|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
IP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$444.30 |
| Max. Negotiated Rate |
$615.19 |
| Rate for Payer: Aetna Commercial |
$581.01
|
| Rate for Payer: BCBS Trust/PPO |
$557.97
|
| Rate for Payer: BCN Commercial |
$528.24
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Healthscope Commercial |
$615.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: Nomi Health Commercial |
$560.50
|
| Rate for Payer: PHP Commercial |
$581.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: Priority Health HMO/PPO |
$594.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$601.52
|
| Rate for Payer: UHC Core |
$570.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.66
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$169.86
|
| Rate for Payer: BCN Commercial |
$160.80
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.02
|
| Rate for Payer: BCBS Complete |
$111.95
|
| Rate for Payer: BCBS MAPPO |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$171.06
|
| Rate for Payer: BCN Commercial |
$161.78
|
| Rate for Payer: BCN Medicare Advantage |
$52.02
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$106.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.62
|
| Rate for Payer: Meridian Medicaid |
$111.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PACE Senior Care Partners |
$49.42
|
| Rate for Payer: PACE SWMI |
$52.02
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$52.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Medicare |
$52.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: Railroad Medicare Medicare |
$52.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.02
|
| Rate for Payer: UHC Exchange |
$52.02
|
| Rate for Payer: UHC Medicare Advantage |
$52.02
|
| Rate for Payer: UHCCP Medicaid |
$106.61
|
| Rate for Payer: VA VA |
$52.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$2.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.25
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: BCBS MAPPO |
$2.60
|
| Rate for Payer: BCBS Trust/PPO |
$8.55
|
| Rate for Payer: BCN Commercial |
$8.09
|
| Rate for Payer: BCN Medicare Advantage |
$2.60
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.60
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: PACE Senior Care Partners |
$2.47
|
| Rate for Payer: PACE SWMI |
$2.60
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: PHP Medicare Advantage |
$2.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Medicare |
$2.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.97
|
| Rate for Payer: Railroad Medicare Medicare |
$2.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.60
|
| Rate for Payer: UHC Exchange |
$2.60
|
| Rate for Payer: UHC Medicare Advantage |
$2.60
|
| Rate for Payer: VA VA |
$2.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$8.49
|
| Rate for Payer: BCN Commercial |
$8.04
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Nomi Health Commercial |
$8.53
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health HMO/PPO |
$9.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.15
|
| Rate for Payer: UHC Core |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: Aetna Medicare |
$1.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.62
|
| Rate for Payer: BCBS Complete |
$2.08
|
| Rate for Payer: BCBS MAPPO |
$1.30
|
| Rate for Payer: BCBS Trust/PPO |
$4.27
|
| Rate for Payer: BCN Commercial |
$4.04
|
| Rate for Payer: BCN Medicare Advantage |
$1.30
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.30
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: PACE Senior Care Partners |
$1.24
|
| Rate for Payer: PACE SWMI |
$1.30
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: PHP Medicare Advantage |
$1.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health HMO/PPO |
$4.52
|
| Rate for Payer: Priority Health Medicare |
$1.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC Core |
$4.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.30
|
| Rate for Payer: UHC Exchange |
$1.30
|
| Rate for Payer: UHC Medicare Advantage |
$1.30
|
| Rate for Payer: VA VA |
$1.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: BCBS Trust/PPO |
$4.24
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.26
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health HMO/PPO |
$4.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC Core |
$4.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
IP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.21 |
| Max. Negotiated Rate |
$450.29 |
| Rate for Payer: Aetna Commercial |
$425.27
|
| Rate for Payer: BCBS Trust/PPO |
$408.41
|
| Rate for Payer: BCN Commercial |
$386.65
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$430.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Healthscope Commercial |
$450.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: Nomi Health Commercial |
$410.26
|
| Rate for Payer: PHP Commercial |
$425.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: Priority Health HMO/PPO |
$435.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.28
|
| Rate for Payer: UHC Core |
$417.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.24
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$450.29 |
| Rate for Payer: Aetna Commercial |
$425.27
|
| Rate for Payer: Aetna Medicare |
$130.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.35
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$125.08
|
| Rate for Payer: BCBS Trust/PPO |
$411.31
|
| Rate for Payer: BCN Commercial |
$389.00
|
| Rate for Payer: BCN Medicare Advantage |
$125.08
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$430.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.08
|
| Rate for Payer: Healthscope Commercial |
$450.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.24
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: Nomi Health Commercial |
$410.26
|
| Rate for Payer: PACE Senior Care Partners |
$118.83
|
| Rate for Payer: PACE SWMI |
$125.08
|
| Rate for Payer: PHP Commercial |
$425.27
|
| Rate for Payer: PHP Medicare Advantage |
$125.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: Priority Health HMO/PPO |
$435.28
|
| Rate for Payer: Priority Health Medicare |
$126.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.21
|
| Rate for Payer: Railroad Medicare Medicare |
$125.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.28
|
| Rate for Payer: UHC Core |
$417.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.08
|
| Rate for Payer: UHC Exchange |
$125.08
|
| Rate for Payer: UHC Medicare Advantage |
$125.08
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$125.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.24
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.52 |
| Max. Negotiated Rate |
$380.92 |
| Rate for Payer: Aetna Commercial |
$359.75
|
| Rate for Payer: Aetna Medicare |
$110.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.26
|
| Rate for Payer: BCBS Complete |
$226.27
|
| Rate for Payer: BCBS MAPPO |
$105.81
|
| Rate for Payer: BCBS Trust/PPO |
$347.95
|
| Rate for Payer: BCN Commercial |
$329.07
|
| Rate for Payer: BCN Medicare Advantage |
$105.81
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$363.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.81
|
| Rate for Payer: Healthscope Commercial |
$380.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.43
|
| Rate for Payer: Mclaren Medicaid |
$215.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.10
|
| Rate for Payer: Meridian Medicaid |
$226.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: Nomi Health Commercial |
$347.06
|
| Rate for Payer: PACE Senior Care Partners |
$100.52
|
| Rate for Payer: PACE SWMI |
$105.81
|
| Rate for Payer: PHP Commercial |
$359.75
|
| Rate for Payer: PHP Medicare Advantage |
$105.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: Priority Health HMO/PPO |
$368.22
|
| Rate for Payer: Priority Health Medicare |
$106.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.57
|
| Rate for Payer: Railroad Medicare Medicare |
$105.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.45
|
| Rate for Payer: UHC Core |
$353.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.81
|
| Rate for Payer: UHC Exchange |
$105.81
|
| Rate for Payer: UHC Medicare Advantage |
$105.81
|
| Rate for Payer: UHCCP Medicaid |
$215.48
|
| Rate for Payer: VA VA |
$105.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.43
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$275.11 |
| Max. Negotiated Rate |
$380.92 |
| Rate for Payer: Aetna Commercial |
$359.75
|
| Rate for Payer: BCBS Trust/PPO |
$345.49
|
| Rate for Payer: BCN Commercial |
$327.08
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$363.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Healthscope Commercial |
$380.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: Nomi Health Commercial |
$347.06
|
| Rate for Payer: PHP Commercial |
$359.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: Priority Health HMO/PPO |
$368.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$283.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.45
|
| Rate for Payer: UHC Core |
$353.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.43
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$374.60 |
| Max. Negotiated Rate |
$518.68 |
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: BCBS Trust/PPO |
$470.44
|
| Rate for Payer: BCN Commercial |
$445.37
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$495.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Healthscope Commercial |
$518.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: Nomi Health Commercial |
$472.57
|
| Rate for Payer: PHP Commercial |
$489.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: Priority Health HMO/PPO |
$501.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.15
|
| Rate for Payer: UHC Core |
$481.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.23
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.87 |
| Max. Negotiated Rate |
$518.68 |
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: Aetna Medicare |
$149.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.10
|
| Rate for Payer: BCBS Complete |
$172.73
|
| Rate for Payer: BCBS MAPPO |
$144.08
|
| Rate for Payer: BCBS Trust/PPO |
$473.78
|
| Rate for Payer: BCN Commercial |
$448.08
|
| Rate for Payer: BCN Medicare Advantage |
$144.08
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$495.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.08
|
| Rate for Payer: Healthscope Commercial |
$518.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.23
|
| Rate for Payer: Mclaren Medicaid |
$164.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.28
|
| Rate for Payer: Meridian Medicaid |
$172.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: Nomi Health Commercial |
$472.57
|
| Rate for Payer: PACE Senior Care Partners |
$136.87
|
| Rate for Payer: PACE SWMI |
$144.08
|
| Rate for Payer: PHP Commercial |
$489.86
|
| Rate for Payer: PHP Medicare Advantage |
$144.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: Priority Health HMO/PPO |
$501.39
|
| Rate for Payer: Priority Health Medicare |
$145.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.13
|
| Rate for Payer: Railroad Medicare Medicare |
$144.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.15
|
| Rate for Payer: UHC Core |
$481.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.08
|
| Rate for Payer: UHC Exchange |
$144.08
|
| Rate for Payer: UHC Medicare Advantage |
$144.08
|
| Rate for Payer: UHCCP Medicaid |
$164.50
|
| Rate for Payer: VA VA |
$144.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.23
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.51 |
| Max. Negotiated Rate |
$179.32 |
| Rate for Payer: Aetna Commercial |
$169.36
|
| Rate for Payer: BCBS Trust/PPO |
$162.65
|
| Rate for Payer: BCN Commercial |
$153.98
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: Nomi Health Commercial |
$163.38
|
| Rate for Payer: PHP Commercial |
$169.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: Priority Health HMO/PPO |
$173.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.34
|
| Rate for Payer: UHC Core |
$166.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.44
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.32 |
| Max. Negotiated Rate |
$179.32 |
| Rate for Payer: Aetna Commercial |
$169.36
|
| Rate for Payer: Aetna Medicare |
$51.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.27
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$49.81
|
| Rate for Payer: BCBS Trust/PPO |
$163.80
|
| Rate for Payer: BCN Commercial |
$154.92
|
| Rate for Payer: BCN Medicare Advantage |
$49.81
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.81
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.44
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.30
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: Nomi Health Commercial |
$163.38
|
| Rate for Payer: PACE Senior Care Partners |
$47.32
|
| Rate for Payer: PACE SWMI |
$49.81
|
| Rate for Payer: PHP Commercial |
$169.36
|
| Rate for Payer: PHP Medicare Advantage |
$49.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: Priority Health HMO/PPO |
$173.35
|
| Rate for Payer: Priority Health Medicare |
$50.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.50
|
| Rate for Payer: Railroad Medicare Medicare |
$49.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.34
|
| Rate for Payer: UHC Core |
$166.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.81
|
| Rate for Payer: UHC Exchange |
$49.81
|
| Rate for Payer: UHC Medicare Advantage |
$49.81
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$49.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.44
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.94 |
| Max. Negotiated Rate |
$966.10 |
| Rate for Payer: Aetna Commercial |
$912.43
|
| Rate for Payer: Aetna Medicare |
$279.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.45
|
| Rate for Payer: BCBS Complete |
$429.38
|
| Rate for Payer: BCBS MAPPO |
$268.36
|
| Rate for Payer: BCBS Trust/PPO |
$882.48
|
| Rate for Payer: BCN Commercial |
$834.61
|
| Rate for Payer: BCN Medicare Advantage |
$268.36
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.36
|
| Rate for Payer: Healthscope Commercial |
$966.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: Nomi Health Commercial |
$880.23
|
| Rate for Payer: PACE Senior Care Partners |
$254.94
|
| Rate for Payer: PACE SWMI |
$268.36
|
| Rate for Payer: PHP Commercial |
$912.43
|
| Rate for Payer: PHP Medicare Advantage |
$268.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: Priority Health HMO/PPO |
$933.90
|
| Rate for Payer: Priority Health Medicare |
$271.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.21
|
| Rate for Payer: Railroad Medicare Medicare |
$268.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.64
|
| Rate for Payer: UHC Core |
$896.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.36
|
| Rate for Payer: UHC Exchange |
$268.36
|
| Rate for Payer: UHC Medicare Advantage |
$268.36
|
| Rate for Payer: VA VA |
$268.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.09
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.74 |
| Max. Negotiated Rate |
$966.10 |
| Rate for Payer: Aetna Commercial |
$912.43
|
| Rate for Payer: BCBS Trust/PPO |
$876.26
|
| Rate for Payer: BCN Commercial |
$829.56
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Healthscope Commercial |
$966.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: Nomi Health Commercial |
$880.23
|
| Rate for Payer: PHP Commercial |
$912.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: Priority Health HMO/PPO |
$933.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.64
|
| Rate for Payer: UHC Core |
$896.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.09
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$955.60 |
| Max. Negotiated Rate |
$1,323.14 |
| Rate for Payer: Aetna Commercial |
$1,249.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,200.08
|
| Rate for Payer: BCN Commercial |
$1,136.13
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,264.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Healthscope Commercial |
$1,323.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: Nomi Health Commercial |
$1,205.52
|
| Rate for Payer: PHP Commercial |
$1,249.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,279.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$985.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,293.73
|
| Rate for Payer: UHC Core |
$1,227.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.61
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$349.16 |
| Max. Negotiated Rate |
$1,323.14 |
| Rate for Payer: Aetna Commercial |
$1,249.63
|
| Rate for Payer: Aetna Medicare |
$382.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$459.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$459.42
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$367.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,208.61
|
| Rate for Payer: BCN Commercial |
$1,143.04
|
| Rate for Payer: BCN Medicare Advantage |
$367.54
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,264.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.54
|
| Rate for Payer: Healthscope Commercial |
$1,323.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.61
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$385.91
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: Nomi Health Commercial |
$1,205.52
|
| Rate for Payer: PACE Senior Care Partners |
$349.16
|
| Rate for Payer: PACE SWMI |
$367.54
|
| Rate for Payer: PHP Commercial |
$1,249.63
|
| Rate for Payer: PHP Medicare Advantage |
$367.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,279.03
|
| Rate for Payer: Priority Health Medicare |
$371.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$985.00
|
| Rate for Payer: Railroad Medicare Medicare |
$367.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,293.73
|
| Rate for Payer: UHC Core |
$1,227.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$367.54
|
| Rate for Payer: UHC Exchange |
$367.54
|
| Rate for Payer: UHC Medicare Advantage |
$367.54
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$367.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.61
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$988.88 |
| Max. Negotiated Rate |
$1,369.22 |
| Rate for Payer: Aetna Commercial |
$1,293.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.88
|
| Rate for Payer: BCN Commercial |
$1,175.70
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,308.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Healthscope Commercial |
$1,369.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: Nomi Health Commercial |
$1,247.51
|
| Rate for Payer: PHP Commercial |
$1,293.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: Priority Health HMO/PPO |
$1,323.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.79
|
| Rate for Payer: UHC Core |
$1,270.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.01
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$361.32 |
| Max. Negotiated Rate |
$1,411.07 |
| Rate for Payer: Aetna Commercial |
$1,293.15
|
| Rate for Payer: Aetna Medicare |
$395.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.42
|
| Rate for Payer: BCBS Complete |
$1,411.07
|
| Rate for Payer: BCBS MAPPO |
$380.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.70
|
| Rate for Payer: BCN Commercial |
$1,182.85
|
| Rate for Payer: BCN Medicare Advantage |
$380.34
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,308.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.34
|
| Rate for Payer: Healthscope Commercial |
$1,369.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.01
|
| Rate for Payer: Mclaren Medicaid |
$1,343.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.35
|
| Rate for Payer: Meridian Medicaid |
$1,411.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: Nomi Health Commercial |
$1,247.51
|
| Rate for Payer: PACE Senior Care Partners |
$361.32
|
| Rate for Payer: PACE SWMI |
$380.34
|
| Rate for Payer: PHP Commercial |
$1,293.15
|
| Rate for Payer: PHP Medicare Advantage |
$380.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,343.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: Priority Health HMO/PPO |
$1,323.57
|
| Rate for Payer: Priority Health Medicare |
$384.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,019.30
|
| Rate for Payer: Railroad Medicare Medicare |
$380.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.79
|
| Rate for Payer: UHC Core |
$1,270.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.34
|
| Rate for Payer: UHC Exchange |
$380.34
|
| Rate for Payer: UHC Medicare Advantage |
$380.34
|
| Rate for Payer: UHCCP Medicaid |
$1,343.79
|
| Rate for Payer: VA VA |
$380.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.01
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.02 |
| Max. Negotiated Rate |
$149.57 |
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: BCBS Trust/PPO |
$135.66
|
| Rate for Payer: BCN Commercial |
$128.43
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Healthscope Commercial |
$149.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: Nomi Health Commercial |
$136.28
|
| Rate for Payer: PHP Commercial |
$141.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: Priority Health HMO/PPO |
$144.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.25
|
| Rate for Payer: UHC Core |
$138.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.47 |
| Max. Negotiated Rate |
$149.57 |
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.93
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$136.62
|
| Rate for Payer: BCN Commercial |
$129.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.55
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.55
|
| Rate for Payer: Healthscope Commercial |
$149.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.62
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: Nomi Health Commercial |
$136.28
|
| Rate for Payer: PACE Senior Care Partners |
$39.47
|
| Rate for Payer: PACE SWMI |
$41.55
|
| Rate for Payer: PHP Commercial |
$141.26
|
| Rate for Payer: PHP Medicare Advantage |
$41.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: Priority Health HMO/PPO |
$144.59
|
| Rate for Payer: Priority Health Medicare |
$41.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.35
|
| Rate for Payer: Railroad Medicare Medicare |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.25
|
| Rate for Payer: UHC Core |
$138.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.55
|
| Rate for Payer: UHC Exchange |
$41.55
|
| Rate for Payer: UHC Medicare Advantage |
$41.55
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$41.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
