|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.12 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$297.50
|
| Rate for Payer: Aetna Medicare |
$91.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.38
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$87.50
|
| Rate for Payer: BCBS Trust/PPO |
$272.12
|
| Rate for Payer: BCN Commercial |
$272.12
|
| Rate for Payer: BCN Medicare Advantage |
$87.50
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.50
|
| Rate for Payer: Healthscope Commercial |
$315.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.50
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.50
|
| Rate for Payer: PACE Senior Care Partners |
$83.12
|
| Rate for Payer: PACE SWMI |
$87.50
|
| Rate for Payer: PHP Commercial |
$297.50
|
| Rate for Payer: PHP Medicare Advantage |
$87.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.50
|
| Rate for Payer: Priority Health Medicare |
$87.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.46
|
| Rate for Payer: Railroad Medicare Medicare |
$87.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.00
|
| Rate for Payer: UHC Core |
$292.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.50
|
| Rate for Payer: UHC Medicare Advantage |
$90.12
|
| Rate for Payer: VA VA |
$87.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.50
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$498.77 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna Medicare |
$546.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.28
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$525.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.81
|
| Rate for Payer: BCN Commercial |
$1,632.81
|
| Rate for Payer: BCN Medicare Advantage |
$525.02
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.02
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Senior Care Partners |
$498.77
|
| Rate for Payer: PACE SWMI |
$525.02
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: PHP Medicare Advantage |
$525.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.07
|
| Rate for Payer: Priority Health Medicare |
$525.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.84
|
| Rate for Payer: Railroad Medicare Medicare |
$525.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.07
|
| Rate for Payer: UHC Core |
$1,753.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$525.02
|
| Rate for Payer: UHC Medicare Advantage |
$540.77
|
| Rate for Payer: VA VA |
$525.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,280.84 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.94
|
| Rate for Payer: BCN Commercial |
$1,622.94
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,848.07
|
| Rate for Payer: UHC Core |
$1,753.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,040.06 |
| Max. Negotiated Rate |
$4,486.07 |
| Rate for Payer: Aetna Commercial |
$4,236.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,852.04
|
| Rate for Payer: BCN Commercial |
$3,852.04
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$4,286.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Healthscope Commercial |
$4,486.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,738.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: PHP Commercial |
$4,236.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,336.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,386.38
|
| Rate for Payer: UHC Core |
$4,162.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,738.39
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,183.82 |
| Max. Negotiated Rate |
$4,486.07 |
| Rate for Payer: Aetna Commercial |
$4,236.84
|
| Rate for Payer: Aetna Medicare |
$1,295.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,557.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,557.66
|
| Rate for Payer: BCBS Complete |
$1,933.98
|
| Rate for Payer: BCBS MAPPO |
$1,246.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,875.46
|
| Rate for Payer: BCN Commercial |
$3,875.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.13
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$4,286.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.13
|
| Rate for Payer: Healthscope Commercial |
$4,486.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,738.39
|
| Rate for Payer: Mclaren Medicaid |
$1,841.89
|
| Rate for Payer: Meridian Medicaid |
$1,933.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,308.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,433.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,183.82
|
| Rate for Payer: PACE SWMI |
$1,246.13
|
| Rate for Payer: PHP Commercial |
$4,236.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,841.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,336.53
|
| Rate for Payer: Priority Health Medicare |
$1,246.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,040.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,246.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,386.38
|
| Rate for Payer: UHC Core |
$4,162.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,246.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,283.51
|
| Rate for Payer: VA VA |
$1,246.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,738.39
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,830.91 |
| Max. Negotiated Rate |
$2,701.79 |
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,319.94
|
| Rate for Payer: BCN Commercial |
$2,319.94
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,611.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,641.75
|
| Rate for Payer: UHC Core |
$2,506.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$712.97 |
| Max. Negotiated Rate |
$2,704.89 |
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: Aetna Medicare |
$780.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$938.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$938.12
|
| Rate for Payer: BCBS Complete |
$2,704.89
|
| Rate for Payer: BCBS MAPPO |
$750.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,334.05
|
| Rate for Payer: BCN Commercial |
$2,334.05
|
| Rate for Payer: BCN Medicare Advantage |
$750.50
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.50
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Mclaren Medicaid |
$2,576.08
|
| Rate for Payer: Meridian Medicaid |
$2,704.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$788.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$863.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PACE Senior Care Partners |
$712.97
|
| Rate for Payer: PACE SWMI |
$750.50
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: PHP Medicare Advantage |
$750.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,576.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,611.73
|
| Rate for Payer: Priority Health Medicare |
$750.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.91
|
| Rate for Payer: Railroad Medicare Medicare |
$750.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,641.75
|
| Rate for Payer: UHC Core |
$2,506.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$750.50
|
| Rate for Payer: UHC Medicare Advantage |
$773.01
|
| Rate for Payer: VA VA |
$750.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$784.27 |
| Max. Negotiated Rate |
$5,851.75 |
| Rate for Payer: Aetna Commercial |
$2,806.86
|
| Rate for Payer: Aetna Medicare |
$858.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,031.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,031.93
|
| Rate for Payer: BCBS Complete |
$5,851.75
|
| Rate for Payer: BCBS MAPPO |
$825.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,567.45
|
| Rate for Payer: BCN Commercial |
$2,567.45
|
| Rate for Payer: BCN Medicare Advantage |
$825.55
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$2,839.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$825.55
|
| Rate for Payer: Healthscope Commercial |
$2,971.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.64
|
| Rate for Payer: Mclaren Medicaid |
$5,573.10
|
| Rate for Payer: Meridian Medicaid |
$5,851.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$866.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$949.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: PACE Senior Care Partners |
$784.27
|
| Rate for Payer: PACE SWMI |
$825.55
|
| Rate for Payer: PHP Commercial |
$2,806.86
|
| Rate for Payer: PHP Medicare Advantage |
$825.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,573.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,872.91
|
| Rate for Payer: Priority Health Medicare |
$825.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,014.01
|
| Rate for Payer: Railroad Medicare Medicare |
$825.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,905.93
|
| Rate for Payer: UHC Core |
$2,757.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$825.55
|
| Rate for Payer: UHC Medicare Advantage |
$850.31
|
| Rate for Payer: VA VA |
$825.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.64
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,014.01 |
| Max. Negotiated Rate |
$2,971.97 |
| Rate for Payer: Aetna Commercial |
$2,806.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,551.93
|
| Rate for Payer: BCN Commercial |
$2,551.93
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$2,839.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Healthscope Commercial |
$2,971.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: PHP Commercial |
$2,806.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,872.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,014.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,905.93
|
| Rate for Payer: UHC Core |
$2,757.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.64
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,818.21 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,105.12
|
| Rate for Payer: BCN Commercial |
$6,105.12
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,876.25 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,054.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,468.75
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,975.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,142.25
|
| Rate for Payer: BCN Commercial |
$6,142.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,975.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,975.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,073.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,271.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,876.25
|
| Rate for Payer: PACE SWMI |
$1,975.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Medicare |
$1,975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,975.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,034.25
|
| Rate for Payer: VA VA |
$1,975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$632.18 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: Aetna Medicare |
$692.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$831.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$831.82
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$665.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,069.57
|
| Rate for Payer: BCN Commercial |
$2,069.57
|
| Rate for Payer: BCN Medicare Advantage |
$665.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$665.46
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$698.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$765.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PACE Senior Care Partners |
$632.18
|
| Rate for Payer: PACE SWMI |
$665.46
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: PHP Medicare Advantage |
$665.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.78
|
| Rate for Payer: Priority Health Medicare |
$665.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: Railroad Medicare Medicare |
$665.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$665.46
|
| Rate for Payer: UHC Medicare Advantage |
$685.42
|
| Rate for Payer: VA VA |
$665.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,623.44 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.05
|
| Rate for Payer: BCN Commercial |
$2,057.05
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,315.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,623.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,342.40
|
| Rate for Payer: UHC Core |
$2,222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,876.25 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,054.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,468.75
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,975.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,142.25
|
| Rate for Payer: BCN Commercial |
$6,142.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,975.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,975.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,073.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,271.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,876.25
|
| Rate for Payer: PACE SWMI |
$1,975.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,975.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Medicare |
$1,975.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,975.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,975.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,034.25
|
| Rate for Payer: VA VA |
$1,975.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,818.21 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,105.12
|
| Rate for Payer: BCN Commercial |
$6,105.12
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,873.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,818.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,952.00
|
| Rate for Payer: UHC Core |
$6,596.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,187.50 |
| Max. Negotiated Rate |
$4,500.00 |
| Rate for Payer: Aetna Commercial |
$4,250.00
|
| Rate for Payer: Aetna Medicare |
$1,300.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,562.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,562.50
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$1,250.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,887.50
|
| Rate for Payer: BCN Commercial |
$3,887.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,250.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,250.00
|
| Rate for Payer: Healthscope Commercial |
$4,500.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.00
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,312.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,437.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,187.50
|
| Rate for Payer: PACE SWMI |
$1,250.00
|
| Rate for Payer: PHP Commercial |
$4,250.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,250.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,350.00
|
| Rate for Payer: Priority Health Medicare |
$1,250.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,250.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,400.00
|
| Rate for Payer: UHC Core |
$4,175.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,250.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,287.50
|
| Rate for Payer: VA VA |
$1,250.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,049.50 |
| Max. Negotiated Rate |
$4,500.00 |
| Rate for Payer: Aetna Commercial |
$4,250.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,864.00
|
| Rate for Payer: BCN Commercial |
$3,864.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Healthscope Commercial |
$4,500.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PHP Commercial |
$4,250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,350.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,400.00
|
| Rate for Payer: UHC Core |
$4,175.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.00
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,102.95
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.95 |
| Max. Negotiated Rate |
$992.66 |
| Rate for Payer: Aetna Commercial |
$937.51
|
| Rate for Payer: Aetna Medicare |
$286.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$344.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$344.67
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$275.74
|
| Rate for Payer: BCBS Trust/PPO |
$857.54
|
| Rate for Payer: BCN Commercial |
$857.54
|
| Rate for Payer: BCN Medicare Advantage |
$275.74
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cofinity Commercial |
$948.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.74
|
| Rate for Payer: Healthscope Commercial |
$992.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$827.21
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$289.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$317.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.51
|
| Rate for Payer: PACE Senior Care Partners |
$261.95
|
| Rate for Payer: PACE SWMI |
$275.74
|
| Rate for Payer: PHP Commercial |
$937.51
|
| Rate for Payer: PHP Medicare Advantage |
$275.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$959.57
|
| Rate for Payer: Priority Health Medicare |
$275.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$672.69
|
| Rate for Payer: Railroad Medicare Medicare |
$275.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.60
|
| Rate for Payer: UHC Core |
$920.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.74
|
| Rate for Payer: UHC Medicare Advantage |
$284.01
|
| Rate for Payer: VA VA |
$275.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$827.21
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,102.95
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$672.69 |
| Max. Negotiated Rate |
$992.66 |
| Rate for Payer: Aetna Commercial |
$937.51
|
| Rate for Payer: BCBS Trust/PPO |
$852.36
|
| Rate for Payer: BCN Commercial |
$852.36
|
| Rate for Payer: Cash Price |
$882.36
|
| Rate for Payer: Cofinity Commercial |
$948.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.36
|
| Rate for Payer: Healthscope Commercial |
$992.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$827.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.51
|
| Rate for Payer: PHP Commercial |
$937.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$959.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$672.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.60
|
| Rate for Payer: UHC Core |
$920.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$827.21
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,228.27
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$766.71 |
| Max. Negotiated Rate |
$2,905.44 |
| Rate for Payer: Aetna Commercial |
$2,744.03
|
| Rate for Payer: Aetna Medicare |
$839.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,008.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,008.83
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$807.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.98
|
| Rate for Payer: BCN Commercial |
$2,509.98
|
| Rate for Payer: BCN Medicare Advantage |
$807.07
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cofinity Commercial |
$2,776.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$807.07
|
| Rate for Payer: Healthscope Commercial |
$2,905.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,421.20
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$847.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$928.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,744.03
|
| Rate for Payer: PACE Senior Care Partners |
$766.71
|
| Rate for Payer: PACE SWMI |
$807.07
|
| Rate for Payer: PHP Commercial |
$2,744.03
|
| Rate for Payer: PHP Medicare Advantage |
$807.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,808.59
|
| Rate for Payer: Priority Health Medicare |
$807.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,968.92
|
| Rate for Payer: Railroad Medicare Medicare |
$807.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,840.88
|
| Rate for Payer: UHC Core |
$2,695.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$807.07
|
| Rate for Payer: UHC Medicare Advantage |
$831.28
|
| Rate for Payer: VA VA |
$807.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,421.20
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,228.27
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,968.92 |
| Max. Negotiated Rate |
$2,905.44 |
| Rate for Payer: Aetna Commercial |
$2,744.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,494.81
|
| Rate for Payer: BCN Commercial |
$2,494.81
|
| Rate for Payer: Cash Price |
$2,582.62
|
| Rate for Payer: Cofinity Commercial |
$2,776.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.62
|
| Rate for Payer: Healthscope Commercial |
$2,905.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,421.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,744.03
|
| Rate for Payer: PHP Commercial |
$2,744.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,259.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,808.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,968.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,840.88
|
| Rate for Payer: UHC Core |
$2,695.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,421.20
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$964.69
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$588.36 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: BCBS Trust/PPO |
$745.51
|
| Rate for Payer: BCN Commercial |
$745.51
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$964.69
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.11 |
| Max. Negotiated Rate |
$868.22 |
| Rate for Payer: Aetna Commercial |
$819.99
|
| Rate for Payer: Aetna Medicare |
$250.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$301.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$301.47
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$241.17
|
| Rate for Payer: BCBS Trust/PPO |
$750.05
|
| Rate for Payer: BCN Commercial |
$750.05
|
| Rate for Payer: BCN Medicare Advantage |
$241.17
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cash Price |
$771.75
|
| Rate for Payer: Cofinity Commercial |
$829.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$771.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.17
|
| Rate for Payer: Healthscope Commercial |
$868.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.52
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$819.99
|
| Rate for Payer: PACE Senior Care Partners |
$229.11
|
| Rate for Payer: PACE SWMI |
$241.17
|
| Rate for Payer: PHP Commercial |
$819.99
|
| Rate for Payer: PHP Medicare Advantage |
$241.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.28
|
| Rate for Payer: Priority Health Medicare |
$241.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.36
|
| Rate for Payer: Railroad Medicare Medicare |
$241.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$848.93
|
| Rate for Payer: UHC Core |
$805.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.17
|
| Rate for Payer: UHC Medicare Advantage |
$248.41
|
| Rate for Payer: VA VA |
$241.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.52
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$532.68
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.88 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: BCBS Trust/PPO |
$411.66
|
| Rate for Payer: BCN Commercial |
$411.66
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.76
|
| Rate for Payer: UHC Core |
$444.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$532.68
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.51 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: Aetna Medicare |
$138.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.46
|
| Rate for Payer: BCBS Complete |
$274.44
|
| Rate for Payer: BCBS MAPPO |
$133.17
|
| Rate for Payer: BCBS Trust/PPO |
$414.16
|
| Rate for Payer: BCN Commercial |
$414.16
|
| Rate for Payer: BCN Medicare Advantage |
$133.17
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Mclaren Medicaid |
$261.37
|
| Rate for Payer: Meridian Medicaid |
$274.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PACE Senior Care Partners |
$126.51
|
| Rate for Payer: PACE SWMI |
$133.17
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: PHP Medicare Advantage |
$133.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.43
|
| Rate for Payer: Priority Health Medicare |
$133.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.88
|
| Rate for Payer: Railroad Medicare Medicare |
$133.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.76
|
| Rate for Payer: UHC Core |
$444.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.17
|
| Rate for Payer: UHC Medicare Advantage |
$137.17
|
| Rate for Payer: VA VA |
$133.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
