|
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
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$10,769.70
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,495.71 |
| Max. Negotiated Rate |
$9,692.73 |
| Rate for Payer: Aetna Commercial |
$9,154.25
|
| Rate for Payer: Aetna Commercial |
$6,102.83
|
| Rate for Payer: BCBS Trust/PPO |
$8,894.70
|
| Rate for Payer: BCBS Trust/PPO |
$5,929.80
|
| Rate for Payer: BCN Commercial |
$8,894.70
|
| Rate for Payer: BCN Commercial |
$5,929.80
|
| Rate for Payer: Cash Price |
$8,615.76
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$6,174.63
|
| Rate for Payer: Cofinity Commercial |
$9,261.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,615.76
|
| Rate for Payer: Healthscope Commercial |
$9,692.73
|
| Rate for Payer: Healthscope Commercial |
$6,461.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,077.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,384.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,154.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Nomi Health Commercial |
$8,831.15
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,077.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,384.85
|
| Rate for Payer: PHP Commercial |
$6,102.83
|
| Rate for Payer: PHP Commercial |
$9,154.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,246.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,369.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,495.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,997.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,477.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,318.22
|
| Rate for Payer: UHC Core |
$8,992.70
|
| Rate for Payer: UHC Core |
$5,995.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,077.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,384.85
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$10,769.70
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,898.70 |
| Max. Negotiated Rate |
$9,692.73 |
| Rate for Payer: Aetna Commercial |
$9,154.25
|
| Rate for Payer: Aetna Commercial |
$6,102.83
|
| Rate for Payer: Aetna Medicare |
$1,866.75
|
| Rate for Payer: Aetna Medicare |
$2,800.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,243.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,365.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,365.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,243.69
|
| Rate for Payer: BCBS Complete |
$1,993.47
|
| Rate for Payer: BCBS Complete |
$1,328.98
|
| Rate for Payer: BCBS MAPPO |
$2,692.43
|
| Rate for Payer: BCBS MAPPO |
$1,794.95
|
| Rate for Payer: BCBS Trust/PPO |
$8,853.77
|
| Rate for Payer: BCBS Trust/PPO |
$5,902.51
|
| Rate for Payer: BCN Commercial |
$5,902.51
|
| Rate for Payer: BCN Commercial |
$8,853.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,794.95
|
| Rate for Payer: BCN Medicare Advantage |
$2,692.43
|
| Rate for Payer: Cash Price |
$8,615.76
|
| Rate for Payer: Cash Price |
$5,743.84
|
| Rate for Payer: Cofinity Commercial |
$9,261.94
|
| Rate for Payer: Cofinity Commercial |
$6,174.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,615.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,794.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,692.43
|
| Rate for Payer: Healthscope Commercial |
$9,692.73
|
| Rate for Payer: Healthscope Commercial |
$6,461.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,077.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,384.85
|
| Rate for Payer: Mclaren Medicaid |
$1,265.80
|
| Rate for Payer: Mclaren Medicaid |
$1,898.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,884.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,827.05
|
| Rate for Payer: Meridian Medicaid |
$1,993.47
|
| Rate for Payer: Meridian Medicaid |
$1,328.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,064.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,096.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,974.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,961.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,154.25
|
| Rate for Payer: Nomi Health Commercial |
$5,887.44
|
| Rate for Payer: Nomi Health Commercial |
$8,831.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,077.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,384.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,705.20
|
| Rate for Payer: PACE Senior Care Partners |
$2,557.80
|
| Rate for Payer: PACE SWMI |
$1,794.95
|
| Rate for Payer: PACE SWMI |
$2,692.43
|
| Rate for Payer: PHP Commercial |
$9,154.25
|
| Rate for Payer: PHP Commercial |
$6,102.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,692.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,794.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,265.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,898.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,246.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,369.64
|
| Rate for Payer: Priority Health Medicare |
$1,812.90
|
| Rate for Payer: Priority Health Medicare |
$2,719.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,495.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,997.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,692.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,794.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,477.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,318.22
|
| Rate for Payer: UHC Core |
$5,995.13
|
| Rate for Payer: UHC Core |
$8,992.70
|
| Rate for Payer: UHC Exchange |
$1,794.95
|
| Rate for Payer: UHC Exchange |
$2,692.43
|
| Rate for Payer: UHC Medicaid |
$1,265.80
|
| Rate for Payer: UHC Medicaid |
$1,898.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,692.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,794.95
|
| Rate for Payer: UHCCP Medicaid |
$1,898.70
|
| Rate for Payer: UHCCP Medicaid |
$1,265.80
|
| Rate for Payer: VA VA |
$2,692.43
|
| Rate for Payer: VA VA |
$1,794.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,384.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,077.27
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,602.48
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$458.82 |
| Max. Negotiated Rate |
$2,342.23 |
| Rate for Payer: Aetna Commercial |
$2,212.11
|
| Rate for Payer: Aetna Medicare |
$676.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.27
|
| Rate for Payer: BCBS Complete |
$481.72
|
| Rate for Payer: BCBS MAPPO |
$650.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,139.50
|
| Rate for Payer: BCN Commercial |
$2,139.50
|
| Rate for Payer: BCN Medicare Advantage |
$650.62
|
| Rate for Payer: Cash Price |
$2,081.98
|
| Rate for Payer: Cofinity Commercial |
$2,238.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.62
|
| Rate for Payer: Healthscope Commercial |
$2,342.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,951.86
|
| Rate for Payer: Mclaren Medicaid |
$458.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.15
|
| Rate for Payer: Meridian Medicaid |
$481.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$715.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,212.11
|
| Rate for Payer: Nomi Health Commercial |
$2,134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,951.86
|
| Rate for Payer: PACE Senior Care Partners |
$618.09
|
| Rate for Payer: PACE SWMI |
$650.62
|
| Rate for Payer: PHP Commercial |
$2,212.11
|
| Rate for Payer: PHP Medicare Advantage |
$650.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,264.16
|
| Rate for Payer: Priority Health Medicare |
$657.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,811.33
|
| Rate for Payer: Railroad Medicare Medicare |
$650.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,290.18
|
| Rate for Payer: UHC Core |
$2,173.07
|
| Rate for Payer: UHC Exchange |
$650.62
|
| Rate for Payer: UHC Medicaid |
$458.82
|
| Rate for Payer: UHC Medicare Advantage |
$650.62
|
| Rate for Payer: UHCCP Medicaid |
$458.82
|
| Rate for Payer: VA VA |
$650.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,951.86
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,602.48
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,811.33 |
| Max. Negotiated Rate |
$2,342.23 |
| Rate for Payer: Aetna Commercial |
$2,212.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,149.39
|
| Rate for Payer: BCN Commercial |
$2,149.39
|
| Rate for Payer: Cash Price |
$2,081.98
|
| Rate for Payer: Cofinity Commercial |
$2,238.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,081.98
|
| Rate for Payer: Healthscope Commercial |
$2,342.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,951.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,212.11
|
| Rate for Payer: Nomi Health Commercial |
$2,134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,951.86
|
| Rate for Payer: PHP Commercial |
$2,212.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,264.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,811.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,290.18
|
| Rate for Payer: UHC Core |
$2,173.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,951.86
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$385.45
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$268.27 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: BCBS Trust/PPO |
$318.34
|
| Rate for Payer: BCN Commercial |
$318.34
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.20
|
| Rate for Payer: UHC Core |
$321.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$385.45
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna Medicare |
$100.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.45
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$96.36
|
| Rate for Payer: BCBS Trust/PPO |
$316.88
|
| Rate for Payer: BCN Commercial |
$316.88
|
| Rate for Payer: BCN Medicare Advantage |
$96.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Mclaren Medicaid |
$67.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.18
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Nomi Health Commercial |
$316.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PACE Senior Care Partners |
$91.54
|
| Rate for Payer: PACE SWMI |
$96.36
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: PHP Medicare Advantage |
$96.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.34
|
| Rate for Payer: Priority Health Medicare |
$97.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.27
|
| Rate for Payer: Railroad Medicare Medicare |
$96.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.20
|
| Rate for Payer: UHC Core |
$321.85
|
| Rate for Payer: UHC Exchange |
$96.36
|
| Rate for Payer: UHC Medicaid |
$67.95
|
| Rate for Payer: UHC Medicare Advantage |
$96.36
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$96.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$971.03
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.19 |
| Max. Negotiated Rate |
$873.93 |
| Rate for Payer: Aetna Commercial |
$825.38
|
| Rate for Payer: Aetna Medicare |
$252.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.45
|
| Rate for Payer: BCBS Complete |
$179.74
|
| Rate for Payer: BCBS MAPPO |
$242.76
|
| Rate for Payer: BCBS Trust/PPO |
$798.28
|
| Rate for Payer: BCN Commercial |
$798.28
|
| Rate for Payer: BCN Medicare Advantage |
$242.76
|
| Rate for Payer: Cash Price |
$776.82
|
| Rate for Payer: Cofinity Commercial |
$835.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.76
|
| Rate for Payer: Healthscope Commercial |
$873.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.27
|
| Rate for Payer: Mclaren Medicaid |
$171.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.90
|
| Rate for Payer: Meridian Medicaid |
$179.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$267.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.38
|
| Rate for Payer: Nomi Health Commercial |
$796.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.27
|
| Rate for Payer: PACE Senior Care Partners |
$230.62
|
| Rate for Payer: PACE SWMI |
$242.76
|
| Rate for Payer: PHP Commercial |
$825.38
|
| Rate for Payer: PHP Medicare Advantage |
$242.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$844.80
|
| Rate for Payer: Priority Health Medicare |
$245.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$675.84
|
| Rate for Payer: Railroad Medicare Medicare |
$242.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.51
|
| Rate for Payer: UHC Core |
$810.81
|
| Rate for Payer: UHC Exchange |
$242.76
|
| Rate for Payer: UHC Medicaid |
$171.19
|
| Rate for Payer: UHC Medicare Advantage |
$242.76
|
| Rate for Payer: UHCCP Medicaid |
$171.19
|
| Rate for Payer: VA VA |
$242.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.27
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$971.03
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$675.84 |
| Max. Negotiated Rate |
$873.93 |
| Rate for Payer: Aetna Commercial |
$825.38
|
| Rate for Payer: BCBS Trust/PPO |
$801.97
|
| Rate for Payer: BCN Commercial |
$801.97
|
| Rate for Payer: Cash Price |
$776.82
|
| Rate for Payer: Cofinity Commercial |
$835.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.82
|
| Rate for Payer: Healthscope Commercial |
$873.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.38
|
| Rate for Payer: Nomi Health Commercial |
$796.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$728.27
|
| Rate for Payer: PHP Commercial |
$825.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$844.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$675.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.51
|
| Rate for Payer: UHC Core |
$810.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.27
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$252.40
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$175.67 |
| Max. Negotiated Rate |
$227.16 |
| Rate for Payer: Aetna Commercial |
$214.54
|
| Rate for Payer: BCBS Trust/PPO |
$208.46
|
| Rate for Payer: BCN Commercial |
$208.46
|
| Rate for Payer: Cash Price |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$217.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.92
|
| Rate for Payer: Healthscope Commercial |
$227.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.54
|
| Rate for Payer: Nomi Health Commercial |
$206.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.30
|
| Rate for Payer: PHP Commercial |
$214.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.11
|
| Rate for Payer: UHC Core |
$210.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.30
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$252.40
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$227.16 |
| Rate for Payer: Aetna Commercial |
$214.54
|
| Rate for Payer: Aetna Medicare |
$65.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.88
|
| Rate for Payer: BCBS Complete |
$46.72
|
| Rate for Payer: BCBS MAPPO |
$63.10
|
| Rate for Payer: BCBS Trust/PPO |
$207.50
|
| Rate for Payer: BCN Commercial |
$207.50
|
| Rate for Payer: BCN Medicare Advantage |
$63.10
|
| Rate for Payer: Cash Price |
$201.92
|
| Rate for Payer: Cash Price |
$201.92
|
| Rate for Payer: Cofinity Commercial |
$217.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.10
|
| Rate for Payer: Healthscope Commercial |
$227.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.30
|
| Rate for Payer: Mclaren Medicaid |
$44.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.25
|
| Rate for Payer: Meridian Medicaid |
$46.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.54
|
| Rate for Payer: Nomi Health Commercial |
$206.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.30
|
| Rate for Payer: PACE Senior Care Partners |
$59.95
|
| Rate for Payer: PACE SWMI |
$63.10
|
| Rate for Payer: PHP Commercial |
$214.54
|
| Rate for Payer: PHP Medicare Advantage |
$63.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.59
|
| Rate for Payer: Priority Health Medicare |
$63.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.67
|
| Rate for Payer: Railroad Medicare Medicare |
$63.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.11
|
| Rate for Payer: UHC Core |
$210.75
|
| Rate for Payer: UHC Exchange |
$63.10
|
| Rate for Payer: UHC Medicaid |
$44.50
|
| Rate for Payer: UHC Medicare Advantage |
$63.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$63.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.30
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,750.99
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$308.70 |
| Max. Negotiated Rate |
$1,575.89 |
| Rate for Payer: Aetna Commercial |
$1,488.34
|
| Rate for Payer: Aetna Medicare |
$455.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$547.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$547.18
|
| Rate for Payer: BCBS Complete |
$324.11
|
| Rate for Payer: BCBS MAPPO |
$437.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.49
|
| Rate for Payer: BCN Commercial |
$1,439.49
|
| Rate for Payer: BCN Medicare Advantage |
$437.75
|
| Rate for Payer: Cash Price |
$1,400.79
|
| Rate for Payer: Cofinity Commercial |
$1,505.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.75
|
| Rate for Payer: Healthscope Commercial |
$1,575.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.24
|
| Rate for Payer: Mclaren Medicaid |
$308.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.63
|
| Rate for Payer: Meridian Medicaid |
$324.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$503.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$481.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.34
|
| Rate for Payer: Nomi Health Commercial |
$1,435.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.24
|
| Rate for Payer: PACE Senior Care Partners |
$415.86
|
| Rate for Payer: PACE SWMI |
$437.75
|
| Rate for Payer: PHP Commercial |
$1,488.34
|
| Rate for Payer: PHP Medicare Advantage |
$437.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$308.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,523.36
|
| Rate for Payer: Priority Health Medicare |
$442.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.69
|
| Rate for Payer: Railroad Medicare Medicare |
$437.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,540.87
|
| Rate for Payer: UHC Core |
$1,462.08
|
| Rate for Payer: UHC Exchange |
$437.75
|
| Rate for Payer: UHC Medicaid |
$308.70
|
| Rate for Payer: UHC Medicare Advantage |
$437.75
|
| Rate for Payer: UHCCP Medicaid |
$308.70
|
| Rate for Payer: VA VA |
$437.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.24
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,750.99
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,218.69 |
| Max. Negotiated Rate |
$1,575.89 |
| Rate for Payer: Aetna Commercial |
$1,488.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,446.14
|
| Rate for Payer: BCN Commercial |
$1,446.14
|
| Rate for Payer: Cash Price |
$1,400.79
|
| Rate for Payer: Cofinity Commercial |
$1,505.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.79
|
| Rate for Payer: Healthscope Commercial |
$1,575.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.34
|
| Rate for Payer: Nomi Health Commercial |
$1,435.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.24
|
| Rate for Payer: PHP Commercial |
$1,488.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,523.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,218.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,540.87
|
| Rate for Payer: UHC Core |
$1,462.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.24
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,260.44
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,965.27 |
| Max. Negotiated Rate |
$3,834.40 |
| Rate for Payer: Aetna Commercial |
$3,621.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,518.70
|
| Rate for Payer: BCN Commercial |
$3,518.70
|
| Rate for Payer: Cash Price |
$3,408.35
|
| Rate for Payer: Cofinity Commercial |
$3,663.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,408.35
|
| Rate for Payer: Healthscope Commercial |
$3,834.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,195.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,621.37
|
| Rate for Payer: Nomi Health Commercial |
$3,493.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,195.33
|
| Rate for Payer: PHP Commercial |
$3,621.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,706.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,965.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,749.19
|
| Rate for Payer: UHC Core |
$3,557.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,195.33
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,260.44
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$751.12 |
| Max. Negotiated Rate |
$3,834.40 |
| Rate for Payer: Aetna Commercial |
$3,621.37
|
| Rate for Payer: Aetna Medicare |
$1,107.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,331.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,331.39
|
| Rate for Payer: BCBS Complete |
$788.61
|
| Rate for Payer: BCBS MAPPO |
$1,065.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,502.51
|
| Rate for Payer: BCN Commercial |
$3,502.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.11
|
| Rate for Payer: Cash Price |
$3,408.35
|
| Rate for Payer: Cofinity Commercial |
$3,663.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,408.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.11
|
| Rate for Payer: Healthscope Commercial |
$3,834.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,195.33
|
| Rate for Payer: Mclaren Medicaid |
$751.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,118.37
|
| Rate for Payer: Meridian Medicaid |
$788.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,224.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,171.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,621.37
|
| Rate for Payer: Nomi Health Commercial |
$3,493.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,195.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,011.85
|
| Rate for Payer: PACE SWMI |
$1,065.11
|
| Rate for Payer: PHP Commercial |
$3,621.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$751.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,706.58
|
| Rate for Payer: Priority Health Medicare |
$1,075.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,965.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,065.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,749.19
|
| Rate for Payer: UHC Core |
$3,557.47
|
| Rate for Payer: UHC Exchange |
$1,065.11
|
| Rate for Payer: UHC Medicaid |
$751.12
|
| Rate for Payer: UHC Medicare Advantage |
$1,065.11
|
| Rate for Payer: UHCCP Medicaid |
$751.12
|
| Rate for Payer: VA VA |
$1,065.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,195.33
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,184.69
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.16 |
| Max. Negotiated Rate |
$1,966.22 |
| Rate for Payer: Aetna Commercial |
$1,856.99
|
| Rate for Payer: Aetna Medicare |
$568.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.72
|
| Rate for Payer: BCBS Complete |
$404.39
|
| Rate for Payer: BCBS MAPPO |
$546.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.03
|
| Rate for Payer: BCN Commercial |
$1,796.03
|
| Rate for Payer: BCN Medicare Advantage |
$546.17
|
| Rate for Payer: Cash Price |
$1,747.75
|
| Rate for Payer: Cofinity Commercial |
$1,878.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.17
|
| Rate for Payer: Healthscope Commercial |
$1,966.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.52
|
| Rate for Payer: Mclaren Medicaid |
$385.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.48
|
| Rate for Payer: Meridian Medicaid |
$404.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,856.99
|
| Rate for Payer: Nomi Health Commercial |
$1,791.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.52
|
| Rate for Payer: PACE Senior Care Partners |
$518.86
|
| Rate for Payer: PACE SWMI |
$546.17
|
| Rate for Payer: PHP Commercial |
$1,856.99
|
| Rate for Payer: PHP Medicare Advantage |
$546.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.68
|
| Rate for Payer: Priority Health Medicare |
$551.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.54
|
| Rate for Payer: Railroad Medicare Medicare |
$546.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.53
|
| Rate for Payer: UHC Core |
$1,824.22
|
| Rate for Payer: UHC Exchange |
$546.17
|
| Rate for Payer: UHC Medicaid |
$385.16
|
| Rate for Payer: UHC Medicare Advantage |
$546.17
|
| Rate for Payer: UHCCP Medicaid |
$385.16
|
| Rate for Payer: VA VA |
$546.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.52
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,184.69
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.54 |
| Max. Negotiated Rate |
$1,966.22 |
| Rate for Payer: Aetna Commercial |
$1,856.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.34
|
| Rate for Payer: BCN Commercial |
$1,804.34
|
| Rate for Payer: Cash Price |
$1,747.75
|
| Rate for Payer: Cofinity Commercial |
$1,878.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.75
|
| Rate for Payer: Healthscope Commercial |
$1,966.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,856.99
|
| Rate for Payer: Nomi Health Commercial |
$1,791.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.52
|
| Rate for Payer: PHP Commercial |
$1,856.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.53
|
| Rate for Payer: UHC Core |
$1,824.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.52
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$116.12
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$104.51 |
| Rate for Payer: Aetna Commercial |
$98.70
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.29
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCBS Trust/PPO |
$95.46
|
| Rate for Payer: BCN Commercial |
$95.46
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: Cash Price |
$92.90
|
| Rate for Payer: Cofinity Commercial |
$99.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$104.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.09
|
| Rate for Payer: Mclaren Medicaid |
$20.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.70
|
| Rate for Payer: Nomi Health Commercial |
$95.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.09
|
| Rate for Payer: PACE Senior Care Partners |
$27.58
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PHP Commercial |
$98.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.02
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.82
|
| Rate for Payer: Railroad Medicare Medicare |
$29.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.19
|
| Rate for Payer: UHC Core |
$96.96
|
| Rate for Payer: UHC Exchange |
$29.03
|
| Rate for Payer: UHC Medicaid |
$20.47
|
| Rate for Payer: UHC Medicare Advantage |
$29.03
|
| Rate for Payer: UHCCP Medicaid |
$20.47
|
| Rate for Payer: VA VA |
$29.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.09
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
IP
|
$116.12
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.82 |
| Max. Negotiated Rate |
$104.51 |
| Rate for Payer: Aetna Commercial |
$98.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.90
|
| Rate for Payer: BCN Commercial |
$95.90
|
| Rate for Payer: Cash Price |
$92.90
|
| Rate for Payer: Cofinity Commercial |
$99.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.90
|
| Rate for Payer: Healthscope Commercial |
$104.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.70
|
| Rate for Payer: Nomi Health Commercial |
$95.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.09
|
| Rate for Payer: PHP Commercial |
$98.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.19
|
| Rate for Payer: UHC Core |
$96.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.09
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
IP
|
$2,832.85
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETERAL STENT
|
Facility
|
OP
|
$2,832.85
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$990.91
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.70 |
| Max. Negotiated Rate |
$891.82 |
| Rate for Payer: Aetna Commercial |
$842.27
|
| Rate for Payer: Aetna Medicare |
$257.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.66
|
| Rate for Payer: BCBS Complete |
$183.42
|
| Rate for Payer: BCBS MAPPO |
$247.73
|
| Rate for Payer: BCBS Trust/PPO |
$814.63
|
| Rate for Payer: BCN Commercial |
$814.63
|
| Rate for Payer: BCN Medicare Advantage |
$247.73
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cofinity Commercial |
$852.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.73
|
| Rate for Payer: Healthscope Commercial |
$891.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.18
|
| Rate for Payer: Mclaren Medicaid |
$174.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.11
|
| Rate for Payer: Meridian Medicaid |
$183.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$272.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.27
|
| Rate for Payer: Nomi Health Commercial |
$812.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.18
|
| Rate for Payer: PACE Senior Care Partners |
$235.34
|
| Rate for Payer: PACE SWMI |
$247.73
|
| Rate for Payer: PHP Commercial |
$842.27
|
| Rate for Payer: PHP Medicare Advantage |
$247.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$862.09
|
| Rate for Payer: Priority Health Medicare |
$250.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.67
|
| Rate for Payer: Railroad Medicare Medicare |
$247.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.00
|
| Rate for Payer: UHC Core |
$827.41
|
| Rate for Payer: UHC Exchange |
$247.73
|
| Rate for Payer: UHC Medicaid |
$174.70
|
| Rate for Payer: UHC Medicare Advantage |
$247.73
|
| Rate for Payer: UHCCP Medicaid |
$174.70
|
| Rate for Payer: VA VA |
$247.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.18
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$990.91
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.67 |
| Max. Negotiated Rate |
$891.82 |
| Rate for Payer: Aetna Commercial |
$842.27
|
| Rate for Payer: BCBS Trust/PPO |
$818.39
|
| Rate for Payer: BCN Commercial |
$818.39
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cofinity Commercial |
$852.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.73
|
| Rate for Payer: Healthscope Commercial |
$891.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.27
|
| Rate for Payer: Nomi Health Commercial |
$812.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.18
|
| Rate for Payer: PHP Commercial |
$842.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$862.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$689.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.00
|
| Rate for Payer: UHC Core |
$827.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.18
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$943.15
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.43 |
| Max. Negotiated Rate |
$848.84 |
| Rate for Payer: Aetna Commercial |
$801.68
|
| Rate for Payer: BCBS Trust/PPO |
$778.95
|
| Rate for Payer: BCN Commercial |
$778.95
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cofinity Commercial |
$811.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.52
|
| Rate for Payer: Healthscope Commercial |
$848.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.68
|
| Rate for Payer: Nomi Health Commercial |
$773.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.36
|
| Rate for Payer: PHP Commercial |
$801.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$820.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.97
|
| Rate for Payer: UHC Core |
$787.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.36
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$943.15
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$166.28 |
| Max. Negotiated Rate |
$848.84 |
| Rate for Payer: Aetna Commercial |
$801.68
|
| Rate for Payer: Aetna Medicare |
$245.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.73
|
| Rate for Payer: BCBS Complete |
$174.58
|
| Rate for Payer: BCBS MAPPO |
$235.79
|
| Rate for Payer: BCBS Trust/PPO |
$775.36
|
| Rate for Payer: BCN Commercial |
$775.36
|
| Rate for Payer: BCN Medicare Advantage |
$235.79
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cofinity Commercial |
$811.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.79
|
| Rate for Payer: Healthscope Commercial |
$848.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.36
|
| Rate for Payer: Mclaren Medicaid |
$166.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.58
|
| Rate for Payer: Meridian Medicaid |
$174.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.68
|
| Rate for Payer: Nomi Health Commercial |
$773.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.36
|
| Rate for Payer: PACE Senior Care Partners |
$224.00
|
| Rate for Payer: PACE SWMI |
$235.79
|
| Rate for Payer: PHP Commercial |
$801.68
|
| Rate for Payer: PHP Medicare Advantage |
$235.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$820.54
|
| Rate for Payer: Priority Health Medicare |
$238.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.43
|
| Rate for Payer: Railroad Medicare Medicare |
$235.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.97
|
| Rate for Payer: UHC Core |
$787.53
|
| Rate for Payer: UHC Exchange |
$235.79
|
| Rate for Payer: UHC Medicaid |
$166.28
|
| Rate for Payer: UHC Medicare Advantage |
$235.79
|
| Rate for Payer: UHCCP Medicaid |
$166.28
|
| Rate for Payer: VA VA |
$235.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.36
|
|
