|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.12 |
| 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 |
$118.78
|
| 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 |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| 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 |
$113.12
|
| 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 |
$113.12
|
| Rate for Payer: VA VA |
$125.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.24
|
|
|
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 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 |
$230.94
|
| 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 |
$219.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.10
|
| Rate for Payer: Meridian Medicaid |
$230.94
|
| 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 |
$219.93
|
| 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 |
$219.93
|
| 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 |
$176.30
|
| 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 |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.28
|
| Rate for Payer: Meridian Medicaid |
$176.30
|
| 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 |
$167.90
|
| 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 |
$167.90
|
| Rate for Payer: VA VA |
$144.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.23
|
|
|
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 |
$97.86
|
| 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 |
$171.35
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.30
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$93.19
|
| Rate for Payer: VA VA |
$49.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.44
|
|
|
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 |
$171.35
|
| 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 INFUSION PUMP
|
Facility
|
IP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.74 |
| Max. Negotiated Rate |
$966.11 |
| 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 |
$966.11
|
| 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 INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.94 |
| Max. Negotiated Rate |
$966.11 |
| 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 |
$966.11
|
| 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 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 |
$1,323.13 |
| 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 |
$895.16
|
| 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 |
$1,323.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.61
|
| Rate for Payer: Mclaren Medicaid |
$852.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$385.91
|
| Rate for Payer: Meridian Medicaid |
$895.16
|
| 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 |
$852.47
|
| 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 |
$852.47
|
| Rate for Payer: VA VA |
$367.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.61
|
|
|
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 |
$1,323.13 |
| 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 |
$1,323.13
|
| 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 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 |
$1,440.19 |
| 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 |
$1,440.19
|
| 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 |
$1,369.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.01
|
| Rate for Payer: Mclaren Medicaid |
$1,371.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.35
|
| Rate for Payer: Meridian Medicaid |
$1,440.19
|
| 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 |
$1,371.52
|
| 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 |
$1,371.52
|
| Rate for Payer: VA VA |
$380.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.01
|
|
|
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 |
$1,369.21 |
| 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 |
$1,369.21
|
| 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 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 |
$97.86
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.62
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$93.19
|
| Rate for Payer: VA VA |
$41.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
|
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 GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,445.62
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.33 |
| Max. Negotiated Rate |
$1,440.19 |
| Rate for Payer: Aetna Commercial |
$1,228.78
|
| Rate for Payer: Aetna Medicare |
$375.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$451.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$451.76
|
| Rate for Payer: BCBS Complete |
$1,440.19
|
| Rate for Payer: BCBS MAPPO |
$361.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.44
|
| Rate for Payer: BCN Commercial |
$1,123.97
|
| Rate for Payer: BCN Medicare Advantage |
$361.40
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cofinity Commercial |
$1,243.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.40
|
| Rate for Payer: Healthscope Commercial |
$1,301.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,084.21
|
| Rate for Payer: Mclaren Medicaid |
$1,371.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.48
|
| Rate for Payer: Meridian Medicaid |
$1,440.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$415.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,228.78
|
| Rate for Payer: Nomi Health Commercial |
$1,185.41
|
| Rate for Payer: PACE Senior Care Partners |
$343.33
|
| Rate for Payer: PACE SWMI |
$361.40
|
| Rate for Payer: PHP Commercial |
$1,228.78
|
| Rate for Payer: PHP Medicare Advantage |
$361.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,371.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,257.69
|
| Rate for Payer: Priority Health Medicare |
$365.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.57
|
| Rate for Payer: Railroad Medicare Medicare |
$361.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.15
|
| Rate for Payer: UHC Core |
$1,207.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$361.40
|
| Rate for Payer: UHC Exchange |
$361.40
|
| Rate for Payer: UHC Medicare Advantage |
$361.40
|
| Rate for Payer: UHCCP Medicaid |
$1,371.52
|
| Rate for Payer: VA VA |
$361.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.21
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,445.62
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$939.65 |
| Max. Negotiated Rate |
$1,301.06 |
| Rate for Payer: Aetna Commercial |
$1,228.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.06
|
| Rate for Payer: BCN Commercial |
$1,117.18
|
| Rate for Payer: Cash Price |
$1,156.50
|
| Rate for Payer: Cofinity Commercial |
$1,243.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,156.50
|
| Rate for Payer: Healthscope Commercial |
$1,301.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,084.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,228.78
|
| Rate for Payer: Nomi Health Commercial |
$1,185.41
|
| Rate for Payer: PHP Commercial |
$1,228.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,257.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$968.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.15
|
| Rate for Payer: UHC Core |
$1,207.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.21
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$379.93
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.23 |
| Max. Negotiated Rate |
$341.94 |
| Rate for Payer: Aetna Commercial |
$322.94
|
| Rate for Payer: Aetna Medicare |
$98.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.73
|
| Rate for Payer: BCBS Complete |
$151.97
|
| Rate for Payer: BCBS MAPPO |
$94.98
|
| Rate for Payer: BCBS Trust/PPO |
$312.34
|
| Rate for Payer: BCN Commercial |
$295.40
|
| Rate for Payer: BCN Medicare Advantage |
$94.98
|
| Rate for Payer: Cash Price |
$303.94
|
| Rate for Payer: Cofinity Commercial |
$326.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.98
|
| Rate for Payer: Healthscope Commercial |
$341.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.94
|
| Rate for Payer: Nomi Health Commercial |
$311.54
|
| Rate for Payer: PACE Senior Care Partners |
$90.23
|
| Rate for Payer: PACE SWMI |
$94.98
|
| Rate for Payer: PHP Commercial |
$322.94
|
| Rate for Payer: PHP Medicare Advantage |
$94.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.95
|
| Rate for Payer: Priority Health HMO/PPO |
$330.54
|
| Rate for Payer: Priority Health Medicare |
$95.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.55
|
| Rate for Payer: Railroad Medicare Medicare |
$94.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.34
|
| Rate for Payer: UHC Core |
$317.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.98
|
| Rate for Payer: UHC Exchange |
$94.98
|
| Rate for Payer: UHC Medicare Advantage |
$94.98
|
| Rate for Payer: VA VA |
$94.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.95
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$379.93
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$246.95 |
| Max. Negotiated Rate |
$341.94 |
| Rate for Payer: Aetna Commercial |
$322.94
|
| Rate for Payer: BCBS Trust/PPO |
$310.14
|
| Rate for Payer: BCN Commercial |
$293.61
|
| Rate for Payer: Cash Price |
$303.94
|
| Rate for Payer: Cofinity Commercial |
$326.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.94
|
| Rate for Payer: Healthscope Commercial |
$341.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.94
|
| Rate for Payer: Nomi Health Commercial |
$311.54
|
| Rate for Payer: PHP Commercial |
$322.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.95
|
| Rate for Payer: Priority Health HMO/PPO |
$330.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.34
|
| Rate for Payer: UHC Core |
$317.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.95
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,545.54
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$604.57 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$2,163.71
|
| Rate for Payer: Aetna Medicare |
$661.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$795.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$795.48
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$636.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.69
|
| Rate for Payer: BCN Commercial |
$1,979.16
|
| Rate for Payer: BCN Medicare Advantage |
$636.38
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,189.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.38
|
| Rate for Payer: Healthscope Commercial |
$2,290.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,909.15
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.20
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$731.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PACE Senior Care Partners |
$604.57
|
| Rate for Payer: PACE SWMI |
$636.38
|
| Rate for Payer: PHP Commercial |
$2,163.71
|
| Rate for Payer: PHP Medicare Advantage |
$636.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.62
|
| Rate for Payer: Priority Health Medicare |
$642.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.51
|
| Rate for Payer: Railroad Medicare Medicare |
$636.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,240.08
|
| Rate for Payer: UHC Core |
$2,125.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.38
|
| Rate for Payer: UHC Exchange |
$636.38
|
| Rate for Payer: UHC Medicare Advantage |
$636.38
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$636.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.15
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,545.54
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,654.60 |
| Max. Negotiated Rate |
$2,290.99 |
| Rate for Payer: Aetna Commercial |
$2,163.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.92
|
| Rate for Payer: BCN Commercial |
$1,967.19
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,189.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,290.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,909.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PHP Commercial |
$2,163.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,240.08
|
| Rate for Payer: UHC Core |
$2,125.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.15
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,545.54
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,654.60 |
| Max. Negotiated Rate |
$2,290.99 |
| Rate for Payer: Aetna Commercial |
$2,163.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,077.92
|
| Rate for Payer: BCN Commercial |
$1,967.19
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,189.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Healthscope Commercial |
$2,290.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,909.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PHP Commercial |
$2,163.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,240.08
|
| Rate for Payer: UHC Core |
$2,125.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.15
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,545.54
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.57 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$2,163.71
|
| Rate for Payer: Aetna Medicare |
$661.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$795.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$795.48
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$636.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,092.69
|
| Rate for Payer: BCN Commercial |
$1,979.16
|
| Rate for Payer: BCN Medicare Advantage |
$636.38
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cash Price |
$2,036.43
|
| Rate for Payer: Cofinity Commercial |
$2,189.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$636.38
|
| Rate for Payer: Healthscope Commercial |
$2,290.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,909.15
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.20
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$731.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.71
|
| Rate for Payer: Nomi Health Commercial |
$2,087.34
|
| Rate for Payer: PACE Senior Care Partners |
$604.57
|
| Rate for Payer: PACE SWMI |
$636.38
|
| Rate for Payer: PHP Commercial |
$2,163.71
|
| Rate for Payer: PHP Medicare Advantage |
$636.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,214.62
|
| Rate for Payer: Priority Health Medicare |
$642.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.51
|
| Rate for Payer: Railroad Medicare Medicare |
$636.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,240.08
|
| Rate for Payer: UHC Core |
$2,125.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$636.38
|
| Rate for Payer: UHC Exchange |
$636.38
|
| Rate for Payer: UHC Medicare Advantage |
$636.38
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$636.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.15
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$703.61 |
| Max. Negotiated Rate |
$2,666.31 |
| Rate for Payer: Aetna Commercial |
$2,518.18
|
| Rate for Payer: Aetna Medicare |
$770.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$925.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$925.80
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$740.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.53
|
| Rate for Payer: BCN Commercial |
$2,303.40
|
| Rate for Payer: BCN Medicare Advantage |
$740.64
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,547.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.64
|
| Rate for Payer: Healthscope Commercial |
$2,666.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,221.93
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.67
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$851.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PACE Senior Care Partners |
$703.61
|
| Rate for Payer: PACE SWMI |
$740.64
|
| Rate for Payer: PHP Commercial |
$2,518.18
|
| Rate for Payer: PHP Medicare Advantage |
$740.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO |
$2,577.44
|
| Rate for Payer: Priority Health Medicare |
$748.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,984.92
|
| Rate for Payer: Railroad Medicare Medicare |
$740.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.06
|
| Rate for Payer: UHC Core |
$2,473.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.64
|
| Rate for Payer: UHC Exchange |
$740.64
|
| Rate for Payer: UHC Medicare Advantage |
$740.64
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$740.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
