|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
OP
|
$1,660.51
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$394.37 |
| Max. Negotiated Rate |
$1,494.46 |
| Rate for Payer: Aetna Commercial |
$1,411.43
|
| Rate for Payer: Aetna Medicare |
$431.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$518.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$518.91
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$415.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,291.05
|
| Rate for Payer: BCCCP Commercial |
$656.55
|
| Rate for Payer: BCN Commercial |
$1,291.05
|
| Rate for Payer: BCN Medicare Advantage |
$415.13
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cofinity Commercial |
$1,428.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.13
|
| Rate for Payer: Healthscope Commercial |
$1,494.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.38
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$477.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.43
|
| Rate for Payer: PACE Senior Care Partners |
$394.37
|
| Rate for Payer: PACE SWMI |
$415.13
|
| Rate for Payer: PHP Commercial |
$1,411.43
|
| Rate for Payer: PHP Medicare Advantage |
$415.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,444.64
|
| Rate for Payer: Priority Health Medicare |
$415.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,012.75
|
| Rate for Payer: Railroad Medicare Medicare |
$415.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,461.25
|
| Rate for Payer: UHC Core |
$1,386.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.13
|
| Rate for Payer: UHC Medicare Advantage |
$427.58
|
| Rate for Payer: VA VA |
$415.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.38
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,660.51
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.75 |
| Max. Negotiated Rate |
$1,494.46 |
| Rate for Payer: Aetna Commercial |
$1,411.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.24
|
| Rate for Payer: BCN Commercial |
$1,283.24
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cofinity Commercial |
$1,428.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.41
|
| Rate for Payer: Healthscope Commercial |
$1,494.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.43
|
| Rate for Payer: PHP Commercial |
$1,411.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,444.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,012.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,461.25
|
| Rate for Payer: UHC Core |
$1,386.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.38
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
IP
|
$2,343.35
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.21 |
| Max. Negotiated Rate |
$2,109.02 |
| Rate for Payer: Aetna Commercial |
$1,991.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.94
|
| Rate for Payer: BCN Commercial |
$1,810.94
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cofinity Commercial |
$2,015.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.68
|
| Rate for Payer: Healthscope Commercial |
$2,109.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,991.85
|
| Rate for Payer: PHP Commercial |
$1,991.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,640.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,038.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,062.15
|
| Rate for Payer: UHC Core |
$1,956.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.51
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
OP
|
$2,343.35
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$268.69 |
| Max. Negotiated Rate |
$2,109.02 |
| Rate for Payer: Aetna Commercial |
$1,991.85
|
| Rate for Payer: Aetna Medicare |
$609.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$732.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$732.30
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$585.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,821.95
|
| Rate for Payer: BCCCP Commercial |
$268.69
|
| Rate for Payer: BCN Commercial |
$1,821.95
|
| Rate for Payer: BCN Medicare Advantage |
$585.84
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cofinity Commercial |
$2,015.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.84
|
| Rate for Payer: Healthscope Commercial |
$2,109.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.51
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$615.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$673.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,991.85
|
| Rate for Payer: PACE Senior Care Partners |
$556.55
|
| Rate for Payer: PACE SWMI |
$585.84
|
| Rate for Payer: PHP Commercial |
$1,991.85
|
| Rate for Payer: PHP Medicare Advantage |
$585.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,640.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,038.71
|
| Rate for Payer: Priority Health Medicare |
$585.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.21
|
| Rate for Payer: Railroad Medicare Medicare |
$585.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,062.15
|
| Rate for Payer: UHC Core |
$1,956.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.84
|
| Rate for Payer: UHC Medicare Advantage |
$603.41
|
| Rate for Payer: VA VA |
$585.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.51
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
OP
|
$1,924.49
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$382.11 |
| Max. Negotiated Rate |
$1,732.04 |
| Rate for Payer: Aetna Commercial |
$1,635.82
|
| Rate for Payer: Aetna Medicare |
$500.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.40
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$481.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.29
|
| Rate for Payer: BCCCP Commercial |
$382.11
|
| Rate for Payer: BCN Commercial |
$1,496.29
|
| Rate for Payer: BCN Medicare Advantage |
$481.12
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cofinity Commercial |
$1,655.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.12
|
| Rate for Payer: Healthscope Commercial |
$1,732.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.37
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$505.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,635.82
|
| Rate for Payer: PACE Senior Care Partners |
$457.07
|
| Rate for Payer: PACE SWMI |
$481.12
|
| Rate for Payer: PHP Commercial |
$1,635.82
|
| Rate for Payer: PHP Medicare Advantage |
$481.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.31
|
| Rate for Payer: Priority Health Medicare |
$481.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,173.75
|
| Rate for Payer: Railroad Medicare Medicare |
$481.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,693.55
|
| Rate for Payer: UHC Core |
$1,606.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.12
|
| Rate for Payer: UHC Medicare Advantage |
$495.56
|
| Rate for Payer: VA VA |
$481.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.37
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
IP
|
$1,924.49
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,173.75 |
| Max. Negotiated Rate |
$1,732.04 |
| Rate for Payer: Aetna Commercial |
$1,635.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.25
|
| Rate for Payer: BCN Commercial |
$1,487.25
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cofinity Commercial |
$1,655.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.59
|
| Rate for Payer: Healthscope Commercial |
$1,732.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,635.82
|
| Rate for Payer: PHP Commercial |
$1,635.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,173.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,693.55
|
| Rate for Payer: UHC Core |
$1,606.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.37
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
OP
|
$7,123.41
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,691.81 |
| Max. Negotiated Rate |
$6,411.07 |
| Rate for Payer: Aetna Commercial |
$6,054.90
|
| Rate for Payer: Aetna Medicare |
$1,852.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,226.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,226.07
|
| Rate for Payer: BCBS Complete |
$2,849.36
|
| Rate for Payer: BCBS MAPPO |
$1,780.85
|
| Rate for Payer: BCBS Trust/PPO |
$5,538.45
|
| Rate for Payer: BCN Commercial |
$5,538.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,780.85
|
| Rate for Payer: Cash Price |
$5,698.73
|
| Rate for Payer: Cofinity Commercial |
$6,126.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,698.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,780.85
|
| Rate for Payer: Healthscope Commercial |
$6,411.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,342.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,869.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,047.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,054.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,691.81
|
| Rate for Payer: PACE SWMI |
$1,780.85
|
| Rate for Payer: PHP Commercial |
$6,054.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,780.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,986.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,197.37
|
| Rate for Payer: Priority Health Medicare |
$1,780.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,344.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,780.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,268.60
|
| Rate for Payer: UHC Core |
$5,948.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,780.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,834.28
|
| Rate for Payer: VA VA |
$1,780.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,342.56
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
IP
|
$7,123.41
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,344.57 |
| Max. Negotiated Rate |
$6,411.07 |
| Rate for Payer: Aetna Commercial |
$6,054.90
|
| Rate for Payer: BCBS Trust/PPO |
$5,504.97
|
| Rate for Payer: BCN Commercial |
$5,504.97
|
| Rate for Payer: Cash Price |
$5,698.73
|
| Rate for Payer: Cofinity Commercial |
$6,126.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,698.73
|
| Rate for Payer: Healthscope Commercial |
$6,411.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,342.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,054.90
|
| Rate for Payer: PHP Commercial |
$6,054.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,986.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,197.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,344.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,268.60
|
| Rate for Payer: UHC Core |
$5,948.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,342.56
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
IP
|
$1,000.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$609.90 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: BCBS Trust/PPO |
$772.80
|
| Rate for Payer: BCN Commercial |
$772.80
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.00
|
| Rate for Payer: UHC Core |
$835.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
OP
|
$1,000.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.50 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: Aetna Medicare |
$260.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$312.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$312.50
|
| Rate for Payer: BCBS Complete |
$400.00
|
| Rate for Payer: BCBS MAPPO |
$250.00
|
| Rate for Payer: BCBS Trust/PPO |
$777.50
|
| Rate for Payer: BCN Commercial |
$777.50
|
| Rate for Payer: BCN Medicare Advantage |
$250.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PACE Senior Care Partners |
$237.50
|
| Rate for Payer: PACE SWMI |
$250.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: PHP Medicare Advantage |
$250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.00
|
| Rate for Payer: Priority Health Medicare |
$250.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.90
|
| Rate for Payer: Railroad Medicare Medicare |
$250.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.00
|
| Rate for Payer: UHC Core |
$835.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.00
|
| Rate for Payer: UHC Medicare Advantage |
$257.50
|
| Rate for Payer: VA VA |
$250.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$828.96
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.88 |
| Max. Negotiated Rate |
$746.06 |
| Rate for Payer: Aetna Commercial |
$704.62
|
| Rate for Payer: Aetna Medicare |
$215.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$259.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$259.05
|
| Rate for Payer: BCBS Complete |
$331.58
|
| Rate for Payer: BCBS MAPPO |
$207.24
|
| Rate for Payer: BCBS Trust/PPO |
$644.52
|
| Rate for Payer: BCN Commercial |
$644.52
|
| Rate for Payer: BCN Medicare Advantage |
$207.24
|
| Rate for Payer: Cash Price |
$663.17
|
| Rate for Payer: Cofinity Commercial |
$712.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.24
|
| Rate for Payer: Healthscope Commercial |
$746.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$621.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$704.62
|
| Rate for Payer: PACE Senior Care Partners |
$196.88
|
| Rate for Payer: PACE SWMI |
$207.24
|
| Rate for Payer: PHP Commercial |
$704.62
|
| Rate for Payer: PHP Medicare Advantage |
$207.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.20
|
| Rate for Payer: Priority Health Medicare |
$207.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.58
|
| Rate for Payer: Railroad Medicare Medicare |
$207.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.48
|
| Rate for Payer: UHC Core |
$692.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.24
|
| Rate for Payer: UHC Medicare Advantage |
$213.46
|
| Rate for Payer: VA VA |
$207.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$621.72
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
IP
|
$828.96
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$505.58 |
| Max. Negotiated Rate |
$746.06 |
| Rate for Payer: Aetna Commercial |
$704.62
|
| Rate for Payer: BCBS Trust/PPO |
$640.62
|
| Rate for Payer: BCN Commercial |
$640.62
|
| Rate for Payer: Cash Price |
$663.17
|
| Rate for Payer: Cofinity Commercial |
$712.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.17
|
| Rate for Payer: Healthscope Commercial |
$746.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$621.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$704.62
|
| Rate for Payer: PHP Commercial |
$704.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.48
|
| Rate for Payer: UHC Core |
$692.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$621.72
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,100.84
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$261.45 |
| Max. Negotiated Rate |
$990.76 |
| Rate for Payer: Aetna Commercial |
$935.71
|
| Rate for Payer: Aetna Medicare |
$286.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$344.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$344.01
|
| Rate for Payer: BCBS Complete |
$440.34
|
| Rate for Payer: BCBS MAPPO |
$275.21
|
| Rate for Payer: BCBS Trust/PPO |
$855.90
|
| Rate for Payer: BCN Commercial |
$855.90
|
| Rate for Payer: BCN Medicare Advantage |
$275.21
|
| Rate for Payer: Cash Price |
$880.67
|
| Rate for Payer: Cofinity Commercial |
$946.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.21
|
| Rate for Payer: Healthscope Commercial |
$990.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$316.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.71
|
| Rate for Payer: PACE Senior Care Partners |
$261.45
|
| Rate for Payer: PACE SWMI |
$275.21
|
| Rate for Payer: PHP Commercial |
$935.71
|
| Rate for Payer: PHP Medicare Advantage |
$275.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.73
|
| Rate for Payer: Priority Health Medicare |
$275.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.40
|
| Rate for Payer: Railroad Medicare Medicare |
$275.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.74
|
| Rate for Payer: UHC Core |
$919.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.21
|
| Rate for Payer: UHC Medicare Advantage |
$283.47
|
| Rate for Payer: VA VA |
$275.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.63
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,100.84
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$671.40 |
| Max. Negotiated Rate |
$990.76 |
| Rate for Payer: Aetna Commercial |
$935.71
|
| Rate for Payer: BCBS Trust/PPO |
$850.73
|
| Rate for Payer: BCN Commercial |
$850.73
|
| Rate for Payer: Cash Price |
$880.67
|
| Rate for Payer: Cofinity Commercial |
$946.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.67
|
| Rate for Payer: Healthscope Commercial |
$990.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.71
|
| Rate for Payer: PHP Commercial |
$935.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.74
|
| Rate for Payer: UHC Core |
$919.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.63
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
IP
|
$10,241.99
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,246.59 |
| Max. Negotiated Rate |
$9,217.79 |
| Rate for Payer: Aetna Commercial |
$8,705.69
|
| Rate for Payer: BCBS Trust/PPO |
$7,915.01
|
| Rate for Payer: BCN Commercial |
$7,915.01
|
| Rate for Payer: Cash Price |
$8,193.59
|
| Rate for Payer: Cofinity Commercial |
$8,808.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,193.59
|
| Rate for Payer: Healthscope Commercial |
$9,217.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,681.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,705.69
|
| Rate for Payer: PHP Commercial |
$8,705.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,169.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,910.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,246.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,012.95
|
| Rate for Payer: UHC Core |
$8,552.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,681.49
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
OP
|
$10,241.99
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,432.47 |
| Max. Negotiated Rate |
$9,217.79 |
| Rate for Payer: Aetna Commercial |
$8,705.69
|
| Rate for Payer: Aetna Medicare |
$2,662.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,200.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,200.62
|
| Rate for Payer: BCBS Complete |
$4,096.80
|
| Rate for Payer: BCBS MAPPO |
$2,560.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,963.15
|
| Rate for Payer: BCN Commercial |
$7,963.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,560.50
|
| Rate for Payer: Cash Price |
$8,193.59
|
| Rate for Payer: Cofinity Commercial |
$8,808.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,193.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,560.50
|
| Rate for Payer: Healthscope Commercial |
$9,217.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,681.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,688.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,944.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,705.69
|
| Rate for Payer: PACE Senior Care Partners |
$2,432.47
|
| Rate for Payer: PACE SWMI |
$2,560.50
|
| Rate for Payer: PHP Commercial |
$8,705.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,560.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,169.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,910.53
|
| Rate for Payer: Priority Health Medicare |
$2,560.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,246.59
|
| Rate for Payer: Railroad Medicare Medicare |
$2,560.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,012.95
|
| Rate for Payer: UHC Core |
$8,552.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,560.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,637.31
|
| Rate for Payer: VA VA |
$2,560.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,681.49
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,000.76
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$610.36 |
| Max. Negotiated Rate |
$900.68 |
| Rate for Payer: Aetna Commercial |
$850.65
|
| Rate for Payer: BCBS Trust/PPO |
$773.39
|
| Rate for Payer: BCN Commercial |
$773.39
|
| Rate for Payer: Cash Price |
$800.61
|
| Rate for Payer: Cofinity Commercial |
$860.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.61
|
| Rate for Payer: Healthscope Commercial |
$900.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.65
|
| Rate for Payer: PHP Commercial |
$850.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.67
|
| Rate for Payer: UHC Core |
$835.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.57
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,000.76
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.68 |
| Max. Negotiated Rate |
$900.68 |
| Rate for Payer: Aetna Commercial |
$850.65
|
| Rate for Payer: Aetna Medicare |
$260.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$312.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$312.74
|
| Rate for Payer: BCBS Complete |
$400.30
|
| Rate for Payer: BCBS MAPPO |
$250.19
|
| Rate for Payer: BCBS Trust/PPO |
$778.09
|
| Rate for Payer: BCN Commercial |
$778.09
|
| Rate for Payer: BCN Medicare Advantage |
$250.19
|
| Rate for Payer: Cash Price |
$800.61
|
| Rate for Payer: Cofinity Commercial |
$860.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.19
|
| Rate for Payer: Healthscope Commercial |
$900.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.65
|
| Rate for Payer: PACE Senior Care Partners |
$237.68
|
| Rate for Payer: PACE SWMI |
$250.19
|
| Rate for Payer: PHP Commercial |
$850.65
|
| Rate for Payer: PHP Medicare Advantage |
$250.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.66
|
| Rate for Payer: Priority Health Medicare |
$250.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.36
|
| Rate for Payer: Railroad Medicare Medicare |
$250.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.67
|
| Rate for Payer: UHC Core |
$835.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.19
|
| Rate for Payer: UHC Medicare Advantage |
$257.70
|
| Rate for Payer: VA VA |
$250.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.57
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
OP
|
$912.16
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.64 |
| Max. Negotiated Rate |
$820.94 |
| Rate for Payer: Aetna Commercial |
$775.34
|
| Rate for Payer: Aetna Medicare |
$237.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$285.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$285.05
|
| Rate for Payer: BCBS Complete |
$364.86
|
| Rate for Payer: BCBS MAPPO |
$228.04
|
| Rate for Payer: BCBS Trust/PPO |
$709.20
|
| Rate for Payer: BCN Commercial |
$709.20
|
| Rate for Payer: BCN Medicare Advantage |
$228.04
|
| Rate for Payer: Cash Price |
$729.73
|
| Rate for Payer: Cofinity Commercial |
$784.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.04
|
| Rate for Payer: Healthscope Commercial |
$820.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$239.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$262.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$775.34
|
| Rate for Payer: PACE Senior Care Partners |
$216.64
|
| Rate for Payer: PACE SWMI |
$228.04
|
| Rate for Payer: PHP Commercial |
$775.34
|
| Rate for Payer: PHP Medicare Advantage |
$228.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$793.58
|
| Rate for Payer: Priority Health Medicare |
$228.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.33
|
| Rate for Payer: Railroad Medicare Medicare |
$228.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.70
|
| Rate for Payer: UHC Core |
$761.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.04
|
| Rate for Payer: UHC Medicare Advantage |
$234.88
|
| Rate for Payer: VA VA |
$228.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.12
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
IP
|
$912.16
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$556.33 |
| Max. Negotiated Rate |
$820.94 |
| Rate for Payer: Aetna Commercial |
$775.34
|
| Rate for Payer: BCBS Trust/PPO |
$704.92
|
| Rate for Payer: BCN Commercial |
$704.92
|
| Rate for Payer: Cash Price |
$729.73
|
| Rate for Payer: Cofinity Commercial |
$784.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.73
|
| Rate for Payer: Healthscope Commercial |
$820.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$684.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$775.34
|
| Rate for Payer: PHP Commercial |
$775.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$793.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.70
|
| Rate for Payer: UHC Core |
$761.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$684.12
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
IP
|
$5,773.44
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,521.22 |
| Max. Negotiated Rate |
$5,196.10 |
| Rate for Payer: Aetna Commercial |
$4,907.42
|
| Rate for Payer: BCBS Trust/PPO |
$4,461.71
|
| Rate for Payer: BCN Commercial |
$4,461.71
|
| Rate for Payer: Cash Price |
$4,618.75
|
| Rate for Payer: Cofinity Commercial |
$4,965.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,618.75
|
| Rate for Payer: Healthscope Commercial |
$5,196.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,330.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,907.42
|
| Rate for Payer: PHP Commercial |
$4,907.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,041.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,022.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,521.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,080.63
|
| Rate for Payer: UHC Core |
$4,820.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,330.08
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
OP
|
$5,773.44
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,371.19 |
| Max. Negotiated Rate |
$5,196.10 |
| Rate for Payer: Aetna Commercial |
$4,907.42
|
| Rate for Payer: Aetna Medicare |
$1,501.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,804.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,804.20
|
| Rate for Payer: BCBS Complete |
$2,309.38
|
| Rate for Payer: BCBS MAPPO |
$1,443.36
|
| Rate for Payer: BCBS Trust/PPO |
$4,488.85
|
| Rate for Payer: BCN Commercial |
$4,488.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,443.36
|
| Rate for Payer: Cash Price |
$4,618.75
|
| Rate for Payer: Cofinity Commercial |
$4,965.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,618.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,443.36
|
| Rate for Payer: Healthscope Commercial |
$5,196.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,330.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,515.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,659.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,907.42
|
| Rate for Payer: PACE Senior Care Partners |
$1,371.19
|
| Rate for Payer: PACE SWMI |
$1,443.36
|
| Rate for Payer: PHP Commercial |
$4,907.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,443.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,041.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,022.89
|
| Rate for Payer: Priority Health Medicare |
$1,443.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,521.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,443.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,080.63
|
| Rate for Payer: UHC Core |
$4,820.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,443.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,486.66
|
| Rate for Payer: VA VA |
$1,443.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,330.08
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
IP
|
$5,409.65
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,299.35 |
| Max. Negotiated Rate |
$4,868.68 |
| Rate for Payer: Aetna Commercial |
$4,598.20
|
| Rate for Payer: BCBS Trust/PPO |
$4,180.58
|
| Rate for Payer: BCN Commercial |
$4,180.58
|
| Rate for Payer: Cash Price |
$4,327.72
|
| Rate for Payer: Cofinity Commercial |
$4,652.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.72
|
| Rate for Payer: Healthscope Commercial |
$4,868.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,057.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,598.20
|
| Rate for Payer: PHP Commercial |
$4,598.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,706.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,299.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,760.49
|
| Rate for Payer: UHC Core |
$4,517.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,057.24
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
OP
|
$5,409.65
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,284.79 |
| Max. Negotiated Rate |
$4,868.68 |
| Rate for Payer: Aetna Commercial |
$4,598.20
|
| Rate for Payer: Aetna Medicare |
$1,406.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,690.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,690.52
|
| Rate for Payer: BCBS Complete |
$2,163.86
|
| Rate for Payer: BCBS MAPPO |
$1,352.41
|
| Rate for Payer: BCBS Trust/PPO |
$4,206.00
|
| Rate for Payer: BCN Commercial |
$4,206.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,352.41
|
| Rate for Payer: Cash Price |
$4,327.72
|
| Rate for Payer: Cofinity Commercial |
$4,652.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,352.41
|
| Rate for Payer: Healthscope Commercial |
$4,868.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,057.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,420.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,555.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,598.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,284.79
|
| Rate for Payer: PACE SWMI |
$1,352.41
|
| Rate for Payer: PHP Commercial |
$4,598.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,352.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,706.40
|
| Rate for Payer: Priority Health Medicare |
$1,352.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,299.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,352.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,760.49
|
| Rate for Payer: UHC Core |
$4,517.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,352.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,392.98
|
| Rate for Payer: VA VA |
$1,352.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,057.24
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,282.56
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,002.03 |
| Max. Negotiated Rate |
$2,954.30 |
| Rate for Payer: Aetna Commercial |
$2,790.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,536.76
|
| Rate for Payer: BCN Commercial |
$2,536.76
|
| Rate for Payer: Cash Price |
$2,626.05
|
| Rate for Payer: Cofinity Commercial |
$2,823.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,626.05
|
| Rate for Payer: Healthscope Commercial |
$2,954.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,461.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,790.18
|
| Rate for Payer: PHP Commercial |
$2,790.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,297.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,855.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,002.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,888.65
|
| Rate for Payer: UHC Core |
$2,740.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,461.92
|
|
