|
HC REMOVE FB EYE
|
Facility
|
OP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.99 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: Aetna Medicare |
$96.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.78
|
| Rate for Payer: BCBS Complete |
$148.19
|
| Rate for Payer: BCBS MAPPO |
$92.62
|
| Rate for Payer: BCBS Trust/PPO |
$288.05
|
| Rate for Payer: BCN Commercial |
$288.05
|
| Rate for Payer: BCN Medicare Advantage |
$92.62
|
| 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: Health Alliance Plan Medicare Advantage |
$92.62
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PACE Senior Care Partners |
$87.99
|
| Rate for Payer: PACE SWMI |
$92.62
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: PHP Medicare Advantage |
$92.62
|
| 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 Medicare |
$92.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$225.96
|
| Rate for Payer: Railroad Medicare Medicare |
$92.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.02
|
| Rate for Payer: UHC Core |
$309.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.62
|
| Rate for Payer: UHC Medicare Advantage |
$95.40
|
| Rate for Payer: VA VA |
$92.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.66 |
| Max. Negotiated Rate |
$839.99 |
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: Aetna Medicare |
$242.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.66
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$233.33
|
| Rate for Payer: BCBS Trust/PPO |
$725.66
|
| Rate for Payer: BCN Commercial |
$725.66
|
| Rate for Payer: BCN Medicare Advantage |
$233.33
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.33
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.99
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$245.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PACE Senior Care Partners |
$221.66
|
| Rate for Payer: PACE SWMI |
$233.33
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: PHP Medicare Advantage |
$233.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.99
|
| Rate for Payer: Priority Health Medicare |
$233.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.23
|
| Rate for Payer: Railroad Medicare Medicare |
$233.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.32
|
| Rate for Payer: UHC Core |
$779.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.33
|
| Rate for Payer: UHC Medicare Advantage |
$240.33
|
| Rate for Payer: VA VA |
$233.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.99
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$569.23 |
| Max. Negotiated Rate |
$839.99 |
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: BCBS Trust/PPO |
$721.27
|
| Rate for Payer: BCN Commercial |
$721.27
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.32
|
| Rate for Payer: UHC Core |
$779.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.99
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$57.62 |
| Max. Negotiated Rate |
$218.34 |
| Rate for Payer: Aetna Commercial |
$206.21
|
| Rate for Payer: Aetna Medicare |
$63.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.81
|
| Rate for Payer: BCBS Complete |
$97.04
|
| Rate for Payer: BCBS MAPPO |
$60.65
|
| Rate for Payer: BCBS Trust/PPO |
$188.62
|
| Rate for Payer: BCN Commercial |
$188.62
|
| Rate for Payer: BCN Medicare Advantage |
$60.65
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$208.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.65
|
| Rate for Payer: Healthscope Commercial |
$218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: PACE Senior Care Partners |
$57.62
|
| Rate for Payer: PACE SWMI |
$60.65
|
| Rate for Payer: PHP Commercial |
$206.21
|
| Rate for Payer: PHP Medicare Advantage |
$60.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.06
|
| Rate for Payer: Priority Health Medicare |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.96
|
| Rate for Payer: Railroad Medicare Medicare |
$60.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.49
|
| Rate for Payer: UHC Core |
$202.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.65
|
| Rate for Payer: UHC Medicare Advantage |
$62.47
|
| Rate for Payer: VA VA |
$60.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.95
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.96 |
| Max. Negotiated Rate |
$218.34 |
| Rate for Payer: Aetna Commercial |
$206.21
|
| Rate for Payer: BCBS Trust/PPO |
$187.48
|
| Rate for Payer: BCN Commercial |
$187.48
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$208.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Healthscope Commercial |
$218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: PHP Commercial |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.49
|
| Rate for Payer: UHC Core |
$202.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.95
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,026.46 |
| Max. Negotiated Rate |
$1,514.70 |
| Rate for Payer: Aetna Commercial |
$1,430.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.62
|
| Rate for Payer: BCN Commercial |
$1,300.62
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,447.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Healthscope Commercial |
$1,514.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.55
|
| Rate for Payer: PHP Commercial |
$1,430.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,464.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,481.04
|
| Rate for Payer: UHC Core |
$1,405.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.25
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$399.71 |
| Max. Negotiated Rate |
$1,514.70 |
| Rate for Payer: Aetna Commercial |
$1,430.55
|
| Rate for Payer: Aetna Medicare |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$525.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$525.94
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$420.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.53
|
| Rate for Payer: BCN Commercial |
$1,308.53
|
| Rate for Payer: BCN Medicare Advantage |
$420.75
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,447.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.75
|
| Rate for Payer: Healthscope Commercial |
$1,514.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.25
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$441.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$483.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.55
|
| Rate for Payer: PACE Senior Care Partners |
$399.71
|
| Rate for Payer: PACE SWMI |
$420.75
|
| Rate for Payer: PHP Commercial |
$1,430.55
|
| Rate for Payer: PHP Medicare Advantage |
$420.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,464.21
|
| Rate for Payer: Priority Health Medicare |
$420.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.46
|
| Rate for Payer: Railroad Medicare Medicare |
$420.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,481.04
|
| Rate for Payer: UHC Core |
$1,405.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.75
|
| Rate for Payer: UHC Medicare Advantage |
$433.37
|
| Rate for Payer: VA VA |
$420.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.25
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$972.56 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna Medicare |
$1,064.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,279.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,279.69
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,023.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,183.86
|
| Rate for Payer: BCN Commercial |
$3,183.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.75
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.75
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,071.25
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,074.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,177.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,480.75
|
| Rate for Payer: PACE Senior Care Partners |
$972.56
|
| Rate for Payer: PACE SWMI |
$1,023.75
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,866.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,562.65
|
| Rate for Payer: Priority Health Medicare |
$1,023.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,497.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,023.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,603.60
|
| Rate for Payer: UHC Core |
$3,419.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,054.46
|
| Rate for Payer: VA VA |
$1,023.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,071.25
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,497.54 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.62
|
| Rate for Payer: BCN Commercial |
$3,164.62
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,071.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,480.75
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,866.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,562.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,497.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,603.60
|
| Rate for Payer: UHC Core |
$3,419.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,071.25
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,280.70 |
| Max. Negotiated Rate |
$1,889.86 |
| Rate for Payer: Aetna Commercial |
$1,784.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,622.76
|
| Rate for Payer: BCN Commercial |
$1,622.76
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,805.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Healthscope Commercial |
$1,889.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,574.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,784.87
|
| Rate for Payer: PHP Commercial |
$1,784.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,826.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,847.87
|
| Rate for Payer: UHC Core |
$1,753.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,574.89
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$498.71 |
| Max. Negotiated Rate |
$1,889.86 |
| Rate for Payer: Aetna Commercial |
$1,784.87
|
| Rate for Payer: Aetna Medicare |
$545.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.63
|
| Rate for Payer: BCN Commercial |
$1,632.63
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,805.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,889.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,574.89
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,784.87
|
| Rate for Payer: PACE Senior Care Partners |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$1,784.87
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,826.87
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,280.70
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,847.87
|
| Rate for Payer: UHC Core |
$1,753.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Medicare Advantage |
$540.71
|
| Rate for Payer: VA VA |
$524.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,574.89
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$111.61
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$100.45 |
| Rate for Payer: Aetna Commercial |
$94.87
|
| Rate for Payer: Aetna Medicare |
$29.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.88
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$27.90
|
| Rate for Payer: BCBS Trust/PPO |
$86.78
|
| Rate for Payer: BCN Commercial |
$86.78
|
| Rate for Payer: BCN Medicare Advantage |
$27.90
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.90
|
| Rate for Payer: Healthscope Commercial |
$100.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.71
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.87
|
| Rate for Payer: PACE Senior Care Partners |
$26.51
|
| Rate for Payer: PACE SWMI |
$27.90
|
| Rate for Payer: PHP Commercial |
$94.87
|
| Rate for Payer: PHP Medicare Advantage |
$27.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.10
|
| Rate for Payer: Priority Health Medicare |
$27.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$27.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.22
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$28.74
|
| Rate for Payer: VA VA |
$27.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.71
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
IP
|
$111.61
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$100.45 |
| Rate for Payer: Aetna Commercial |
$94.87
|
| Rate for Payer: BCBS Trust/PPO |
$86.25
|
| Rate for Payer: BCN Commercial |
$86.25
|
| Rate for Payer: Cash Price |
$89.29
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.29
|
| Rate for Payer: Healthscope Commercial |
$100.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.87
|
| Rate for Payer: PHP Commercial |
$94.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.22
|
| Rate for Payer: UHC Core |
$93.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.71
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
IP
|
$2,722.84
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETERAL STENT
|
Facility
|
OP
|
$2,722.84
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$952.43
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$226.20 |
| Max. Negotiated Rate |
$1,402.94 |
| Rate for Payer: Aetna Commercial |
$809.57
|
| Rate for Payer: Aetna Medicare |
$247.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.63
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$238.11
|
| Rate for Payer: BCBS Trust/PPO |
$740.51
|
| Rate for Payer: BCN Commercial |
$740.51
|
| Rate for Payer: BCN Medicare Advantage |
$238.11
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cofinity Commercial |
$819.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.11
|
| Rate for Payer: Healthscope Commercial |
$857.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$714.32
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$809.57
|
| Rate for Payer: PACE Senior Care Partners |
$226.20
|
| Rate for Payer: PACE SWMI |
$238.11
|
| Rate for Payer: PHP Commercial |
$809.57
|
| Rate for Payer: PHP Medicare Advantage |
$238.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.61
|
| Rate for Payer: Priority Health Medicare |
$238.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.89
|
| Rate for Payer: Railroad Medicare Medicare |
$238.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.14
|
| Rate for Payer: UHC Core |
$795.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.11
|
| Rate for Payer: UHC Medicare Advantage |
$245.25
|
| Rate for Payer: VA VA |
$238.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$714.32
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$952.43
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$580.89 |
| Max. Negotiated Rate |
$857.19 |
| Rate for Payer: Aetna Commercial |
$809.57
|
| Rate for Payer: BCBS Trust/PPO |
$736.04
|
| Rate for Payer: BCN Commercial |
$736.04
|
| Rate for Payer: Cash Price |
$761.94
|
| Rate for Payer: Cofinity Commercial |
$819.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.94
|
| Rate for Payer: Healthscope Commercial |
$857.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$714.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$809.57
|
| Rate for Payer: PHP Commercial |
$809.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$580.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$838.14
|
| Rate for Payer: UHC Core |
$795.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$714.32
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$906.53
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.30 |
| Max. Negotiated Rate |
$815.88 |
| Rate for Payer: Aetna Commercial |
$770.55
|
| Rate for Payer: Aetna Medicare |
$235.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.29
|
| Rate for Payer: BCBS Complete |
$470.52
|
| Rate for Payer: BCBS MAPPO |
$226.63
|
| Rate for Payer: BCBS Trust/PPO |
$704.83
|
| Rate for Payer: BCN Commercial |
$704.83
|
| Rate for Payer: BCN Medicare Advantage |
$226.63
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cofinity Commercial |
$779.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.63
|
| Rate for Payer: Healthscope Commercial |
$815.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.90
|
| Rate for Payer: Mclaren Medicaid |
$448.11
|
| Rate for Payer: Meridian Medicaid |
$470.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.55
|
| Rate for Payer: PACE Senior Care Partners |
$215.30
|
| Rate for Payer: PACE SWMI |
$226.63
|
| Rate for Payer: PHP Commercial |
$770.55
|
| Rate for Payer: PHP Medicare Advantage |
$226.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$448.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.68
|
| Rate for Payer: Priority Health Medicare |
$226.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.89
|
| Rate for Payer: Railroad Medicare Medicare |
$226.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.75
|
| Rate for Payer: UHC Core |
$756.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.63
|
| Rate for Payer: UHC Medicare Advantage |
$233.43
|
| Rate for Payer: VA VA |
$226.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.90
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$906.53
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$552.89 |
| Max. Negotiated Rate |
$815.88 |
| Rate for Payer: Aetna Commercial |
$770.55
|
| Rate for Payer: BCBS Trust/PPO |
$700.57
|
| Rate for Payer: BCN Commercial |
$700.57
|
| Rate for Payer: Cash Price |
$725.22
|
| Rate for Payer: Cofinity Commercial |
$779.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$725.22
|
| Rate for Payer: Healthscope Commercial |
$815.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.55
|
| Rate for Payer: PHP Commercial |
$770.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$788.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$797.75
|
| Rate for Payer: UHC Core |
$756.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.90
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,852.25
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$677.41 |
| Max. Negotiated Rate |
$2,567.02 |
| Rate for Payer: Aetna Commercial |
$2,424.41
|
| Rate for Payer: Aetna Medicare |
$741.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$891.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$891.33
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$713.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,217.62
|
| Rate for Payer: BCN Commercial |
$2,217.62
|
| Rate for Payer: BCN Medicare Advantage |
$713.06
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cofinity Commercial |
$2,452.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,281.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$713.06
|
| Rate for Payer: Healthscope Commercial |
$2,567.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,139.19
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$748.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,424.41
|
| Rate for Payer: PACE Senior Care Partners |
$677.41
|
| Rate for Payer: PACE SWMI |
$713.06
|
| Rate for Payer: PHP Commercial |
$2,424.41
|
| Rate for Payer: PHP Medicare Advantage |
$713.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,996.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,481.46
|
| Rate for Payer: Priority Health Medicare |
$713.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,739.59
|
| Rate for Payer: Railroad Medicare Medicare |
$713.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,509.98
|
| Rate for Payer: UHC Core |
$2,381.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$713.06
|
| Rate for Payer: UHC Medicare Advantage |
$734.45
|
| Rate for Payer: VA VA |
$713.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,139.19
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,852.25
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,739.59 |
| Max. Negotiated Rate |
$2,567.02 |
| Rate for Payer: Aetna Commercial |
$2,424.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.22
|
| Rate for Payer: BCN Commercial |
$2,204.22
|
| Rate for Payer: Cash Price |
$2,281.80
|
| Rate for Payer: Cofinity Commercial |
$2,452.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,281.80
|
| Rate for Payer: Healthscope Commercial |
$2,567.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,139.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,424.41
|
| Rate for Payer: PHP Commercial |
$2,424.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,996.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,481.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,739.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,509.98
|
| Rate for Payer: UHC Core |
$2,381.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,139.19
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,200.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,001.18 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,336.96
|
| Rate for Payer: BCN Commercial |
$6,336.96
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,200.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,947.50 |
| Max. Negotiated Rate |
$7,380.00 |
| Rate for Payer: Aetna Commercial |
$6,970.00
|
| Rate for Payer: Aetna Medicare |
$2,132.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,562.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,562.50
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$2,050.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,375.50
|
| Rate for Payer: BCN Commercial |
$6,375.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,050.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cash Price |
$6,560.00
|
| Rate for Payer: Cofinity Commercial |
$7,052.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,050.00
|
| Rate for Payer: Healthscope Commercial |
$7,380.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,150.00
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,152.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,357.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,970.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,947.50
|
| Rate for Payer: PACE SWMI |
$2,050.00
|
| Rate for Payer: PHP Commercial |
$6,970.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,050.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,740.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,134.00
|
| Rate for Payer: Priority Health Medicare |
$2,050.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,001.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,050.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,216.00
|
| Rate for Payer: UHC Core |
$6,847.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,050.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,111.50
|
| Rate for Payer: VA VA |
$2,050.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,150.00
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,473.72
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,728.52 |
| Max. Negotiated Rate |
$4,026.35 |
| Rate for Payer: Aetna Commercial |
$3,802.66
|
| Rate for Payer: BCBS Trust/PPO |
$3,457.29
|
| Rate for Payer: BCN Commercial |
$3,457.29
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cofinity Commercial |
$3,847.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,578.98
|
| Rate for Payer: Healthscope Commercial |
$4,026.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,355.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,802.66
|
| Rate for Payer: PHP Commercial |
$3,802.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,892.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,728.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,936.87
|
| Rate for Payer: UHC Core |
$3,735.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,355.29
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,473.72
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,062.51 |
| Max. Negotiated Rate |
$4,026.35 |
| Rate for Payer: Aetna Commercial |
$3,802.66
|
| Rate for Payer: Aetna Medicare |
$1,163.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,398.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,398.04
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$1,118.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,478.32
|
| Rate for Payer: BCN Commercial |
$3,478.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,118.43
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cash Price |
$3,578.98
|
| Rate for Payer: Cofinity Commercial |
$3,847.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,578.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,118.43
|
| Rate for Payer: Healthscope Commercial |
$4,026.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,355.29
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,174.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,286.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,802.66
|
| Rate for Payer: PACE Senior Care Partners |
$1,062.51
|
| Rate for Payer: PACE SWMI |
$1,118.43
|
| Rate for Payer: PHP Commercial |
$3,802.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,118.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,131.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,892.14
|
| Rate for Payer: Priority Health Medicare |
$1,118.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,728.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,118.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,936.87
|
| Rate for Payer: UHC Core |
$3,735.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,118.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,151.98
|
| Rate for Payer: VA VA |
$1,118.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,355.29
|
|
