|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.75
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$11.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PACE Senior Care Partners |
$10.45
|
| Rate for Payer: PACE SWMI |
$11.00
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: PHP Medicare Advantage |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.28
|
| Rate for Payer: Priority Health Medicare |
$11.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.84
|
| Rate for Payer: Railroad Medicare Medicare |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$11.33
|
| Rate for Payer: VA VA |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.91 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.69
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$7.75
|
| Rate for Payer: BCBS Trust/PPO |
$24.10
|
| Rate for Payer: BCN Commercial |
$24.10
|
| Rate for Payer: BCN Medicare Advantage |
$7.75
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.75
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PACE Senior Care Partners |
$7.36
|
| Rate for Payer: PACE SWMI |
$7.75
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Medicare |
$7.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.75
|
| Rate for Payer: UHC Medicare Advantage |
$7.98
|
| Rate for Payer: VA VA |
$7.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,004.99
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,188.69 |
| Max. Negotiated Rate |
$4,504.49 |
| Rate for Payer: Aetna Commercial |
$4,254.24
|
| Rate for Payer: Aetna Medicare |
$1,301.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,564.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,564.06
|
| Rate for Payer: BCBS Complete |
$1,256.10
|
| Rate for Payer: BCBS MAPPO |
$1,251.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,891.38
|
| Rate for Payer: BCN Commercial |
$3,891.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,251.25
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cofinity Commercial |
$4,304.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,003.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,251.25
|
| Rate for Payer: Healthscope Commercial |
$4,504.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,753.74
|
| Rate for Payer: Mclaren Medicaid |
$1,196.28
|
| Rate for Payer: Meridian Medicaid |
$1,256.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,313.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,438.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,254.24
|
| Rate for Payer: PACE Senior Care Partners |
$1,188.69
|
| Rate for Payer: PACE SWMI |
$1,251.25
|
| Rate for Payer: PHP Commercial |
$4,254.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,251.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,196.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,503.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,354.34
|
| Rate for Payer: Priority Health Medicare |
$1,251.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,052.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,251.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,404.39
|
| Rate for Payer: UHC Core |
$4,179.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,251.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,288.78
|
| Rate for Payer: VA VA |
$1,251.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,753.74
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,004.99
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,052.54 |
| Max. Negotiated Rate |
$4,504.49 |
| Rate for Payer: Aetna Commercial |
$4,254.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,867.86
|
| Rate for Payer: BCN Commercial |
$3,867.86
|
| Rate for Payer: Cash Price |
$4,003.99
|
| Rate for Payer: Cofinity Commercial |
$4,304.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,003.99
|
| Rate for Payer: Healthscope Commercial |
$4,504.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,753.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,254.24
|
| Rate for Payer: PHP Commercial |
$4,254.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,503.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,354.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,052.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,404.39
|
| Rate for Payer: UHC Core |
$4,179.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,753.74
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.84
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS MAPPO |
$8.67
|
| Rate for Payer: BCBS Trust/PPO |
$26.96
|
| Rate for Payer: BCN Commercial |
$26.96
|
| Rate for Payer: BCN Medicare Advantage |
$8.67
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.67
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Mclaren Medicaid |
$6.41
|
| Rate for Payer: Meridian Medicaid |
$6.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PACE Senior Care Partners |
$8.24
|
| Rate for Payer: PACE SWMI |
$8.67
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: PHP Medicare Advantage |
$8.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.17
|
| Rate for Payer: Priority Health Medicare |
$8.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.15
|
| Rate for Payer: Railroad Medicare Medicare |
$8.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.52
|
| Rate for Payer: UHC Core |
$28.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.67
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: VA VA |
$8.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.15 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: BCBS Trust/PPO |
$26.80
|
| Rate for Payer: BCN Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.52
|
| Rate for Payer: UHC Core |
$28.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC RENIN
|
Facility
|
IP
|
$40.70
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.82 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: BCBS Trust/PPO |
$31.45
|
| Rate for Payer: BCN Commercial |
$31.45
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$33.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
|
HC RENIN
|
Facility
|
OP
|
$40.70
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: Aetna Medicare |
$10.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$17.04
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCBS Trust/PPO |
$31.64
|
| Rate for Payer: BCN Commercial |
$31.64
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Mclaren Medicaid |
$16.23
|
| Rate for Payer: Meridian Medicaid |
$17.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.41
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.82
|
| Rate for Payer: UHC Core |
$33.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.18
|
| Rate for Payer: UHC Medicare Advantage |
$10.48
|
| Rate for Payer: VA VA |
$10.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.39
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Aetna Commercial |
$0.33
|
| Rate for Payer: Aetna Medicare |
$0.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.12
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: BCN Medicare Advantage |
$0.10
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.10
|
| Rate for Payer: Healthscope Commercial |
$0.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.33
|
| Rate for Payer: PACE Senior Care Partners |
$0.09
|
| Rate for Payer: PACE SWMI |
$0.10
|
| Rate for Payer: PHP Commercial |
$0.33
|
| Rate for Payer: PHP Medicare Advantage |
$0.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.34
|
| Rate for Payer: Priority Health Medicare |
$0.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.24
|
| Rate for Payer: Railroad Medicare Medicare |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Core |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.10
|
| Rate for Payer: UHC Medicare Advantage |
$0.10
|
| Rate for Payer: VA VA |
$0.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.29
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.39
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Aetna Commercial |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$0.30
|
| Rate for Payer: BCN Commercial |
$0.30
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.31
|
| Rate for Payer: Healthscope Commercial |
$0.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.33
|
| Rate for Payer: PHP Commercial |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Core |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.29
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,550.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$368.12 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Aetna Commercial |
$1,317.50
|
| Rate for Payer: Aetna Medicare |
$403.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$484.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$484.38
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$387.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.12
|
| Rate for Payer: BCN Commercial |
$1,205.12
|
| Rate for Payer: BCN Medicare Advantage |
$387.50
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.50
|
| Rate for Payer: Healthscope Commercial |
$1,395.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,162.50
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$406.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$445.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PACE Senior Care Partners |
$368.12
|
| Rate for Payer: PACE SWMI |
$387.50
|
| Rate for Payer: PHP Commercial |
$1,317.50
|
| Rate for Payer: PHP Medicare Advantage |
$387.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,348.50
|
| Rate for Payer: Priority Health Medicare |
$387.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.34
|
| Rate for Payer: Railroad Medicare Medicare |
$387.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.00
|
| Rate for Payer: UHC Core |
$1,294.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.50
|
| Rate for Payer: UHC Medicare Advantage |
$399.12
|
| Rate for Payer: VA VA |
$387.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,162.50
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,550.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$945.34 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Aetna Commercial |
$1,317.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.84
|
| Rate for Payer: BCN Commercial |
$1,197.84
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Healthscope Commercial |
$1,395.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,162.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PHP Commercial |
$1,317.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,348.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.00
|
| Rate for Payer: UHC Core |
$1,294.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,162.50
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,550.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$945.34 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Aetna Commercial |
$1,317.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.84
|
| Rate for Payer: BCN Commercial |
$1,197.84
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Healthscope Commercial |
$1,395.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,162.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PHP Commercial |
$1,317.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,348.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.00
|
| Rate for Payer: UHC Core |
$1,294.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,162.50
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,550.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$368.12 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Aetna Commercial |
$1,317.50
|
| Rate for Payer: Aetna Medicare |
$403.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$484.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$484.38
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$387.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.12
|
| Rate for Payer: BCN Commercial |
$1,205.12
|
| Rate for Payer: BCN Medicare Advantage |
$387.50
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cash Price |
$1,240.00
|
| Rate for Payer: Cofinity Commercial |
$1,333.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.50
|
| Rate for Payer: Healthscope Commercial |
$1,395.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,162.50
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$406.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$445.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,317.50
|
| Rate for Payer: PACE Senior Care Partners |
$368.12
|
| Rate for Payer: PACE SWMI |
$387.50
|
| Rate for Payer: PHP Commercial |
$1,317.50
|
| Rate for Payer: PHP Medicare Advantage |
$387.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,085.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,348.50
|
| Rate for Payer: Priority Health Medicare |
$387.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$945.34
|
| Rate for Payer: Railroad Medicare Medicare |
$387.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,364.00
|
| Rate for Payer: UHC Core |
$1,294.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.50
|
| Rate for Payer: UHC Medicare Advantage |
$399.12
|
| Rate for Payer: VA VA |
$387.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,162.50
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,630.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$387.12 |
| Max. Negotiated Rate |
$1,467.00 |
| Rate for Payer: Aetna Commercial |
$1,385.50
|
| Rate for Payer: Aetna Medicare |
$423.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$509.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$509.38
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$407.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,267.32
|
| Rate for Payer: BCN Commercial |
$1,267.32
|
| Rate for Payer: BCN Medicare Advantage |
$407.50
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,401.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,304.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.50
|
| Rate for Payer: Healthscope Commercial |
$1,467.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,222.50
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$427.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$468.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,385.50
|
| Rate for Payer: PACE Senior Care Partners |
$387.12
|
| Rate for Payer: PACE SWMI |
$407.50
|
| Rate for Payer: PHP Commercial |
$1,385.50
|
| Rate for Payer: PHP Medicare Advantage |
$407.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,418.10
|
| Rate for Payer: Priority Health Medicare |
$407.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$994.14
|
| Rate for Payer: Railroad Medicare Medicare |
$407.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,434.40
|
| Rate for Payer: UHC Core |
$1,361.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.50
|
| Rate for Payer: UHC Medicare Advantage |
$419.72
|
| Rate for Payer: VA VA |
$407.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,222.50
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,630.00
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$994.14 |
| Max. Negotiated Rate |
$1,467.00 |
| Rate for Payer: Aetna Commercial |
$1,385.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.66
|
| Rate for Payer: BCN Commercial |
$1,259.66
|
| Rate for Payer: Cash Price |
$1,304.00
|
| Rate for Payer: Cofinity Commercial |
$1,401.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,304.00
|
| Rate for Payer: Healthscope Commercial |
$1,467.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,222.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,385.50
|
| Rate for Payer: PHP Commercial |
$1,385.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,141.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,418.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$994.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,434.40
|
| Rate for Payer: UHC Core |
$1,361.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,222.50
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,048.38
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$639.41 |
| Max. Negotiated Rate |
$943.54 |
| Rate for Payer: Aetna Commercial |
$891.12
|
| Rate for Payer: BCBS Trust/PPO |
$810.19
|
| Rate for Payer: BCN Commercial |
$810.19
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$901.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Healthscope Commercial |
$943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$786.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$891.12
|
| Rate for Payer: PHP Commercial |
$891.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.57
|
| Rate for Payer: UHC Core |
$875.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$786.28
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,048.38
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$248.99 |
| Max. Negotiated Rate |
$943.54 |
| Rate for Payer: Aetna Commercial |
$891.12
|
| Rate for Payer: Aetna Medicare |
$272.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$327.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$327.62
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$262.10
|
| Rate for Payer: BCBS Trust/PPO |
$815.12
|
| Rate for Payer: BCN Commercial |
$815.12
|
| Rate for Payer: BCN Medicare Advantage |
$262.10
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$901.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.10
|
| Rate for Payer: Healthscope Commercial |
$943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$786.28
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$275.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$891.12
|
| Rate for Payer: PACE Senior Care Partners |
$248.99
|
| Rate for Payer: PACE SWMI |
$262.10
|
| Rate for Payer: PHP Commercial |
$891.12
|
| Rate for Payer: PHP Medicare Advantage |
$262.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.09
|
| Rate for Payer: Priority Health Medicare |
$262.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.41
|
| Rate for Payer: Railroad Medicare Medicare |
$262.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.57
|
| Rate for Payer: UHC Core |
$875.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.10
|
| Rate for Payer: UHC Medicare Advantage |
$269.96
|
| Rate for Payer: VA VA |
$262.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$786.28
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,132.31
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,520.30 |
| Max. Negotiated Rate |
$3,719.08 |
| Rate for Payer: Aetna Commercial |
$3,512.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,193.45
|
| Rate for Payer: BCN Commercial |
$3,193.45
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,553.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Healthscope Commercial |
$3,719.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,099.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: PHP Commercial |
$3,512.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,595.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,520.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,636.43
|
| Rate for Payer: UHC Core |
$3,450.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,099.23
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,132.31
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$981.42 |
| Max. Negotiated Rate |
$3,719.08 |
| Rate for Payer: Aetna Commercial |
$3,512.46
|
| Rate for Payer: Aetna Medicare |
$1,074.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,291.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,291.35
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$1,033.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,212.87
|
| Rate for Payer: BCN Commercial |
$3,212.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.08
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cash Price |
$3,305.85
|
| Rate for Payer: Cofinity Commercial |
$3,553.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,305.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.08
|
| Rate for Payer: Healthscope Commercial |
$3,719.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,099.23
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,084.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,188.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,512.46
|
| Rate for Payer: PACE Senior Care Partners |
$981.42
|
| Rate for Payer: PACE SWMI |
$1,033.08
|
| Rate for Payer: PHP Commercial |
$3,512.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,892.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,595.11
|
| Rate for Payer: Priority Health Medicare |
$1,033.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,520.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,033.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,636.43
|
| Rate for Payer: UHC Core |
$3,450.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,064.07
|
| Rate for Payer: VA VA |
$1,033.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,099.23
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,207.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,566.33 |
| Max. Negotiated Rate |
$3,787.01 |
| Rate for Payer: Aetna Commercial |
$3,576.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,251.78
|
| Rate for Payer: BCN Commercial |
$3,251.78
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cofinity Commercial |
$3,618.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,366.23
|
| Rate for Payer: Healthscope Commercial |
$3,787.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,155.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,576.62
|
| Rate for Payer: PHP Commercial |
$3,576.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,945.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,660.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,566.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,702.86
|
| Rate for Payer: UHC Core |
$3,513.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,155.84
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,207.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$999.35 |
| Max. Negotiated Rate |
$3,787.01 |
| Rate for Payer: Aetna Commercial |
$3,576.62
|
| Rate for Payer: Aetna Medicare |
$1,094.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,314.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,314.93
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$1,051.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,271.56
|
| Rate for Payer: BCN Commercial |
$3,271.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,051.95
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cash Price |
$3,366.23
|
| Rate for Payer: Cofinity Commercial |
$3,618.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,366.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,051.95
|
| Rate for Payer: Healthscope Commercial |
$3,787.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,155.84
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,104.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,209.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,576.62
|
| Rate for Payer: PACE Senior Care Partners |
$999.35
|
| Rate for Payer: PACE SWMI |
$1,051.95
|
| Rate for Payer: PHP Commercial |
$3,576.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,051.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,945.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,660.78
|
| Rate for Payer: Priority Health Medicare |
$1,051.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,566.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,051.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,702.86
|
| Rate for Payer: UHC Core |
$3,513.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,051.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.51
|
| Rate for Payer: VA VA |
$1,051.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,155.84
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,789.72
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,137.56 |
| Max. Negotiated Rate |
$4,310.75 |
| Rate for Payer: Aetna Commercial |
$4,071.26
|
| Rate for Payer: Aetna Medicare |
$1,245.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,496.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,496.79
|
| Rate for Payer: BCBS Complete |
$2,704.89
|
| Rate for Payer: BCBS MAPPO |
$1,197.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,724.01
|
| Rate for Payer: BCN Commercial |
$3,724.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,197.43
|
| Rate for Payer: Cash Price |
$3,831.78
|
| Rate for Payer: Cash Price |
$3,831.78
|
| Rate for Payer: Cofinity Commercial |
$4,119.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,831.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,197.43
|
| Rate for Payer: Healthscope Commercial |
$4,310.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,592.29
|
| Rate for Payer: Mclaren Medicaid |
$2,576.08
|
| Rate for Payer: Meridian Medicaid |
$2,704.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,257.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,377.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,071.26
|
| Rate for Payer: PACE Senior Care Partners |
$1,137.56
|
| Rate for Payer: PACE SWMI |
$1,197.43
|
| Rate for Payer: PHP Commercial |
$4,071.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,197.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,576.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,167.06
|
| Rate for Payer: Priority Health Medicare |
$1,197.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,921.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,197.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,214.95
|
| Rate for Payer: UHC Core |
$3,999.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,197.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,233.35
|
| Rate for Payer: VA VA |
$1,197.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,592.29
|
|
