|
HC TENOTOMY
|
Facility
|
OP
|
$2,835.96
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$673.54 |
| Max. Negotiated Rate |
$2,552.36 |
| Rate for Payer: Aetna Commercial |
$2,410.57
|
| Rate for Payer: Aetna Medicare |
$737.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$886.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$886.24
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$708.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,204.96
|
| Rate for Payer: BCN Commercial |
$2,204.96
|
| Rate for Payer: BCN Medicare Advantage |
$708.99
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cofinity Commercial |
$2,438.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,268.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.99
|
| Rate for Payer: Healthscope Commercial |
$2,552.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,126.97
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$744.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$815.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,410.57
|
| Rate for Payer: PACE Senior Care Partners |
$673.54
|
| Rate for Payer: PACE SWMI |
$708.99
|
| Rate for Payer: PHP Commercial |
$2,410.57
|
| Rate for Payer: PHP Medicare Advantage |
$708.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,985.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,467.29
|
| Rate for Payer: Priority Health Medicare |
$708.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,729.65
|
| Rate for Payer: Railroad Medicare Medicare |
$708.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,495.64
|
| Rate for Payer: UHC Core |
$2,368.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$708.99
|
| Rate for Payer: UHC Medicare Advantage |
$730.26
|
| Rate for Payer: VA VA |
$708.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,126.97
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,835.96
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,729.65 |
| Max. Negotiated Rate |
$2,552.36 |
| Rate for Payer: Aetna Commercial |
$2,410.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,191.63
|
| Rate for Payer: BCN Commercial |
$2,191.63
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cofinity Commercial |
$2,438.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,268.77
|
| Rate for Payer: Healthscope Commercial |
$2,552.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,126.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,410.57
|
| Rate for Payer: PHP Commercial |
$2,410.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,985.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,467.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,729.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,495.64
|
| Rate for Payer: UHC Core |
$2,368.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,126.97
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,557.94 |
| Max. Negotiated Rate |
$3,774.64 |
| Rate for Payer: Aetna Commercial |
$3,564.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,241.15
|
| Rate for Payer: BCN Commercial |
$3,241.15
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$3,606.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Healthscope Commercial |
$3,774.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,145.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: PHP Commercial |
$3,564.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,648.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,557.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,690.76
|
| Rate for Payer: UHC Core |
$3,502.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,145.53
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$996.08 |
| Max. Negotiated Rate |
$3,774.64 |
| Rate for Payer: Aetna Commercial |
$3,564.93
|
| Rate for Payer: Aetna Medicare |
$1,090.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,310.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,310.64
|
| Rate for Payer: BCBS Complete |
$1,677.62
|
| Rate for Payer: BCBS MAPPO |
$1,048.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,260.87
|
| Rate for Payer: BCN Commercial |
$3,260.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.51
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$3,606.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.51
|
| Rate for Payer: Healthscope Commercial |
$3,774.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,145.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,100.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,205.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: PACE Senior Care Partners |
$996.08
|
| Rate for Payer: PACE SWMI |
$1,048.51
|
| Rate for Payer: PHP Commercial |
$3,564.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,648.81
|
| Rate for Payer: Priority Health Medicare |
$1,048.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,557.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,690.76
|
| Rate for Payer: UHC Core |
$3,502.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,079.97
|
| Rate for Payer: VA VA |
$1,048.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,145.53
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,687.27 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,405.03
|
| Rate for Payer: BCN Commercial |
$3,405.03
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,833.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,877.36
|
| Rate for Payer: UHC Core |
$3,679.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,046.45 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna Medicare |
$1,145.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,376.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,376.90
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$1,101.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,425.73
|
| Rate for Payer: BCN Commercial |
$3,425.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.52
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.52
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,156.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,266.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,046.45
|
| Rate for Payer: PACE SWMI |
$1,101.52
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,833.30
|
| Rate for Payer: Priority Health Medicare |
$1,101.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,101.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,877.36
|
| Rate for Payer: UHC Core |
$3,679.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,134.57
|
| Rate for Payer: VA VA |
$1,101.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,046.45 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna Medicare |
$1,145.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,376.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,376.90
|
| Rate for Payer: BCBS Complete |
$1,762.44
|
| Rate for Payer: BCBS MAPPO |
$1,101.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,425.73
|
| Rate for Payer: BCN Commercial |
$3,425.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,101.52
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,101.52
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,156.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,266.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,046.45
|
| Rate for Payer: PACE SWMI |
$1,101.52
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,101.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,833.30
|
| Rate for Payer: Priority Health Medicare |
$1,101.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,101.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,877.36
|
| Rate for Payer: UHC Core |
$3,679.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,101.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,134.57
|
| Rate for Payer: VA VA |
$1,101.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,687.27 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,405.03
|
| Rate for Payer: BCN Commercial |
$3,405.03
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,833.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,877.36
|
| Rate for Payer: UHC Core |
$3,679.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,130.80 |
| Max. Negotiated Rate |
$4,619.97 |
| Rate for Payer: Aetna Commercial |
$4,363.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,967.01
|
| Rate for Payer: BCN Commercial |
$3,967.01
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$4,414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Healthscope Commercial |
$4,619.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,849.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: PHP Commercial |
$4,363.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,465.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,130.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,517.30
|
| Rate for Payer: UHC Core |
$4,286.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,849.98
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,219.16 |
| Max. Negotiated Rate |
$4,619.97 |
| Rate for Payer: Aetna Commercial |
$4,363.30
|
| Rate for Payer: Aetna Medicare |
$1,334.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,604.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,604.16
|
| Rate for Payer: BCBS Complete |
$2,053.32
|
| Rate for Payer: BCBS MAPPO |
$1,283.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,991.14
|
| Rate for Payer: BCN Commercial |
$3,991.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,283.32
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$4,414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,283.32
|
| Rate for Payer: Healthscope Commercial |
$4,619.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,849.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,347.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,475.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,219.16
|
| Rate for Payer: PACE SWMI |
$1,283.32
|
| Rate for Payer: PHP Commercial |
$4,363.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,283.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,465.97
|
| Rate for Payer: Priority Health Medicare |
$1,283.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,130.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,283.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,517.30
|
| Rate for Payer: UHC Core |
$4,286.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,283.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,321.82
|
| Rate for Payer: VA VA |
$1,283.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,849.98
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,664.59
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,235.03 |
| Max. Negotiated Rate |
$3,298.13 |
| Rate for Payer: Aetna Commercial |
$3,114.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,832.00
|
| Rate for Payer: BCN Commercial |
$2,832.00
|
| Rate for Payer: Cash Price |
$2,931.67
|
| Rate for Payer: Cofinity Commercial |
$3,151.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.67
|
| Rate for Payer: Healthscope Commercial |
$3,298.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,748.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,114.90
|
| Rate for Payer: PHP Commercial |
$3,114.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,188.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,224.84
|
| Rate for Payer: UHC Core |
$3,059.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,748.44
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,664.59
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$870.34 |
| Max. Negotiated Rate |
$3,298.13 |
| Rate for Payer: Aetna Commercial |
$3,114.90
|
| Rate for Payer: Aetna Medicare |
$952.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,145.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,145.18
|
| Rate for Payer: BCBS Complete |
$1,465.84
|
| Rate for Payer: BCBS MAPPO |
$916.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,849.22
|
| Rate for Payer: BCN Commercial |
$2,849.22
|
| Rate for Payer: BCN Medicare Advantage |
$916.15
|
| Rate for Payer: Cash Price |
$2,931.67
|
| Rate for Payer: Cofinity Commercial |
$3,151.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.15
|
| Rate for Payer: Healthscope Commercial |
$3,298.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,748.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$961.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,053.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,114.90
|
| Rate for Payer: PACE Senior Care Partners |
$870.34
|
| Rate for Payer: PACE SWMI |
$916.15
|
| Rate for Payer: PHP Commercial |
$3,114.90
|
| Rate for Payer: PHP Medicare Advantage |
$916.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,188.19
|
| Rate for Payer: Priority Health Medicare |
$916.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,235.03
|
| Rate for Payer: Railroad Medicare Medicare |
$916.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,224.84
|
| Rate for Payer: UHC Core |
$3,059.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$916.15
|
| Rate for Payer: UHC Medicare Advantage |
$943.63
|
| Rate for Payer: VA VA |
$916.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,748.44
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,500.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$831.26 |
| Max. Negotiated Rate |
$3,150.03 |
| Rate for Payer: Aetna Commercial |
$2,975.03
|
| Rate for Payer: Aetna Medicare |
$910.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,093.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,093.76
|
| Rate for Payer: BCBS Complete |
$1,400.01
|
| Rate for Payer: BCBS MAPPO |
$875.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.27
|
| Rate for Payer: BCN Commercial |
$2,721.27
|
| Rate for Payer: BCN Medicare Advantage |
$875.01
|
| Rate for Payer: Cash Price |
$2,800.02
|
| Rate for Payer: Cofinity Commercial |
$3,010.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.01
|
| Rate for Payer: Healthscope Commercial |
$3,150.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,625.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$918.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,006.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.03
|
| Rate for Payer: PACE Senior Care Partners |
$831.26
|
| Rate for Payer: PACE SWMI |
$875.01
|
| Rate for Payer: PHP Commercial |
$2,975.03
|
| Rate for Payer: PHP Medicare Advantage |
$875.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.03
|
| Rate for Payer: Priority Health Medicare |
$875.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,134.67
|
| Rate for Payer: Railroad Medicare Medicare |
$875.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.03
|
| Rate for Payer: UHC Core |
$2,922.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.01
|
| Rate for Payer: UHC Medicare Advantage |
$901.26
|
| Rate for Payer: VA VA |
$875.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,625.02
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,500.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,134.67 |
| Max. Negotiated Rate |
$3,150.03 |
| Rate for Payer: Aetna Commercial |
$2,975.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,704.82
|
| Rate for Payer: BCN Commercial |
$2,704.82
|
| Rate for Payer: Cash Price |
$2,800.02
|
| Rate for Payer: Cofinity Commercial |
$3,010.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,800.02
|
| Rate for Payer: Healthscope Commercial |
$3,150.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,625.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,975.03
|
| Rate for Payer: PHP Commercial |
$2,975.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,450.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,045.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,134.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.03
|
| Rate for Payer: UHC Core |
$2,922.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,625.02
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
OP
|
$4,731.68
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,123.77 |
| Max. Negotiated Rate |
$4,258.51 |
| Rate for Payer: Aetna Commercial |
$4,021.93
|
| Rate for Payer: Aetna Medicare |
$1,230.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,478.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,478.65
|
| Rate for Payer: BCBS Complete |
$1,892.67
|
| Rate for Payer: BCBS MAPPO |
$1,182.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,678.88
|
| Rate for Payer: BCN Commercial |
$3,678.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.92
|
| Rate for Payer: Cash Price |
$3,785.34
|
| Rate for Payer: Cofinity Commercial |
$4,069.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,785.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.92
|
| Rate for Payer: Healthscope Commercial |
$4,258.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,548.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,242.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,360.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,021.93
|
| Rate for Payer: PACE Senior Care Partners |
$1,123.77
|
| Rate for Payer: PACE SWMI |
$1,182.92
|
| Rate for Payer: PHP Commercial |
$4,021.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,312.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,116.56
|
| Rate for Payer: Priority Health Medicare |
$1,182.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,885.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,182.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,163.88
|
| Rate for Payer: UHC Core |
$3,950.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,182.92
|
| Rate for Payer: UHC Medicare Advantage |
$1,218.41
|
| Rate for Payer: VA VA |
$1,182.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,548.76
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
IP
|
$4,731.68
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,885.85 |
| Max. Negotiated Rate |
$4,258.51 |
| Rate for Payer: Aetna Commercial |
$4,021.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,656.64
|
| Rate for Payer: BCN Commercial |
$3,656.64
|
| Rate for Payer: Cash Price |
$3,785.34
|
| Rate for Payer: Cofinity Commercial |
$4,069.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,785.34
|
| Rate for Payer: Healthscope Commercial |
$4,258.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,548.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,021.93
|
| Rate for Payer: PHP Commercial |
$4,021.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,312.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,116.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,885.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,163.88
|
| Rate for Payer: UHC Core |
$3,950.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,548.76
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
OP
|
$2,175.64
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$516.71 |
| Max. Negotiated Rate |
$1,958.08 |
| Rate for Payer: Aetna Commercial |
$1,849.29
|
| Rate for Payer: Aetna Medicare |
$565.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$679.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$679.89
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$543.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,691.56
|
| Rate for Payer: BCN Commercial |
$1,691.56
|
| Rate for Payer: BCN Medicare Advantage |
$543.91
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cofinity Commercial |
$1,871.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.91
|
| Rate for Payer: Healthscope Commercial |
$1,958.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.73
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$571.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$625.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.29
|
| Rate for Payer: PACE Senior Care Partners |
$516.71
|
| Rate for Payer: PACE SWMI |
$543.91
|
| Rate for Payer: PHP Commercial |
$1,849.29
|
| Rate for Payer: PHP Medicare Advantage |
$543.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.81
|
| Rate for Payer: Priority Health Medicare |
$543.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,326.92
|
| Rate for Payer: Railroad Medicare Medicare |
$543.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.56
|
| Rate for Payer: UHC Core |
$1,816.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.91
|
| Rate for Payer: UHC Medicare Advantage |
$560.23
|
| Rate for Payer: VA VA |
$543.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.73
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
IP
|
$2,175.64
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,326.92 |
| Max. Negotiated Rate |
$1,958.08 |
| Rate for Payer: Aetna Commercial |
$1,849.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,681.33
|
| Rate for Payer: BCN Commercial |
$1,681.33
|
| Rate for Payer: Cash Price |
$1,740.51
|
| Rate for Payer: Cofinity Commercial |
$1,871.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.51
|
| Rate for Payer: Healthscope Commercial |
$1,958.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.29
|
| Rate for Payer: PHP Commercial |
$1,849.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,522.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,892.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,326.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.56
|
| Rate for Payer: UHC Core |
$1,816.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.73
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$19.74
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$19.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
IP
|
$43.91
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$39.52 |
| Rate for Payer: Aetna Commercial |
$37.32
|
| Rate for Payer: BCBS Trust/PPO |
$33.93
|
| Rate for Payer: BCN Commercial |
$33.93
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cofinity Commercial |
$37.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.13
|
| Rate for Payer: Healthscope Commercial |
$39.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.32
|
| Rate for Payer: PHP Commercial |
$37.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.64
|
| Rate for Payer: UHC Core |
$36.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.93
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
OP
|
$43.91
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$39.52 |
| Rate for Payer: Aetna Commercial |
$37.32
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.72
|
| Rate for Payer: BCBS Complete |
$19.74
|
| Rate for Payer: BCBS MAPPO |
$10.98
|
| Rate for Payer: BCBS Trust/PPO |
$34.14
|
| Rate for Payer: BCN Commercial |
$34.14
|
| Rate for Payer: BCN Medicare Advantage |
$10.98
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cash Price |
$35.13
|
| Rate for Payer: Cofinity Commercial |
$37.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.98
|
| Rate for Payer: Healthscope Commercial |
$39.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.93
|
| Rate for Payer: Mclaren Medicaid |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$19.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.32
|
| Rate for Payer: PACE Senior Care Partners |
$10.43
|
| Rate for Payer: PACE SWMI |
$10.98
|
| Rate for Payer: PHP Commercial |
$37.32
|
| Rate for Payer: PHP Medicare Advantage |
$10.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.20
|
| Rate for Payer: Priority Health Medicare |
$10.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.78
|
| Rate for Payer: Railroad Medicare Medicare |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.64
|
| Rate for Payer: UHC Core |
$36.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.31
|
| Rate for Payer: VA VA |
$10.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.93
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: Aetna Medicare |
$20.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.00
|
| Rate for Payer: BCBS Complete |
$39.74
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.20
|
| Rate for Payer: BCN Commercial |
$62.20
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Mclaren Medicaid |
$37.84
|
| Rate for Payer: Meridian Medicaid |
$39.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$20.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$20.60
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: BCBS Trust/PPO |
$61.82
|
| Rate for Payer: BCN Commercial |
$61.82
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC TESTOSTERONE LEVEL
|
Facility
|
IP
|
$85.13
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100430
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.92 |
| Max. Negotiated Rate |
$76.62 |
| Rate for Payer: Aetna Commercial |
$72.36
|
| Rate for Payer: BCBS Trust/PPO |
$65.79
|
| Rate for Payer: BCN Commercial |
$65.79
|
| Rate for Payer: Cash Price |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$73.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.10
|
| Rate for Payer: Healthscope Commercial |
$76.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.36
|
| Rate for Payer: PHP Commercial |
$72.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.91
|
| Rate for Payer: UHC Core |
$71.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
