|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,477.77
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.53 |
| Max. Negotiated Rate |
$1,329.99 |
| Rate for Payer: Aetna Commercial |
$1,256.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.49
|
| Rate for Payer: BCN Commercial |
$1,220.49
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cofinity Commercial |
$1,270.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.22
|
| Rate for Payer: Healthscope Commercial |
$1,329.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.10
|
| Rate for Payer: Nomi Health Commercial |
$1,211.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.33
|
| Rate for Payer: PHP Commercial |
$1,256.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,285.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.44
|
| Rate for Payer: UHC Core |
$1,233.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.33
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,477.77
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.33 |
| Max. Negotiated Rate |
$1,329.99 |
| Rate for Payer: Aetna Commercial |
$1,256.10
|
| Rate for Payer: Aetna Medicare |
$384.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$461.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$461.80
|
| Rate for Payer: BCBS Complete |
$273.54
|
| Rate for Payer: BCBS MAPPO |
$369.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,214.87
|
| Rate for Payer: BCCCP Commercial |
$225.33
|
| Rate for Payer: BCN Commercial |
$1,214.87
|
| Rate for Payer: BCN Medicare Advantage |
$369.44
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cash Price |
$1,182.22
|
| Rate for Payer: Cofinity Commercial |
$1,270.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.44
|
| Rate for Payer: Healthscope Commercial |
$1,329.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.33
|
| Rate for Payer: Mclaren Medicaid |
$260.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$387.91
|
| Rate for Payer: Meridian Medicaid |
$273.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.10
|
| Rate for Payer: Nomi Health Commercial |
$1,211.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.33
|
| Rate for Payer: PACE Senior Care Partners |
$350.97
|
| Rate for Payer: PACE SWMI |
$369.44
|
| Rate for Payer: PHP Commercial |
$1,256.10
|
| Rate for Payer: PHP Medicare Advantage |
$369.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,285.66
|
| Rate for Payer: Priority Health Medicare |
$373.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.53
|
| Rate for Payer: Railroad Medicare Medicare |
$369.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.44
|
| Rate for Payer: UHC Core |
$1,233.94
|
| Rate for Payer: UHC Exchange |
$369.44
|
| Rate for Payer: UHC Medicaid |
$260.53
|
| Rate for Payer: UHC Medicare Advantage |
$369.44
|
| Rate for Payer: UHCCP Medicaid |
$260.53
|
| Rate for Payer: VA VA |
$369.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.33
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
OP
|
$1,727.59
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.57 |
| Max. Negotiated Rate |
$1,554.83 |
| Rate for Payer: Aetna Commercial |
$1,468.45
|
| Rate for Payer: Aetna Medicare |
$449.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$539.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$539.87
|
| Rate for Payer: BCBS Complete |
$319.78
|
| Rate for Payer: BCBS MAPPO |
$431.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,420.25
|
| Rate for Payer: BCCCP Commercial |
$566.80
|
| Rate for Payer: BCN Commercial |
$1,420.25
|
| Rate for Payer: BCN Medicare Advantage |
$431.90
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cofinity Commercial |
$1,485.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,382.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$431.90
|
| Rate for Payer: Healthscope Commercial |
$1,554.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,295.69
|
| Rate for Payer: Mclaren Medicaid |
$304.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$453.49
|
| Rate for Payer: Meridian Medicaid |
$319.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$496.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$475.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,468.45
|
| Rate for Payer: Nomi Health Commercial |
$1,416.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.69
|
| Rate for Payer: PACE Senior Care Partners |
$410.30
|
| Rate for Payer: PACE SWMI |
$431.90
|
| Rate for Payer: PHP Commercial |
$1,468.45
|
| Rate for Payer: PHP Medicare Advantage |
$431.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,503.00
|
| Rate for Payer: Priority Health Medicare |
$436.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.40
|
| Rate for Payer: Railroad Medicare Medicare |
$431.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,520.28
|
| Rate for Payer: UHC Core |
$1,442.54
|
| Rate for Payer: UHC Exchange |
$431.90
|
| Rate for Payer: UHC Medicaid |
$304.57
|
| Rate for Payer: UHC Medicare Advantage |
$431.90
|
| Rate for Payer: UHCCP Medicaid |
$304.57
|
| Rate for Payer: VA VA |
$431.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,295.69
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,727.59
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,202.40 |
| Max. Negotiated Rate |
$1,554.83 |
| Rate for Payer: Aetna Commercial |
$1,468.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.82
|
| Rate for Payer: BCN Commercial |
$1,426.82
|
| Rate for Payer: Cash Price |
$1,382.07
|
| Rate for Payer: Cofinity Commercial |
$1,485.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,382.07
|
| Rate for Payer: Healthscope Commercial |
$1,554.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,295.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,468.45
|
| Rate for Payer: Nomi Health Commercial |
$1,416.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,295.69
|
| Rate for Payer: PHP Commercial |
$1,468.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,503.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,202.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,520.28
|
| Rate for Payer: UHC Core |
$1,442.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,295.69
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
OP
|
$2,438.02
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.24 |
| Max. Negotiated Rate |
$2,194.22 |
| Rate for Payer: Aetna Commercial |
$2,072.32
|
| Rate for Payer: Aetna Medicare |
$633.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$761.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$761.88
|
| Rate for Payer: BCBS Complete |
$451.28
|
| Rate for Payer: BCBS MAPPO |
$609.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,004.30
|
| Rate for Payer: BCCCP Commercial |
$240.24
|
| Rate for Payer: BCN Commercial |
$2,004.30
|
| Rate for Payer: BCN Medicare Advantage |
$609.50
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cofinity Commercial |
$2,096.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.50
|
| Rate for Payer: Healthscope Commercial |
$2,194.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,828.52
|
| Rate for Payer: Mclaren Medicaid |
$429.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$639.98
|
| Rate for Payer: Meridian Medicaid |
$451.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$700.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,072.32
|
| Rate for Payer: Nomi Health Commercial |
$1,999.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.52
|
| Rate for Payer: PACE Senior Care Partners |
$579.03
|
| Rate for Payer: PACE SWMI |
$609.50
|
| Rate for Payer: PHP Commercial |
$2,072.32
|
| Rate for Payer: PHP Medicare Advantage |
$609.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,121.08
|
| Rate for Payer: Priority Health Medicare |
$615.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.86
|
| Rate for Payer: Railroad Medicare Medicare |
$609.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,145.46
|
| Rate for Payer: UHC Core |
$2,035.75
|
| Rate for Payer: UHC Exchange |
$609.50
|
| Rate for Payer: UHC Medicaid |
$429.82
|
| Rate for Payer: UHC Medicare Advantage |
$609.50
|
| Rate for Payer: UHCCP Medicaid |
$429.82
|
| Rate for Payer: VA VA |
$609.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,828.52
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
IP
|
$2,438.02
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,696.86 |
| Max. Negotiated Rate |
$2,194.22 |
| Rate for Payer: Aetna Commercial |
$2,072.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,013.56
|
| Rate for Payer: BCN Commercial |
$2,013.56
|
| Rate for Payer: Cash Price |
$1,950.42
|
| Rate for Payer: Cofinity Commercial |
$2,096.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.42
|
| Rate for Payer: Healthscope Commercial |
$2,194.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,828.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,072.32
|
| Rate for Payer: Nomi Health Commercial |
$1,999.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,828.52
|
| Rate for Payer: PHP Commercial |
$2,072.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,121.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,145.46
|
| Rate for Payer: UHC Core |
$2,035.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,828.52
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
OP
|
$2,002.24
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.02 |
| Max. Negotiated Rate |
$1,802.02 |
| Rate for Payer: Aetna Commercial |
$1,701.90
|
| Rate for Payer: Aetna Medicare |
$520.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.70
|
| Rate for Payer: BCBS Complete |
$370.61
|
| Rate for Payer: BCBS MAPPO |
$500.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.04
|
| Rate for Payer: BCCCP Commercial |
$330.02
|
| Rate for Payer: BCN Commercial |
$1,646.04
|
| Rate for Payer: BCN Medicare Advantage |
$500.56
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cofinity Commercial |
$1,721.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.56
|
| Rate for Payer: Healthscope Commercial |
$1,802.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.68
|
| Rate for Payer: Mclaren Medicaid |
$352.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.59
|
| Rate for Payer: Meridian Medicaid |
$370.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,701.90
|
| Rate for Payer: Nomi Health Commercial |
$1,641.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.68
|
| Rate for Payer: PACE Senior Care Partners |
$475.53
|
| Rate for Payer: PACE SWMI |
$500.56
|
| Rate for Payer: PHP Commercial |
$1,701.90
|
| Rate for Payer: PHP Medicare Advantage |
$500.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,741.95
|
| Rate for Payer: Priority Health Medicare |
$505.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,393.56
|
| Rate for Payer: Railroad Medicare Medicare |
$500.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.97
|
| Rate for Payer: UHC Core |
$1,671.87
|
| Rate for Payer: UHC Exchange |
$500.56
|
| Rate for Payer: UHC Medicaid |
$352.99
|
| Rate for Payer: UHC Medicare Advantage |
$500.56
|
| Rate for Payer: UHCCP Medicaid |
$352.99
|
| Rate for Payer: VA VA |
$500.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.68
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
IP
|
$2,002.24
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,393.56 |
| Max. Negotiated Rate |
$1,802.02 |
| Rate for Payer: Aetna Commercial |
$1,701.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,653.65
|
| Rate for Payer: BCN Commercial |
$1,653.65
|
| Rate for Payer: Cash Price |
$1,601.79
|
| Rate for Payer: Cofinity Commercial |
$1,721.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.79
|
| Rate for Payer: Healthscope Commercial |
$1,802.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,701.90
|
| Rate for Payer: Nomi Health Commercial |
$1,641.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,501.68
|
| Rate for Payer: PHP Commercial |
$1,701.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,741.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,393.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.97
|
| Rate for Payer: UHC Core |
$1,671.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.68
|
|
|
HC PLACEMENT FIDUCIAL MARKERS
|
Facility
|
OP
|
$1,092.42
|
|
| Hospital Charge Code |
36000120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.59 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: Aetna Medicare |
$284.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.38
|
| Rate for Payer: BCBS Complete |
$202.21
|
| Rate for Payer: BCBS MAPPO |
$273.11
|
| Rate for Payer: BCBS Trust/PPO |
$898.08
|
| Rate for Payer: BCN Commercial |
$898.08
|
| Rate for Payer: BCN Medicare Advantage |
$273.11
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.11
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Mclaren Medicaid |
$192.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.76
|
| Rate for Payer: Meridian Medicaid |
$202.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.32
|
| Rate for Payer: PACE Senior Care Partners |
$259.45
|
| Rate for Payer: PACE SWMI |
$273.11
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: PHP Medicare Advantage |
$273.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Medicare |
$275.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.32
|
| Rate for Payer: Railroad Medicare Medicare |
$273.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: UHC Exchange |
$273.11
|
| Rate for Payer: UHC Medicaid |
$192.59
|
| Rate for Payer: UHC Medicare Advantage |
$273.11
|
| Rate for Payer: UHCCP Medicaid |
$192.59
|
| Rate for Payer: VA VA |
$273.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC PLACEMENT FIDUCIAL MARKERS
|
Facility
|
IP
|
$1,092.42
|
|
| Hospital Charge Code |
36000120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$760.32 |
| Max. Negotiated Rate |
$983.18 |
| Rate for Payer: Aetna Commercial |
$928.56
|
| Rate for Payer: BCBS Trust/PPO |
$902.23
|
| Rate for Payer: BCN Commercial |
$902.23
|
| Rate for Payer: Cash Price |
$873.94
|
| Rate for Payer: Cofinity Commercial |
$939.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.94
|
| Rate for Payer: Healthscope Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$819.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.56
|
| Rate for Payer: Nomi Health Commercial |
$895.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$819.32
|
| Rate for Payer: PHP Commercial |
$928.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$950.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$961.33
|
| Rate for Payer: UHC Core |
$912.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$819.32
|
|
|
HC PLACEMENT OF BAKRI BALLOON
|
Facility
|
IP
|
$510.33
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000013
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$355.19 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: BCBS Trust/PPO |
$421.48
|
| Rate for Payer: BCN Commercial |
$421.48
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$443.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$355.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.09
|
| Rate for Payer: UHC Core |
$426.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC PLACEMENT OF BAKRI BALLOON
|
Facility
|
OP
|
$510.33
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000013
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$89.97 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: Aetna Medicare |
$132.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.48
|
| Rate for Payer: BCBS Complete |
$94.46
|
| Rate for Payer: BCBS MAPPO |
$127.58
|
| Rate for Payer: BCBS Trust/PPO |
$419.54
|
| Rate for Payer: BCN Commercial |
$419.54
|
| Rate for Payer: BCN Medicare Advantage |
$127.58
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.58
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: Mclaren Medicaid |
$89.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.96
|
| Rate for Payer: Meridian Medicaid |
$94.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Nomi Health Commercial |
$418.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PACE Senior Care Partners |
$121.20
|
| Rate for Payer: PACE SWMI |
$127.58
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: PHP Medicare Advantage |
$127.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$443.99
|
| Rate for Payer: Priority Health Medicare |
$128.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$355.19
|
| Rate for Payer: Railroad Medicare Medicare |
$127.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.09
|
| Rate for Payer: UHC Core |
$426.13
|
| Rate for Payer: UHC Exchange |
$127.58
|
| Rate for Payer: UHC Medicaid |
$89.97
|
| Rate for Payer: UHC Medicare Advantage |
$127.58
|
| Rate for Payer: UHCCP Medicaid |
$89.97
|
| Rate for Payer: VA VA |
$127.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC PLACEMENT OF JADA SYSTEM
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000012
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC PLACEMENT OF JADA SYSTEM
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
72000012
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
OP
|
$7,411.20
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,306.59 |
| Max. Negotiated Rate |
$6,670.08 |
| Rate for Payer: Aetna Commercial |
$6,299.52
|
| Rate for Payer: Aetna Medicare |
$1,926.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,316.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,316.00
|
| Rate for Payer: BCBS Complete |
$1,371.81
|
| Rate for Payer: BCBS MAPPO |
$1,852.80
|
| Rate for Payer: BCBS Trust/PPO |
$6,092.75
|
| Rate for Payer: BCN Commercial |
$6,092.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,852.80
|
| Rate for Payer: Cash Price |
$5,928.96
|
| Rate for Payer: Cofinity Commercial |
$6,373.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,928.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,852.80
|
| Rate for Payer: Healthscope Commercial |
$6,670.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,558.40
|
| Rate for Payer: Mclaren Medicaid |
$1,306.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,945.44
|
| Rate for Payer: Meridian Medicaid |
$1,371.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,130.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,038.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,299.52
|
| Rate for Payer: Nomi Health Commercial |
$6,077.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,558.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,760.16
|
| Rate for Payer: PACE SWMI |
$1,852.80
|
| Rate for Payer: PHP Commercial |
$6,299.52
|
| Rate for Payer: PHP Medicare Advantage |
$1,852.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,306.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,447.74
|
| Rate for Payer: Priority Health Medicare |
$1,871.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,158.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,852.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,521.86
|
| Rate for Payer: UHC Core |
$6,188.35
|
| Rate for Payer: UHC Exchange |
$1,852.80
|
| Rate for Payer: UHC Medicaid |
$1,306.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,852.80
|
| Rate for Payer: UHCCP Medicaid |
$1,306.59
|
| Rate for Payer: VA VA |
$1,852.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,558.40
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
IP
|
$7,411.20
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,158.20 |
| Max. Negotiated Rate |
$6,670.08 |
| Rate for Payer: Aetna Commercial |
$6,299.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,120.91
|
| Rate for Payer: BCN Commercial |
$6,120.91
|
| Rate for Payer: Cash Price |
$5,928.96
|
| Rate for Payer: Cofinity Commercial |
$6,373.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,928.96
|
| Rate for Payer: Healthscope Commercial |
$6,670.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,558.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,299.52
|
| Rate for Payer: Nomi Health Commercial |
$6,077.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,558.40
|
| Rate for Payer: PHP Commercial |
$6,299.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,447.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,158.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,521.86
|
| Rate for Payer: UHC Core |
$6,188.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,558.40
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
OP
|
$1,040.40
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.42 |
| Max. Negotiated Rate |
$936.36 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: Aetna Medicare |
$270.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.12
|
| Rate for Payer: BCBS Complete |
$192.58
|
| Rate for Payer: BCBS MAPPO |
$260.10
|
| Rate for Payer: BCBS Trust/PPO |
$855.31
|
| Rate for Payer: BCN Commercial |
$855.31
|
| Rate for Payer: BCN Medicare Advantage |
$260.10
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.10
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.30
|
| Rate for Payer: Mclaren Medicaid |
$183.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.11
|
| Rate for Payer: Meridian Medicaid |
$192.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PACE Senior Care Partners |
$247.09
|
| Rate for Payer: PACE SWMI |
$260.10
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: PHP Medicare Advantage |
$260.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.15
|
| Rate for Payer: Priority Health Medicare |
$262.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.12
|
| Rate for Payer: Railroad Medicare Medicare |
$260.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.55
|
| Rate for Payer: UHC Core |
$868.73
|
| Rate for Payer: UHC Exchange |
$260.10
|
| Rate for Payer: UHC Medicaid |
$183.42
|
| Rate for Payer: UHC Medicare Advantage |
$260.10
|
| Rate for Payer: UHCCP Medicaid |
$183.42
|
| Rate for Payer: VA VA |
$260.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.30
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
IP
|
$1,040.40
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.12 |
| Max. Negotiated Rate |
$936.36 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: BCBS Trust/PPO |
$859.27
|
| Rate for Payer: BCN Commercial |
$859.27
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.55
|
| Rate for Payer: UHC Core |
$868.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.30
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
IP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.27 |
| Max. Negotiated Rate |
$776.21 |
| Rate for Payer: Aetna Commercial |
$733.08
|
| Rate for Payer: BCBS Trust/PPO |
$712.30
|
| Rate for Payer: BCN Commercial |
$712.30
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Commercial |
$741.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Healthscope Commercial |
$776.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Nomi Health Commercial |
$707.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: PHP Commercial |
$733.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$750.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$600.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.96
|
| Rate for Payer: UHC Core |
$720.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.84
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$152.05 |
| Max. Negotiated Rate |
$776.21 |
| Rate for Payer: Aetna Commercial |
$733.08
|
| Rate for Payer: Aetna Medicare |
$224.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.52
|
| Rate for Payer: BCBS Complete |
$159.64
|
| Rate for Payer: BCBS MAPPO |
$215.61
|
| Rate for Payer: BCBS Trust/PPO |
$709.02
|
| Rate for Payer: BCN Commercial |
$709.02
|
| Rate for Payer: BCN Medicare Advantage |
$215.61
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Commercial |
$741.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.61
|
| Rate for Payer: Healthscope Commercial |
$776.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.84
|
| Rate for Payer: Mclaren Medicaid |
$152.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.39
|
| Rate for Payer: Meridian Medicaid |
$159.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Nomi Health Commercial |
$707.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: PACE Senior Care Partners |
$204.83
|
| Rate for Payer: PACE SWMI |
$215.61
|
| Rate for Payer: PHP Commercial |
$733.08
|
| Rate for Payer: PHP Medicare Advantage |
$215.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$750.33
|
| Rate for Payer: Priority Health Medicare |
$217.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$600.27
|
| Rate for Payer: Railroad Medicare Medicare |
$215.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.96
|
| Rate for Payer: UHC Core |
$720.15
|
| Rate for Payer: UHC Exchange |
$215.61
|
| Rate for Payer: UHC Medicaid |
$152.05
|
| Rate for Payer: UHC Medicare Advantage |
$215.61
|
| Rate for Payer: UHCCP Medicaid |
$152.05
|
| Rate for Payer: VA VA |
$215.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.84
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$797.14 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: BCBS Trust/PPO |
$945.92
|
| Rate for Payer: BCN Commercial |
$945.92
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.88
|
| Rate for Payer: UHC Core |
$956.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: Aetna Medicare |
$297.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.91
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: BCBS MAPPO |
$286.33
|
| Rate for Payer: BCBS Trust/PPO |
$941.57
|
| Rate for Payer: BCN Commercial |
$941.57
|
| Rate for Payer: BCN Medicare Advantage |
$286.33
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.33
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: Mclaren Medicaid |
$201.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.65
|
| Rate for Payer: Meridian Medicaid |
$212.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PACE Senior Care Partners |
$272.01
|
| Rate for Payer: PACE SWMI |
$286.33
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: PHP Medicare Advantage |
$286.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.43
|
| Rate for Payer: Priority Health Medicare |
$289.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.14
|
| Rate for Payer: Railroad Medicare Medicare |
$286.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.88
|
| Rate for Payer: UHC Core |
$956.34
|
| Rate for Payer: UHC Exchange |
$286.33
|
| Rate for Payer: UHC Medicaid |
$201.92
|
| Rate for Payer: UHC Medicare Advantage |
$286.33
|
| Rate for Payer: UHCCP Medicaid |
$201.92
|
| Rate for Payer: VA VA |
$286.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
IP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,416.42 |
| Max. Negotiated Rate |
$9,590.19 |
| Rate for Payer: Aetna Commercial |
$9,057.40
|
| Rate for Payer: BCBS Trust/PPO |
$8,800.60
|
| Rate for Payer: BCN Commercial |
$8,800.60
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Commercial |
$9,163.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Healthscope Commercial |
$9,590.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,991.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Nomi Health Commercial |
$8,737.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: PHP Commercial |
$9,057.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,270.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,416.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,377.08
|
| Rate for Payer: UHC Core |
$8,897.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,991.83
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
OP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,878.61 |
| Max. Negotiated Rate |
$9,590.19 |
| Rate for Payer: Aetna Commercial |
$9,057.40
|
| Rate for Payer: Aetna Medicare |
$2,770.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,329.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,329.93
|
| Rate for Payer: BCBS Complete |
$1,972.38
|
| Rate for Payer: BCBS MAPPO |
$2,663.94
|
| Rate for Payer: BCBS Trust/PPO |
$8,760.11
|
| Rate for Payer: BCN Commercial |
$8,760.11
|
| Rate for Payer: BCN Medicare Advantage |
$2,663.94
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Commercial |
$9,163.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,663.94
|
| Rate for Payer: Healthscope Commercial |
$9,590.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,991.83
|
| Rate for Payer: Mclaren Medicaid |
$1,878.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,797.14
|
| Rate for Payer: Meridian Medicaid |
$1,972.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,063.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,930.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Nomi Health Commercial |
$8,737.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: PACE Senior Care Partners |
$2,530.75
|
| Rate for Payer: PACE SWMI |
$2,663.94
|
| Rate for Payer: PHP Commercial |
$9,057.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,663.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,878.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,270.52
|
| Rate for Payer: Priority Health Medicare |
$2,690.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,416.42
|
| Rate for Payer: Railroad Medicare Medicare |
$2,663.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,377.08
|
| Rate for Payer: UHC Core |
$8,897.57
|
| Rate for Payer: UHC Exchange |
$2,663.94
|
| Rate for Payer: UHC Medicaid |
$1,878.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,663.94
|
| Rate for Payer: UHCCP Medicaid |
$1,878.61
|
| Rate for Payer: VA VA |
$2,663.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,991.83
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,071.82
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$745.99 |
| Max. Negotiated Rate |
$964.64 |
| Rate for Payer: Aetna Commercial |
$911.05
|
| Rate for Payer: BCBS Trust/PPO |
$885.22
|
| Rate for Payer: BCN Commercial |
$885.22
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cofinity Commercial |
$921.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.46
|
| Rate for Payer: Healthscope Commercial |
$964.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.05
|
| Rate for Payer: Nomi Health Commercial |
$878.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.87
|
| Rate for Payer: PHP Commercial |
$911.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$932.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$745.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$943.20
|
| Rate for Payer: UHC Core |
$894.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.87
|
|
