|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.74 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Medicare |
$91.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.44
|
| Rate for Payer: BCBS Complete |
$64.82
|
| Rate for Payer: BCBS MAPPO |
$87.55
|
| Rate for Payer: BCBS Trust/PPO |
$287.90
|
| Rate for Payer: BCN Commercial |
$287.90
|
| Rate for Payer: BCN Medicare Advantage |
$87.55
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.55
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Mclaren Medicaid |
$61.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.93
|
| Rate for Payer: Meridian Medicaid |
$64.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.67
|
| Rate for Payer: Nomi Health Commercial |
$287.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.65
|
| Rate for Payer: PACE Senior Care Partners |
$83.17
|
| Rate for Payer: PACE SWMI |
$87.55
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$87.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$304.67
|
| Rate for Payer: Priority Health Medicare |
$88.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.74
|
| Rate for Payer: Railroad Medicare Medicare |
$87.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Exchange |
$87.55
|
| Rate for Payer: UHC Medicaid |
$61.74
|
| Rate for Payer: UHC Medicare Advantage |
$87.55
|
| Rate for Payer: UHCCP Medicaid |
$61.74
|
| Rate for Payer: VA VA |
$87.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$796.53 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: BCBS Trust/PPO |
$945.19
|
| Rate for Payer: BCN Commercial |
$945.19
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.76 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$297.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.64
|
| Rate for Payer: BCBS Complete |
$211.84
|
| Rate for Payer: BCBS MAPPO |
$286.11
|
| Rate for Payer: BCBS Trust/PPO |
$940.84
|
| Rate for Payer: BCN Commercial |
$940.84
|
| Rate for Payer: BCN Medicare Advantage |
$286.11
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Mclaren Medicaid |
$201.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.42
|
| Rate for Payer: Meridian Medicaid |
$211.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PACE Senior Care Partners |
$271.80
|
| Rate for Payer: PACE SWMI |
$286.11
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$286.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Medicare |
$288.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.53
|
| Rate for Payer: Railroad Medicare Medicare |
$286.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: UHC Exchange |
$286.11
|
| Rate for Payer: UHC Medicaid |
$201.76
|
| Rate for Payer: UHC Medicare Advantage |
$286.11
|
| Rate for Payer: UHCCP Medicaid |
$201.76
|
| Rate for Payer: VA VA |
$286.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.44 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: BCBS Trust/PPO |
$300.74
|
| Rate for Payer: BCN Commercial |
$300.74
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$298.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.11
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna Medicare |
$94.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.79
|
| Rate for Payer: BCBS Complete |
$67.40
|
| Rate for Payer: BCBS MAPPO |
$91.03
|
| Rate for Payer: BCBS Trust/PPO |
$299.36
|
| Rate for Payer: BCN Commercial |
$299.36
|
| Rate for Payer: BCN Medicare Advantage |
$91.03
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.03
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.11
|
| Rate for Payer: Mclaren Medicaid |
$64.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.59
|
| Rate for Payer: Meridian Medicaid |
$67.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$298.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PACE Senior Care Partners |
$86.48
|
| Rate for Payer: PACE SWMI |
$91.03
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: PHP Medicare Advantage |
$91.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.80
|
| Rate for Payer: Priority Health Medicare |
$91.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.44
|
| Rate for Payer: Railroad Medicare Medicare |
$91.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: UHC Exchange |
$91.03
|
| Rate for Payer: UHC Medicaid |
$64.20
|
| Rate for Payer: UHC Medicare Advantage |
$91.03
|
| Rate for Payer: UHCCP Medicaid |
$64.20
|
| Rate for Payer: VA VA |
$91.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.11
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.20 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$568.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.79
|
| Rate for Payer: BCBS Complete |
$404.43
|
| Rate for Payer: BCBS MAPPO |
$546.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.22
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$546.23
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Mclaren Medicaid |
$385.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.54
|
| Rate for Payer: Meridian Medicaid |
$404.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Senior Care Partners |
$518.92
|
| Rate for Payer: PACE SWMI |
$546.23
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$546.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Medicare |
$551.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: Railroad Medicare Medicare |
$546.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: UHC Exchange |
$546.23
|
| Rate for Payer: UHC Medicaid |
$385.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.23
|
| Rate for Payer: UHCCP Medicaid |
$385.20
|
| Rate for Payer: VA VA |
$546.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,609.38 |
| Max. Negotiated Rate |
$4,667.30 |
| Rate for Payer: Aetna Commercial |
$4,408.01
|
| Rate for Payer: BCBS Trust/PPO |
$4,283.03
|
| Rate for Payer: BCN Commercial |
$4,283.03
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Commercial |
$4,459.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Healthscope Commercial |
$4,667.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,889.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Nomi Health Commercial |
$4,252.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: PHP Commercial |
$4,408.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,511.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,609.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,563.58
|
| Rate for Payer: UHC Core |
$4,330.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,889.42
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,185.89
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$914.27 |
| Max. Negotiated Rate |
$4,667.30 |
| Rate for Payer: Aetna Commercial |
$4,408.01
|
| Rate for Payer: Aetna Medicare |
$1,348.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,620.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,620.59
|
| Rate for Payer: BCBS Complete |
$959.91
|
| Rate for Payer: BCBS MAPPO |
$1,296.47
|
| Rate for Payer: BCBS Trust/PPO |
$4,263.32
|
| Rate for Payer: BCN Commercial |
$4,263.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,296.47
|
| Rate for Payer: Cash Price |
$4,148.71
|
| Rate for Payer: Cofinity Commercial |
$4,459.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,148.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,296.47
|
| Rate for Payer: Healthscope Commercial |
$4,667.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,889.42
|
| Rate for Payer: Mclaren Medicaid |
$914.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,361.30
|
| Rate for Payer: Meridian Medicaid |
$959.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,490.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,426.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,408.01
|
| Rate for Payer: Nomi Health Commercial |
$4,252.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,889.42
|
| Rate for Payer: PACE Senior Care Partners |
$1,231.65
|
| Rate for Payer: PACE SWMI |
$1,296.47
|
| Rate for Payer: PHP Commercial |
$4,408.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,296.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$914.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,511.72
|
| Rate for Payer: Priority Health Medicare |
$1,309.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,609.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,296.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,563.58
|
| Rate for Payer: UHC Core |
$4,330.22
|
| Rate for Payer: UHC Exchange |
$1,296.47
|
| Rate for Payer: UHC Medicaid |
$914.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,296.47
|
| Rate for Payer: UHCCP Medicaid |
$914.27
|
| Rate for Payer: VA VA |
$1,296.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,889.42
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$566.83 |
| Max. Negotiated Rate |
$2,893.62 |
| Rate for Payer: Aetna Commercial |
$2,732.86
|
| Rate for Payer: Aetna Medicare |
$835.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,004.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,004.73
|
| Rate for Payer: BCBS Complete |
$595.12
|
| Rate for Payer: BCBS MAPPO |
$803.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,643.16
|
| Rate for Payer: BCN Commercial |
$2,643.16
|
| Rate for Payer: BCN Medicare Advantage |
$803.78
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Commercial |
$2,765.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.78
|
| Rate for Payer: Healthscope Commercial |
$2,893.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,411.35
|
| Rate for Payer: Mclaren Medicaid |
$566.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.97
|
| Rate for Payer: Meridian Medicaid |
$595.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$924.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$884.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Nomi Health Commercial |
$2,636.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: PACE Senior Care Partners |
$763.59
|
| Rate for Payer: PACE SWMI |
$803.78
|
| Rate for Payer: PHP Commercial |
$2,732.86
|
| Rate for Payer: PHP Medicare Advantage |
$803.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$566.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,797.16
|
| Rate for Payer: Priority Health Medicare |
$811.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,237.73
|
| Rate for Payer: Railroad Medicare Medicare |
$803.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,829.31
|
| Rate for Payer: UHC Core |
$2,684.63
|
| Rate for Payer: UHC Exchange |
$803.78
|
| Rate for Payer: UHC Medicaid |
$566.83
|
| Rate for Payer: UHC Medicare Advantage |
$803.78
|
| Rate for Payer: UHCCP Medicaid |
$566.83
|
| Rate for Payer: VA VA |
$803.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,411.35
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,215.13
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,237.73 |
| Max. Negotiated Rate |
$2,893.62 |
| Rate for Payer: Aetna Commercial |
$2,732.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,655.38
|
| Rate for Payer: BCN Commercial |
$2,655.38
|
| Rate for Payer: Cash Price |
$2,572.10
|
| Rate for Payer: Cofinity Commercial |
$2,765.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,572.10
|
| Rate for Payer: Healthscope Commercial |
$2,893.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,411.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,732.86
|
| Rate for Payer: Nomi Health Commercial |
$2,636.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,411.35
|
| Rate for Payer: PHP Commercial |
$2,732.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,797.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,829.31
|
| Rate for Payer: UHC Core |
$2,684.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,411.35
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.51 |
| Max. Negotiated Rate |
$3,182.98 |
| Rate for Payer: Aetna Commercial |
$3,006.14
|
| Rate for Payer: Aetna Medicare |
$919.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,105.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,105.20
|
| Rate for Payer: BCBS Complete |
$654.63
|
| Rate for Payer: BCBS MAPPO |
$884.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,907.47
|
| Rate for Payer: BCN Commercial |
$2,907.47
|
| Rate for Payer: BCN Medicare Advantage |
$884.16
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Commercial |
$3,041.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$884.16
|
| Rate for Payer: Healthscope Commercial |
$3,182.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,652.48
|
| Rate for Payer: Mclaren Medicaid |
$623.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$928.37
|
| Rate for Payer: Meridian Medicaid |
$654.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,016.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$972.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Nomi Health Commercial |
$2,900.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: PACE Senior Care Partners |
$839.95
|
| Rate for Payer: PACE SWMI |
$884.16
|
| Rate for Payer: PHP Commercial |
$3,006.14
|
| Rate for Payer: PHP Medicare Advantage |
$884.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,076.88
|
| Rate for Payer: Priority Health Medicare |
$893.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.50
|
| Rate for Payer: Railroad Medicare Medicare |
$884.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,112.24
|
| Rate for Payer: UHC Core |
$2,953.09
|
| Rate for Payer: UHC Exchange |
$884.16
|
| Rate for Payer: UHC Medicaid |
$623.51
|
| Rate for Payer: UHC Medicare Advantage |
$884.16
|
| Rate for Payer: UHCCP Medicaid |
$623.51
|
| Rate for Payer: VA VA |
$884.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,652.48
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,536.64
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,461.50 |
| Max. Negotiated Rate |
$3,182.98 |
| Rate for Payer: Aetna Commercial |
$3,006.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,920.91
|
| Rate for Payer: BCN Commercial |
$2,920.91
|
| Rate for Payer: Cash Price |
$2,829.31
|
| Rate for Payer: Cofinity Commercial |
$3,041.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,829.31
|
| Rate for Payer: Healthscope Commercial |
$3,182.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,652.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,006.14
|
| Rate for Payer: Nomi Health Commercial |
$2,900.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.48
|
| Rate for Payer: PHP Commercial |
$3,006.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,076.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,461.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,112.24
|
| Rate for Payer: UHC Core |
$2,953.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,652.48
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,720.54 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,788.20
|
| Rate for Payer: BCN Commercial |
$6,788.20
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,449.04 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$2,136.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,568.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,568.49
|
| Rate for Payer: BCBS Complete |
$1,521.37
|
| Rate for Payer: BCBS MAPPO |
$2,054.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,756.97
|
| Rate for Payer: BCN Commercial |
$6,756.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,054.79
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,054.79
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$1,449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,157.53
|
| Rate for Payer: Meridian Medicaid |
$1,521.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,363.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,260.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,952.05
|
| Rate for Payer: PACE SWMI |
$2,054.79
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,054.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Medicare |
$2,075.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,054.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: UHC Exchange |
$2,054.79
|
| Rate for Payer: UHC Medicaid |
$1,449.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,054.79
|
| Rate for Payer: UHCCP Medicaid |
$1,449.04
|
| Rate for Payer: VA VA |
$2,054.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$2,492.42 |
| Rate for Payer: Aetna Commercial |
$2,353.96
|
| Rate for Payer: Aetna Medicare |
$720.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$865.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$865.42
|
| Rate for Payer: BCBS Complete |
$512.61
|
| Rate for Payer: BCBS MAPPO |
$692.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,276.69
|
| Rate for Payer: BCN Commercial |
$2,276.69
|
| Rate for Payer: BCN Medicare Advantage |
$692.34
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Commercial |
$2,381.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$692.34
|
| Rate for Payer: Healthscope Commercial |
$2,492.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,077.02
|
| Rate for Payer: Mclaren Medicaid |
$488.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$726.96
|
| Rate for Payer: Meridian Medicaid |
$512.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$761.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Nomi Health Commercial |
$2,270.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: PACE Senior Care Partners |
$657.72
|
| Rate for Payer: PACE SWMI |
$692.34
|
| Rate for Payer: PHP Commercial |
$2,353.96
|
| Rate for Payer: PHP Medicare Advantage |
$692.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,409.34
|
| Rate for Payer: Priority Health Medicare |
$699.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,927.47
|
| Rate for Payer: Railroad Medicare Medicare |
$692.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,437.04
|
| Rate for Payer: UHC Core |
$2,312.42
|
| Rate for Payer: UHC Exchange |
$692.34
|
| Rate for Payer: UHC Medicaid |
$488.24
|
| Rate for Payer: UHC Medicare Advantage |
$692.34
|
| Rate for Payer: UHCCP Medicaid |
$488.24
|
| Rate for Payer: VA VA |
$692.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,077.02
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,769.36
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,927.47 |
| Max. Negotiated Rate |
$2,492.42 |
| Rate for Payer: Aetna Commercial |
$2,353.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,287.21
|
| Rate for Payer: BCN Commercial |
$2,287.21
|
| Rate for Payer: Cash Price |
$2,215.49
|
| Rate for Payer: Cofinity Commercial |
$2,381.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,215.49
|
| Rate for Payer: Healthscope Commercial |
$2,492.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,077.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,353.96
|
| Rate for Payer: Nomi Health Commercial |
$2,270.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,077.02
|
| Rate for Payer: PHP Commercial |
$2,353.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,409.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,927.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,437.04
|
| Rate for Payer: UHC Core |
$2,312.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,077.02
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
OP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$246.18 |
| Max. Negotiated Rate |
$1,256.73 |
| Rate for Payer: Aetna Commercial |
$1,186.91
|
| Rate for Payer: Aetna Medicare |
$363.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$436.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$436.37
|
| Rate for Payer: BCBS Complete |
$258.47
|
| Rate for Payer: BCBS MAPPO |
$349.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,147.96
|
| Rate for Payer: BCN Commercial |
$1,147.96
|
| Rate for Payer: BCN Medicare Advantage |
$349.09
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Commercial |
$1,200.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.09
|
| Rate for Payer: Healthscope Commercial |
$1,256.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,047.28
|
| Rate for Payer: Mclaren Medicaid |
$246.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.55
|
| Rate for Payer: Meridian Medicaid |
$258.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$401.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$384.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Nomi Health Commercial |
$1,145.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: PACE Senior Care Partners |
$331.64
|
| Rate for Payer: PACE SWMI |
$349.09
|
| Rate for Payer: PHP Commercial |
$1,186.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$246.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,214.84
|
| Rate for Payer: Priority Health Medicare |
$352.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$971.87
|
| Rate for Payer: Railroad Medicare Medicare |
$349.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,228.81
|
| Rate for Payer: UHC Core |
$1,165.97
|
| Rate for Payer: UHC Exchange |
$349.09
|
| Rate for Payer: UHC Medicaid |
$246.18
|
| Rate for Payer: UHC Medicare Advantage |
$349.09
|
| Rate for Payer: UHCCP Medicaid |
$246.18
|
| Rate for Payer: VA VA |
$349.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,047.28
|
|
|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
IP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$971.87 |
| Max. Negotiated Rate |
$1,256.73 |
| Rate for Payer: Aetna Commercial |
$1,186.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.26
|
| Rate for Payer: BCN Commercial |
$1,153.26
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Commercial |
$1,200.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,256.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,047.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Nomi Health Commercial |
$1,145.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: PHP Commercial |
$1,186.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,214.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$971.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,228.81
|
| Rate for Payer: UHC Core |
$1,165.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,047.28
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,449.04 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$2,136.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,568.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,568.49
|
| Rate for Payer: BCBS Complete |
$1,521.37
|
| Rate for Payer: BCBS MAPPO |
$2,054.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,756.97
|
| Rate for Payer: BCN Commercial |
$6,756.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,054.79
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,054.79
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$1,449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,157.53
|
| Rate for Payer: Meridian Medicaid |
$1,521.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,363.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,260.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,952.05
|
| Rate for Payer: PACE SWMI |
$2,054.79
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,054.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Medicare |
$2,075.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,054.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: UHC Exchange |
$2,054.79
|
| Rate for Payer: UHC Medicaid |
$1,449.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,054.79
|
| Rate for Payer: UHCCP Medicaid |
$1,449.04
|
| Rate for Payer: VA VA |
$2,054.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,720.54 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,788.20
|
| Rate for Payer: BCN Commercial |
$6,788.20
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$917.11 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: Aetna Medicare |
$1,352.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,625.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,625.62
|
| Rate for Payer: BCBS Complete |
$962.89
|
| Rate for Payer: BCBS MAPPO |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,276.56
|
| Rate for Payer: BCN Commercial |
$4,276.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,300.50
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,300.50
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,901.50
|
| Rate for Payer: Mclaren Medicaid |
$917.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,365.53
|
| Rate for Payer: Meridian Medicaid |
$962.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,495.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,430.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$4,265.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,235.47
|
| Rate for Payer: PACE SWMI |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,300.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$917.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,525.74
|
| Rate for Payer: Priority Health Medicare |
$1,313.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,620.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,300.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,577.76
|
| Rate for Payer: UHC Core |
$4,343.67
|
| Rate for Payer: UHC Exchange |
$1,300.50
|
| Rate for Payer: UHC Medicaid |
$917.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,300.50
|
| Rate for Payer: UHCCP Medicaid |
$917.11
|
| Rate for Payer: VA VA |
$1,300.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,901.50
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,620.59 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,296.33
|
| Rate for Payer: BCN Commercial |
$4,296.33
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,901.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$4,265.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,525.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,620.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,577.76
|
| Rate for Payer: UHC Core |
$4,343.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,901.50
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$798.67 |
| Max. Negotiated Rate |
$1,032.76 |
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: BCBS Trust/PPO |
$947.73
|
| Rate for Payer: BCN Commercial |
$947.73
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$940.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$998.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.81
|
| Rate for Payer: UHC Core |
$958.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.63
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.31 |
| Max. Negotiated Rate |
$1,032.76 |
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: Aetna Medicare |
$298.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$358.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$358.60
|
| Rate for Payer: BCBS Complete |
$212.40
|
| Rate for Payer: BCBS MAPPO |
$286.88
|
| Rate for Payer: BCBS Trust/PPO |
$943.37
|
| Rate for Payer: BCN Commercial |
$943.37
|
| Rate for Payer: BCN Medicare Advantage |
$286.88
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.88
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.63
|
| Rate for Payer: Mclaren Medicaid |
$202.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.22
|
| Rate for Payer: Meridian Medicaid |
$212.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$315.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$940.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PACE Senior Care Partners |
$272.53
|
| Rate for Payer: PACE SWMI |
$286.88
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: PHP Medicare Advantage |
$286.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$998.33
|
| Rate for Payer: Priority Health Medicare |
$289.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.67
|
| Rate for Payer: Railroad Medicare Medicare |
$286.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,009.81
|
| Rate for Payer: UHC Core |
$958.17
|
| Rate for Payer: UHC Exchange |
$286.88
|
| Rate for Payer: UHC Medicaid |
$202.31
|
| Rate for Payer: UHC Medicare Advantage |
$286.88
|
| Rate for Payer: UHCCP Medicaid |
$202.31
|
| Rate for Payer: VA VA |
$286.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.63
|
|
