|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$355.46
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$84.42 |
| Max. Negotiated Rate |
$319.91 |
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: Aetna Medicare |
$92.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.08
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$88.86
|
| Rate for Payer: BCBS Trust/PPO |
$292.22
|
| Rate for Payer: BCN Commercial |
$276.37
|
| Rate for Payer: BCN Medicare Advantage |
$88.86
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.86
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.31
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: Nomi Health Commercial |
$291.48
|
| Rate for Payer: PACE Senior Care Partners |
$84.42
|
| Rate for Payer: PACE SWMI |
$88.86
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: PHP Medicare Advantage |
$88.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health HMO/PPO |
$309.25
|
| Rate for Payer: Priority Health Medicare |
$89.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.16
|
| Rate for Payer: Railroad Medicare Medicare |
$88.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Core |
$296.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.86
|
| Rate for Payer: UHC Exchange |
$88.86
|
| Rate for Payer: UHC Medicare Advantage |
$88.86
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$88.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$355.46
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$231.05 |
| Max. Negotiated Rate |
$319.91 |
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: BCBS Trust/PPO |
$290.16
|
| Rate for Payer: BCN Commercial |
$274.70
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: Nomi Health Commercial |
$291.48
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health HMO/PPO |
$309.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Core |
$296.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$46,227.59
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,979.05 |
| Max. Negotiated Rate |
$41,604.83 |
| Rate for Payer: Aetna Commercial |
$39,293.45
|
| Rate for Payer: Aetna Medicare |
$12,019.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,446.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,446.12
|
| Rate for Payer: BCBS Complete |
$18,491.04
|
| Rate for Payer: BCBS MAPPO |
$11,556.90
|
| Rate for Payer: BCBS Trust/PPO |
$38,003.70
|
| Rate for Payer: BCN Commercial |
$35,941.95
|
| Rate for Payer: BCN Medicare Advantage |
$11,556.90
|
| Rate for Payer: Cash Price |
$36,982.07
|
| Rate for Payer: Cofinity Commercial |
$39,755.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,982.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,556.90
|
| Rate for Payer: Healthscope Commercial |
$41,604.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34,670.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,134.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,290.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,293.45
|
| Rate for Payer: Nomi Health Commercial |
$37,906.62
|
| Rate for Payer: PACE Senior Care Partners |
$10,979.05
|
| Rate for Payer: PACE SWMI |
$11,556.90
|
| Rate for Payer: PHP Commercial |
$39,293.45
|
| Rate for Payer: PHP Medicare Advantage |
$11,556.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30,047.93
|
| Rate for Payer: Priority Health HMO/PPO |
$40,218.00
|
| Rate for Payer: Priority Health Medicare |
$11,672.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30,972.49
|
| Rate for Payer: Railroad Medicare Medicare |
$11,556.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,680.28
|
| Rate for Payer: UHC Core |
$38,600.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,556.90
|
| Rate for Payer: UHC Exchange |
$11,556.90
|
| Rate for Payer: UHC Medicare Advantage |
$11,556.90
|
| Rate for Payer: VA VA |
$11,556.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34,670.69
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$46,227.59
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30,047.93 |
| Max. Negotiated Rate |
$41,604.83 |
| Rate for Payer: Aetna Commercial |
$39,293.45
|
| Rate for Payer: BCBS Trust/PPO |
$37,735.58
|
| Rate for Payer: BCN Commercial |
$35,724.68
|
| Rate for Payer: Cash Price |
$36,982.07
|
| Rate for Payer: Cofinity Commercial |
$39,755.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,982.07
|
| Rate for Payer: Healthscope Commercial |
$41,604.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34,670.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,293.45
|
| Rate for Payer: Nomi Health Commercial |
$37,906.62
|
| Rate for Payer: PHP Commercial |
$39,293.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30,047.93
|
| Rate for Payer: Priority Health HMO/PPO |
$40,218.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30,972.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,680.28
|
| Rate for Payer: UHC Core |
$38,600.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34,670.69
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.62 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna Medicare |
$88.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.08
|
| Rate for Payer: BCBS Complete |
$135.78
|
| Rate for Payer: BCBS MAPPO |
$84.86
|
| Rate for Payer: BCBS Trust/PPO |
$279.06
|
| Rate for Payer: BCN Commercial |
$263.92
|
| Rate for Payer: BCN Medicare Advantage |
$84.86
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.86
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: Nomi Health Commercial |
$278.35
|
| Rate for Payer: PACE Senior Care Partners |
$80.62
|
| Rate for Payer: PACE SWMI |
$84.86
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: PHP Medicare Advantage |
$84.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health HMO/PPO |
$295.32
|
| Rate for Payer: Priority Health Medicare |
$85.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.43
|
| Rate for Payer: Railroad Medicare Medicare |
$84.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.72
|
| Rate for Payer: UHC Core |
$283.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.86
|
| Rate for Payer: UHC Exchange |
$84.86
|
| Rate for Payer: UHC Medicare Advantage |
$84.86
|
| Rate for Payer: VA VA |
$84.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$220.64 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: BCBS Trust/PPO |
$277.09
|
| Rate for Payer: BCN Commercial |
$262.33
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: Nomi Health Commercial |
$278.35
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health HMO/PPO |
$295.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.72
|
| Rate for Payer: UHC Core |
$283.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$696.01 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: Aetna Medicare |
$761.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$915.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$915.81
|
| Rate for Payer: BCBS Complete |
$1,172.23
|
| Rate for Payer: BCBS MAPPO |
$732.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,409.23
|
| Rate for Payer: BCN Commercial |
$2,278.53
|
| Rate for Payer: BCN Medicare Advantage |
$732.64
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.64
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$842.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: Nomi Health Commercial |
$2,403.08
|
| Rate for Payer: PACE Senior Care Partners |
$696.01
|
| Rate for Payer: PACE SWMI |
$732.64
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: PHP Medicare Advantage |
$732.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,549.60
|
| Rate for Payer: Priority Health Medicare |
$739.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,963.49
|
| Rate for Payer: Railroad Medicare Medicare |
$732.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,578.91
|
| Rate for Payer: UHC Core |
$2,447.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.64
|
| Rate for Payer: UHC Exchange |
$732.64
|
| Rate for Payer: UHC Medicare Advantage |
$732.64
|
| Rate for Payer: VA VA |
$732.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.94
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,904.88 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,392.23
|
| Rate for Payer: BCN Commercial |
$2,264.75
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: Nomi Health Commercial |
$2,403.08
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,549.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,963.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,578.91
|
| Rate for Payer: UHC Core |
$2,447.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.94
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,202.63
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,031.71 |
| Max. Negotiated Rate |
$5,582.37 |
| Rate for Payer: Aetna Commercial |
$5,272.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,063.21
|
| Rate for Payer: BCN Commercial |
$4,793.39
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cofinity Commercial |
$5,334.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,962.10
|
| Rate for Payer: Healthscope Commercial |
$5,582.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,651.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,272.24
|
| Rate for Payer: Nomi Health Commercial |
$5,086.16
|
| Rate for Payer: PHP Commercial |
$5,272.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,031.71
|
| Rate for Payer: Priority Health HMO/PPO |
$5,396.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,155.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,458.31
|
| Rate for Payer: UHC Core |
$5,179.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,651.97
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,202.63
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,473.12 |
| Max. Negotiated Rate |
$21,146.38 |
| Rate for Payer: Aetna Commercial |
$5,272.24
|
| Rate for Payer: Aetna Medicare |
$1,612.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,938.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,938.32
|
| Rate for Payer: BCBS Complete |
$21,146.38
|
| Rate for Payer: BCBS MAPPO |
$1,550.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,099.18
|
| Rate for Payer: BCN Commercial |
$4,822.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,550.66
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cofinity Commercial |
$5,334.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,962.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,550.66
|
| Rate for Payer: Healthscope Commercial |
$5,582.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,651.97
|
| Rate for Payer: Mclaren Medicaid |
$20,138.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,628.19
|
| Rate for Payer: Meridian Medicaid |
$21,146.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,783.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,272.24
|
| Rate for Payer: Nomi Health Commercial |
$5,086.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,473.12
|
| Rate for Payer: PACE SWMI |
$1,550.66
|
| Rate for Payer: PHP Commercial |
$5,272.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,550.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,138.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,031.71
|
| Rate for Payer: Priority Health HMO/PPO |
$5,396.29
|
| Rate for Payer: Priority Health Medicare |
$1,566.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,155.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,550.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,458.31
|
| Rate for Payer: UHC Core |
$5,179.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,550.66
|
| Rate for Payer: UHC Exchange |
$1,550.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,550.66
|
| Rate for Payer: UHCCP Medicaid |
$20,138.09
|
| Rate for Payer: VA VA |
$1,550.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,651.97
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$72,139.89
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46,890.93 |
| Max. Negotiated Rate |
$64,925.90 |
| Rate for Payer: Aetna Commercial |
$61,318.91
|
| Rate for Payer: BCBS Trust/PPO |
$58,887.79
|
| Rate for Payer: BCN Commercial |
$55,749.71
|
| Rate for Payer: Cash Price |
$57,711.91
|
| Rate for Payer: Cofinity Commercial |
$62,040.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,711.91
|
| Rate for Payer: Healthscope Commercial |
$64,925.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,104.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,318.91
|
| Rate for Payer: Nomi Health Commercial |
$59,154.71
|
| Rate for Payer: PHP Commercial |
$61,318.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46,890.93
|
| Rate for Payer: Priority Health HMO/PPO |
$62,761.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48,333.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,483.10
|
| Rate for Payer: UHC Core |
$60,236.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,104.92
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$72,139.89
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17,133.22 |
| Max. Negotiated Rate |
$64,925.90 |
| Rate for Payer: Aetna Commercial |
$61,318.91
|
| Rate for Payer: Aetna Medicare |
$18,756.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,543.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,543.72
|
| Rate for Payer: BCBS Complete |
$28,855.96
|
| Rate for Payer: BCBS MAPPO |
$18,034.97
|
| Rate for Payer: BCBS Trust/PPO |
$59,306.20
|
| Rate for Payer: BCN Commercial |
$56,088.76
|
| Rate for Payer: BCN Medicare Advantage |
$18,034.97
|
| Rate for Payer: Cash Price |
$57,711.91
|
| Rate for Payer: Cofinity Commercial |
$62,040.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,711.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,034.97
|
| Rate for Payer: Healthscope Commercial |
$64,925.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,104.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,936.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,740.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,318.91
|
| Rate for Payer: Nomi Health Commercial |
$59,154.71
|
| Rate for Payer: PACE Senior Care Partners |
$17,133.22
|
| Rate for Payer: PACE SWMI |
$18,034.97
|
| Rate for Payer: PHP Commercial |
$61,318.91
|
| Rate for Payer: PHP Medicare Advantage |
$18,034.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46,890.93
|
| Rate for Payer: Priority Health HMO/PPO |
$62,761.70
|
| Rate for Payer: Priority Health Medicare |
$18,215.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48,333.73
|
| Rate for Payer: Railroad Medicare Medicare |
$18,034.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63,483.10
|
| Rate for Payer: UHC Core |
$60,236.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,034.97
|
| Rate for Payer: UHC Exchange |
$18,034.97
|
| Rate for Payer: UHC Medicare Advantage |
$18,034.97
|
| Rate for Payer: VA VA |
$18,034.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,104.92
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$543.33
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.04 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna Medicare |
$141.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.79
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$135.83
|
| Rate for Payer: BCBS Trust/PPO |
$446.67
|
| Rate for Payer: BCN Commercial |
$422.44
|
| Rate for Payer: BCN Medicare Advantage |
$135.83
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$282.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: Nomi Health Commercial |
$445.53
|
| Rate for Payer: PACE Senior Care Partners |
$129.04
|
| Rate for Payer: PACE SWMI |
$135.83
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: PHP Medicare Advantage |
$135.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health HMO/PPO |
$472.70
|
| Rate for Payer: Priority Health Medicare |
$137.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.03
|
| Rate for Payer: Railroad Medicare Medicare |
$135.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.13
|
| Rate for Payer: UHC Core |
$453.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.83
|
| Rate for Payer: UHC Exchange |
$135.83
|
| Rate for Payer: UHC Medicare Advantage |
$135.83
|
| Rate for Payer: UHCCP Medicaid |
$282.67
|
| Rate for Payer: VA VA |
$135.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$543.33
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$353.16 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: BCBS Trust/PPO |
$443.52
|
| Rate for Payer: BCN Commercial |
$419.89
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: Nomi Health Commercial |
$445.53
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health HMO/PPO |
$472.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.13
|
| Rate for Payer: UHC Core |
$453.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,125.70
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$4,631.70 |
| Max. Negotiated Rate |
$6,413.13 |
| Rate for Payer: Aetna Commercial |
$6,056.84
|
| Rate for Payer: BCBS Trust/PPO |
$5,816.71
|
| Rate for Payer: BCN Commercial |
$5,506.74
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cofinity Commercial |
$6,128.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,700.56
|
| Rate for Payer: Healthscope Commercial |
$6,413.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,344.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.84
|
| Rate for Payer: Nomi Health Commercial |
$5,843.07
|
| Rate for Payer: PHP Commercial |
$6,056.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.70
|
| Rate for Payer: Priority Health HMO/PPO |
$6,199.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,774.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,270.62
|
| Rate for Payer: UHC Core |
$5,949.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,344.28
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,125.70
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$969.25 |
| Max. Negotiated Rate |
$6,413.13 |
| Rate for Payer: Aetna Commercial |
$6,056.84
|
| Rate for Payer: Aetna Medicare |
$1,852.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,226.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,226.78
|
| Rate for Payer: BCBS Complete |
$1,017.78
|
| Rate for Payer: BCBS MAPPO |
$1,781.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,858.04
|
| Rate for Payer: BCN Commercial |
$5,540.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,781.42
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cofinity Commercial |
$6,128.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,700.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,781.42
|
| Rate for Payer: Healthscope Commercial |
$6,413.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,344.28
|
| Rate for Payer: Mclaren Medicaid |
$969.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,870.50
|
| Rate for Payer: Meridian Medicaid |
$1,017.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.84
|
| Rate for Payer: Nomi Health Commercial |
$5,843.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,692.35
|
| Rate for Payer: PACE SWMI |
$1,781.42
|
| Rate for Payer: PHP Commercial |
$6,056.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,781.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$969.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.70
|
| Rate for Payer: Priority Health HMO/PPO |
$6,199.36
|
| Rate for Payer: Priority Health Medicare |
$1,799.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,774.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,781.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,270.62
|
| Rate for Payer: UHC Core |
$5,949.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,781.42
|
| Rate for Payer: UHC Exchange |
$1,781.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,781.42
|
| Rate for Payer: UHCCP Medicaid |
$969.25
|
| Rate for Payer: VA VA |
$1,781.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,344.28
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$784.03
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$186.21 |
| Max. Negotiated Rate |
$783.03 |
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: Aetna Medicare |
$203.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.01
|
| Rate for Payer: BCBS Complete |
$783.03
|
| Rate for Payer: BCBS MAPPO |
$196.01
|
| Rate for Payer: BCBS Trust/PPO |
$644.55
|
| Rate for Payer: BCN Commercial |
$609.58
|
| Rate for Payer: BCN Medicare Advantage |
$196.01
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cofinity Commercial |
$674.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$627.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.01
|
| Rate for Payer: Healthscope Commercial |
$705.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$588.02
|
| Rate for Payer: Mclaren Medicaid |
$745.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.81
|
| Rate for Payer: Meridian Medicaid |
$783.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.43
|
| Rate for Payer: Nomi Health Commercial |
$642.90
|
| Rate for Payer: PACE Senior Care Partners |
$186.21
|
| Rate for Payer: PACE SWMI |
$196.01
|
| Rate for Payer: PHP Commercial |
$666.43
|
| Rate for Payer: PHP Medicare Advantage |
$196.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$745.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.62
|
| Rate for Payer: Priority Health HMO/PPO |
$682.11
|
| Rate for Payer: Priority Health Medicare |
$197.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$525.30
|
| Rate for Payer: Railroad Medicare Medicare |
$196.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.95
|
| Rate for Payer: UHC Core |
$654.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.01
|
| Rate for Payer: UHC Exchange |
$196.01
|
| Rate for Payer: UHC Medicare Advantage |
$196.01
|
| Rate for Payer: UHCCP Medicaid |
$745.69
|
| Rate for Payer: VA VA |
$196.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$588.02
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$784.03
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$509.62 |
| Max. Negotiated Rate |
$705.63 |
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: BCBS Trust/PPO |
$640.00
|
| Rate for Payer: BCN Commercial |
$605.90
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cofinity Commercial |
$674.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$627.22
|
| Rate for Payer: Healthscope Commercial |
$705.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$588.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.43
|
| Rate for Payer: Nomi Health Commercial |
$642.90
|
| Rate for Payer: PHP Commercial |
$666.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.62
|
| Rate for Payer: Priority Health HMO/PPO |
$682.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$525.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.95
|
| Rate for Payer: UHC Core |
$654.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$588.02
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,411.53
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3,517.49 |
| Max. Negotiated Rate |
$4,870.38 |
| Rate for Payer: Aetna Commercial |
$4,599.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,417.43
|
| Rate for Payer: BCN Commercial |
$4,182.03
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cofinity Commercial |
$4,653.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.22
|
| Rate for Payer: Healthscope Commercial |
$4,870.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,058.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,599.80
|
| Rate for Payer: Nomi Health Commercial |
$4,437.45
|
| Rate for Payer: PHP Commercial |
$4,599.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,517.49
|
| Rate for Payer: Priority Health HMO/PPO |
$4,708.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,625.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,762.15
|
| Rate for Payer: UHC Core |
$4,518.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,058.65
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,411.53
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,285.24 |
| Max. Negotiated Rate |
$4,870.38 |
| Rate for Payer: Aetna Commercial |
$4,599.80
|
| Rate for Payer: Aetna Medicare |
$1,407.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,691.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,691.10
|
| Rate for Payer: BCBS Complete |
$1,453.57
|
| Rate for Payer: BCBS MAPPO |
$1,352.88
|
| Rate for Payer: BCBS Trust/PPO |
$4,448.82
|
| Rate for Payer: BCN Commercial |
$4,207.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.88
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cofinity Commercial |
$4,653.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.88
|
| Rate for Payer: Healthscope Commercial |
$4,870.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,058.65
|
| Rate for Payer: Mclaren Medicaid |
$1,384.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.53
|
| Rate for Payer: Meridian Medicaid |
$1,453.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,555.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,599.80
|
| Rate for Payer: Nomi Health Commercial |
$4,437.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,285.24
|
| Rate for Payer: PACE SWMI |
$1,352.88
|
| Rate for Payer: PHP Commercial |
$4,599.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,384.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,517.49
|
| Rate for Payer: Priority Health HMO/PPO |
$4,708.03
|
| Rate for Payer: Priority Health Medicare |
$1,366.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,625.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,352.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,762.15
|
| Rate for Payer: UHC Core |
$4,518.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.88
|
| Rate for Payer: UHC Exchange |
$1,352.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,352.88
|
| Rate for Payer: UHCCP Medicaid |
$1,384.26
|
| Rate for Payer: VA VA |
$1,352.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,058.65
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,586.26 |
| Max. Negotiated Rate |
$4,965.60 |
| Rate for Payer: Aetna Commercial |
$4,689.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,503.80
|
| Rate for Payer: BCN Commercial |
$4,263.79
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$4,744.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Healthscope Commercial |
$4,965.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: Nomi Health Commercial |
$4,524.21
|
| Rate for Payer: PHP Commercial |
$4,689.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: Priority Health HMO/PPO |
$4,800.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,696.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,855.25
|
| Rate for Payer: UHC Core |
$4,606.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.00
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,310.37 |
| Max. Negotiated Rate |
$4,965.60 |
| Rate for Payer: Aetna Commercial |
$4,689.73
|
| Rate for Payer: Aetna Medicare |
$1,434.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,724.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,724.17
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$1,379.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,535.80
|
| Rate for Payer: BCN Commercial |
$4,289.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.33
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$4,744.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.33
|
| Rate for Payer: Healthscope Commercial |
$4,965.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.00
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.30
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: Nomi Health Commercial |
$4,524.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,310.37
|
| Rate for Payer: PACE SWMI |
$1,379.33
|
| Rate for Payer: PHP Commercial |
$4,689.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: Priority Health HMO/PPO |
$4,800.08
|
| Rate for Payer: Priority Health Medicare |
$1,393.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,696.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,855.25
|
| Rate for Payer: UHC Core |
$4,606.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,379.33
|
| Rate for Payer: UHC Exchange |
$1,379.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,379.33
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$1,379.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.00
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$100.19 |
| Rate for Payer: Aetna Commercial |
$94.62
|
| Rate for Payer: BCBS Trust/PPO |
$90.87
|
| Rate for Payer: BCN Commercial |
$86.03
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$95.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Healthscope Commercial |
$100.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: Nomi Health Commercial |
$91.28
|
| Rate for Payer: PHP Commercial |
$94.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: Priority Health HMO/PPO |
$96.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.96
|
| Rate for Payer: UHC Core |
$92.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.49
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.44 |
| Max. Negotiated Rate |
$100.19 |
| Rate for Payer: Aetna Commercial |
$94.62
|
| Rate for Payer: Aetna Medicare |
$28.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.79
|
| Rate for Payer: BCBS Complete |
$44.53
|
| Rate for Payer: BCBS MAPPO |
$27.83
|
| Rate for Payer: BCBS Trust/PPO |
$91.52
|
| Rate for Payer: BCN Commercial |
$86.55
|
| Rate for Payer: BCN Medicare Advantage |
$27.83
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$95.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.83
|
| Rate for Payer: Healthscope Commercial |
$100.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: Nomi Health Commercial |
$91.28
|
| Rate for Payer: PACE Senior Care Partners |
$26.44
|
| Rate for Payer: PACE SWMI |
$27.83
|
| Rate for Payer: PHP Commercial |
$94.62
|
| Rate for Payer: PHP Medicare Advantage |
$27.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: Priority Health HMO/PPO |
$96.85
|
| Rate for Payer: Priority Health Medicare |
$28.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.58
|
| Rate for Payer: Railroad Medicare Medicare |
$27.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.96
|
| Rate for Payer: UHC Core |
$92.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.83
|
| Rate for Payer: UHC Exchange |
$27.83
|
| Rate for Payer: UHC Medicare Advantage |
$27.83
|
| Rate for Payer: VA VA |
$27.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.49
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.38 |
| Max. Negotiated Rate |
$455.33 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna Medicare |
$127.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.13
|
| Rate for Payer: BCBS Complete |
$455.33
|
| Rate for Payer: BCBS MAPPO |
$122.51
|
| Rate for Payer: BCBS Trust/PPO |
$402.85
|
| Rate for Payer: BCN Commercial |
$381.00
|
| Rate for Payer: BCN Medicare Advantage |
$122.51
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$421.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.51
|
| Rate for Payer: Healthscope Commercial |
$441.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Mclaren Medicaid |
$433.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.63
|
| Rate for Payer: Meridian Medicaid |
$455.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: PACE Senior Care Partners |
$116.38
|
| Rate for Payer: PACE SWMI |
$122.51
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: PHP Medicare Advantage |
$122.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health HMO/PPO |
$426.33
|
| Rate for Payer: Priority Health Medicare |
$123.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.32
|
| Rate for Payer: Railroad Medicare Medicare |
$122.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.23
|
| Rate for Payer: UHC Core |
$409.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.51
|
| Rate for Payer: UHC Exchange |
$122.51
|
| Rate for Payer: UHC Medicare Advantage |
$122.51
|
| Rate for Payer: UHCCP Medicaid |
$433.62
|
| Rate for Payer: VA VA |
$122.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
