|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.52 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$197.06
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.56 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: Aetna Medicare |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.69
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS MAPPO |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$198.26
|
| Rate for Payer: BCN Commercial |
$198.26
|
| Rate for Payer: BCN Medicare Advantage |
$63.75
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.75
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: PHP Medicare Advantage |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.85
|
| Rate for Payer: Priority Health Medicare |
$63.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: Railroad Medicare Medicare |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.75
|
| Rate for Payer: UHC Medicare Advantage |
$65.66
|
| Rate for Payer: VA VA |
$63.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,722.84
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.67 |
| Max. Negotiated Rate |
$2,450.56 |
| Rate for Payer: Aetna Commercial |
$2,314.41
|
| Rate for Payer: Aetna Medicare |
$707.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$850.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$850.89
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$680.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,117.01
|
| Rate for Payer: BCN Commercial |
$2,117.01
|
| Rate for Payer: BCN Medicare Advantage |
$680.71
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cofinity Commercial |
$2,341.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,178.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$680.71
|
| Rate for Payer: Healthscope Commercial |
$2,450.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,042.13
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$714.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$782.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,314.41
|
| Rate for Payer: PACE Senior Care Partners |
$646.67
|
| Rate for Payer: PACE SWMI |
$680.71
|
| Rate for Payer: PHP Commercial |
$2,314.41
|
| Rate for Payer: PHP Medicare Advantage |
$680.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,905.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,368.87
|
| Rate for Payer: Priority Health Medicare |
$680.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,660.66
|
| Rate for Payer: Railroad Medicare Medicare |
$680.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,396.10
|
| Rate for Payer: UHC Core |
$2,273.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$680.71
|
| Rate for Payer: UHC Medicare Advantage |
$701.13
|
| Rate for Payer: VA VA |
$680.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,042.13
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,722.84
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,660.66 |
| Max. Negotiated Rate |
$2,450.56 |
| Rate for Payer: Aetna Commercial |
$2,314.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,104.21
|
| Rate for Payer: BCN Commercial |
$2,104.21
|
| Rate for Payer: Cash Price |
$2,178.27
|
| Rate for Payer: Cofinity Commercial |
$2,341.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,178.27
|
| Rate for Payer: Healthscope Commercial |
$2,450.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,042.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,314.41
|
| Rate for Payer: PHP Commercial |
$2,314.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,905.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,368.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,660.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,396.10
|
| Rate for Payer: UHC Core |
$2,273.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,042.13
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$844.26
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.51 |
| Max. Negotiated Rate |
$759.83 |
| Rate for Payer: Aetna Commercial |
$717.62
|
| Rate for Payer: Aetna Medicare |
$219.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.83
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$211.06
|
| Rate for Payer: BCBS Trust/PPO |
$656.41
|
| Rate for Payer: BCN Commercial |
$656.41
|
| Rate for Payer: BCN Medicare Advantage |
$211.06
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cofinity Commercial |
$726.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$675.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.06
|
| Rate for Payer: Healthscope Commercial |
$759.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$633.20
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$221.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$717.62
|
| Rate for Payer: PACE Senior Care Partners |
$200.51
|
| Rate for Payer: PACE SWMI |
$211.06
|
| Rate for Payer: PHP Commercial |
$717.62
|
| Rate for Payer: PHP Medicare Advantage |
$211.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$734.51
|
| Rate for Payer: Priority Health Medicare |
$211.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$514.91
|
| Rate for Payer: Railroad Medicare Medicare |
$211.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.95
|
| Rate for Payer: UHC Core |
$704.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.06
|
| Rate for Payer: UHC Medicare Advantage |
$217.40
|
| Rate for Payer: VA VA |
$211.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$633.20
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$844.26
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$514.91 |
| Max. Negotiated Rate |
$759.83 |
| Rate for Payer: Aetna Commercial |
$717.62
|
| Rate for Payer: BCBS Trust/PPO |
$652.44
|
| Rate for Payer: BCN Commercial |
$652.44
|
| Rate for Payer: Cash Price |
$675.41
|
| Rate for Payer: Cofinity Commercial |
$726.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$675.41
|
| Rate for Payer: Healthscope Commercial |
$759.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$633.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$717.62
|
| Rate for Payer: PHP Commercial |
$717.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$734.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$514.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.95
|
| Rate for Payer: UHC Core |
$704.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$633.20
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$170.37
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$40.46 |
| Max. Negotiated Rate |
$184.98 |
| Rate for Payer: Aetna Commercial |
$144.81
|
| Rate for Payer: Aetna Medicare |
$44.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.24
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$42.59
|
| Rate for Payer: BCBS Trust/PPO |
$132.46
|
| Rate for Payer: BCN Commercial |
$132.46
|
| Rate for Payer: BCN Medicare Advantage |
$42.59
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.59
|
| Rate for Payer: Healthscope Commercial |
$153.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.78
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.81
|
| Rate for Payer: PACE Senior Care Partners |
$40.46
|
| Rate for Payer: PACE SWMI |
$42.59
|
| Rate for Payer: PHP Commercial |
$144.81
|
| Rate for Payer: PHP Medicare Advantage |
$42.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.22
|
| Rate for Payer: Priority Health Medicare |
$42.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.91
|
| Rate for Payer: Railroad Medicare Medicare |
$42.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.93
|
| Rate for Payer: UHC Core |
$142.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.59
|
| Rate for Payer: UHC Medicare Advantage |
$43.87
|
| Rate for Payer: VA VA |
$42.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.78
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$170.37
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$103.91 |
| Max. Negotiated Rate |
$153.33 |
| Rate for Payer: Aetna Commercial |
$144.81
|
| Rate for Payer: BCBS Trust/PPO |
$131.66
|
| Rate for Payer: BCN Commercial |
$131.66
|
| Rate for Payer: Cash Price |
$136.30
|
| Rate for Payer: Cofinity Commercial |
$146.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.30
|
| Rate for Payer: Healthscope Commercial |
$153.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.81
|
| Rate for Payer: PHP Commercial |
$144.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$148.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.93
|
| Rate for Payer: UHC Core |
$142.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.78
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$190.11
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$45.15 |
| Max. Negotiated Rate |
$184.98 |
| Rate for Payer: Aetna Commercial |
$161.59
|
| Rate for Payer: Aetna Medicare |
$49.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.41
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$47.53
|
| Rate for Payer: BCBS Trust/PPO |
$147.81
|
| Rate for Payer: BCN Commercial |
$147.81
|
| Rate for Payer: BCN Medicare Advantage |
$47.53
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$163.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.53
|
| Rate for Payer: Healthscope Commercial |
$171.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.58
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PACE Senior Care Partners |
$45.15
|
| Rate for Payer: PACE SWMI |
$47.53
|
| Rate for Payer: PHP Commercial |
$161.59
|
| Rate for Payer: PHP Medicare Advantage |
$47.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.40
|
| Rate for Payer: Priority Health Medicare |
$47.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.95
|
| Rate for Payer: Railroad Medicare Medicare |
$47.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.30
|
| Rate for Payer: UHC Core |
$158.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.53
|
| Rate for Payer: UHC Medicare Advantage |
$48.95
|
| Rate for Payer: VA VA |
$47.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.58
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$190.11
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$115.95 |
| Max. Negotiated Rate |
$171.10 |
| Rate for Payer: Aetna Commercial |
$161.59
|
| Rate for Payer: BCBS Trust/PPO |
$146.92
|
| Rate for Payer: BCN Commercial |
$146.92
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$163.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Healthscope Commercial |
$171.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PHP Commercial |
$161.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.30
|
| Rate for Payer: UHC Core |
$158.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.58
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$345.19
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$81.98 |
| Max. Negotiated Rate |
$310.67 |
| Rate for Payer: Aetna Commercial |
$293.41
|
| Rate for Payer: Aetna Medicare |
$89.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.87
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$86.30
|
| Rate for Payer: BCBS Trust/PPO |
$268.39
|
| Rate for Payer: BCN Commercial |
$268.39
|
| Rate for Payer: BCN Medicare Advantage |
$86.30
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cofinity Commercial |
$296.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.30
|
| Rate for Payer: Healthscope Commercial |
$310.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.89
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.41
|
| Rate for Payer: PACE Senior Care Partners |
$81.98
|
| Rate for Payer: PACE SWMI |
$86.30
|
| Rate for Payer: PHP Commercial |
$293.41
|
| Rate for Payer: PHP Medicare Advantage |
$86.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.32
|
| Rate for Payer: Priority Health Medicare |
$86.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.53
|
| Rate for Payer: Railroad Medicare Medicare |
$86.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.77
|
| Rate for Payer: UHC Core |
$288.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.30
|
| Rate for Payer: UHC Medicare Advantage |
$88.89
|
| Rate for Payer: VA VA |
$86.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.89
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$345.19
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$210.53 |
| Max. Negotiated Rate |
$310.67 |
| Rate for Payer: Aetna Commercial |
$293.41
|
| Rate for Payer: BCBS Trust/PPO |
$266.76
|
| Rate for Payer: BCN Commercial |
$266.76
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cofinity Commercial |
$296.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.15
|
| Rate for Payer: Healthscope Commercial |
$310.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.41
|
| Rate for Payer: PHP Commercial |
$293.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.77
|
| Rate for Payer: UHC Core |
$288.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.89
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna Medicare |
$54.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.37
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$52.29
|
| Rate for Payer: BCBS Trust/PPO |
$162.63
|
| Rate for Payer: BCN Commercial |
$162.63
|
| Rate for Payer: BCN Medicare Advantage |
$52.29
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.29
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Senior Care Partners |
$49.68
|
| Rate for Payer: PACE SWMI |
$52.29
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: PHP Medicare Advantage |
$52.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.98
|
| Rate for Payer: Priority Health Medicare |
$52.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.57
|
| Rate for Payer: Railroad Medicare Medicare |
$52.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.07
|
| Rate for Payer: UHC Core |
$174.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.29
|
| Rate for Payer: UHC Medicare Advantage |
$53.86
|
| Rate for Payer: VA VA |
$52.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$127.57 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: BCBS Trust/PPO |
$161.65
|
| Rate for Payer: BCN Commercial |
$161.65
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.07
|
| Rate for Payer: UHC Core |
$174.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.26 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.76
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCBS Trust/PPO |
$108.87
|
| Rate for Payer: BCN Commercial |
$108.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Senior Care Partners |
$33.26
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.83
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.40
|
| Rate for Payer: Railroad Medicare Medicare |
$35.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.23
|
| Rate for Payer: UHC Core |
$116.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$36.06
|
| Rate for Payer: VA VA |
$35.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.40 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.22
|
| Rate for Payer: BCN Commercial |
$108.22
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.23
|
| Rate for Payer: UHC Core |
$116.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$127.57 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: BCBS Trust/PPO |
$161.65
|
| Rate for Payer: BCN Commercial |
$161.65
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.07
|
| Rate for Payer: UHC Core |
$174.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna Medicare |
$54.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.37
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$52.29
|
| Rate for Payer: BCBS Trust/PPO |
$162.63
|
| Rate for Payer: BCN Commercial |
$162.63
|
| Rate for Payer: BCN Medicare Advantage |
$52.29
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.29
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Senior Care Partners |
$49.68
|
| Rate for Payer: PACE SWMI |
$52.29
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: PHP Medicare Advantage |
$52.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.98
|
| Rate for Payer: Priority Health Medicare |
$52.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.57
|
| Rate for Payer: Railroad Medicare Medicare |
$52.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.07
|
| Rate for Payer: UHC Core |
$174.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.29
|
| Rate for Payer: UHC Medicare Advantage |
$53.86
|
| Rate for Payer: VA VA |
$52.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.40 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: BCBS Trust/PPO |
$108.22
|
| Rate for Payer: BCN Commercial |
$108.22
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.23
|
| Rate for Payer: UHC Core |
$116.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.26 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.76
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCBS Trust/PPO |
$108.87
|
| Rate for Payer: BCN Commercial |
$108.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Senior Care Partners |
$33.26
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.83
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.40
|
| Rate for Payer: Railroad Medicare Medicare |
$35.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.23
|
| Rate for Payer: UHC Core |
$116.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$36.06
|
| Rate for Payer: VA VA |
$35.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,638.99 |
| Max. Negotiated Rate |
$6,210.90 |
| Rate for Payer: Aetna Commercial |
$5,865.85
|
| Rate for Payer: Aetna Medicare |
$1,794.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,156.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,156.56
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$1,725.25
|
| Rate for Payer: BCBS Trust/PPO |
$5,365.53
|
| Rate for Payer: BCN Commercial |
$5,365.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,725.25
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$5,934.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,725.25
|
| Rate for Payer: Healthscope Commercial |
$6,210.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,175.75
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,811.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,984.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,638.99
|
| Rate for Payer: PACE SWMI |
$1,725.25
|
| Rate for Payer: PHP Commercial |
$5,865.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,725.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,003.87
|
| Rate for Payer: Priority Health Medicare |
$1,725.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,208.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,725.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,072.88
|
| Rate for Payer: UHC Core |
$5,762.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,725.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,777.01
|
| Rate for Payer: VA VA |
$1,725.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,175.75
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,208.92 |
| Max. Negotiated Rate |
$6,210.90 |
| Rate for Payer: Aetna Commercial |
$5,865.85
|
| Rate for Payer: BCBS Trust/PPO |
$5,333.09
|
| Rate for Payer: BCN Commercial |
$5,333.09
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$5,934.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Healthscope Commercial |
$6,210.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,175.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: PHP Commercial |
$5,865.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,003.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,208.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,072.88
|
| Rate for Payer: UHC Core |
$5,762.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,175.75
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,525.62 |
| Max. Negotiated Rate |
$2,251.28 |
| Rate for Payer: Aetna Commercial |
$2,126.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,933.10
|
| Rate for Payer: BCN Commercial |
$1,933.10
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$2,151.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Healthscope Commercial |
$2,251.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.21
|
| Rate for Payer: PHP Commercial |
$2,126.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,176.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,525.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.25
|
| Rate for Payer: UHC Core |
$2,088.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.06
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.09 |
| Max. Negotiated Rate |
$2,251.28 |
| Rate for Payer: Aetna Commercial |
$2,126.21
|
| Rate for Payer: Aetna Medicare |
$650.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.69
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$625.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.85
|
| Rate for Payer: BCN Commercial |
$1,944.85
|
| Rate for Payer: BCN Medicare Advantage |
$625.36
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$2,151.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.36
|
| Rate for Payer: Healthscope Commercial |
$2,251.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.06
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.21
|
| Rate for Payer: PACE Senior Care Partners |
$594.09
|
| Rate for Payer: PACE SWMI |
$625.36
|
| Rate for Payer: PHP Commercial |
$2,126.21
|
| Rate for Payer: PHP Medicare Advantage |
$625.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,176.24
|
| Rate for Payer: Priority Health Medicare |
$625.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,525.62
|
| Rate for Payer: Railroad Medicare Medicare |
$625.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.25
|
| Rate for Payer: UHC Core |
$2,088.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.36
|
| Rate for Payer: UHC Medicare Advantage |
$644.12
|
| Rate for Payer: VA VA |
$625.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.06
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.96 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: BCBS Trust/PPO |
$286.31
|
| Rate for Payer: BCN Commercial |
$286.31
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$322.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.02
|
| Rate for Payer: UHC Core |
$309.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
