|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
IP
|
$592.06
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$384.84 |
| Max. Negotiated Rate |
$532.85 |
| Rate for Payer: Aetna Commercial |
$503.25
|
| Rate for Payer: BCBS Trust/PPO |
$483.30
|
| Rate for Payer: BCN Commercial |
$457.54
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cofinity Commercial |
$509.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.65
|
| Rate for Payer: Healthscope Commercial |
$532.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.25
|
| Rate for Payer: Nomi Health Commercial |
$485.49
|
| Rate for Payer: PHP Commercial |
$503.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.84
|
| Rate for Payer: Priority Health HMO/PPO |
$515.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.01
|
| Rate for Payer: UHC Core |
$494.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.04
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
OP
|
$592.06
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.89 |
| Max. Negotiated Rate |
$532.85 |
| Rate for Payer: Aetna Commercial |
$503.25
|
| Rate for Payer: Aetna Medicare |
$153.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.02
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$148.02
|
| Rate for Payer: BCBS Trust/PPO |
$486.73
|
| Rate for Payer: BCCCP Commercial |
$64.89
|
| Rate for Payer: BCN Commercial |
$460.33
|
| Rate for Payer: BCN Medicare Advantage |
$148.02
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cofinity Commercial |
$509.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.02
|
| Rate for Payer: Healthscope Commercial |
$532.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.04
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.42
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.25
|
| Rate for Payer: Nomi Health Commercial |
$485.49
|
| Rate for Payer: PACE Senior Care Partners |
$140.61
|
| Rate for Payer: PACE SWMI |
$148.02
|
| Rate for Payer: PHP Commercial |
$503.25
|
| Rate for Payer: PHP Medicare Advantage |
$148.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.84
|
| Rate for Payer: Priority Health HMO/PPO |
$515.09
|
| Rate for Payer: Priority Health Medicare |
$149.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.68
|
| Rate for Payer: Railroad Medicare Medicare |
$148.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.01
|
| Rate for Payer: UHC Core |
$494.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.02
|
| Rate for Payer: UHC Exchange |
$148.02
|
| Rate for Payer: UHC Medicare Advantage |
$148.02
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$148.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.04
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
IP
|
$714.47
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$464.41 |
| Max. Negotiated Rate |
$643.02 |
| Rate for Payer: Aetna Commercial |
$607.30
|
| Rate for Payer: BCBS Trust/PPO |
$583.22
|
| Rate for Payer: BCN Commercial |
$552.14
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$614.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.58
|
| Rate for Payer: Healthscope Commercial |
$643.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.30
|
| Rate for Payer: Nomi Health Commercial |
$585.87
|
| Rate for Payer: PHP Commercial |
$607.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.41
|
| Rate for Payer: Priority Health HMO/PPO |
$621.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.73
|
| Rate for Payer: UHC Core |
$596.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.85
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
OP
|
$714.47
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$50.35 |
| Max. Negotiated Rate |
$643.02 |
| Rate for Payer: Aetna Commercial |
$607.30
|
| Rate for Payer: Aetna Medicare |
$185.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.27
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$178.62
|
| Rate for Payer: BCBS Trust/PPO |
$587.37
|
| Rate for Payer: BCCCP Commercial |
$50.35
|
| Rate for Payer: BCN Commercial |
$555.50
|
| Rate for Payer: BCN Medicare Advantage |
$178.62
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$614.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.62
|
| Rate for Payer: Healthscope Commercial |
$643.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.85
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.55
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.30
|
| Rate for Payer: Nomi Health Commercial |
$585.87
|
| Rate for Payer: PACE Senior Care Partners |
$169.69
|
| Rate for Payer: PACE SWMI |
$178.62
|
| Rate for Payer: PHP Commercial |
$607.30
|
| Rate for Payer: PHP Medicare Advantage |
$178.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.41
|
| Rate for Payer: Priority Health HMO/PPO |
$621.59
|
| Rate for Payer: Priority Health Medicare |
$180.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.69
|
| Rate for Payer: Railroad Medicare Medicare |
$178.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.73
|
| Rate for Payer: UHC Core |
$596.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.62
|
| Rate for Payer: UHC Exchange |
$178.62
|
| Rate for Payer: UHC Medicare Advantage |
$178.62
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$178.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.85
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.70 |
| Max. Negotiated Rate |
$75.74 |
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$68.69
|
| Rate for Payer: BCN Commercial |
$65.03
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$75.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: Nomi Health Commercial |
$69.00
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health HMO/PPO |
$73.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.05
|
| Rate for Payer: UHC Core |
$70.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$75.74 |
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: Aetna Medicare |
$21.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.30
|
| Rate for Payer: BCBS Complete |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$21.04
|
| Rate for Payer: BCBS Trust/PPO |
$69.18
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$21.04
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.04
|
| Rate for Payer: Healthscope Commercial |
$75.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: Nomi Health Commercial |
$69.00
|
| Rate for Payer: PACE Senior Care Partners |
$19.99
|
| Rate for Payer: PACE SWMI |
$21.04
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: PHP Medicare Advantage |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health HMO/PPO |
$73.21
|
| Rate for Payer: Priority Health Medicare |
$21.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: Railroad Medicare Medicare |
$21.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.05
|
| Rate for Payer: UHC Core |
$70.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.04
|
| Rate for Payer: UHC Exchange |
$21.04
|
| Rate for Payer: UHC Medicare Advantage |
$21.04
|
| Rate for Payer: VA VA |
$21.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$969.00 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna Medicare |
$1,060.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,275.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,275.00
|
| Rate for Payer: BCBS Complete |
$1,190.46
|
| Rate for Payer: BCBS MAPPO |
$1,020.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,354.17
|
| Rate for Payer: BCN Commercial |
$3,172.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Mclaren Medicaid |
$1,133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.00
|
| Rate for Payer: Meridian Medicaid |
$1,190.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,173.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: PACE Senior Care Partners |
$969.00
|
| Rate for Payer: PACE SWMI |
$1,020.00
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,133.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,549.60
|
| Rate for Payer: Priority Health Medicare |
$1,030.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,590.40
|
| Rate for Payer: UHC Core |
$3,406.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,020.00
|
| Rate for Payer: UHC Exchange |
$1,020.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,020.00
|
| Rate for Payer: UHCCP Medicaid |
$1,133.70
|
| Rate for Payer: VA VA |
$1,020.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,652.00 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,330.50
|
| Rate for Payer: BCN Commercial |
$3,153.02
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,549.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,590.40
|
| Rate for Payer: UHC Core |
$3,406.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$494.19
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$444.77 |
| Rate for Payer: Aetna Commercial |
$420.06
|
| Rate for Payer: Aetna Medicare |
$128.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.43
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$123.55
|
| Rate for Payer: BCBS Trust/PPO |
$406.27
|
| Rate for Payer: BCN Commercial |
$384.23
|
| Rate for Payer: BCN Medicare Advantage |
$123.55
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cofinity Commercial |
$425.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.55
|
| Rate for Payer: Healthscope Commercial |
$444.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.64
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.72
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.06
|
| Rate for Payer: Nomi Health Commercial |
$405.24
|
| Rate for Payer: PACE Senior Care Partners |
$117.37
|
| Rate for Payer: PACE SWMI |
$123.55
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: PHP Medicare Advantage |
$123.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.22
|
| Rate for Payer: Priority Health HMO/PPO |
$429.95
|
| Rate for Payer: Priority Health Medicare |
$124.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.11
|
| Rate for Payer: Railroad Medicare Medicare |
$123.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.89
|
| Rate for Payer: UHC Core |
$412.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.55
|
| Rate for Payer: UHC Exchange |
$123.55
|
| Rate for Payer: UHC Medicare Advantage |
$123.55
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$123.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.64
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$494.19
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.22 |
| Max. Negotiated Rate |
$444.77 |
| Rate for Payer: Aetna Commercial |
$420.06
|
| Rate for Payer: BCBS Trust/PPO |
$403.41
|
| Rate for Payer: BCN Commercial |
$381.91
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cofinity Commercial |
$425.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.35
|
| Rate for Payer: Healthscope Commercial |
$444.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.06
|
| Rate for Payer: Nomi Health Commercial |
$405.24
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.22
|
| Rate for Payer: Priority Health HMO/PPO |
$429.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.89
|
| Rate for Payer: UHC Core |
$412.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.64
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,492.97
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$970.43 |
| Max. Negotiated Rate |
$1,343.67 |
| Rate for Payer: Aetna Commercial |
$1,269.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.71
|
| Rate for Payer: BCN Commercial |
$1,153.77
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cofinity Commercial |
$1,283.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,194.38
|
| Rate for Payer: Healthscope Commercial |
$1,343.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,269.02
|
| Rate for Payer: Nomi Health Commercial |
$1,224.24
|
| Rate for Payer: PHP Commercial |
$1,269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,298.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.81
|
| Rate for Payer: UHC Core |
$1,246.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.73
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,492.97
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.58 |
| Max. Negotiated Rate |
$1,343.67 |
| Rate for Payer: Aetna Commercial |
$1,269.02
|
| Rate for Payer: Aetna Medicare |
$388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.55
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$373.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.37
|
| Rate for Payer: BCN Commercial |
$1,160.78
|
| Rate for Payer: BCN Medicare Advantage |
$373.24
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cofinity Commercial |
$1,283.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,194.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.24
|
| Rate for Payer: Healthscope Commercial |
$1,343.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.73
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.90
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$429.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,269.02
|
| Rate for Payer: Nomi Health Commercial |
$1,224.24
|
| Rate for Payer: PACE Senior Care Partners |
$354.58
|
| Rate for Payer: PACE SWMI |
$373.24
|
| Rate for Payer: PHP Commercial |
$1,269.02
|
| Rate for Payer: PHP Medicare Advantage |
$373.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,298.88
|
| Rate for Payer: Priority Health Medicare |
$376.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.29
|
| Rate for Payer: Railroad Medicare Medicare |
$373.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,313.81
|
| Rate for Payer: UHC Core |
$1,246.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$373.24
|
| Rate for Payer: UHC Exchange |
$373.24
|
| Rate for Payer: UHC Medicare Advantage |
$373.24
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$373.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.73
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,156.68
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$274.71 |
| Max. Negotiated Rate |
$1,041.01 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$300.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.46
|
| Rate for Payer: BCBS Complete |
$462.67
|
| Rate for Payer: BCBS MAPPO |
$289.17
|
| Rate for Payer: BCBS Trust/PPO |
$950.91
|
| Rate for Payer: BCN Commercial |
$899.32
|
| Rate for Payer: BCN Medicare Advantage |
$289.17
|
| Rate for Payer: Cash Price |
$925.34
|
| Rate for Payer: Cofinity Commercial |
$994.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.17
|
| Rate for Payer: Healthscope Commercial |
$1,041.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.18
|
| Rate for Payer: Nomi Health Commercial |
$948.48
|
| Rate for Payer: PACE Senior Care Partners |
$274.71
|
| Rate for Payer: PACE SWMI |
$289.17
|
| Rate for Payer: PHP Commercial |
$983.18
|
| Rate for Payer: PHP Medicare Advantage |
$289.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,006.31
|
| Rate for Payer: Priority Health Medicare |
$292.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$774.98
|
| Rate for Payer: Railroad Medicare Medicare |
$289.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.88
|
| Rate for Payer: UHC Core |
$965.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.17
|
| Rate for Payer: UHC Exchange |
$289.17
|
| Rate for Payer: UHC Medicare Advantage |
$289.17
|
| Rate for Payer: VA VA |
$289.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.51
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,156.68
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$751.84 |
| Max. Negotiated Rate |
$1,041.01 |
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: BCBS Trust/PPO |
$944.20
|
| Rate for Payer: BCN Commercial |
$893.88
|
| Rate for Payer: Cash Price |
$925.34
|
| Rate for Payer: Cofinity Commercial |
$994.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.34
|
| Rate for Payer: Healthscope Commercial |
$1,041.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.18
|
| Rate for Payer: Nomi Health Commercial |
$948.48
|
| Rate for Payer: PHP Commercial |
$983.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,006.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$774.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.88
|
| Rate for Payer: UHC Core |
$965.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.51
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.80
|
| Rate for Payer: BCN Commercial |
$35.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO |
$40.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$12.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.47
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS MAPPO |
$11.58
|
| Rate for Payer: BCBS Trust/PPO |
$38.07
|
| Rate for Payer: BCN Commercial |
$36.01
|
| Rate for Payer: BCN Medicare Advantage |
$11.58
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.58
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$2.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.16
|
| Rate for Payer: Meridian Medicaid |
$2.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: PACE Senior Care Partners |
$11.00
|
| Rate for Payer: PACE SWMI |
$11.58
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$11.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO |
$40.29
|
| Rate for Payer: Priority Health Medicare |
$11.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.58
|
| Rate for Payer: UHC Exchange |
$11.58
|
| Rate for Payer: UHC Medicare Advantage |
$11.58
|
| Rate for Payer: UHCCP Medicaid |
$2.75
|
| Rate for Payer: VA VA |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,169.57
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,465.27 |
| Max. Negotiated Rate |
$5,552.61 |
| Rate for Payer: Aetna Commercial |
$5,244.13
|
| Rate for Payer: Aetna Medicare |
$1,604.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,927.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,927.99
|
| Rate for Payer: BCBS Complete |
$2,467.83
|
| Rate for Payer: BCBS MAPPO |
$1,542.39
|
| Rate for Payer: BCBS Trust/PPO |
$5,072.00
|
| Rate for Payer: BCN Commercial |
$4,796.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,542.39
|
| Rate for Payer: Cash Price |
$4,935.66
|
| Rate for Payer: Cofinity Commercial |
$5,305.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,935.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,542.39
|
| Rate for Payer: Healthscope Commercial |
$5,552.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,627.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,619.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,773.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,244.13
|
| Rate for Payer: Nomi Health Commercial |
$5,059.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,465.27
|
| Rate for Payer: PACE SWMI |
$1,542.39
|
| Rate for Payer: PHP Commercial |
$5,244.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,542.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.22
|
| Rate for Payer: Priority Health HMO/PPO |
$5,367.53
|
| Rate for Payer: Priority Health Medicare |
$1,557.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,133.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,542.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,429.22
|
| Rate for Payer: UHC Core |
$5,151.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,542.39
|
| Rate for Payer: UHC Exchange |
$1,542.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,542.39
|
| Rate for Payer: VA VA |
$1,542.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,627.18
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,169.57
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,010.22 |
| Max. Negotiated Rate |
$5,552.61 |
| Rate for Payer: Aetna Commercial |
$5,244.13
|
| Rate for Payer: BCBS Trust/PPO |
$5,036.22
|
| Rate for Payer: BCN Commercial |
$4,767.84
|
| Rate for Payer: Cash Price |
$4,935.66
|
| Rate for Payer: Cofinity Commercial |
$5,305.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,935.66
|
| Rate for Payer: Healthscope Commercial |
$5,552.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,627.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,244.13
|
| Rate for Payer: Nomi Health Commercial |
$5,059.05
|
| Rate for Payer: PHP Commercial |
$5,244.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.22
|
| Rate for Payer: Priority Health HMO/PPO |
$5,367.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,133.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,429.22
|
| Rate for Payer: UHC Core |
$5,151.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,627.18
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,398.08
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,858.75 |
| Max. Negotiated Rate |
$3,958.27 |
| Rate for Payer: Aetna Commercial |
$3,738.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,590.15
|
| Rate for Payer: BCN Commercial |
$3,398.84
|
| Rate for Payer: Cash Price |
$3,518.46
|
| Rate for Payer: Cofinity Commercial |
$3,782.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,518.46
|
| Rate for Payer: Healthscope Commercial |
$3,958.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,298.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,738.37
|
| Rate for Payer: Nomi Health Commercial |
$3,606.43
|
| Rate for Payer: PHP Commercial |
$3,738.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.75
|
| Rate for Payer: Priority Health HMO/PPO |
$3,826.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,946.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,870.31
|
| Rate for Payer: UHC Core |
$3,672.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,298.56
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,398.08
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,044.54 |
| Max. Negotiated Rate |
$3,958.27 |
| Rate for Payer: Aetna Commercial |
$3,738.37
|
| Rate for Payer: Aetna Medicare |
$1,143.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,374.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,374.40
|
| Rate for Payer: BCBS Complete |
$1,759.23
|
| Rate for Payer: BCBS MAPPO |
$1,099.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,615.66
|
| Rate for Payer: BCN Commercial |
$3,419.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.52
|
| Rate for Payer: Cash Price |
$3,518.46
|
| Rate for Payer: Cofinity Commercial |
$3,782.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,518.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.52
|
| Rate for Payer: Healthscope Commercial |
$3,958.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,298.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,264.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,738.37
|
| Rate for Payer: Nomi Health Commercial |
$3,606.43
|
| Rate for Payer: PACE Senior Care Partners |
$1,044.54
|
| Rate for Payer: PACE SWMI |
$1,099.52
|
| Rate for Payer: PHP Commercial |
$3,738.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.75
|
| Rate for Payer: Priority Health HMO/PPO |
$3,826.33
|
| Rate for Payer: Priority Health Medicare |
$1,110.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,946.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,099.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,870.31
|
| Rate for Payer: UHC Core |
$3,672.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.52
|
| Rate for Payer: UHC Exchange |
$1,099.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.52
|
| Rate for Payer: VA VA |
$1,099.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,298.56
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,887.06 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$2,065.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,482.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,482.98
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$1,986.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,532.02
|
| Rate for Payer: BCN Commercial |
$6,177.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.38
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.38
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.70
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,887.06
|
| Rate for Payer: PACE SWMI |
$1,986.38
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Medicare |
$2,006.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,986.38
|
| Rate for Payer: UHC Exchange |
$1,986.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,986.38
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$1,986.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,485.94
|
| Rate for Payer: BCN Commercial |
$6,140.31
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,913.78 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$2,095.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,518.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,518.12
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$2,014.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,624.48
|
| Rate for Payer: BCN Commercial |
$6,265.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,913.78
|
| Rate for Payer: PACE SWMI |
$2,014.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Medicare |
$2,034.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,014.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.50
|
| Rate for Payer: UHC Exchange |
$2,014.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.50
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
