|
HC PINWORM EXAM
|
Facility
|
IP
|
$56.60
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.39 |
| Max. Negotiated Rate |
$50.94 |
| Rate for Payer: Aetna Commercial |
$48.11
|
| Rate for Payer: BCBS Trust/PPO |
$46.75
|
| Rate for Payer: BCN Commercial |
$46.75
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cofinity Commercial |
$48.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.28
|
| Rate for Payer: Healthscope Commercial |
$50.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.11
|
| Rate for Payer: Nomi Health Commercial |
$46.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.45
|
| Rate for Payer: PHP Commercial |
$48.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.81
|
| Rate for Payer: UHC Core |
$47.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.45
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
IP
|
$9,503.13
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,614.18 |
| Max. Negotiated Rate |
$8,552.82 |
| Rate for Payer: Aetna Commercial |
$8,077.66
|
| Rate for Payer: BCBS Trust/PPO |
$7,848.64
|
| Rate for Payer: BCN Commercial |
$7,848.64
|
| Rate for Payer: Cash Price |
$7,602.50
|
| Rate for Payer: Cofinity Commercial |
$8,172.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,602.50
|
| Rate for Payer: Healthscope Commercial |
$8,552.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,127.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,077.66
|
| Rate for Payer: Nomi Health Commercial |
$7,792.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,127.35
|
| Rate for Payer: PHP Commercial |
$8,077.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,267.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,614.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,362.75
|
| Rate for Payer: UHC Core |
$7,935.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,127.35
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,503.13
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,675.40 |
| Max. Negotiated Rate |
$8,552.82 |
| Rate for Payer: Aetna Commercial |
$8,077.66
|
| Rate for Payer: Aetna Medicare |
$2,470.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,969.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,969.73
|
| Rate for Payer: BCBS Complete |
$1,759.03
|
| Rate for Payer: BCBS MAPPO |
$2,375.78
|
| Rate for Payer: BCBS Trust/PPO |
$7,812.52
|
| Rate for Payer: BCN Commercial |
$7,812.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,375.78
|
| Rate for Payer: Cash Price |
$7,602.50
|
| Rate for Payer: Cofinity Commercial |
$8,172.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,602.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,375.78
|
| Rate for Payer: Healthscope Commercial |
$8,552.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,127.35
|
| Rate for Payer: Mclaren Medicaid |
$1,675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,494.57
|
| Rate for Payer: Meridian Medicaid |
$1,759.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,732.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,613.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,077.66
|
| Rate for Payer: Nomi Health Commercial |
$7,792.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,127.35
|
| Rate for Payer: PACE Senior Care Partners |
$2,256.99
|
| Rate for Payer: PACE SWMI |
$2,375.78
|
| Rate for Payer: PHP Commercial |
$8,077.66
|
| Rate for Payer: PHP Medicare Advantage |
$2,375.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,675.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,267.72
|
| Rate for Payer: Priority Health Medicare |
$2,399.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,614.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,375.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,362.75
|
| Rate for Payer: UHC Core |
$7,935.11
|
| Rate for Payer: UHC Exchange |
$2,375.78
|
| Rate for Payer: UHC Medicaid |
$1,675.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,375.78
|
| Rate for Payer: UHCCP Medicaid |
$1,675.40
|
| Rate for Payer: VA VA |
$2,375.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,127.35
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,962.82
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,519.45 |
| Max. Negotiated Rate |
$17,966.54 |
| Rate for Payer: Aetna Commercial |
$16,968.40
|
| Rate for Payer: Aetna Medicare |
$5,190.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,238.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,238.38
|
| Rate for Payer: BCBS Complete |
$3,695.12
|
| Rate for Payer: BCBS MAPPO |
$4,990.70
|
| Rate for Payer: BCBS Trust/PPO |
$16,411.43
|
| Rate for Payer: BCN Commercial |
$16,411.43
|
| Rate for Payer: BCN Medicare Advantage |
$4,990.70
|
| Rate for Payer: Cash Price |
$15,970.26
|
| Rate for Payer: Cofinity Commercial |
$17,168.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,970.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,990.70
|
| Rate for Payer: Healthscope Commercial |
$17,966.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,972.11
|
| Rate for Payer: Mclaren Medicaid |
$3,519.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,240.24
|
| Rate for Payer: Meridian Medicaid |
$3,695.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,739.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,489.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,968.40
|
| Rate for Payer: Nomi Health Commercial |
$16,369.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,972.11
|
| Rate for Payer: PACE Senior Care Partners |
$4,741.17
|
| Rate for Payer: PACE SWMI |
$4,990.70
|
| Rate for Payer: PHP Commercial |
$16,968.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,990.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,519.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,367.65
|
| Rate for Payer: Priority Health Medicare |
$5,040.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,894.12
|
| Rate for Payer: Railroad Medicare Medicare |
$4,990.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,567.28
|
| Rate for Payer: UHC Core |
$16,668.95
|
| Rate for Payer: UHC Exchange |
$4,990.70
|
| Rate for Payer: UHC Medicaid |
$3,519.45
|
| Rate for Payer: UHC Medicare Advantage |
$4,990.70
|
| Rate for Payer: UHCCP Medicaid |
$3,519.45
|
| Rate for Payer: VA VA |
$4,990.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,972.11
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,962.82
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,894.12 |
| Max. Negotiated Rate |
$17,966.54 |
| Rate for Payer: Aetna Commercial |
$16,968.40
|
| Rate for Payer: BCBS Trust/PPO |
$16,487.29
|
| Rate for Payer: BCN Commercial |
$16,487.29
|
| Rate for Payer: Cash Price |
$15,970.26
|
| Rate for Payer: Cofinity Commercial |
$17,168.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,970.26
|
| Rate for Payer: Healthscope Commercial |
$17,966.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,972.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,968.40
|
| Rate for Payer: Nomi Health Commercial |
$16,369.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,972.11
|
| Rate for Payer: PHP Commercial |
$16,968.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,367.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,894.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,567.28
|
| Rate for Payer: UHC Core |
$16,668.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,972.11
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PISTACHIO NUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PITOCIN AUGMENTATION
|
Facility
|
OP
|
$484.53
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$85.42 |
| Max. Negotiated Rate |
$436.08 |
| Rate for Payer: Aetna Commercial |
$411.85
|
| Rate for Payer: Aetna Medicare |
$125.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.42
|
| Rate for Payer: BCBS Complete |
$89.69
|
| Rate for Payer: BCBS MAPPO |
$121.13
|
| Rate for Payer: BCBS Trust/PPO |
$398.33
|
| Rate for Payer: BCN Commercial |
$398.33
|
| Rate for Payer: BCN Medicare Advantage |
$121.13
|
| Rate for Payer: Cash Price |
$387.62
|
| Rate for Payer: Cofinity Commercial |
$416.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.13
|
| Rate for Payer: Healthscope Commercial |
$436.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.40
|
| Rate for Payer: Mclaren Medicaid |
$85.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.19
|
| Rate for Payer: Meridian Medicaid |
$89.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$411.85
|
| Rate for Payer: Nomi Health Commercial |
$397.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.40
|
| Rate for Payer: PACE Senior Care Partners |
$115.08
|
| Rate for Payer: PACE SWMI |
$121.13
|
| Rate for Payer: PHP Commercial |
$411.85
|
| Rate for Payer: PHP Medicare Advantage |
$121.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$421.54
|
| Rate for Payer: Priority Health Medicare |
$122.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$337.23
|
| Rate for Payer: Railroad Medicare Medicare |
$121.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.39
|
| Rate for Payer: UHC Core |
$404.58
|
| Rate for Payer: UHC Exchange |
$121.13
|
| Rate for Payer: UHC Medicaid |
$85.42
|
| Rate for Payer: UHC Medicare Advantage |
$121.13
|
| Rate for Payer: UHCCP Medicaid |
$85.42
|
| Rate for Payer: VA VA |
$121.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.40
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
IP
|
$484.53
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$337.23 |
| Max. Negotiated Rate |
$436.08 |
| Rate for Payer: Aetna Commercial |
$411.85
|
| Rate for Payer: BCBS Trust/PPO |
$400.17
|
| Rate for Payer: BCN Commercial |
$400.17
|
| Rate for Payer: Cash Price |
$387.62
|
| Rate for Payer: Cofinity Commercial |
$416.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.62
|
| Rate for Payer: Healthscope Commercial |
$436.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$411.85
|
| Rate for Payer: Nomi Health Commercial |
$397.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$363.40
|
| Rate for Payer: PHP Commercial |
$411.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$421.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$337.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.39
|
| Rate for Payer: UHC Core |
$404.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.40
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: BCBS Complete |
$4.12
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.31
|
| Rate for Payer: BCN Commercial |
$18.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$4.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.70
|
| Rate for Payer: PACE Senior Care Partners |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.37
|
| Rate for Payer: Priority Health Medicare |
$5.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.60
|
| Rate for Payer: UHC Core |
$18.60
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicaid |
$3.93
|
| Rate for Payer: UHC Medicare Advantage |
$5.57
|
| Rate for Payer: UHCCP Medicaid |
$3.93
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: BCBS Trust/PPO |
$18.39
|
| Rate for Payer: BCN Commercial |
$18.39
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.70
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.60
|
| Rate for Payer: UHC Core |
$18.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$662.31 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna Medicare |
$976.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,173.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,173.97
|
| Rate for Payer: BCBS Complete |
$695.37
|
| Rate for Payer: BCBS MAPPO |
$939.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,088.38
|
| Rate for Payer: BCN Commercial |
$3,088.38
|
| Rate for Payer: BCN Medicare Advantage |
$939.17
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$939.17
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Mclaren Medicaid |
$662.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$986.13
|
| Rate for Payer: Meridian Medicaid |
$695.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,080.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,033.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Senior Care Partners |
$892.22
|
| Rate for Payer: PACE SWMI |
$939.17
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: PHP Medicare Advantage |
$939.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,268.33
|
| Rate for Payer: Priority Health Medicare |
$948.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,614.66
|
| Rate for Payer: Railroad Medicare Medicare |
$939.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,305.90
|
| Rate for Payer: UHC Core |
$3,136.84
|
| Rate for Payer: UHC Exchange |
$939.17
|
| Rate for Payer: UHC Medicaid |
$662.31
|
| Rate for Payer: UHC Medicare Advantage |
$939.17
|
| Rate for Payer: UHCCP Medicaid |
$662.31
|
| Rate for Payer: VA VA |
$939.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC PLACE ACCESS BILE TREE RENDEZVOUS PROCEDURE
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
36100498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,614.66 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,102.66
|
| Rate for Payer: BCN Commercial |
$3,102.66
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,268.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,614.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,305.90
|
| Rate for Payer: UHC Core |
$3,136.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$662.31 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna Medicare |
$976.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,173.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,173.97
|
| Rate for Payer: BCBS Complete |
$695.37
|
| Rate for Payer: BCBS MAPPO |
$939.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,088.38
|
| Rate for Payer: BCN Commercial |
$3,088.38
|
| Rate for Payer: BCN Medicare Advantage |
$939.17
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$939.17
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Mclaren Medicaid |
$662.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$986.13
|
| Rate for Payer: Meridian Medicaid |
$695.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,080.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,033.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Senior Care Partners |
$892.22
|
| Rate for Payer: PACE SWMI |
$939.17
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: PHP Medicare Advantage |
$939.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,268.33
|
| Rate for Payer: Priority Health Medicare |
$948.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,614.66
|
| Rate for Payer: Railroad Medicare Medicare |
$939.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,305.90
|
| Rate for Payer: UHC Core |
$3,136.84
|
| Rate for Payer: UHC Exchange |
$939.17
|
| Rate for Payer: UHC Medicaid |
$662.31
|
| Rate for Payer: UHC Medicare Advantage |
$939.17
|
| Rate for Payer: UHCCP Medicaid |
$662.31
|
| Rate for Payer: VA VA |
$939.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,614.66 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,102.66
|
| Rate for Payer: BCN Commercial |
$3,102.66
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$3,080.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,268.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,614.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,305.90
|
| Rate for Payer: UHC Core |
$3,136.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,340.62
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$588.95 |
| Max. Negotiated Rate |
$3,006.56 |
| Rate for Payer: Aetna Commercial |
$2,839.53
|
| Rate for Payer: Aetna Medicare |
$868.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,043.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,043.94
|
| Rate for Payer: BCBS Complete |
$618.35
|
| Rate for Payer: BCBS MAPPO |
$835.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,746.32
|
| Rate for Payer: BCN Commercial |
$2,746.32
|
| Rate for Payer: BCN Medicare Advantage |
$835.15
|
| Rate for Payer: Cash Price |
$2,672.50
|
| Rate for Payer: Cofinity Commercial |
$2,872.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,672.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.15
|
| Rate for Payer: Healthscope Commercial |
$3,006.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,505.47
|
| Rate for Payer: Mclaren Medicaid |
$588.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.91
|
| Rate for Payer: Meridian Medicaid |
$618.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$960.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$918.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,839.53
|
| Rate for Payer: Nomi Health Commercial |
$2,739.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,505.47
|
| Rate for Payer: PACE Senior Care Partners |
$793.40
|
| Rate for Payer: PACE SWMI |
$835.15
|
| Rate for Payer: PHP Commercial |
$2,839.53
|
| Rate for Payer: PHP Medicare Advantage |
$835.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,906.34
|
| Rate for Payer: Priority Health Medicare |
$843.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,325.07
|
| Rate for Payer: Railroad Medicare Medicare |
$835.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,939.75
|
| Rate for Payer: UHC Core |
$2,789.42
|
| Rate for Payer: UHC Exchange |
$835.15
|
| Rate for Payer: UHC Medicaid |
$588.95
|
| Rate for Payer: UHC Medicare Advantage |
$835.15
|
| Rate for Payer: UHCCP Medicaid |
$588.95
|
| Rate for Payer: VA VA |
$835.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,505.47
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,340.62
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,325.07 |
| Max. Negotiated Rate |
$3,006.56 |
| Rate for Payer: Aetna Commercial |
$2,839.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,759.02
|
| Rate for Payer: BCN Commercial |
$2,759.02
|
| Rate for Payer: Cash Price |
$2,672.50
|
| Rate for Payer: Cofinity Commercial |
$2,872.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,672.50
|
| Rate for Payer: Healthscope Commercial |
$3,006.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,505.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,839.53
|
| Rate for Payer: Nomi Health Commercial |
$2,739.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,505.47
|
| Rate for Payer: PHP Commercial |
$2,839.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,906.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,325.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,939.75
|
| Rate for Payer: UHC Core |
$2,789.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,505.47
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,224.00
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$851.90 |
| Max. Negotiated Rate |
$1,101.60 |
| Rate for Payer: Aetna Commercial |
$1,040.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.90
|
| Rate for Payer: BCN Commercial |
$1,010.90
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$1,052.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.20
|
| Rate for Payer: Healthscope Commercial |
$1,101.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.40
|
| Rate for Payer: Nomi Health Commercial |
$1,003.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: PHP Commercial |
$1,040.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,064.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$851.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.12
|
| Rate for Payer: UHC Core |
$1,022.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.00
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,224.00
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.92 |
| Max. Negotiated Rate |
$1,101.60 |
| Rate for Payer: Aetna Commercial |
$1,040.40
|
| Rate for Payer: Aetna Medicare |
$318.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.50
|
| Rate for Payer: BCBS Complete |
$226.56
|
| Rate for Payer: BCBS MAPPO |
$306.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.25
|
| Rate for Payer: BCCCP Commercial |
$156.92
|
| Rate for Payer: BCN Commercial |
$1,006.25
|
| Rate for Payer: BCN Medicare Advantage |
$306.00
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$1,052.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$1,101.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.00
|
| Rate for Payer: Mclaren Medicaid |
$215.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.30
|
| Rate for Payer: Meridian Medicaid |
$226.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,040.40
|
| Rate for Payer: Nomi Health Commercial |
$1,003.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: PACE Senior Care Partners |
$290.70
|
| Rate for Payer: PACE SWMI |
$306.00
|
| Rate for Payer: PHP Commercial |
$1,040.40
|
| Rate for Payer: PHP Medicare Advantage |
$306.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,064.88
|
| Rate for Payer: Priority Health Medicare |
$309.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$851.90
|
| Rate for Payer: Railroad Medicare Medicare |
$306.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.12
|
| Rate for Payer: UHC Core |
$1,022.04
|
| Rate for Payer: UHC Exchange |
$306.00
|
| Rate for Payer: UHC Medicaid |
$215.79
|
| Rate for Payer: UHC Medicare Advantage |
$306.00
|
| Rate for Payer: UHCCP Medicaid |
$215.79
|
| Rate for Payer: VA VA |
$306.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.00
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,791.10
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.77 |
| Max. Negotiated Rate |
$1,611.99 |
| Rate for Payer: Aetna Commercial |
$1,522.43
|
| Rate for Payer: Aetna Medicare |
$465.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$559.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$559.72
|
| Rate for Payer: BCBS Complete |
$331.53
|
| Rate for Payer: BCBS MAPPO |
$447.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,472.46
|
| Rate for Payer: BCCCP Commercial |
$432.83
|
| Rate for Payer: BCN Commercial |
$1,472.46
|
| Rate for Payer: BCN Medicare Advantage |
$447.77
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cofinity Commercial |
$1,540.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$447.77
|
| Rate for Payer: Healthscope Commercial |
$1,611.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,343.33
|
| Rate for Payer: Mclaren Medicaid |
$315.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$470.16
|
| Rate for Payer: Meridian Medicaid |
$331.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$514.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$492.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,522.43
|
| Rate for Payer: Nomi Health Commercial |
$1,468.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.33
|
| Rate for Payer: PACE Senior Care Partners |
$425.39
|
| Rate for Payer: PACE SWMI |
$447.77
|
| Rate for Payer: PHP Commercial |
$1,522.43
|
| Rate for Payer: PHP Medicare Advantage |
$447.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$315.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,558.26
|
| Rate for Payer: Priority Health Medicare |
$452.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.61
|
| Rate for Payer: Railroad Medicare Medicare |
$447.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,576.17
|
| Rate for Payer: UHC Core |
$1,495.57
|
| Rate for Payer: UHC Exchange |
$447.77
|
| Rate for Payer: UHC Medicaid |
$315.77
|
| Rate for Payer: UHC Medicare Advantage |
$447.77
|
| Rate for Payer: UHCCP Medicaid |
$315.77
|
| Rate for Payer: VA VA |
$447.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,343.33
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,791.10
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,246.61 |
| Max. Negotiated Rate |
$1,611.99 |
| Rate for Payer: Aetna Commercial |
$1,522.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,479.27
|
| Rate for Payer: BCN Commercial |
$1,479.27
|
| Rate for Payer: Cash Price |
$1,432.88
|
| Rate for Payer: Cofinity Commercial |
$1,540.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,432.88
|
| Rate for Payer: Healthscope Commercial |
$1,611.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,343.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,522.43
|
| Rate for Payer: Nomi Health Commercial |
$1,468.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,343.33
|
| Rate for Payer: PHP Commercial |
$1,522.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,558.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,576.17
|
| Rate for Payer: UHC Core |
$1,495.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,343.33
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,149.22
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.66 |
| Max. Negotiated Rate |
$1,934.30 |
| Rate for Payer: Aetna Commercial |
$1,826.84
|
| Rate for Payer: Aetna Medicare |
$558.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.63
|
| Rate for Payer: BCBS Complete |
$397.82
|
| Rate for Payer: BCBS MAPPO |
$537.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,766.87
|
| Rate for Payer: BCCCP Commercial |
$171.66
|
| Rate for Payer: BCN Commercial |
$1,766.87
|
| Rate for Payer: BCN Medicare Advantage |
$537.30
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cofinity Commercial |
$1,848.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,719.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.30
|
| Rate for Payer: Healthscope Commercial |
$1,934.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,611.91
|
| Rate for Payer: Mclaren Medicaid |
$378.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.17
|
| Rate for Payer: Meridian Medicaid |
$397.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,826.84
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,611.91
|
| Rate for Payer: PACE Senior Care Partners |
$510.44
|
| Rate for Payer: PACE SWMI |
$537.30
|
| Rate for Payer: PHP Commercial |
$1,826.84
|
| Rate for Payer: PHP Medicare Advantage |
$537.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,869.82
|
| Rate for Payer: Priority Health Medicare |
$542.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,495.86
|
| Rate for Payer: Railroad Medicare Medicare |
$537.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,891.31
|
| Rate for Payer: UHC Core |
$1,794.60
|
| Rate for Payer: UHC Exchange |
$537.30
|
| Rate for Payer: UHC Medicaid |
$378.91
|
| Rate for Payer: UHC Medicare Advantage |
$537.30
|
| Rate for Payer: UHCCP Medicaid |
$378.91
|
| Rate for Payer: VA VA |
$537.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,611.91
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,149.22
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,495.86 |
| Max. Negotiated Rate |
$1,934.30 |
| Rate for Payer: Aetna Commercial |
$1,826.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.04
|
| Rate for Payer: BCN Commercial |
$1,775.04
|
| Rate for Payer: Cash Price |
$1,719.38
|
| Rate for Payer: Cofinity Commercial |
$1,848.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,719.38
|
| Rate for Payer: Healthscope Commercial |
$1,934.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,611.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,826.84
|
| Rate for Payer: Nomi Health Commercial |
$1,762.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,611.91
|
| Rate for Payer: PHP Commercial |
$1,826.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,869.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,495.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,891.31
|
| Rate for Payer: UHC Core |
$1,794.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,611.91
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,977.05
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$266.26 |
| Max. Negotiated Rate |
$2,679.34 |
| Rate for Payer: Aetna Commercial |
$2,530.49
|
| Rate for Payer: Aetna Medicare |
$774.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$930.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$930.33
|
| Rate for Payer: BCBS Complete |
$551.05
|
| Rate for Payer: BCBS MAPPO |
$744.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,447.43
|
| Rate for Payer: BCCCP Commercial |
$266.26
|
| Rate for Payer: BCN Commercial |
$2,447.43
|
| Rate for Payer: BCN Medicare Advantage |
$744.26
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cofinity Commercial |
$2,560.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.26
|
| Rate for Payer: Healthscope Commercial |
$2,679.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,232.79
|
| Rate for Payer: Mclaren Medicaid |
$524.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$781.48
|
| Rate for Payer: Meridian Medicaid |
$551.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$855.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$818.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,530.49
|
| Rate for Payer: Nomi Health Commercial |
$2,441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,232.79
|
| Rate for Payer: PACE Senior Care Partners |
$707.05
|
| Rate for Payer: PACE SWMI |
$744.26
|
| Rate for Payer: PHP Commercial |
$2,530.49
|
| Rate for Payer: PHP Medicare Advantage |
$744.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$524.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,590.03
|
| Rate for Payer: Priority Health Medicare |
$751.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,072.03
|
| Rate for Payer: Railroad Medicare Medicare |
$744.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,619.80
|
| Rate for Payer: UHC Core |
$2,485.84
|
| Rate for Payer: UHC Exchange |
$744.26
|
| Rate for Payer: UHC Medicaid |
$524.85
|
| Rate for Payer: UHC Medicare Advantage |
$744.26
|
| Rate for Payer: UHCCP Medicaid |
$524.85
|
| Rate for Payer: VA VA |
$744.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,232.79
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,977.05
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,072.03 |
| Max. Negotiated Rate |
$2,679.34 |
| Rate for Payer: Aetna Commercial |
$2,530.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.75
|
| Rate for Payer: BCN Commercial |
$2,458.75
|
| Rate for Payer: Cash Price |
$2,381.64
|
| Rate for Payer: Cofinity Commercial |
$2,560.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,381.64
|
| Rate for Payer: Healthscope Commercial |
$2,679.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,232.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,530.49
|
| Rate for Payer: Nomi Health Commercial |
$2,441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,232.79
|
| Rate for Payer: PHP Commercial |
$2,530.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,590.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,072.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,619.80
|
| Rate for Payer: UHC Core |
$2,485.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,232.79
|
|
