|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
OP
|
$252.82
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$303.32 |
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: Aetna Medicare |
$65.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.01
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$63.20
|
| Rate for Payer: BCBS Trust/PPO |
$207.84
|
| Rate for Payer: BCN Commercial |
$196.57
|
| Rate for Payer: BCN Medicare Advantage |
$63.20
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.37
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: Nomi Health Commercial |
$207.31
|
| Rate for Payer: PACE Senior Care Partners |
$60.04
|
| Rate for Payer: PACE SWMI |
$63.20
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: PHP Medicare Advantage |
$63.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health HMO/PPO |
$219.95
|
| Rate for Payer: Priority Health Medicare |
$63.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.39
|
| Rate for Payer: Railroad Medicare Medicare |
$63.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.48
|
| Rate for Payer: UHC Core |
$211.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.20
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$63.20
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$63.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
IP
|
$252.82
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.33 |
| Max. Negotiated Rate |
$227.54 |
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: BCBS Trust/PPO |
$206.38
|
| Rate for Payer: BCN Commercial |
$195.38
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: Nomi Health Commercial |
$207.31
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health HMO/PPO |
$219.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.48
|
| Rate for Payer: UHC Core |
$211.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
IP
|
$863.45
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$561.24 |
| Max. Negotiated Rate |
$777.11 |
| Rate for Payer: Aetna Commercial |
$733.93
|
| Rate for Payer: BCBS Trust/PPO |
$704.83
|
| Rate for Payer: BCN Commercial |
$667.27
|
| Rate for Payer: Cash Price |
$690.76
|
| Rate for Payer: Cofinity Commercial |
$742.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.76
|
| Rate for Payer: Healthscope Commercial |
$777.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$647.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.93
|
| Rate for Payer: Nomi Health Commercial |
$708.03
|
| Rate for Payer: PHP Commercial |
$733.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.24
|
| Rate for Payer: Priority Health HMO/PPO |
$751.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.84
|
| Rate for Payer: UHC Core |
$720.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$647.59
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
OP
|
$863.45
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.07 |
| Max. Negotiated Rate |
$777.11 |
| Rate for Payer: Aetna Commercial |
$733.93
|
| Rate for Payer: Aetna Medicare |
$224.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.83
|
| Rate for Payer: BCBS Complete |
$345.38
|
| Rate for Payer: BCBS MAPPO |
$215.86
|
| Rate for Payer: BCBS Trust/PPO |
$709.84
|
| Rate for Payer: BCN Commercial |
$671.33
|
| Rate for Payer: BCN Medicare Advantage |
$215.86
|
| Rate for Payer: Cash Price |
$690.76
|
| Rate for Payer: Cofinity Commercial |
$742.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.86
|
| Rate for Payer: Healthscope Commercial |
$777.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$647.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.93
|
| Rate for Payer: Nomi Health Commercial |
$708.03
|
| Rate for Payer: PACE Senior Care Partners |
$205.07
|
| Rate for Payer: PACE SWMI |
$215.86
|
| Rate for Payer: PHP Commercial |
$733.93
|
| Rate for Payer: PHP Medicare Advantage |
$215.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.24
|
| Rate for Payer: Priority Health HMO/PPO |
$751.20
|
| Rate for Payer: Priority Health Medicare |
$218.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.51
|
| Rate for Payer: Railroad Medicare Medicare |
$215.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.84
|
| Rate for Payer: UHC Core |
$720.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.86
|
| Rate for Payer: UHC Exchange |
$215.86
|
| Rate for Payer: UHC Medicare Advantage |
$215.86
|
| Rate for Payer: VA VA |
$215.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$647.59
|
|
|
HC INJECTION SHUNTOGRAM
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC INJECTION SHUNTOGRAM
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$238.23
|
| Rate for Payer: BCN Commercial |
$225.53
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.31 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$116.74
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.92
|
| Rate for Payer: BCN Commercial |
$226.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.96
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,011.25
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$657.31 |
| Max. Negotiated Rate |
$910.12 |
| Rate for Payer: Aetna Commercial |
$859.56
|
| Rate for Payer: BCBS Trust/PPO |
$825.48
|
| Rate for Payer: BCN Commercial |
$781.49
|
| Rate for Payer: Cash Price |
$809.00
|
| Rate for Payer: Cofinity Commercial |
$869.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.00
|
| Rate for Payer: Healthscope Commercial |
$910.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.56
|
| Rate for Payer: Nomi Health Commercial |
$829.23
|
| Rate for Payer: PHP Commercial |
$859.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.31
|
| Rate for Payer: Priority Health HMO/PPO |
$879.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.90
|
| Rate for Payer: UHC Core |
$844.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.44
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
OP
|
$1,011.25
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.17 |
| Max. Negotiated Rate |
$910.12 |
| Rate for Payer: Aetna Commercial |
$859.56
|
| Rate for Payer: Aetna Medicare |
$262.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$316.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$316.02
|
| Rate for Payer: BCBS Complete |
$404.50
|
| Rate for Payer: BCBS MAPPO |
$252.81
|
| Rate for Payer: BCBS Trust/PPO |
$831.35
|
| Rate for Payer: BCN Commercial |
$786.25
|
| Rate for Payer: BCN Medicare Advantage |
$252.81
|
| Rate for Payer: Cash Price |
$809.00
|
| Rate for Payer: Cofinity Commercial |
$869.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$252.81
|
| Rate for Payer: Healthscope Commercial |
$910.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$265.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$290.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.56
|
| Rate for Payer: Nomi Health Commercial |
$829.23
|
| Rate for Payer: PACE Senior Care Partners |
$240.17
|
| Rate for Payer: PACE SWMI |
$252.81
|
| Rate for Payer: PHP Commercial |
$859.56
|
| Rate for Payer: PHP Medicare Advantage |
$252.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.31
|
| Rate for Payer: Priority Health HMO/PPO |
$879.79
|
| Rate for Payer: Priority Health Medicare |
$255.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$677.54
|
| Rate for Payer: Railroad Medicare Medicare |
$252.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$889.90
|
| Rate for Payer: UHC Core |
$844.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$252.81
|
| Rate for Payer: UHC Exchange |
$252.81
|
| Rate for Payer: UHC Medicare Advantage |
$252.81
|
| Rate for Payer: VA VA |
$252.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.44
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
OP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.86 |
| Max. Negotiated Rate |
$943.07 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna Medicare |
$272.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$327.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$327.45
|
| Rate for Payer: BCBS Complete |
$419.14
|
| Rate for Payer: BCBS MAPPO |
$261.96
|
| Rate for Payer: BCBS Trust/PPO |
$861.44
|
| Rate for Payer: BCN Commercial |
$814.70
|
| Rate for Payer: BCN Medicare Advantage |
$261.96
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.96
|
| Rate for Payer: Healthscope Commercial |
$943.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$890.67
|
| Rate for Payer: Nomi Health Commercial |
$859.24
|
| Rate for Payer: PACE Senior Care Partners |
$248.86
|
| Rate for Payer: PACE SWMI |
$261.96
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: PHP Medicare Advantage |
$261.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$681.10
|
| Rate for Payer: Priority Health HMO/PPO |
$911.63
|
| Rate for Payer: Priority Health Medicare |
$264.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.06
|
| Rate for Payer: Railroad Medicare Medicare |
$261.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.11
|
| Rate for Payer: UHC Core |
$874.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.96
|
| Rate for Payer: UHC Exchange |
$261.96
|
| Rate for Payer: UHC Medicare Advantage |
$261.96
|
| Rate for Payer: VA VA |
$261.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$681.10 |
| Max. Negotiated Rate |
$943.07 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: BCBS Trust/PPO |
$855.36
|
| Rate for Payer: BCN Commercial |
$809.78
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$943.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$890.67
|
| Rate for Payer: Nomi Health Commercial |
$859.24
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$681.10
|
| Rate for Payer: Priority Health HMO/PPO |
$911.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$702.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.11
|
| Rate for Payer: UHC Core |
$874.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
IP
|
$279.36
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$181.58 |
| Max. Negotiated Rate |
$251.42 |
| Rate for Payer: Aetna Commercial |
$237.46
|
| Rate for Payer: BCBS Trust/PPO |
$228.04
|
| Rate for Payer: BCN Commercial |
$215.89
|
| Rate for Payer: Cash Price |
$223.49
|
| Rate for Payer: Cofinity Commercial |
$240.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.49
|
| Rate for Payer: Healthscope Commercial |
$251.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.46
|
| Rate for Payer: Nomi Health Commercial |
$229.08
|
| Rate for Payer: PHP Commercial |
$237.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.58
|
| Rate for Payer: Priority Health HMO/PPO |
$243.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.84
|
| Rate for Payer: UHC Core |
$233.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.52
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
OP
|
$279.36
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.35 |
| Max. Negotiated Rate |
$251.42 |
| Rate for Payer: Aetna Commercial |
$237.46
|
| Rate for Payer: Aetna Medicare |
$72.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.30
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$69.84
|
| Rate for Payer: BCBS Trust/PPO |
$229.66
|
| Rate for Payer: BCN Commercial |
$217.20
|
| Rate for Payer: BCN Medicare Advantage |
$69.84
|
| Rate for Payer: Cash Price |
$223.49
|
| Rate for Payer: Cash Price |
$223.49
|
| Rate for Payer: Cofinity Commercial |
$240.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.84
|
| Rate for Payer: Healthscope Commercial |
$251.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.52
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.33
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.46
|
| Rate for Payer: Nomi Health Commercial |
$229.08
|
| Rate for Payer: PACE Senior Care Partners |
$66.35
|
| Rate for Payer: PACE SWMI |
$69.84
|
| Rate for Payer: PHP Commercial |
$237.46
|
| Rate for Payer: PHP Medicare Advantage |
$69.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.58
|
| Rate for Payer: Priority Health HMO/PPO |
$243.04
|
| Rate for Payer: Priority Health Medicare |
$70.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.17
|
| Rate for Payer: Railroad Medicare Medicare |
$69.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.84
|
| Rate for Payer: UHC Core |
$233.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.84
|
| Rate for Payer: UHC Exchange |
$69.84
|
| Rate for Payer: UHC Medicare Advantage |
$69.84
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.52
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.94 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$175.05
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
IP
|
$1,085.28
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$705.43 |
| Max. Negotiated Rate |
$976.75 |
| Rate for Payer: Aetna Commercial |
$922.49
|
| Rate for Payer: BCBS Trust/PPO |
$885.91
|
| Rate for Payer: BCN Commercial |
$838.70
|
| Rate for Payer: Cash Price |
$868.22
|
| Rate for Payer: Cofinity Commercial |
$933.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.22
|
| Rate for Payer: Healthscope Commercial |
$976.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.49
|
| Rate for Payer: Nomi Health Commercial |
$889.93
|
| Rate for Payer: PHP Commercial |
$922.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.43
|
| Rate for Payer: Priority Health HMO/PPO |
$944.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.05
|
| Rate for Payer: UHC Core |
$906.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.96
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
OP
|
$1,085.28
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.75 |
| Max. Negotiated Rate |
$976.75 |
| Rate for Payer: Aetna Commercial |
$922.49
|
| Rate for Payer: Aetna Medicare |
$282.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.15
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$271.32
|
| Rate for Payer: BCBS Trust/PPO |
$892.21
|
| Rate for Payer: BCN Commercial |
$843.81
|
| Rate for Payer: BCN Medicare Advantage |
$271.32
|
| Rate for Payer: Cash Price |
$868.22
|
| Rate for Payer: Cash Price |
$868.22
|
| Rate for Payer: Cofinity Commercial |
$933.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.32
|
| Rate for Payer: Healthscope Commercial |
$976.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.96
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.89
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$922.49
|
| Rate for Payer: Nomi Health Commercial |
$889.93
|
| Rate for Payer: PACE Senior Care Partners |
$257.75
|
| Rate for Payer: PACE SWMI |
$271.32
|
| Rate for Payer: PHP Commercial |
$922.49
|
| Rate for Payer: PHP Medicare Advantage |
$271.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.43
|
| Rate for Payer: Priority Health HMO/PPO |
$944.19
|
| Rate for Payer: Priority Health Medicare |
$274.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.14
|
| Rate for Payer: Railroad Medicare Medicare |
$271.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.05
|
| Rate for Payer: UHC Core |
$906.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.32
|
| Rate for Payer: UHC Exchange |
$271.32
|
| Rate for Payer: UHC Medicare Advantage |
$271.32
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$271.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.96
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: BCBS Trust/PPO |
$0.13
|
| Rate for Payer: BCN Commercial |
$0.12
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.14
|
| Rate for Payer: Nomi Health Commercial |
$0.13
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.10
|
| Rate for Payer: Priority Health HMO/PPO |
$0.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.14
|
| Rate for Payer: UHC Core |
$0.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: Aetna Medicare |
$0.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.05
|
| Rate for Payer: BCBS Complete |
$0.06
|
| Rate for Payer: BCBS MAPPO |
$0.04
|
| Rate for Payer: BCBS Trust/PPO |
$0.13
|
| Rate for Payer: BCN Commercial |
$0.12
|
| Rate for Payer: BCN Medicare Advantage |
$0.04
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.04
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.14
|
| Rate for Payer: Nomi Health Commercial |
$0.13
|
| Rate for Payer: PACE Senior Care Partners |
$0.04
|
| Rate for Payer: PACE SWMI |
$0.04
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: PHP Medicare Advantage |
$0.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.10
|
| Rate for Payer: Priority Health HMO/PPO |
$0.14
|
| Rate for Payer: Priority Health Medicare |
$0.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.11
|
| Rate for Payer: Railroad Medicare Medicare |
$0.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.14
|
| Rate for Payer: UHC Core |
$0.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.04
|
| Rate for Payer: UHC Exchange |
$0.04
|
| Rate for Payer: UHC Medicare Advantage |
$0.04
|
| Rate for Payer: VA VA |
$0.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
OP
|
$923.66
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$219.37 |
| Max. Negotiated Rate |
$1,124.59 |
| Rate for Payer: Aetna Commercial |
$785.11
|
| Rate for Payer: Aetna Medicare |
$240.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.64
|
| Rate for Payer: BCBS Complete |
$1,124.59
|
| Rate for Payer: BCBS MAPPO |
$230.91
|
| Rate for Payer: BCBS Trust/PPO |
$759.34
|
| Rate for Payer: BCN Commercial |
$718.15
|
| Rate for Payer: BCN Medicare Advantage |
$230.91
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cofinity Commercial |
$794.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.91
|
| Rate for Payer: Healthscope Commercial |
$831.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.75
|
| Rate for Payer: Mclaren Medicaid |
$1,070.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.46
|
| Rate for Payer: Meridian Medicaid |
$1,124.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.11
|
| Rate for Payer: Nomi Health Commercial |
$757.40
|
| Rate for Payer: PACE Senior Care Partners |
$219.37
|
| Rate for Payer: PACE SWMI |
$230.91
|
| Rate for Payer: PHP Commercial |
$785.11
|
| Rate for Payer: PHP Medicare Advantage |
$230.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.38
|
| Rate for Payer: Priority Health HMO/PPO |
$803.58
|
| Rate for Payer: Priority Health Medicare |
$233.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.85
|
| Rate for Payer: Railroad Medicare Medicare |
$230.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.82
|
| Rate for Payer: UHC Core |
$771.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.91
|
| Rate for Payer: UHC Exchange |
$230.91
|
| Rate for Payer: UHC Medicare Advantage |
$230.91
|
| Rate for Payer: UHCCP Medicaid |
$1,070.97
|
| Rate for Payer: VA VA |
$230.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.75
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
IP
|
$923.66
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.38 |
| Max. Negotiated Rate |
$831.29 |
| Rate for Payer: Aetna Commercial |
$785.11
|
| Rate for Payer: BCBS Trust/PPO |
$753.98
|
| Rate for Payer: BCN Commercial |
$713.80
|
| Rate for Payer: Cash Price |
$738.93
|
| Rate for Payer: Cofinity Commercial |
$794.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.93
|
| Rate for Payer: Healthscope Commercial |
$831.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.11
|
| Rate for Payer: Nomi Health Commercial |
$757.40
|
| Rate for Payer: PHP Commercial |
$785.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.38
|
| Rate for Payer: Priority Health HMO/PPO |
$803.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.82
|
| Rate for Payer: UHC Core |
$771.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.75
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
OP
|
$1,724.42
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.55 |
| Max. Negotiated Rate |
$1,551.98 |
| Rate for Payer: Aetna Commercial |
$1,465.76
|
| Rate for Payer: Aetna Medicare |
$448.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$538.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$538.88
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$431.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,417.65
|
| Rate for Payer: BCN Commercial |
$1,340.74
|
| Rate for Payer: BCN Medicare Advantage |
$431.11
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cofinity Commercial |
$1,483.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.11
|
| Rate for Payer: Healthscope Commercial |
$1,551.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.32
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.66
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$495.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.76
|
| Rate for Payer: Nomi Health Commercial |
$1,414.02
|
| Rate for Payer: PACE Senior Care Partners |
$409.55
|
| Rate for Payer: PACE SWMI |
$431.11
|
| Rate for Payer: PHP Commercial |
$1,465.76
|
| Rate for Payer: PHP Medicare Advantage |
$431.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1,500.25
|
| Rate for Payer: Priority Health Medicare |
$435.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,155.36
|
| Rate for Payer: Railroad Medicare Medicare |
$431.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,517.49
|
| Rate for Payer: UHC Core |
$1,439.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$431.11
|
| Rate for Payer: UHC Exchange |
$431.11
|
| Rate for Payer: UHC Medicare Advantage |
$431.11
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$431.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.32
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
IP
|
$1,724.42
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,120.87 |
| Max. Negotiated Rate |
$1,551.98 |
| Rate for Payer: Aetna Commercial |
$1,465.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,407.64
|
| Rate for Payer: BCN Commercial |
$1,332.63
|
| Rate for Payer: Cash Price |
$1,379.54
|
| Rate for Payer: Cofinity Commercial |
$1,483.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.54
|
| Rate for Payer: Healthscope Commercial |
$1,551.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.76
|
| Rate for Payer: Nomi Health Commercial |
$1,414.02
|
| Rate for Payer: PHP Commercial |
$1,465.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,120.87
|
| Rate for Payer: Priority Health HMO/PPO |
$1,500.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,155.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,517.49
|
| Rate for Payer: UHC Core |
$1,439.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.32
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
IP
|
$2,586.63
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,681.31 |
| Max. Negotiated Rate |
$2,327.97 |
| Rate for Payer: Aetna Commercial |
$2,198.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.47
|
| Rate for Payer: BCN Commercial |
$1,998.95
|
| Rate for Payer: Cash Price |
$2,069.30
|
| Rate for Payer: Cofinity Commercial |
$2,224.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,069.30
|
| Rate for Payer: Healthscope Commercial |
$2,327.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,939.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,198.64
|
| Rate for Payer: Nomi Health Commercial |
$2,121.04
|
| Rate for Payer: PHP Commercial |
$2,198.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,681.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,250.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,276.23
|
| Rate for Payer: UHC Core |
$2,159.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,939.97
|
|
