|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,113.91 |
| Max. Negotiated Rate |
$1,440.40 |
| Rate for Payer: Aetna Commercial |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.80
|
| Rate for Payer: BCN Commercial |
$1,321.80
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Commercial |
$1,376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Healthscope Commercial |
$1,440.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$1,312.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: PHP Commercial |
$1,360.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.39
|
| Rate for Payer: UHC Core |
$1,336.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.33
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$282.16 |
| Max. Negotiated Rate |
$1,440.40 |
| Rate for Payer: Aetna Commercial |
$1,360.37
|
| Rate for Payer: Aetna Medicare |
$416.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$500.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$500.14
|
| Rate for Payer: BCBS Complete |
$296.24
|
| Rate for Payer: BCBS MAPPO |
$400.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.72
|
| Rate for Payer: BCN Commercial |
$1,315.72
|
| Rate for Payer: BCN Medicare Advantage |
$400.11
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Commercial |
$1,376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.11
|
| Rate for Payer: Healthscope Commercial |
$1,440.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.33
|
| Rate for Payer: Mclaren Medicaid |
$282.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.12
|
| Rate for Payer: Meridian Medicaid |
$296.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$1,312.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: PACE Senior Care Partners |
$380.10
|
| Rate for Payer: PACE SWMI |
$400.11
|
| Rate for Payer: PHP Commercial |
$1,360.37
|
| Rate for Payer: PHP Medicare Advantage |
$400.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.38
|
| Rate for Payer: Priority Health Medicare |
$404.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.91
|
| Rate for Payer: Railroad Medicare Medicare |
$400.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.39
|
| Rate for Payer: UHC Core |
$1,336.37
|
| Rate for Payer: UHC Exchange |
$400.11
|
| Rate for Payer: UHC Medicaid |
$282.16
|
| Rate for Payer: UHC Medicare Advantage |
$400.11
|
| Rate for Payer: UHCCP Medicaid |
$282.16
|
| Rate for Payer: VA VA |
$400.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.33
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$215.33 |
| Max. Negotiated Rate |
$1,099.26 |
| Rate for Payer: Aetna Commercial |
$1,038.19
|
| Rate for Payer: Aetna Medicare |
$317.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.69
|
| Rate for Payer: BCBS Complete |
$226.08
|
| Rate for Payer: BCBS MAPPO |
$305.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,004.11
|
| Rate for Payer: BCN Commercial |
$1,004.11
|
| Rate for Payer: BCN Medicare Advantage |
$305.35
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Commercial |
$1,050.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.35
|
| Rate for Payer: Healthscope Commercial |
$1,099.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.05
|
| Rate for Payer: Mclaren Medicaid |
$215.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.62
|
| Rate for Payer: Meridian Medicaid |
$226.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Nomi Health Commercial |
$1,001.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: PACE Senior Care Partners |
$290.08
|
| Rate for Payer: PACE SWMI |
$305.35
|
| Rate for Payer: PHP Commercial |
$1,038.19
|
| Rate for Payer: PHP Medicare Advantage |
$305.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,062.62
|
| Rate for Payer: Priority Health Medicare |
$308.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.09
|
| Rate for Payer: Railroad Medicare Medicare |
$305.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.83
|
| Rate for Payer: UHC Core |
$1,019.87
|
| Rate for Payer: UHC Exchange |
$305.35
|
| Rate for Payer: UHC Medicaid |
$215.33
|
| Rate for Payer: UHC Medicare Advantage |
$305.35
|
| Rate for Payer: UHCCP Medicaid |
$215.33
|
| Rate for Payer: VA VA |
$305.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.05
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$850.09 |
| Max. Negotiated Rate |
$1,099.26 |
| Rate for Payer: Aetna Commercial |
$1,038.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.75
|
| Rate for Payer: BCN Commercial |
$1,008.75
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Commercial |
$1,050.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Healthscope Commercial |
$1,099.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Nomi Health Commercial |
$1,001.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: PHP Commercial |
$1,038.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,062.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,074.83
|
| Rate for Payer: UHC Core |
$1,019.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.47 |
| Max. Negotiated Rate |
$1,288.85 |
| Rate for Payer: Aetna Commercial |
$1,217.25
|
| Rate for Payer: Aetna Medicare |
$372.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$447.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$447.52
|
| Rate for Payer: BCBS Complete |
$265.07
|
| Rate for Payer: BCBS MAPPO |
$358.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,177.30
|
| Rate for Payer: BCN Commercial |
$1,177.30
|
| Rate for Payer: BCN Medicare Advantage |
$358.01
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Commercial |
$1,231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.01
|
| Rate for Payer: Healthscope Commercial |
$1,288.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.05
|
| Rate for Payer: Mclaren Medicaid |
$252.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.92
|
| Rate for Payer: Meridian Medicaid |
$265.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$411.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$393.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Nomi Health Commercial |
$1,174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: PACE Senior Care Partners |
$340.11
|
| Rate for Payer: PACE SWMI |
$358.01
|
| Rate for Payer: PHP Commercial |
$1,217.25
|
| Rate for Payer: PHP Medicare Advantage |
$358.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,245.89
|
| Rate for Payer: Priority Health Medicare |
$361.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$996.71
|
| Rate for Payer: Railroad Medicare Medicare |
$358.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,260.21
|
| Rate for Payer: UHC Core |
$1,195.77
|
| Rate for Payer: UHC Exchange |
$358.01
|
| Rate for Payer: UHC Medicaid |
$252.47
|
| Rate for Payer: UHC Medicare Advantage |
$358.01
|
| Rate for Payer: UHCCP Medicaid |
$252.47
|
| Rate for Payer: VA VA |
$358.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$996.71 |
| Max. Negotiated Rate |
$1,288.85 |
| Rate for Payer: Aetna Commercial |
$1,217.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.74
|
| Rate for Payer: BCN Commercial |
$1,182.74
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Commercial |
$1,231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Healthscope Commercial |
$1,288.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Nomi Health Commercial |
$1,174.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: PHP Commercial |
$1,217.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,245.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$996.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,260.21
|
| Rate for Payer: UHC Core |
$1,195.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.58 |
| Max. Negotiated Rate |
$1,105.64 |
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: Aetna Medicare |
$319.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$383.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$383.90
|
| Rate for Payer: BCBS Complete |
$227.39
|
| Rate for Payer: BCBS MAPPO |
$307.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.94
|
| Rate for Payer: BCN Commercial |
$1,009.94
|
| Rate for Payer: BCN Medicare Advantage |
$307.12
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.12
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Mclaren Medicaid |
$216.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.48
|
| Rate for Payer: Meridian Medicaid |
$227.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$337.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PACE Senior Care Partners |
$291.77
|
| Rate for Payer: PACE SWMI |
$307.12
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: PHP Medicare Advantage |
$307.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,068.79
|
| Rate for Payer: Priority Health Medicare |
$310.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$855.03
|
| Rate for Payer: Railroad Medicare Medicare |
$307.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.07
|
| Rate for Payer: UHC Core |
$1,025.79
|
| Rate for Payer: UHC Exchange |
$307.12
|
| Rate for Payer: UHC Medicaid |
$216.58
|
| Rate for Payer: UHC Medicare Advantage |
$307.12
|
| Rate for Payer: UHCCP Medicaid |
$216.58
|
| Rate for Payer: VA VA |
$307.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$855.03 |
| Max. Negotiated Rate |
$1,105.64 |
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.61
|
| Rate for Payer: BCN Commercial |
$1,014.61
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,068.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$855.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.07
|
| Rate for Payer: UHC Core |
$1,025.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.19 |
| Max. Negotiated Rate |
$1,369.12 |
| Rate for Payer: Aetna Commercial |
$1,293.05
|
| Rate for Payer: Aetna Medicare |
$395.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.39
|
| Rate for Payer: BCBS Complete |
$281.58
|
| Rate for Payer: BCBS MAPPO |
$380.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.61
|
| Rate for Payer: BCN Commercial |
$1,250.61
|
| Rate for Payer: BCN Medicare Advantage |
$380.31
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Commercial |
$1,308.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.31
|
| Rate for Payer: Healthscope Commercial |
$1,369.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,140.93
|
| Rate for Payer: Mclaren Medicaid |
$268.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.33
|
| Rate for Payer: Meridian Medicaid |
$281.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Nomi Health Commercial |
$1,247.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: PACE Senior Care Partners |
$361.29
|
| Rate for Payer: PACE SWMI |
$380.31
|
| Rate for Payer: PHP Commercial |
$1,293.05
|
| Rate for Payer: PHP Medicare Advantage |
$380.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,323.48
|
| Rate for Payer: Priority Health Medicare |
$384.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,058.78
|
| Rate for Payer: Railroad Medicare Medicare |
$380.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.69
|
| Rate for Payer: UHC Core |
$1,270.24
|
| Rate for Payer: UHC Exchange |
$380.31
|
| Rate for Payer: UHC Medicaid |
$268.19
|
| Rate for Payer: UHC Medicare Advantage |
$380.31
|
| Rate for Payer: UHCCP Medicaid |
$268.19
|
| Rate for Payer: VA VA |
$380.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,140.93
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,058.78 |
| Max. Negotiated Rate |
$1,369.12 |
| Rate for Payer: Aetna Commercial |
$1,293.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,256.39
|
| Rate for Payer: BCN Commercial |
$1,256.39
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Commercial |
$1,308.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Healthscope Commercial |
$1,369.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,140.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Nomi Health Commercial |
$1,247.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: PHP Commercial |
$1,293.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,323.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,058.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,338.69
|
| Rate for Payer: UHC Core |
$1,270.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,140.93
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$204.65 |
| Max. Negotiated Rate |
$1,044.73 |
| Rate for Payer: Aetna Commercial |
$986.69
|
| Rate for Payer: Aetna Commercial |
$657.79
|
| Rate for Payer: Aetna Medicare |
$201.21
|
| Rate for Payer: Aetna Medicare |
$301.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$241.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$241.83
|
| Rate for Payer: BCBS Complete |
$214.87
|
| Rate for Payer: BCBS Complete |
$143.24
|
| Rate for Payer: BCBS MAPPO |
$290.20
|
| Rate for Payer: BCBS MAPPO |
$193.47
|
| Rate for Payer: BCBS Trust/PPO |
$954.30
|
| Rate for Payer: BCBS Trust/PPO |
$636.20
|
| Rate for Payer: BCN Commercial |
$636.20
|
| Rate for Payer: BCN Commercial |
$954.30
|
| Rate for Payer: BCN Medicare Advantage |
$193.47
|
| Rate for Payer: BCN Medicare Advantage |
$290.20
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cofinity Commercial |
$998.30
|
| Rate for Payer: Cofinity Commercial |
$665.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.20
|
| Rate for Payer: Healthscope Commercial |
$1,044.73
|
| Rate for Payer: Healthscope Commercial |
$696.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.40
|
| Rate for Payer: Mclaren Medicaid |
$136.43
|
| Rate for Payer: Mclaren Medicaid |
$204.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$304.71
|
| Rate for Payer: Meridian Medicaid |
$214.87
|
| Rate for Payer: Meridian Medicaid |
$143.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$212.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$319.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Nomi Health Commercial |
$634.57
|
| Rate for Payer: Nomi Health Commercial |
$951.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: PACE Senior Care Partners |
$183.79
|
| Rate for Payer: PACE Senior Care Partners |
$275.69
|
| Rate for Payer: PACE SWMI |
$193.47
|
| Rate for Payer: PACE SWMI |
$290.20
|
| Rate for Payer: PHP Commercial |
$986.69
|
| Rate for Payer: PHP Commercial |
$657.79
|
| Rate for Payer: PHP Medicare Advantage |
$290.20
|
| Rate for Payer: PHP Medicare Advantage |
$193.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$673.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,009.90
|
| Rate for Payer: Priority Health Medicare |
$195.40
|
| Rate for Payer: Priority Health Medicare |
$293.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$807.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$538.61
|
| Rate for Payer: Railroad Medicare Medicare |
$290.20
|
| Rate for Payer: Railroad Medicare Medicare |
$193.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.01
|
| Rate for Payer: UHC Core |
$646.18
|
| Rate for Payer: UHC Core |
$969.28
|
| Rate for Payer: UHC Exchange |
$193.47
|
| Rate for Payer: UHC Exchange |
$290.20
|
| Rate for Payer: UHC Medicaid |
$136.43
|
| Rate for Payer: UHC Medicaid |
$204.65
|
| Rate for Payer: UHC Medicare Advantage |
$290.20
|
| Rate for Payer: UHC Medicare Advantage |
$193.47
|
| Rate for Payer: UHCCP Medicaid |
$204.65
|
| Rate for Payer: UHCCP Medicaid |
$136.43
|
| Rate for Payer: VA VA |
$290.20
|
| Rate for Payer: VA VA |
$193.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.61
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$807.92 |
| Max. Negotiated Rate |
$1,044.73 |
| Rate for Payer: Aetna Commercial |
$986.69
|
| Rate for Payer: Aetna Commercial |
$657.79
|
| Rate for Payer: BCBS Trust/PPO |
$958.71
|
| Rate for Payer: BCBS Trust/PPO |
$639.14
|
| Rate for Payer: BCN Commercial |
$958.71
|
| Rate for Payer: BCN Commercial |
$639.14
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cofinity Commercial |
$665.53
|
| Rate for Payer: Cofinity Commercial |
$998.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Healthscope Commercial |
$1,044.73
|
| Rate for Payer: Healthscope Commercial |
$696.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Nomi Health Commercial |
$951.86
|
| Rate for Payer: Nomi Health Commercial |
$634.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: PHP Commercial |
$657.79
|
| Rate for Payer: PHP Commercial |
$986.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$673.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,009.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$807.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$538.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,021.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$681.01
|
| Rate for Payer: UHC Core |
$969.28
|
| Rate for Payer: UHC Core |
$646.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.40
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$124.16 |
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: Aetna Medicare |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.11
|
| Rate for Payer: BCBS Complete |
$25.54
|
| Rate for Payer: BCBS MAPPO |
$34.49
|
| Rate for Payer: BCBS Trust/PPO |
$113.42
|
| Rate for Payer: BCN Commercial |
$113.42
|
| Rate for Payer: BCN Medicare Advantage |
$34.49
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.49
|
| Rate for Payer: Healthscope Commercial |
$124.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.47
|
| Rate for Payer: Mclaren Medicaid |
$24.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.21
|
| Rate for Payer: Meridian Medicaid |
$25.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: PACE Senior Care Partners |
$32.77
|
| Rate for Payer: PACE SWMI |
$34.49
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: PHP Medicare Advantage |
$34.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.03
|
| Rate for Payer: Priority Health Medicare |
$34.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.02
|
| Rate for Payer: Railroad Medicare Medicare |
$34.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.40
|
| Rate for Payer: UHC Core |
$115.20
|
| Rate for Payer: UHC Exchange |
$34.49
|
| Rate for Payer: UHC Medicaid |
$24.32
|
| Rate for Payer: UHC Medicare Advantage |
$34.49
|
| Rate for Payer: UHCCP Medicaid |
$24.32
|
| Rate for Payer: VA VA |
$34.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.47
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$96.02 |
| Max. Negotiated Rate |
$124.16 |
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: BCBS Trust/PPO |
$113.94
|
| Rate for Payer: BCN Commercial |
$113.94
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Healthscope Commercial |
$124.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.40
|
| Rate for Payer: UHC Core |
$115.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.47
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$252.54 |
| Rate for Payer: Aetna Commercial |
$238.51
|
| Rate for Payer: BCBS Trust/PPO |
$231.75
|
| Rate for Payer: BCN Commercial |
$231.75
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Healthscope Commercial |
$252.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Nomi Health Commercial |
$230.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: PHP Commercial |
$238.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.93
|
| Rate for Payer: UHC Core |
$234.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.45
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
OP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$49.47 |
| Max. Negotiated Rate |
$252.54 |
| Rate for Payer: Aetna Commercial |
$238.51
|
| Rate for Payer: Aetna Medicare |
$72.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.69
|
| Rate for Payer: BCBS Complete |
$51.94
|
| Rate for Payer: BCBS MAPPO |
$70.15
|
| Rate for Payer: BCBS Trust/PPO |
$230.68
|
| Rate for Payer: BCN Commercial |
$230.68
|
| Rate for Payer: BCN Medicare Advantage |
$70.15
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.15
|
| Rate for Payer: Healthscope Commercial |
$252.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.45
|
| Rate for Payer: Mclaren Medicaid |
$49.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.66
|
| Rate for Payer: Meridian Medicaid |
$51.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Nomi Health Commercial |
$230.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: PACE Senior Care Partners |
$66.64
|
| Rate for Payer: PACE SWMI |
$70.15
|
| Rate for Payer: PHP Commercial |
$238.51
|
| Rate for Payer: PHP Medicare Advantage |
$70.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.12
|
| Rate for Payer: Priority Health Medicare |
$70.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.30
|
| Rate for Payer: Railroad Medicare Medicare |
$70.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.93
|
| Rate for Payer: UHC Core |
$234.30
|
| Rate for Payer: UHC Exchange |
$70.15
|
| Rate for Payer: UHC Medicaid |
$49.47
|
| Rate for Payer: UHC Medicare Advantage |
$70.15
|
| Rate for Payer: UHCCP Medicaid |
$49.47
|
| Rate for Payer: VA VA |
$70.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.45
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,433.90 |
| Max. Negotiated Rate |
$10,905.90 |
| Rate for Payer: Aetna Commercial |
$10,300.02
|
| Rate for Payer: BCBS Trust/PPO |
$10,007.98
|
| Rate for Payer: BCN Commercial |
$10,007.98
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Commercial |
$10,421.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Healthscope Commercial |
$10,905.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,088.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Nomi Health Commercial |
$9,936.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: PHP Commercial |
$10,300.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,542.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,433.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,663.55
|
| Rate for Payer: UHC Core |
$10,118.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,088.25
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,136.35 |
| Max. Negotiated Rate |
$10,905.90 |
| Rate for Payer: Aetna Commercial |
$10,300.02
|
| Rate for Payer: Aetna Medicare |
$3,150.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,786.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,786.77
|
| Rate for Payer: BCBS Complete |
$2,242.98
|
| Rate for Payer: BCBS MAPPO |
$3,029.42
|
| Rate for Payer: BCBS Trust/PPO |
$9,961.94
|
| Rate for Payer: BCN Commercial |
$9,961.94
|
| Rate for Payer: BCN Medicare Advantage |
$3,029.42
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Commercial |
$10,421.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,029.42
|
| Rate for Payer: Healthscope Commercial |
$10,905.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,088.25
|
| Rate for Payer: Mclaren Medicaid |
$2,136.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,180.89
|
| Rate for Payer: Meridian Medicaid |
$2,242.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,483.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,332.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Nomi Health Commercial |
$9,936.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: PACE Senior Care Partners |
$2,877.95
|
| Rate for Payer: PACE SWMI |
$3,029.42
|
| Rate for Payer: PHP Commercial |
$10,300.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,029.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,136.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,542.37
|
| Rate for Payer: Priority Health Medicare |
$3,059.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,433.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,029.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,663.55
|
| Rate for Payer: UHC Core |
$10,118.25
|
| Rate for Payer: UHC Exchange |
$3,029.42
|
| Rate for Payer: UHC Medicaid |
$2,136.35
|
| Rate for Payer: UHC Medicare Advantage |
$3,029.42
|
| Rate for Payer: UHCCP Medicaid |
$2,136.35
|
| Rate for Payer: VA VA |
$3,029.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,088.25
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$347.05 |
| Max. Negotiated Rate |
$1,771.69 |
| Rate for Payer: Aetna Commercial |
$1,673.26
|
| Rate for Payer: Aetna Medicare |
$511.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$615.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$615.17
|
| Rate for Payer: BCBS Complete |
$364.38
|
| Rate for Payer: BCBS MAPPO |
$492.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,618.34
|
| Rate for Payer: BCN Commercial |
$1,618.34
|
| Rate for Payer: BCN Medicare Advantage |
$492.13
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Commercial |
$1,692.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.13
|
| Rate for Payer: Healthscope Commercial |
$1,771.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.40
|
| Rate for Payer: Mclaren Medicaid |
$347.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$516.74
|
| Rate for Payer: Meridian Medicaid |
$364.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$565.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$541.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Nomi Health Commercial |
$1,614.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: PACE Senior Care Partners |
$467.53
|
| Rate for Payer: PACE SWMI |
$492.13
|
| Rate for Payer: PHP Commercial |
$1,673.26
|
| Rate for Payer: PHP Medicare Advantage |
$492.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,712.63
|
| Rate for Payer: Priority Health Medicare |
$497.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,370.10
|
| Rate for Payer: Railroad Medicare Medicare |
$492.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.32
|
| Rate for Payer: UHC Core |
$1,643.73
|
| Rate for Payer: UHC Exchange |
$492.13
|
| Rate for Payer: UHC Medicaid |
$347.05
|
| Rate for Payer: UHC Medicare Advantage |
$492.13
|
| Rate for Payer: UHCCP Medicaid |
$347.05
|
| Rate for Payer: VA VA |
$492.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.40
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,370.10 |
| Max. Negotiated Rate |
$1,771.69 |
| Rate for Payer: Aetna Commercial |
$1,673.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.82
|
| Rate for Payer: BCN Commercial |
$1,625.82
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Commercial |
$1,692.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Healthscope Commercial |
$1,771.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Nomi Health Commercial |
$1,614.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: PHP Commercial |
$1,673.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,712.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,370.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.32
|
| Rate for Payer: UHC Core |
$1,643.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.40
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare |
$18.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.89
|
| Rate for Payer: BCBS Complete |
$12.96
|
| Rate for Payer: BCBS MAPPO |
$17.51
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$57.58
|
| Rate for Payer: BCN Medicare Advantage |
$17.51
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.51
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Mclaren Medicaid |
$12.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.39
|
| Rate for Payer: Meridian Medicaid |
$12.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Senior Care Partners |
$16.63
|
| Rate for Payer: PACE SWMI |
$17.51
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: PHP Medicare Advantage |
$17.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Medicare |
$17.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: Railroad Medicare Medicare |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: UHC Exchange |
$17.51
|
| Rate for Payer: UHC Medicaid |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
| Rate for Payer: VA VA |
$17.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: BCBS Trust/PPO |
$57.85
|
| Rate for Payer: BCN Commercial |
$57.85
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
