|
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 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 |
$302.95
|
| 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 |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| 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 |
$288.51
|
| 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 |
$288.51
|
| 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
|
OP
|
$7,125.70
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$989.25 |
| Max. Negotiated Rate |
$6,413.13 |
| Rate for Payer: Aetna Commercial |
$6,056.85
|
| 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 |
$1,038.78
|
| 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 |
$5,344.27
|
| Rate for Payer: Mclaren Medicaid |
$989.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,870.50
|
| Rate for Payer: Meridian Medicaid |
$1,038.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.85
|
| 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 |
$6,056.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,781.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$989.25
|
| 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 |
$989.25
|
| Rate for Payer: VA VA |
$1,781.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,344.27
|
|
|
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 |
$6,056.85
|
| 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 |
$5,344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.85
|
| Rate for Payer: Nomi Health Commercial |
$5,843.07
|
| Rate for Payer: PHP Commercial |
$6,056.85
|
| 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 |
$5,344.27
|
|
|
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
|
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 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 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 |
$1,555.23
|
| 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 |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.30
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| 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 |
$1,481.07
|
| 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 |
$1,481.07
|
| 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
|
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 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 SINGLE LESION
|
Facility
|
IP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.52 |
| Max. Negotiated Rate |
$441.03 |
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: BCBS Trust/PPO |
$400.01
|
| Rate for Payer: BCN Commercial |
$378.70
|
| 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: Healthscope Commercial |
$441.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: Nomi Health Commercial |
$401.82
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health HMO/PPO |
$426.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.23
|
| Rate for Payer: UHC Core |
$409.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
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 |
$464.73 |
| 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 |
$464.73
|
| 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 |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.63
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| 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 |
$442.57
|
| 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 |
$442.57
|
| Rate for Payer: VA VA |
$122.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$475.98 |
| Max. Negotiated Rate |
$1,803.71 |
| Rate for Payer: Aetna Commercial |
$1,703.50
|
| Rate for Payer: Aetna Medicare |
$521.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$626.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$626.29
|
| Rate for Payer: BCBS Complete |
$801.65
|
| Rate for Payer: BCBS MAPPO |
$501.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.59
|
| Rate for Payer: BCN Commercial |
$1,558.20
|
| Rate for Payer: BCN Medicare Advantage |
$501.03
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,723.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.03
|
| Rate for Payer: Healthscope Commercial |
$1,803.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$526.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$576.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: Nomi Health Commercial |
$1,643.38
|
| Rate for Payer: PACE Senior Care Partners |
$475.98
|
| Rate for Payer: PACE SWMI |
$501.03
|
| Rate for Payer: PHP Commercial |
$1,703.50
|
| Rate for Payer: PHP Medicare Advantage |
$501.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,743.58
|
| Rate for Payer: Priority Health Medicare |
$506.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,342.76
|
| Rate for Payer: Railroad Medicare Medicare |
$501.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.63
|
| Rate for Payer: UHC Core |
$1,673.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.03
|
| Rate for Payer: UHC Exchange |
$501.03
|
| Rate for Payer: UHC Medicare Advantage |
$501.03
|
| Rate for Payer: VA VA |
$501.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.09
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,302.68 |
| Max. Negotiated Rate |
$1,803.71 |
| Rate for Payer: Aetna Commercial |
$1,703.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.96
|
| Rate for Payer: BCN Commercial |
$1,548.78
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,723.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Healthscope Commercial |
$1,803.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: Nomi Health Commercial |
$1,643.38
|
| Rate for Payer: PHP Commercial |
$1,703.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,743.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,342.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.63
|
| Rate for Payer: UHC Core |
$1,673.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.09
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$408.41 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: BCBS Trust/PPO |
$512.90
|
| Rate for Payer: BCN Commercial |
$485.57
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO |
$546.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.92
|
| Rate for Payer: UHC Core |
$524.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$149.23 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna Medicare |
$163.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.35
|
| Rate for Payer: BCBS Complete |
$176.30
|
| Rate for Payer: BCBS MAPPO |
$157.08
|
| Rate for Payer: BCBS Trust/PPO |
$516.54
|
| Rate for Payer: BCN Commercial |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$157.08
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.08
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Mclaren Medicaid |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.93
|
| Rate for Payer: Meridian Medicaid |
$176.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PACE Senior Care Partners |
$149.23
|
| Rate for Payer: PACE SWMI |
$157.08
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: PHP Medicare Advantage |
$157.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO |
$546.64
|
| Rate for Payer: Priority Health Medicare |
$158.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.97
|
| Rate for Payer: Railroad Medicare Medicare |
$157.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.92
|
| Rate for Payer: UHC Core |
$524.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.08
|
| Rate for Payer: UHC Exchange |
$157.08
|
| Rate for Payer: UHC Medicare Advantage |
$157.08
|
| Rate for Payer: UHCCP Medicaid |
$167.90
|
| Rate for Payer: VA VA |
$157.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,180.50 |
| Max. Negotiated Rate |
$7,173.00 |
| Rate for Payer: Aetna Commercial |
$6,774.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,505.91
|
| Rate for Payer: BCN Commercial |
$6,159.22
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$6,854.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Healthscope Commercial |
$7,173.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,977.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: Nomi Health Commercial |
$6,535.40
|
| Rate for Payer: PHP Commercial |
$6,774.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health HMO/PPO |
$6,933.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,339.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,013.60
|
| Rate for Payer: UHC Core |
$6,654.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,977.50
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,892.88 |
| Max. Negotiated Rate |
$7,173.00 |
| Rate for Payer: Aetna Commercial |
$6,774.50
|
| Rate for Payer: Aetna Medicare |
$2,072.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,490.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,490.62
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$1,992.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,552.14
|
| Rate for Payer: BCN Commercial |
$6,196.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,992.50
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$6,854.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,992.50
|
| Rate for Payer: Healthscope Commercial |
$7,173.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,977.50
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,092.12
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,291.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: Nomi Health Commercial |
$6,535.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,892.88
|
| Rate for Payer: PACE SWMI |
$1,992.50
|
| Rate for Payer: PHP Commercial |
$6,774.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,992.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health HMO/PPO |
$6,933.90
|
| Rate for Payer: Priority Health Medicare |
$2,012.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,339.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,992.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,013.60
|
| Rate for Payer: UHC Core |
$6,654.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,992.50
|
| Rate for Payer: UHC Exchange |
$1,992.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,992.50
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$1,992.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,977.50
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.95 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: BCBS Trust/PPO |
$541.21
|
| Rate for Payer: BCN Commercial |
$512.37
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$543.66
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO |
$576.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.46 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$172.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.19
|
| Rate for Payer: BCBS Complete |
$176.30
|
| Rate for Payer: BCBS MAPPO |
$165.75
|
| Rate for Payer: BCBS Trust/PPO |
$545.05
|
| Rate for Payer: BCN Commercial |
$515.48
|
| Rate for Payer: BCN Medicare Advantage |
$165.75
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.75
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Mclaren Medicaid |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.04
|
| Rate for Payer: Meridian Medicaid |
$176.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$543.66
|
| Rate for Payer: PACE Senior Care Partners |
$157.46
|
| Rate for Payer: PACE SWMI |
$165.75
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$165.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO |
$576.81
|
| Rate for Payer: Priority Health Medicare |
$167.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$444.21
|
| Rate for Payer: Railroad Medicare Medicare |
$165.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.75
|
| Rate for Payer: UHC Exchange |
$165.75
|
| Rate for Payer: UHC Medicare Advantage |
$165.75
|
| Rate for Payer: UHCCP Medicaid |
$167.90
|
| Rate for Payer: VA VA |
$165.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
