|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,337.66 |
| Max. Negotiated Rate |
$3,022.83 |
| Rate for Payer: Aetna Commercial |
$2,854.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,773.95
|
| Rate for Payer: BCN Commercial |
$2,773.95
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Commercial |
$2,888.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Healthscope Commercial |
$3,022.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,519.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$2,754.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PHP Commercial |
$2,854.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,922.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,337.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,955.66
|
| Rate for Payer: UHC Core |
$2,804.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,519.03
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.14 |
| Max. Negotiated Rate |
$3,022.83 |
| Rate for Payer: Aetna Commercial |
$2,854.89
|
| Rate for Payer: Aetna Medicare |
$873.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,049.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,049.59
|
| Rate for Payer: BCBS Complete |
$621.70
|
| Rate for Payer: BCBS MAPPO |
$839.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,761.19
|
| Rate for Payer: BCN Commercial |
$2,761.19
|
| Rate for Payer: BCN Medicare Advantage |
$839.67
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Commercial |
$2,888.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$839.67
|
| Rate for Payer: Healthscope Commercial |
$3,022.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,519.03
|
| Rate for Payer: Mclaren Medicaid |
$592.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$881.66
|
| Rate for Payer: Meridian Medicaid |
$621.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$965.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$923.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$2,754.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PACE Senior Care Partners |
$797.69
|
| Rate for Payer: PACE SWMI |
$839.67
|
| Rate for Payer: PHP Commercial |
$2,854.89
|
| Rate for Payer: PHP Medicare Advantage |
$839.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$592.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,922.07
|
| Rate for Payer: Priority Health Medicare |
$848.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,337.66
|
| Rate for Payer: Railroad Medicare Medicare |
$839.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,955.66
|
| Rate for Payer: UHC Core |
$2,804.51
|
| Rate for Payer: UHC Exchange |
$839.67
|
| Rate for Payer: UHC Medicaid |
$592.14
|
| Rate for Payer: UHC Medicare Advantage |
$839.67
|
| Rate for Payer: UHCCP Medicaid |
$592.14
|
| Rate for Payer: VA VA |
$839.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,519.03
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$176.95 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: Aetna Medicare |
$260.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.64
|
| Rate for Payer: BCBS Complete |
$185.78
|
| Rate for Payer: BCBS MAPPO |
$250.91
|
| Rate for Payer: BCBS Trust/PPO |
$825.11
|
| Rate for Payer: BCN Commercial |
$825.11
|
| Rate for Payer: BCN Medicare Advantage |
$250.91
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.91
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Mclaren Medicaid |
$176.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.46
|
| Rate for Payer: Meridian Medicaid |
$185.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$276.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Senior Care Partners |
$238.37
|
| Rate for Payer: PACE SWMI |
$250.91
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: PHP Medicare Advantage |
$250.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Medicare |
$253.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: Railroad Medicare Medicare |
$250.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: UHC Exchange |
$250.91
|
| Rate for Payer: UHC Medicaid |
$176.95
|
| Rate for Payer: UHC Medicare Advantage |
$250.91
|
| Rate for Payer: UHCCP Medicaid |
$176.95
|
| Rate for Payer: VA VA |
$250.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.55 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: BCBS Trust/PPO |
$828.92
|
| Rate for Payer: BCN Commercial |
$828.92
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$823.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.22
|
| Rate for Payer: UHC Core |
$838.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.72 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: BCBS Trust/PPO |
$457.71
|
| Rate for Payer: BCN Commercial |
$457.71
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$482.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.70
|
| Rate for Payer: UHC Core |
$462.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.71 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna Medicare |
$144.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.19
|
| Rate for Payer: BCBS Complete |
$102.58
|
| Rate for Payer: BCBS MAPPO |
$138.55
|
| Rate for Payer: BCBS Trust/PPO |
$455.61
|
| Rate for Payer: BCN Commercial |
$455.61
|
| Rate for Payer: BCN Medicare Advantage |
$138.55
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.55
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Mclaren Medicaid |
$97.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.48
|
| Rate for Payer: Meridian Medicaid |
$102.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$454.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PACE Senior Care Partners |
$131.62
|
| Rate for Payer: PACE SWMI |
$138.55
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: PHP Medicare Advantage |
$138.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$482.15
|
| Rate for Payer: Priority Health Medicare |
$139.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$385.72
|
| Rate for Payer: Railroad Medicare Medicare |
$138.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.70
|
| Rate for Payer: UHC Core |
$462.76
|
| Rate for Payer: UHC Exchange |
$138.55
|
| Rate for Payer: UHC Medicaid |
$97.71
|
| Rate for Payer: UHC Medicare Advantage |
$138.55
|
| Rate for Payer: UHCCP Medicaid |
$97.71
|
| Rate for Payer: VA VA |
$138.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.65 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: BCBS Trust/PPO |
$219.11
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.77 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna Medicare |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.91
|
| Rate for Payer: BCBS Complete |
$49.11
|
| Rate for Payer: BCBS MAPPO |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$218.10
|
| Rate for Payer: BCN Commercial |
$218.10
|
| Rate for Payer: BCN Medicare Advantage |
$66.33
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.33
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Mclaren Medicaid |
$46.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.64
|
| Rate for Payer: Meridian Medicaid |
$49.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.01
|
| Rate for Payer: PACE SWMI |
$66.33
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: PHP Medicare Advantage |
$66.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Medicare |
$66.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: Railroad Medicare Medicare |
$66.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: UHC Exchange |
$66.33
|
| Rate for Payer: UHC Medicaid |
$46.77
|
| Rate for Payer: UHC Medicare Advantage |
$66.33
|
| Rate for Payer: UHCCP Medicaid |
$46.77
|
| Rate for Payer: VA VA |
$66.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$499.43 |
| Max. Negotiated Rate |
$2,549.57 |
| Rate for Payer: Aetna Commercial |
$2,407.92
|
| Rate for Payer: Aetna Medicare |
$736.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$885.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$885.27
|
| Rate for Payer: BCBS Complete |
$524.36
|
| Rate for Payer: BCBS MAPPO |
$708.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,328.89
|
| Rate for Payer: BCN Commercial |
$2,328.89
|
| Rate for Payer: BCN Medicare Advantage |
$708.21
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Commercial |
$2,436.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$708.21
|
| Rate for Payer: Healthscope Commercial |
$2,549.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,124.64
|
| Rate for Payer: Mclaren Medicaid |
$499.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$743.62
|
| Rate for Payer: Meridian Medicaid |
$524.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$814.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$779.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Nomi Health Commercial |
$2,322.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: PACE Senior Care Partners |
$672.80
|
| Rate for Payer: PACE SWMI |
$708.21
|
| Rate for Payer: PHP Commercial |
$2,407.92
|
| Rate for Payer: PHP Medicare Advantage |
$708.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,464.58
|
| Rate for Payer: Priority Health Medicare |
$715.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,971.66
|
| Rate for Payer: Railroad Medicare Medicare |
$708.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,492.91
|
| Rate for Payer: UHC Core |
$2,365.43
|
| Rate for Payer: UHC Exchange |
$708.21
|
| Rate for Payer: UHC Medicaid |
$499.43
|
| Rate for Payer: UHC Medicare Advantage |
$708.21
|
| Rate for Payer: UHCCP Medicaid |
$499.43
|
| Rate for Payer: VA VA |
$708.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,124.64
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,971.66 |
| Max. Negotiated Rate |
$2,549.57 |
| Rate for Payer: Aetna Commercial |
$2,407.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,339.65
|
| Rate for Payer: BCN Commercial |
$2,339.65
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Commercial |
$2,436.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Healthscope Commercial |
$2,549.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,124.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Nomi Health Commercial |
$2,322.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: PHP Commercial |
$2,407.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,464.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,971.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,492.91
|
| Rate for Payer: UHC Core |
$2,365.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,124.64
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.86 |
| Max. Negotiated Rate |
$790.53 |
| Rate for Payer: Aetna Commercial |
$746.61
|
| Rate for Payer: Aetna Medicare |
$228.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.49
|
| Rate for Payer: BCBS Complete |
$162.59
|
| Rate for Payer: BCBS MAPPO |
$219.59
|
| Rate for Payer: BCBS Trust/PPO |
$722.11
|
| Rate for Payer: BCN Commercial |
$722.11
|
| Rate for Payer: BCN Medicare Advantage |
$219.59
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.59
|
| Rate for Payer: Healthscope Commercial |
$790.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.78
|
| Rate for Payer: Mclaren Medicaid |
$154.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.57
|
| Rate for Payer: Meridian Medicaid |
$162.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$241.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Nomi Health Commercial |
$720.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: PACE Senior Care Partners |
$208.61
|
| Rate for Payer: PACE SWMI |
$219.59
|
| Rate for Payer: PHP Commercial |
$746.61
|
| Rate for Payer: PHP Medicare Advantage |
$219.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$764.18
|
| Rate for Payer: Priority Health Medicare |
$221.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.35
|
| Rate for Payer: Railroad Medicare Medicare |
$219.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.97
|
| Rate for Payer: UHC Core |
$733.44
|
| Rate for Payer: UHC Exchange |
$219.59
|
| Rate for Payer: UHC Medicaid |
$154.86
|
| Rate for Payer: UHC Medicare Advantage |
$219.59
|
| Rate for Payer: UHCCP Medicaid |
$154.86
|
| Rate for Payer: VA VA |
$219.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.78
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$611.35 |
| Max. Negotiated Rate |
$790.53 |
| Rate for Payer: Aetna Commercial |
$746.61
|
| Rate for Payer: BCBS Trust/PPO |
$725.45
|
| Rate for Payer: BCN Commercial |
$725.45
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Healthscope Commercial |
$790.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Nomi Health Commercial |
$720.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: PHP Commercial |
$746.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$764.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$611.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.97
|
| Rate for Payer: UHC Core |
$733.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.78
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$123.37 |
| Max. Negotiated Rate |
$159.53 |
| Rate for Payer: Aetna Commercial |
$150.67
|
| Rate for Payer: BCBS Trust/PPO |
$146.40
|
| Rate for Payer: BCN Commercial |
$146.40
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Commercial |
$152.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Healthscope Commercial |
$159.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Nomi Health Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: PHP Commercial |
$150.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$154.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.99
|
| Rate for Payer: UHC Core |
$148.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.94
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$31.25 |
| Max. Negotiated Rate |
$159.53 |
| Rate for Payer: Aetna Commercial |
$150.67
|
| Rate for Payer: Aetna Medicare |
$46.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.39
|
| Rate for Payer: BCBS Complete |
$32.81
|
| Rate for Payer: BCBS MAPPO |
$44.31
|
| Rate for Payer: BCBS Trust/PPO |
$145.73
|
| Rate for Payer: BCN Commercial |
$145.73
|
| Rate for Payer: BCN Medicare Advantage |
$44.31
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Commercial |
$152.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.31
|
| Rate for Payer: Healthscope Commercial |
$159.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.94
|
| Rate for Payer: Mclaren Medicaid |
$31.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.53
|
| Rate for Payer: Meridian Medicaid |
$32.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Nomi Health Commercial |
$145.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: PACE Senior Care Partners |
$42.10
|
| Rate for Payer: PACE SWMI |
$44.31
|
| Rate for Payer: PHP Commercial |
$150.67
|
| Rate for Payer: PHP Medicare Advantage |
$44.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$154.22
|
| Rate for Payer: Priority Health Medicare |
$44.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.37
|
| Rate for Payer: Railroad Medicare Medicare |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.99
|
| Rate for Payer: UHC Core |
$148.01
|
| Rate for Payer: UHC Exchange |
$44.31
|
| Rate for Payer: UHC Medicaid |
$31.25
|
| Rate for Payer: UHC Medicare Advantage |
$44.31
|
| Rate for Payer: UHCCP Medicaid |
$31.25
|
| Rate for Payer: VA VA |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.94
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$137.66 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: BCBS Trust/PPO |
$163.35
|
| Rate for Payer: BCN Commercial |
$163.35
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna Medicare |
$51.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.81
|
| Rate for Payer: BCBS Complete |
$36.61
|
| Rate for Payer: BCBS MAPPO |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$162.60
|
| Rate for Payer: BCN Commercial |
$162.60
|
| Rate for Payer: BCN Medicare Advantage |
$49.45
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.45
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Mclaren Medicaid |
$34.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.92
|
| Rate for Payer: Meridian Medicaid |
$36.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Senior Care Partners |
$46.98
|
| Rate for Payer: PACE SWMI |
$49.45
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: PHP Medicare Advantage |
$49.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Medicare |
$49.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: Railroad Medicare Medicare |
$49.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHC Medicaid |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$49.45
|
| Rate for Payer: UHCCP Medicaid |
$34.87
|
| Rate for Payer: VA VA |
$49.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$63.31 |
| Max. Negotiated Rate |
$323.22 |
| Rate for Payer: Aetna Commercial |
$305.26
|
| Rate for Payer: Aetna Medicare |
$93.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.23
|
| Rate for Payer: BCBS Complete |
$66.47
|
| Rate for Payer: BCBS MAPPO |
$89.78
|
| Rate for Payer: BCBS Trust/PPO |
$295.24
|
| Rate for Payer: BCN Commercial |
$295.24
|
| Rate for Payer: BCN Medicare Advantage |
$89.78
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Commercial |
$308.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.78
|
| Rate for Payer: Healthscope Commercial |
$323.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.35
|
| Rate for Payer: Mclaren Medicaid |
$63.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.27
|
| Rate for Payer: Meridian Medicaid |
$66.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.26
|
| Rate for Payer: Nomi Health Commercial |
$294.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| Rate for Payer: PACE Senior Care Partners |
$85.29
|
| Rate for Payer: PACE SWMI |
$89.78
|
| Rate for Payer: PHP Commercial |
$305.26
|
| Rate for Payer: PHP Medicare Advantage |
$89.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.44
|
| Rate for Payer: Priority Health Medicare |
$90.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.95
|
| Rate for Payer: Railroad Medicare Medicare |
$89.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.03
|
| Rate for Payer: UHC Core |
$299.87
|
| Rate for Payer: UHC Exchange |
$89.78
|
| Rate for Payer: UHC Medicaid |
$63.31
|
| Rate for Payer: UHC Medicare Advantage |
$89.78
|
| Rate for Payer: UHCCP Medicaid |
$63.31
|
| Rate for Payer: VA VA |
$89.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.35
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$249.95 |
| Max. Negotiated Rate |
$323.22 |
| Rate for Payer: Aetna Commercial |
$305.26
|
| Rate for Payer: BCBS Trust/PPO |
$296.61
|
| Rate for Payer: BCN Commercial |
$296.61
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Commercial |
$308.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Healthscope Commercial |
$323.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.26
|
| Rate for Payer: Nomi Health Commercial |
$294.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| Rate for Payer: PHP Commercial |
$305.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.03
|
| Rate for Payer: UHC Core |
$299.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.35
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$217.62
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.46 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna Commercial |
$184.98
|
| Rate for Payer: BCBS Trust/PPO |
$179.73
|
| Rate for Payer: BCN Commercial |
$179.73
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Healthscope Commercial |
$195.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PHP Commercial |
$184.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.51
|
| Rate for Payer: UHC Core |
$181.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.22
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$217.62
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna Commercial |
$184.98
|
| Rate for Payer: Aetna Medicare |
$56.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.01
|
| Rate for Payer: BCBS Complete |
$40.28
|
| Rate for Payer: BCBS MAPPO |
$54.41
|
| Rate for Payer: BCBS Trust/PPO |
$178.91
|
| Rate for Payer: BCN Commercial |
$178.91
|
| Rate for Payer: BCN Medicare Advantage |
$54.41
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.41
|
| Rate for Payer: Healthscope Commercial |
$195.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.22
|
| Rate for Payer: Mclaren Medicaid |
$38.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.13
|
| Rate for Payer: Meridian Medicaid |
$40.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PACE Senior Care Partners |
$51.68
|
| Rate for Payer: PACE SWMI |
$54.41
|
| Rate for Payer: PHP Commercial |
$184.98
|
| Rate for Payer: PHP Medicare Advantage |
$54.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.33
|
| Rate for Payer: Priority Health Medicare |
$54.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.46
|
| Rate for Payer: Railroad Medicare Medicare |
$54.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.51
|
| Rate for Payer: UHC Core |
$181.71
|
| Rate for Payer: UHC Exchange |
$54.41
|
| Rate for Payer: UHC Medicaid |
$38.37
|
| Rate for Payer: UHC Medicare Advantage |
$54.41
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$54.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.22
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$145.69
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.40 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Commercial |
$185.76
|
| Rate for Payer: BCBS Trust/PPO |
$120.33
|
| Rate for Payer: BCBS Trust/PPO |
$180.49
|
| Rate for Payer: BCN Commercial |
$120.33
|
| Rate for Payer: BCN Commercial |
$180.49
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$174.83
|
| Rate for Payer: Cofinity Commercial |
$187.94
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.76
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Nomi Health Commercial |
$179.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: PHP Commercial |
$185.76
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.32
|
| Rate for Payer: UHC Core |
$121.65
|
| Rate for Payer: UHC Core |
$182.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.91
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Commercial |
$185.76
|
| Rate for Payer: Aetna Medicare |
$56.82
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.29
|
| Rate for Payer: BCBS Complete |
$26.97
|
| Rate for Payer: BCBS Complete |
$40.45
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCBS MAPPO |
$54.63
|
| Rate for Payer: BCBS Trust/PPO |
$119.77
|
| Rate for Payer: BCBS Trust/PPO |
$179.66
|
| Rate for Payer: BCN Commercial |
$179.66
|
| Rate for Payer: BCN Commercial |
$119.77
|
| Rate for Payer: BCN Medicare Advantage |
$54.63
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$174.83
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Cofinity Commercial |
$187.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Healthscope Commercial |
$196.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.91
|
| Rate for Payer: Mclaren Medicaid |
$38.53
|
| Rate for Payer: Mclaren Medicaid |
$25.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$26.97
|
| Rate for Payer: Meridian Medicaid |
$40.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$179.20
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.91
|
| Rate for Payer: PACE Senior Care Partners |
$51.90
|
| Rate for Payer: PACE Senior Care Partners |
$34.60
|
| Rate for Payer: PACE SWMI |
$54.63
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Commercial |
$185.76
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: PHP Medicare Advantage |
$54.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Medicare |
$55.18
|
| Rate for Payer: Priority Health Medicare |
$36.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.10
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: Railroad Medicare Medicare |
$54.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.32
|
| Rate for Payer: UHC Core |
$182.48
|
| Rate for Payer: UHC Core |
$121.65
|
| Rate for Payer: UHC Exchange |
$54.63
|
| Rate for Payer: UHC Exchange |
$36.42
|
| Rate for Payer: UHC Medicaid |
$38.53
|
| Rate for Payer: UHC Medicaid |
$25.69
|
| Rate for Payer: UHC Medicare Advantage |
$36.42
|
| Rate for Payer: UHC Medicare Advantage |
$54.63
|
| Rate for Payer: UHCCP Medicaid |
$25.69
|
| Rate for Payer: UHCCP Medicaid |
$38.53
|
| Rate for Payer: VA VA |
$36.42
|
| Rate for Payer: VA VA |
$54.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$217.62
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna Commercial |
$184.98
|
| Rate for Payer: Aetna Medicare |
$56.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.01
|
| Rate for Payer: BCBS Complete |
$40.28
|
| Rate for Payer: BCBS MAPPO |
$54.41
|
| Rate for Payer: BCBS Trust/PPO |
$178.91
|
| Rate for Payer: BCN Commercial |
$178.91
|
| Rate for Payer: BCN Medicare Advantage |
$54.41
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.41
|
| Rate for Payer: Healthscope Commercial |
$195.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.22
|
| Rate for Payer: Mclaren Medicaid |
$38.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.13
|
| Rate for Payer: Meridian Medicaid |
$40.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PACE Senior Care Partners |
$51.68
|
| Rate for Payer: PACE SWMI |
$54.41
|
| Rate for Payer: PHP Commercial |
$184.98
|
| Rate for Payer: PHP Medicare Advantage |
$54.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.33
|
| Rate for Payer: Priority Health Medicare |
$54.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.46
|
| Rate for Payer: Railroad Medicare Medicare |
$54.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.51
|
| Rate for Payer: UHC Core |
$181.71
|
| Rate for Payer: UHC Exchange |
$54.41
|
| Rate for Payer: UHC Medicaid |
$38.37
|
| Rate for Payer: UHC Medicare Advantage |
$54.41
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$54.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.22
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$217.62
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.46 |
| Max. Negotiated Rate |
$195.86 |
| Rate for Payer: Aetna Commercial |
$184.98
|
| Rate for Payer: BCBS Trust/PPO |
$179.73
|
| Rate for Payer: BCN Commercial |
$179.73
|
| Rate for Payer: Cash Price |
$174.10
|
| Rate for Payer: Cofinity Commercial |
$187.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.10
|
| Rate for Payer: Healthscope Commercial |
$195.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.98
|
| Rate for Payer: Nomi Health Commercial |
$178.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.22
|
| Rate for Payer: PHP Commercial |
$184.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.51
|
| Rate for Payer: UHC Core |
$181.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.22
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.53
|
| Rate for Payer: BCBS Complete |
$26.97
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCBS Trust/PPO |
$119.77
|
| Rate for Payer: BCN Commercial |
$119.77
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Mclaren Medicaid |
$25.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$26.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PACE Senior Care Partners |
$34.60
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Medicare |
$36.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.40
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.21
|
| Rate for Payer: UHC Core |
$121.65
|
| Rate for Payer: UHC Exchange |
$36.42
|
| Rate for Payer: UHC Medicaid |
$25.69
|
| Rate for Payer: UHC Medicare Advantage |
$36.42
|
| Rate for Payer: UHCCP Medicaid |
$25.69
|
| Rate for Payer: VA VA |
$36.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
