|
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 |
$297.19
|
| 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 |
$283.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.89
|
| Rate for Payer: Meridian Medicaid |
$297.19
|
| 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 |
$283.02
|
| 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 |
$283.02
|
| 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
|
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 |
$692.74
|
| 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 |
$692.74
|
|
|
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 |
$1,101.85 |
| 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 |
$1,101.85
|
| Rate for Payer: BCBS MAPPO |
$230.92
|
| Rate for Payer: BCBS Trust/PPO |
$759.34
|
| Rate for Payer: BCN Commercial |
$718.15
|
| Rate for Payer: BCN Medicare Advantage |
$230.92
|
| 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 |
$230.92
|
| Rate for Payer: Healthscope Commercial |
$831.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.74
|
| Rate for Payer: Mclaren Medicaid |
$1,049.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.46
|
| Rate for Payer: Meridian Medicaid |
$1,101.85
|
| 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 |
$230.92
|
| Rate for Payer: PHP Commercial |
$785.11
|
| Rate for Payer: PHP Medicare Advantage |
$230.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,049.31
|
| 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 |
$230.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.82
|
| Rate for Payer: UHC Core |
$771.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.92
|
| Rate for Payer: UHC Exchange |
$230.92
|
| Rate for Payer: UHC Medicare Advantage |
$230.92
|
| Rate for Payer: UHCCP Medicaid |
$1,049.31
|
| Rate for Payer: VA VA |
$230.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.74
|
|
|
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 |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$431.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,417.65
|
| Rate for Payer: BCN Commercial |
$1,340.74
|
| Rate for Payer: BCN Medicare Advantage |
$431.10
|
| 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 |
$431.10
|
| Rate for Payer: Healthscope Commercial |
$1,551.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.32
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$452.66
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| 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 |
$431.10
|
| Rate for Payer: PHP Commercial |
$1,465.76
|
| Rate for Payer: PHP Medicare Advantage |
$431.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| 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 |
$431.10
|
| 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 |
$431.10
|
| Rate for Payer: UHC Exchange |
$431.10
|
| Rate for Payer: UHC Medicare Advantage |
$431.10
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$431.10
|
| 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
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
OP
|
$2,586.63
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$614.32 |
| Max. Negotiated Rate |
$2,327.97 |
| Rate for Payer: Aetna Commercial |
$2,198.64
|
| Rate for Payer: Aetna Medicare |
$672.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$808.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$808.32
|
| Rate for Payer: BCBS Complete |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$646.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,126.47
|
| Rate for Payer: BCN Commercial |
$2,011.10
|
| Rate for Payer: BCN Medicare Advantage |
$646.66
|
| Rate for Payer: Cash Price |
$2,069.30
|
| 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: Health Alliance Plan Medicare Advantage |
$646.66
|
| Rate for Payer: Healthscope Commercial |
$2,327.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,939.97
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.99
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$743.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,198.64
|
| Rate for Payer: Nomi Health Commercial |
$2,121.04
|
| Rate for Payer: PACE Senior Care Partners |
$614.32
|
| Rate for Payer: PACE SWMI |
$646.66
|
| Rate for Payer: PHP Commercial |
$2,198.64
|
| Rate for Payer: PHP Medicare Advantage |
$646.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| 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 Medicare |
$653.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.04
|
| Rate for Payer: Railroad Medicare Medicare |
$646.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,276.23
|
| Rate for Payer: UHC Core |
$2,159.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$646.66
|
| Rate for Payer: UHC Exchange |
$646.66
|
| Rate for Payer: UHC Medicare Advantage |
$646.66
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$646.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,939.97
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
OP
|
$911.49
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.48 |
| Max. Negotiated Rate |
$820.34 |
| Rate for Payer: Aetna Commercial |
$774.77
|
| Rate for Payer: Aetna Medicare |
$236.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.84
|
| Rate for Payer: BCBS Complete |
$364.60
|
| Rate for Payer: BCBS MAPPO |
$227.87
|
| Rate for Payer: BCBS Trust/PPO |
$749.34
|
| Rate for Payer: BCN Commercial |
$708.68
|
| Rate for Payer: BCN Medicare Advantage |
$227.87
|
| Rate for Payer: Cash Price |
$729.19
|
| Rate for Payer: Cofinity Commercial |
$783.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.87
|
| Rate for Payer: Healthscope Commercial |
$820.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$239.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$262.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: Nomi Health Commercial |
$747.42
|
| Rate for Payer: PACE Senior Care Partners |
$216.48
|
| Rate for Payer: PACE SWMI |
$227.87
|
| Rate for Payer: PHP Commercial |
$774.77
|
| Rate for Payer: PHP Medicare Advantage |
$227.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.47
|
| Rate for Payer: Priority Health HMO/PPO |
$793.00
|
| Rate for Payer: Priority Health Medicare |
$230.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.70
|
| Rate for Payer: Railroad Medicare Medicare |
$227.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.11
|
| Rate for Payer: UHC Core |
$761.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.87
|
| Rate for Payer: UHC Exchange |
$227.87
|
| Rate for Payer: UHC Medicare Advantage |
$227.87
|
| Rate for Payer: VA VA |
$227.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.62
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
IP
|
$911.49
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.47 |
| Max. Negotiated Rate |
$820.34 |
| Rate for Payer: Aetna Commercial |
$774.77
|
| Rate for Payer: BCBS Trust/PPO |
$744.05
|
| Rate for Payer: BCN Commercial |
$704.40
|
| Rate for Payer: Cash Price |
$729.19
|
| Rate for Payer: Cofinity Commercial |
$783.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.19
|
| Rate for Payer: Healthscope Commercial |
$820.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.77
|
| Rate for Payer: Nomi Health Commercial |
$747.42
|
| Rate for Payer: PHP Commercial |
$774.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.47
|
| Rate for Payer: Priority Health HMO/PPO |
$793.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.11
|
| Rate for Payer: UHC Core |
$761.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.62
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
IP
|
$1,367.24
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$888.71 |
| Max. Negotiated Rate |
$1,230.52 |
| Rate for Payer: Aetna Commercial |
$1,162.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,116.08
|
| Rate for Payer: BCN Commercial |
$1,056.60
|
| Rate for Payer: Cash Price |
$1,093.79
|
| Rate for Payer: Cofinity Commercial |
$1,175.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.79
|
| Rate for Payer: Healthscope Commercial |
$1,230.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.15
|
| Rate for Payer: Nomi Health Commercial |
$1,121.14
|
| Rate for Payer: PHP Commercial |
$1,162.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.71
|
| Rate for Payer: Priority Health HMO/PPO |
$1,189.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$916.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.17
|
| Rate for Payer: UHC Core |
$1,141.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.43
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
OP
|
$1,367.24
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$324.72 |
| Max. Negotiated Rate |
$1,230.52 |
| Rate for Payer: Aetna Commercial |
$1,162.15
|
| Rate for Payer: Aetna Medicare |
$355.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.26
|
| Rate for Payer: BCBS Complete |
$546.90
|
| Rate for Payer: BCBS MAPPO |
$341.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.01
|
| Rate for Payer: BCN Commercial |
$1,063.03
|
| Rate for Payer: BCN Medicare Advantage |
$341.81
|
| Rate for Payer: Cash Price |
$1,093.79
|
| Rate for Payer: Cofinity Commercial |
$1,175.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.81
|
| Rate for Payer: Healthscope Commercial |
$1,230.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,162.15
|
| Rate for Payer: Nomi Health Commercial |
$1,121.14
|
| Rate for Payer: PACE Senior Care Partners |
$324.72
|
| Rate for Payer: PACE SWMI |
$341.81
|
| Rate for Payer: PHP Commercial |
$1,162.15
|
| Rate for Payer: PHP Medicare Advantage |
$341.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.71
|
| Rate for Payer: Priority Health HMO/PPO |
$1,189.50
|
| Rate for Payer: Priority Health Medicare |
$345.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$916.05
|
| Rate for Payer: Railroad Medicare Medicare |
$341.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,203.17
|
| Rate for Payer: UHC Core |
$1,141.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.81
|
| Rate for Payer: UHC Exchange |
$341.81
|
| Rate for Payer: UHC Medicare Advantage |
$341.81
|
| Rate for Payer: VA VA |
$341.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.43
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
IP
|
$972.13
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.88 |
| Max. Negotiated Rate |
$874.92 |
| Rate for Payer: Aetna Commercial |
$826.31
|
| Rate for Payer: BCBS Trust/PPO |
$793.55
|
| Rate for Payer: BCN Commercial |
$751.26
|
| Rate for Payer: Cash Price |
$777.70
|
| Rate for Payer: Cofinity Commercial |
$836.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.70
|
| Rate for Payer: Healthscope Commercial |
$874.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.31
|
| Rate for Payer: Nomi Health Commercial |
$797.15
|
| Rate for Payer: PHP Commercial |
$826.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.88
|
| Rate for Payer: Priority Health HMO/PPO |
$845.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$651.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.47
|
| Rate for Payer: UHC Core |
$811.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.10
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
OP
|
$972.13
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$230.88 |
| Max. Negotiated Rate |
$874.92 |
| Rate for Payer: Aetna Commercial |
$826.31
|
| Rate for Payer: Aetna Medicare |
$252.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.79
|
| Rate for Payer: BCBS Complete |
$388.85
|
| Rate for Payer: BCBS MAPPO |
$243.03
|
| Rate for Payer: BCBS Trust/PPO |
$799.19
|
| Rate for Payer: BCN Commercial |
$755.83
|
| Rate for Payer: BCN Medicare Advantage |
$243.03
|
| Rate for Payer: Cash Price |
$777.70
|
| Rate for Payer: Cofinity Commercial |
$836.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.03
|
| Rate for Payer: Healthscope Commercial |
$874.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.31
|
| Rate for Payer: Nomi Health Commercial |
$797.15
|
| Rate for Payer: PACE Senior Care Partners |
$230.88
|
| Rate for Payer: PACE SWMI |
$243.03
|
| Rate for Payer: PHP Commercial |
$826.31
|
| Rate for Payer: PHP Medicare Advantage |
$243.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.88
|
| Rate for Payer: Priority Health HMO/PPO |
$845.75
|
| Rate for Payer: Priority Health Medicare |
$245.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$651.33
|
| Rate for Payer: Railroad Medicare Medicare |
$243.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.47
|
| Rate for Payer: UHC Core |
$811.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.03
|
| Rate for Payer: UHC Exchange |
$243.03
|
| Rate for Payer: UHC Medicare Advantage |
$243.03
|
| Rate for Payer: VA VA |
$243.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.10
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
OP
|
$1,458.19
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$346.32 |
| Max. Negotiated Rate |
$1,312.37 |
| Rate for Payer: Aetna Commercial |
$1,239.46
|
| Rate for Payer: Aetna Medicare |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$455.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$455.68
|
| Rate for Payer: BCBS Complete |
$583.28
|
| Rate for Payer: BCBS MAPPO |
$364.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.78
|
| Rate for Payer: BCN Commercial |
$1,133.74
|
| Rate for Payer: BCN Medicare Advantage |
$364.55
|
| Rate for Payer: Cash Price |
$1,166.55
|
| Rate for Payer: Cofinity Commercial |
$1,254.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.55
|
| Rate for Payer: Healthscope Commercial |
$1,312.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$419.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.46
|
| Rate for Payer: Nomi Health Commercial |
$1,195.72
|
| Rate for Payer: PACE Senior Care Partners |
$346.32
|
| Rate for Payer: PACE SWMI |
$364.55
|
| Rate for Payer: PHP Commercial |
$1,239.46
|
| Rate for Payer: PHP Medicare Advantage |
$364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.82
|
| Rate for Payer: Priority Health HMO/PPO |
$1,268.63
|
| Rate for Payer: Priority Health Medicare |
$368.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$976.99
|
| Rate for Payer: Railroad Medicare Medicare |
$364.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.21
|
| Rate for Payer: UHC Core |
$1,217.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$364.55
|
| Rate for Payer: UHC Exchange |
$364.55
|
| Rate for Payer: UHC Medicare Advantage |
$364.55
|
| Rate for Payer: VA VA |
$364.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.64
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
IP
|
$1,458.19
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$947.82 |
| Max. Negotiated Rate |
$1,312.37 |
| Rate for Payer: Aetna Commercial |
$1,239.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.32
|
| Rate for Payer: BCN Commercial |
$1,126.89
|
| Rate for Payer: Cash Price |
$1,166.55
|
| Rate for Payer: Cofinity Commercial |
$1,254.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.55
|
| Rate for Payer: Healthscope Commercial |
$1,312.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.46
|
| Rate for Payer: Nomi Health Commercial |
$1,195.72
|
| Rate for Payer: PHP Commercial |
$1,239.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.82
|
| Rate for Payer: Priority Health HMO/PPO |
$1,268.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$976.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.21
|
| Rate for Payer: UHC Core |
$1,217.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.64
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
OP
|
$1,536.98
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$365.03 |
| Max. Negotiated Rate |
$1,383.28 |
| Rate for Payer: Aetna Commercial |
$1,306.43
|
| Rate for Payer: Aetna Medicare |
$399.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.31
|
| Rate for Payer: BCBS Complete |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$384.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.55
|
| Rate for Payer: BCN Commercial |
$1,195.00
|
| Rate for Payer: BCN Medicare Advantage |
$384.24
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cofinity Commercial |
$1,321.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.24
|
| Rate for Payer: Healthscope Commercial |
$1,383.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.74
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.46
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.43
|
| Rate for Payer: Nomi Health Commercial |
$1,260.32
|
| Rate for Payer: PACE Senior Care Partners |
$365.03
|
| Rate for Payer: PACE SWMI |
$384.24
|
| Rate for Payer: PHP Commercial |
$1,306.43
|
| Rate for Payer: PHP Medicare Advantage |
$384.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.17
|
| Rate for Payer: Priority Health Medicare |
$388.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.78
|
| Rate for Payer: Railroad Medicare Medicare |
$384.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.54
|
| Rate for Payer: UHC Core |
$1,283.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.24
|
| Rate for Payer: UHC Exchange |
$384.24
|
| Rate for Payer: UHC Medicare Advantage |
$384.24
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$384.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.74
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
IP
|
$1,536.98
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$999.04 |
| Max. Negotiated Rate |
$1,383.28 |
| Rate for Payer: Aetna Commercial |
$1,306.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.64
|
| Rate for Payer: BCN Commercial |
$1,187.78
|
| Rate for Payer: Cash Price |
$1,229.58
|
| Rate for Payer: Cofinity Commercial |
$1,321.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.58
|
| Rate for Payer: Healthscope Commercial |
$1,383.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.43
|
| Rate for Payer: Nomi Health Commercial |
$1,260.32
|
| Rate for Payer: PHP Commercial |
$1,306.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,337.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,029.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.54
|
| Rate for Payer: UHC Core |
$1,283.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.74
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
OP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$281.50 |
| Max. Negotiated Rate |
$1,066.72 |
| Rate for Payer: Aetna Commercial |
$1,007.46
|
| Rate for Payer: Aetna Medicare |
$308.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.39
|
| Rate for Payer: BCBS Complete |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$296.31
|
| Rate for Payer: BCBS Trust/PPO |
$974.39
|
| Rate for Payer: BCN Commercial |
$921.53
|
| Rate for Payer: BCN Medicare Advantage |
$296.31
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,019.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.31
|
| Rate for Payer: Healthscope Commercial |
$1,066.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.94
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.13
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: PACE Senior Care Partners |
$281.50
|
| Rate for Payer: PACE SWMI |
$296.31
|
| Rate for Payer: PHP Commercial |
$1,007.46
|
| Rate for Payer: PHP Medicare Advantage |
$296.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,031.17
|
| Rate for Payer: Priority Health Medicare |
$299.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$794.12
|
| Rate for Payer: Railroad Medicare Medicare |
$296.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.02
|
| Rate for Payer: UHC Core |
$989.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.31
|
| Rate for Payer: UHC Exchange |
$296.31
|
| Rate for Payer: UHC Medicare Advantage |
$296.31
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$296.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.94
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
IP
|
$1,185.25
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$770.41 |
| Max. Negotiated Rate |
$1,066.72 |
| Rate for Payer: Aetna Commercial |
$1,007.46
|
| Rate for Payer: BCBS Trust/PPO |
$967.52
|
| Rate for Payer: BCN Commercial |
$915.96
|
| Rate for Payer: Cash Price |
$948.20
|
| Rate for Payer: Cofinity Commercial |
$1,019.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.20
|
| Rate for Payer: Healthscope Commercial |
$1,066.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$888.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.46
|
| Rate for Payer: Nomi Health Commercial |
$971.90
|
| Rate for Payer: PHP Commercial |
$1,007.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,031.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$794.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.02
|
| Rate for Payer: UHC Core |
$989.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$888.94
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$327.04 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$358.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.31
|
| Rate for Payer: BCBS Complete |
$378.80
|
| Rate for Payer: BCBS MAPPO |
$344.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.03
|
| Rate for Payer: BCN Commercial |
$1,070.62
|
| Rate for Payer: BCN Medicare Advantage |
$344.25
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.25
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Mclaren Medicaid |
$360.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.46
|
| Rate for Payer: Meridian Medicaid |
$378.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PACE Senior Care Partners |
$327.04
|
| Rate for Payer: PACE SWMI |
$344.25
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$344.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Medicare |
$347.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: Railroad Medicare Medicare |
$344.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.25
|
| Rate for Payer: UHC Exchange |
$344.25
|
| Rate for Payer: UHC Medicare Advantage |
$344.25
|
| Rate for Payer: UHCCP Medicaid |
$360.74
|
| Rate for Payer: VA VA |
$344.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$895.05 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.05
|
| Rate for Payer: BCN Commercial |
$1,064.15
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: Nomi Health Commercial |
$1,129.14
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health HMO/PPO |
$1,197.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.76
|
| Rate for Payer: UHC Core |
$1,149.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
IP
|
$566.97
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$368.53 |
| Max. Negotiated Rate |
$510.27 |
| Rate for Payer: Aetna Commercial |
$481.92
|
| Rate for Payer: BCBS Trust/PPO |
$462.82
|
| Rate for Payer: BCN Commercial |
$438.15
|
| Rate for Payer: Cash Price |
$453.58
|
| Rate for Payer: Cofinity Commercial |
$487.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$453.58
|
| Rate for Payer: Healthscope Commercial |
$510.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.92
|
| Rate for Payer: Nomi Health Commercial |
$464.92
|
| Rate for Payer: PHP Commercial |
$481.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$368.53
|
| Rate for Payer: Priority Health HMO/PPO |
$493.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$379.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$498.93
|
| Rate for Payer: UHC Core |
$473.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.23
|
|
