|
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 |
$1,411.07 |
| 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 |
$1,411.07
|
| 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 |
$1,084.22
|
| Rate for Payer: Mclaren Medicaid |
$1,343.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$379.48
|
| Rate for Payer: Meridian Medicaid |
$1,411.07
|
| 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 |
$1,343.79
|
| 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 |
$1,343.79
|
| Rate for Payer: VA VA |
$361.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,084.22
|
|
|
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 |
$1,084.22
|
| 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 |
$1,084.22
|
|
|
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 |
$2,341.27 |
| 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 |
$2,341.27
|
| 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 |
$1,909.16
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.20
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| 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 |
$2,229.63
|
| 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 |
$2,229.63
|
| Rate for Payer: VA VA |
$636.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.16
|
|
|
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 |
$1,909.16
|
| 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 |
$1,909.16
|
|
|
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 |
$2,341.27 |
| 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 |
$2,341.27
|
| 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 |
$1,909.16
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$668.20
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| 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 |
$2,229.63
|
| 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 |
$2,229.63
|
| Rate for Payer: VA VA |
$636.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,909.16
|
|
|
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 |
$1,909.16
|
| 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 |
$1,909.16
|
|
|
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 |
$2,341.27
|
| 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 |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.67
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| 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 |
$2,229.63
|
| 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 |
$2,229.63
|
| Rate for Payer: VA VA |
$740.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,666.31 |
| Rate for Payer: Aetna Commercial |
$2,518.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.35
|
| Rate for Payer: BCN Commercial |
$2,289.47
|
| 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: Healthscope Commercial |
$2,666.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,221.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PHP Commercial |
$2,518.18
|
| 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 Narrow/Tiered Network |
$1,984.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.06
|
| Rate for Payer: UHC Core |
$2,473.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,666.31 |
| Rate for Payer: Aetna Commercial |
$2,518.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.35
|
| Rate for Payer: BCN Commercial |
$2,289.47
|
| 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: Healthscope Commercial |
$2,666.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,221.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PHP Commercial |
$2,518.18
|
| 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 Narrow/Tiered Network |
$1,984.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.06
|
| Rate for Payer: UHC Core |
$2,473.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
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 |
$2,341.27
|
| 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 |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.67
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| 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 |
$2,229.63
|
| 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 |
$2,229.63
|
| Rate for Payer: VA VA |
$740.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,720.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,118.03 |
| Max. Negotiated Rate |
$1,548.04 |
| Rate for Payer: Aetna Commercial |
$1,462.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,404.08
|
| Rate for Payer: BCN Commercial |
$1,329.25
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cofinity Commercial |
$1,479.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.04
|
| Rate for Payer: Healthscope Commercial |
$1,548.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,290.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.04
|
| Rate for Payer: Nomi Health Commercial |
$1,410.44
|
| Rate for Payer: PHP Commercial |
$1,462.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,496.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,152.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,513.64
|
| Rate for Payer: UHC Core |
$1,436.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,290.04
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,720.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.51 |
| Max. Negotiated Rate |
$1,548.04 |
| Rate for Payer: Aetna Commercial |
$1,462.04
|
| Rate for Payer: Aetna Medicare |
$447.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$537.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$537.52
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$430.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.05
|
| Rate for Payer: BCN Commercial |
$1,337.34
|
| Rate for Payer: BCN Medicare Advantage |
$430.01
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cash Price |
$1,376.04
|
| Rate for Payer: Cofinity Commercial |
$1,479.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,376.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.01
|
| Rate for Payer: Healthscope Commercial |
$1,548.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,290.04
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$451.51
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$494.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,462.04
|
| Rate for Payer: Nomi Health Commercial |
$1,410.44
|
| Rate for Payer: PACE Senior Care Partners |
$408.51
|
| Rate for Payer: PACE SWMI |
$430.01
|
| Rate for Payer: PHP Commercial |
$1,462.04
|
| Rate for Payer: PHP Medicare Advantage |
$430.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,118.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,496.44
|
| Rate for Payer: Priority Health Medicare |
$434.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,152.43
|
| Rate for Payer: Railroad Medicare Medicare |
$430.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,513.64
|
| Rate for Payer: UHC Core |
$1,436.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$430.01
|
| Rate for Payer: UHC Exchange |
$430.01
|
| Rate for Payer: UHC Medicare Advantage |
$430.01
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$430.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,290.04
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.03 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna Medicare |
$426.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$513.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$513.20
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$410.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,350.09
|
| Rate for Payer: BCN Commercial |
$1,276.84
|
| Rate for Payer: BCN Medicare Advantage |
$410.56
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.56
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.09
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$472.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PACE Senior Care Partners |
$390.03
|
| Rate for Payer: PACE SWMI |
$410.56
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: PHP Medicare Advantage |
$410.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Medicare |
$414.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: Railroad Medicare Medicare |
$410.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.56
|
| Rate for Payer: UHC Exchange |
$410.56
|
| Rate for Payer: UHC Medicare Advantage |
$410.56
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$410.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,067.46 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,340.56
|
| Rate for Payer: BCN Commercial |
$1,269.12
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,609.87
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,046.42 |
| Max. Negotiated Rate |
$1,448.88 |
| Rate for Payer: Aetna Commercial |
$1,368.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.14
|
| Rate for Payer: BCN Commercial |
$1,244.11
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cofinity Commercial |
$1,384.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,287.90
|
| Rate for Payer: Healthscope Commercial |
$1,448.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,368.39
|
| Rate for Payer: Nomi Health Commercial |
$1,320.09
|
| Rate for Payer: PHP Commercial |
$1,368.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,400.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,078.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.69
|
| Rate for Payer: UHC Core |
$1,344.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.40
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,609.87
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$382.34 |
| Max. Negotiated Rate |
$1,448.88 |
| Rate for Payer: Aetna Commercial |
$1,368.39
|
| Rate for Payer: Aetna Medicare |
$418.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.08
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$402.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,323.47
|
| Rate for Payer: BCN Commercial |
$1,251.67
|
| Rate for Payer: BCN Medicare Advantage |
$402.47
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cash Price |
$1,287.90
|
| Rate for Payer: Cofinity Commercial |
$1,384.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,287.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.47
|
| Rate for Payer: Healthscope Commercial |
$1,448.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.40
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$422.59
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$462.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,368.39
|
| Rate for Payer: Nomi Health Commercial |
$1,320.09
|
| Rate for Payer: PACE Senior Care Partners |
$382.34
|
| Rate for Payer: PACE SWMI |
$402.47
|
| Rate for Payer: PHP Commercial |
$1,368.39
|
| Rate for Payer: PHP Medicare Advantage |
$402.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,046.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,400.59
|
| Rate for Payer: Priority Health Medicare |
$406.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,078.61
|
| Rate for Payer: Railroad Medicare Medicare |
$402.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,416.69
|
| Rate for Payer: UHC Core |
$1,344.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.47
|
| Rate for Payer: UHC Exchange |
$402.47
|
| Rate for Payer: UHC Medicare Advantage |
$402.47
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$402.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.40
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,344.21 |
| Max. Negotiated Rate |
$3,245.83 |
| Rate for Payer: Aetna Commercial |
$3,065.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,943.97
|
| Rate for Payer: BCN Commercial |
$2,787.09
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cofinity Commercial |
$3,101.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.18
|
| Rate for Payer: Healthscope Commercial |
$3,245.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,704.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: Nomi Health Commercial |
$2,957.31
|
| Rate for Payer: PHP Commercial |
$3,065.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,137.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,416.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,173.70
|
| Rate for Payer: UHC Core |
$3,011.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,704.86
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,606.48
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$856.54 |
| Max. Negotiated Rate |
$4,021.03 |
| Rate for Payer: Aetna Commercial |
$3,065.51
|
| Rate for Payer: Aetna Medicare |
$937.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,127.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,127.02
|
| Rate for Payer: BCBS Complete |
$4,021.03
|
| Rate for Payer: BCBS MAPPO |
$901.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,964.89
|
| Rate for Payer: BCN Commercial |
$2,804.04
|
| Rate for Payer: BCN Medicare Advantage |
$901.62
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cash Price |
$2,885.18
|
| Rate for Payer: Cofinity Commercial |
$3,101.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$901.62
|
| Rate for Payer: Healthscope Commercial |
$3,245.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,704.86
|
| Rate for Payer: Mclaren Medicaid |
$3,829.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$946.70
|
| Rate for Payer: Meridian Medicaid |
$4,021.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,036.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,065.51
|
| Rate for Payer: Nomi Health Commercial |
$2,957.31
|
| Rate for Payer: PACE Senior Care Partners |
$856.54
|
| Rate for Payer: PACE SWMI |
$901.62
|
| Rate for Payer: PHP Commercial |
$3,065.51
|
| Rate for Payer: PHP Medicare Advantage |
$901.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,829.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,344.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,137.64
|
| Rate for Payer: Priority Health Medicare |
$910.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,416.34
|
| Rate for Payer: Railroad Medicare Medicare |
$901.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,173.70
|
| Rate for Payer: UHC Core |
$3,011.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$901.62
|
| Rate for Payer: UHC Exchange |
$901.62
|
| Rate for Payer: UHC Medicare Advantage |
$901.62
|
| Rate for Payer: UHCCP Medicaid |
$3,829.30
|
| Rate for Payer: VA VA |
$901.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,704.86
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$780.30 |
| Max. Negotiated Rate |
$2,956.93 |
| Rate for Payer: Aetna Commercial |
$2,792.66
|
| Rate for Payer: Aetna Medicare |
$854.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,026.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,026.71
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$821.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,700.99
|
| Rate for Payer: BCN Commercial |
$2,554.46
|
| Rate for Payer: BCN Medicare Advantage |
$821.37
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$2,825.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$821.37
|
| Rate for Payer: Healthscope Commercial |
$2,956.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,464.11
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$862.44
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$944.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: Nomi Health Commercial |
$2,694.09
|
| Rate for Payer: PACE Senior Care Partners |
$780.30
|
| Rate for Payer: PACE SWMI |
$821.37
|
| Rate for Payer: PHP Commercial |
$2,792.66
|
| Rate for Payer: PHP Medicare Advantage |
$821.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: Priority Health HMO/PPO |
$2,858.37
|
| Rate for Payer: Priority Health Medicare |
$829.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,201.27
|
| Rate for Payer: Railroad Medicare Medicare |
$821.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,891.22
|
| Rate for Payer: UHC Core |
$2,743.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$821.37
|
| Rate for Payer: UHC Exchange |
$821.37
|
| Rate for Payer: UHC Medicare Advantage |
$821.37
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$821.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,464.11
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$3,285.48
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,135.56 |
| Max. Negotiated Rate |
$2,956.93 |
| Rate for Payer: Aetna Commercial |
$2,792.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,681.94
|
| Rate for Payer: BCN Commercial |
$2,539.02
|
| Rate for Payer: Cash Price |
$2,628.38
|
| Rate for Payer: Cofinity Commercial |
$2,825.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,628.38
|
| Rate for Payer: Healthscope Commercial |
$2,956.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,464.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,792.66
|
| Rate for Payer: Nomi Health Commercial |
$2,694.09
|
| Rate for Payer: PHP Commercial |
$2,792.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,135.56
|
| Rate for Payer: Priority Health HMO/PPO |
$2,858.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,201.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,891.22
|
| Rate for Payer: UHC Core |
$2,743.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,464.11
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
OP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.88 |
| Max. Negotiated Rate |
$1,966.27 |
| Rate for Payer: Aetna Commercial |
$1,857.03
|
| Rate for Payer: Aetna Medicare |
$568.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.73
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$546.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.07
|
| Rate for Payer: BCN Commercial |
$1,698.64
|
| Rate for Payer: BCN Medicare Advantage |
$546.18
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$1,878.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.18
|
| Rate for Payer: Healthscope Commercial |
$1,966.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.56
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.49
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.03
|
| Rate for Payer: Nomi Health Commercial |
$1,791.49
|
| Rate for Payer: PACE Senior Care Partners |
$518.88
|
| Rate for Payer: PACE SWMI |
$546.18
|
| Rate for Payer: PHP Commercial |
$1,857.03
|
| Rate for Payer: PHP Medicare Advantage |
$546.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,900.72
|
| Rate for Payer: Priority Health Medicare |
$551.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.78
|
| Rate for Payer: Railroad Medicare Medicare |
$546.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.57
|
| Rate for Payer: UHC Core |
$1,824.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$546.18
|
| Rate for Payer: UHC Exchange |
$546.18
|
| Rate for Payer: UHC Medicare Advantage |
$546.18
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$546.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.56
|
|
|
HC INSERT PICC 5 YEARS OR ABOVE W IMAGING
|
Facility
|
IP
|
$2,184.74
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
36100553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,420.08 |
| Max. Negotiated Rate |
$1,966.27 |
| Rate for Payer: Aetna Commercial |
$1,857.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,783.40
|
| Rate for Payer: BCN Commercial |
$1,688.37
|
| Rate for Payer: Cash Price |
$1,747.79
|
| Rate for Payer: Cofinity Commercial |
$1,878.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.79
|
| Rate for Payer: Healthscope Commercial |
$1,966.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.03
|
| Rate for Payer: Nomi Health Commercial |
$1,791.49
|
| Rate for Payer: PHP Commercial |
$1,857.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,420.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,900.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.57
|
| Rate for Payer: UHC Core |
$1,824.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.56
|
|
|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.96 |
| Max. Negotiated Rate |
$1,787.51 |
| Rate for Payer: Aetna Commercial |
$1,688.20
|
| Rate for Payer: Aetna Medicare |
$516.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.66
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$496.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.79
|
| Rate for Payer: BCN Commercial |
$1,544.21
|
| Rate for Payer: BCN Medicare Advantage |
$496.53
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,708.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.53
|
| Rate for Payer: Healthscope Commercial |
$1,787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,489.59
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.36
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: Nomi Health Commercial |
$1,628.62
|
| Rate for Payer: PACE Senior Care Partners |
$471.70
|
| Rate for Payer: PACE SWMI |
$496.53
|
| Rate for Payer: PHP Commercial |
$1,688.20
|
| Rate for Payer: PHP Medicare Advantage |
$496.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,727.92
|
| Rate for Payer: Priority Health Medicare |
$501.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.70
|
| Rate for Payer: Railroad Medicare Medicare |
$496.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,747.79
|
| Rate for Payer: UHC Core |
$1,658.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.53
|
| Rate for Payer: UHC Exchange |
$496.53
|
| Rate for Payer: UHC Medicare Advantage |
$496.53
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$496.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,489.59
|
|
