UHC Exchange |
$955.09
|
| Rate for Payer: UHC Medicaid |
$673.53
|
| Rate for Payer: UHC Medicare Advantage |
$955.09
|
| Rate for Payer: UHCCP Medicaid |
$673.53
|
| Rate for Payer: VA VA |
$955.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.26
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,658.96 |
| Max. Negotiated Rate |
$3,438.32 |
| Rate for Payer: Aetna Commercial |
$3,247.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,155.23
|
| Rate for Payer: BCN Commercial |
$3,155.23
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Commercial |
$3,285.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Healthscope Commercial |
$3,438.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Nomi Health Commercial |
$3,132.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: PHP Commercial |
$3,247.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,323.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,658.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,361.91
|
| Rate for Payer: UHC Core |
$3,189.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.26
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$305.57
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.87 |
| Max. Negotiated Rate |
$275.01 |
| Rate for Payer: Aetna Commercial |
$259.73
|
| Rate for Payer: Aetna Medicare |
$79.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.49
|
| Rate for Payer: BCBS Complete |
$56.56
|
| Rate for Payer: BCBS MAPPO |
$76.39
|
| Rate for Payer: BCBS Trust/PPO |
$251.21
|
| Rate for Payer: BCN Commercial |
$251.21
|
| Rate for Payer: BCN Medicare Advantage |
$76.39
|
| Rate for Payer: Cash Price |
$244.46
|
| Rate for Payer: Cofinity Commercial |
$262.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.39
|
| Rate for Payer: Healthscope Commercial |
$275.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.18
|
| Rate for Payer: Mclaren Medicaid |
$53.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.21
|
| Rate for Payer: Meridian Medicaid |
$56.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.73
|
| Rate for Payer: Nomi Health Commercial |
$250.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.18
|
| Rate for Payer: PACE Senior Care Partners |
$72.57
|
| Rate for Payer: PACE SWMI |
$76.39
|
| Rate for Payer: PHP Commercial |
$259.73
|
| Rate for Payer: PHP Medicare Advantage |
$76.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.85
|
| Rate for Payer: Priority Health Medicare |
$77.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.68
|
| Rate for Payer: Railroad Medicare Medicare |
$76.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.90
|
| Rate for Payer: UHC Core |
$255.15
|
| Rate for Payer: UHC Exchange |
$76.39
|
| Rate for Payer: UHC Medicaid |
$53.87
|
| Rate for Payer: UHC Medicare Advantage |
$76.39
|
| Rate for Payer: UHCCP Medicaid |
$53.87
|
| Rate for Payer: VA VA |
$76.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.18
|
|
|
HC INTRODUCER
|
Facility
|
IP
|
$305.57
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.68 |
| Max. Negotiated Rate |
$275.01 |
| Rate for Payer: Aetna Commercial |
$259.73
|
| Rate for Payer: BCBS Trust/PPO |
$252.37
|
| Rate for Payer: BCN Commercial |
$252.37
|
| Rate for Payer: Cash Price |
$244.46
|
| Rate for Payer: Cofinity Commercial |
$262.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.46
|
| Rate for Payer: Healthscope Commercial |
$275.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.73
|
| Rate for Payer: Nomi Health Commercial |
$250.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.18
|
| Rate for Payer: PHP Commercial |
$259.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.90
|
| Rate for Payer: UHC Core |
$255.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.18
|
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.98 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: BCBS Trust/PPO |
$214.76
|
| Rate for Payer: BCN Commercial |
$214.76
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$213.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.83
|
| Rate for Payer: UHC Core |
$217.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.84 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$67.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.26
|
| Rate for Payer: BCBS Complete |
$48.13
|
| Rate for Payer: BCBS MAPPO |
$65.01
|
| Rate for Payer: BCBS Trust/PPO |
$213.77
|
| Rate for Payer: BCN Commercial |
$213.77
|
| Rate for Payer: BCN Medicare Advantage |
$65.01
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.01
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: Mclaren Medicaid |
$45.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.26
|
| Rate for Payer: Meridian Medicaid |
$48.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$213.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PACE Senior Care Partners |
$61.76
|
| Rate for Payer: PACE SWMI |
$65.01
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: PHP Medicare Advantage |
$65.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.23
|
| Rate for Payer: Priority Health Medicare |
$65.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.98
|
| Rate for Payer: Railroad Medicare Medicare |
$65.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.83
|
| Rate for Payer: UHC Core |
$217.13
|
| Rate for Payer: UHC Exchange |
$65.01
|
| Rate for Payer: UHC Medicaid |
$45.84
|
| Rate for Payer: UHC Medicare Advantage |
$65.01
|
| Rate for Payer: UHCCP Medicaid |
$45.84
|
| Rate for Payer: VA VA |
$65.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.21 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: BCBS Trust/PPO |
$79.76
|
| Rate for Payer: BCN Commercial |
$79.76
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare |
$25.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.18
|
| Rate for Payer: BCBS Complete |
$17.88
|
| Rate for Payer: BCBS MAPPO |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.39
|
| Rate for Payer: BCN Commercial |
$79.39
|
| Rate for Payer: BCN Medicare Advantage |
$24.14
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.35
|
| Rate for Payer: Meridian Medicaid |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PACE Senior Care Partners |
$22.94
|
| Rate for Payer: PACE SWMI |
$24.14
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: PHP Medicare Advantage |
$24.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Medicare |
$24.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: Railroad Medicare Medicare |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: UHC Exchange |
$24.14
|
| Rate for Payer: UHC Medicaid |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$24.14
|
| Rate for Payer: UHCCP Medicaid |
$17.03
|
| Rate for Payer: VA VA |
$24.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,454.62 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,912.74
|
| Rate for Payer: BCN Commercial |
$2,912.74
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$621.77 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: Aetna Medicare |
$916.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,102.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,102.11
|
| Rate for Payer: BCBS Complete |
$652.80
|
| Rate for Payer: BCBS MAPPO |
$881.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.34
|
| Rate for Payer: BCN Commercial |
$2,899.34
|
| Rate for Payer: BCN Medicare Advantage |
$881.69
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.69
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Mclaren Medicaid |
$621.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.77
|
| Rate for Payer: Meridian Medicaid |
$652.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Nomi Health Commercial |
$2,891.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PACE Senior Care Partners |
$837.60
|
| Rate for Payer: PACE SWMI |
$881.69
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: PHP Medicare Advantage |
$881.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,068.27
|
| Rate for Payer: Priority Health Medicare |
$890.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,454.62
|
| Rate for Payer: Railroad Medicare Medicare |
$881.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.54
|
| Rate for Payer: UHC Core |
$2,944.84
|
| Rate for Payer: UHC Exchange |
$881.69
|
| Rate for Payer: UHC Medicaid |
$621.77
|
| Rate for Payer: UHC Medicare Advantage |
$881.69
|
| Rate for Payer: UHCCP Medicaid |
$621.77
|
| Rate for Payer: VA VA |
$881.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
IP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.07 |
| Max. Negotiated Rate |
$37.59 |
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: BCBS Trust/PPO |
$34.50
|
| Rate for Payer: BCN Commercial |
$34.50
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Healthscope Commercial |
$37.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.33
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.76
|
| Rate for Payer: UHC Core |
$34.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.33
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
OP
|
$41.77
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$37.59 |
| Rate for Payer: Aetna Commercial |
$35.50
|
| Rate for Payer: Aetna Medicare |
$10.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.05
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$10.44
|
| Rate for Payer: BCBS Trust/PPO |
$34.34
|
| Rate for Payer: BCN Commercial |
$34.34
|
| Rate for Payer: BCN Medicare Advantage |
$10.44
|
| Rate for Payer: Cash Price |
$33.42
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.44
|
| Rate for Payer: Healthscope Commercial |
$37.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.33
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.96
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.50
|
| Rate for Payer: Nomi Health Commercial |
$34.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.33
|
| Rate for Payer: PACE Senior Care Partners |
$9.92
|
| Rate for Payer: PACE SWMI |
$10.44
|
| Rate for Payer: PHP Commercial |
$35.50
|
| Rate for Payer: PHP Medicare Advantage |
$10.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.34
|
| Rate for Payer: Priority Health Medicare |
$10.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.07
|
| Rate for Payer: Railroad Medicare Medicare |
$10.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.76
|
| Rate for Payer: UHC Core |
$34.88
|
| Rate for Payer: UHC Exchange |
$10.44
|
| Rate for Payer: UHC Medicaid |
$7.36
|
| Rate for Payer: UHC Medicare Advantage |
$10.44
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$10.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.33
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
IP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$831.72 |
| Max. Negotiated Rate |
$1,075.50 |
| Rate for Payer: Aetna Commercial |
$1,015.75
|
| Rate for Payer: BCBS Trust/PPO |
$986.95
|
| Rate for Payer: BCN Commercial |
$986.95
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,075.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$896.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.75
|
| Rate for Payer: Nomi Health Commercial |
$979.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$896.25
|
| Rate for Payer: PHP Commercial |
$1,015.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,039.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$831.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.60
|
| Rate for Payer: UHC Core |
$997.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$896.25
|
|
