|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,967.49
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.17 |
| Max. Negotiated Rate |
$2,670.74 |
| Rate for Payer: Aetna Commercial |
$2,522.37
|
| Rate for Payer: Aetna Medicare |
$771.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$927.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$927.34
|
| Rate for Payer: BCBS Complete |
$549.28
|
| Rate for Payer: BCBS MAPPO |
$741.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,439.57
|
| Rate for Payer: BCN Commercial |
$2,439.57
|
| Rate for Payer: BCN Medicare Advantage |
$741.87
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cofinity Commercial |
$2,552.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,373.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$741.87
|
| Rate for Payer: Healthscope Commercial |
$2,670.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,225.62
|
| Rate for Payer: Mclaren Medicaid |
$523.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$778.97
|
| Rate for Payer: Meridian Medicaid |
$549.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$853.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$816.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,522.37
|
| Rate for Payer: Nomi Health Commercial |
$2,433.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,225.62
|
| Rate for Payer: PACE Senior Care Partners |
$704.78
|
| Rate for Payer: PACE SWMI |
$741.87
|
| Rate for Payer: PHP Commercial |
$2,522.37
|
| Rate for Payer: PHP Medicare Advantage |
$741.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$523.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,581.72
|
| Rate for Payer: Priority Health Medicare |
$749.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,065.37
|
| Rate for Payer: Railroad Medicare Medicare |
$741.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,611.39
|
| Rate for Payer: UHC Core |
$2,477.85
|
| Rate for Payer: UHC Exchange |
$741.87
|
| Rate for Payer: UHC Medicaid |
$523.17
|
| Rate for Payer: UHC Medicare Advantage |
$741.87
|
| Rate for Payer: UHCCP Medicaid |
$523.17
|
| Rate for Payer: VA VA |
$741.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,225.62
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,967.49
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,065.37 |
| Max. Negotiated Rate |
$2,670.74 |
| Rate for Payer: Aetna Commercial |
$2,522.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,450.85
|
| Rate for Payer: BCN Commercial |
$2,450.85
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cofinity Commercial |
$2,552.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,373.99
|
| Rate for Payer: Healthscope Commercial |
$2,670.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,225.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,522.37
|
| Rate for Payer: Nomi Health Commercial |
$2,433.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,225.62
|
| Rate for Payer: PHP Commercial |
$2,522.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,581.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,065.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,611.39
|
| Rate for Payer: UHC Core |
$2,477.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,225.62
|
|
|
HC REMOVE & REPLACE SUBSTERN IMPLANT DEFIB PG
|
Facility
|
OP
|
$50,503.93
|
|
|
Service Code
|
CPT 0614T
|
| Hospital Charge Code |
48100135
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,903.84 |
| Max. Negotiated Rate |
$45,453.54 |
| Rate for Payer: Aetna Commercial |
$42,928.34
|
| Rate for Payer: Aetna Medicare |
$13,131.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,782.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,782.48
|
| Rate for Payer: BCBS Complete |
$9,348.28
|
| Rate for Payer: BCBS MAPPO |
$12,625.98
|
| Rate for Payer: BCBS Trust/PPO |
$41,519.28
|
| Rate for Payer: BCN Commercial |
$41,519.28
|
| Rate for Payer: BCN Medicare Advantage |
$12,625.98
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cofinity Commercial |
$43,433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,403.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,625.98
|
| Rate for Payer: Healthscope Commercial |
$45,453.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,877.95
|
| Rate for Payer: Mclaren Medicaid |
$8,903.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,257.28
|
| Rate for Payer: Meridian Medicaid |
$9,348.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,519.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$13,888.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,928.34
|
| Rate for Payer: Nomi Health Commercial |
$41,413.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37,877.95
|
| Rate for Payer: PACE Senior Care Partners |
$11,994.68
|
| Rate for Payer: PACE SWMI |
$12,625.98
|
| Rate for Payer: PHP Commercial |
$42,928.34
|
| Rate for Payer: PHP Medicare Advantage |
$12,625.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,903.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43,938.42
|
| Rate for Payer: Priority Health Medicare |
$12,752.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,150.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12,625.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,443.46
|
| Rate for Payer: UHC Core |
$42,170.78
|
| Rate for Payer: UHC Exchange |
$12,625.98
|
| Rate for Payer: UHC Medicaid |
$8,903.84
|
| Rate for Payer: UHC Medicare Advantage |
$12,625.98
|
| Rate for Payer: UHCCP Medicaid |
$8,903.84
|
| Rate for Payer: VA VA |
$12,625.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,877.95
|
|
|
HC REMOVE & REPLACE SUBSTERN IMPLANT DEFIB PG
|
Facility
|
IP
|
$50,503.93
|
|
|
Service Code
|
CPT 0614T
|
| Hospital Charge Code |
48100135
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$35,150.74 |
| Max. Negotiated Rate |
$45,453.54 |
| Rate for Payer: Aetna Commercial |
$42,928.34
|
| Rate for Payer: BCBS Trust/PPO |
$41,711.20
|
| Rate for Payer: BCN Commercial |
$41,711.20
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cofinity Commercial |
$43,433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,403.14
|
| Rate for Payer: Healthscope Commercial |
$45,453.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,877.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,928.34
|
| Rate for Payer: Nomi Health Commercial |
$41,413.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37,877.95
|
| Rate for Payer: PHP Commercial |
$42,928.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43,938.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35,150.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,443.46
|
| Rate for Payer: UHC Core |
$42,170.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,877.95
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,937.77 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: BCBS Trust/PPO |
$7,045.98
|
| Rate for Payer: BCN Commercial |
$7,045.98
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,531.28
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,504.06 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna Medicare |
$2,218.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,666.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,666.03
|
| Rate for Payer: BCBS Complete |
$1,579.14
|
| Rate for Payer: BCBS MAPPO |
$2,132.82
|
| Rate for Payer: BCBS Trust/PPO |
$7,013.57
|
| Rate for Payer: BCN Commercial |
$7,013.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.82
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.82
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Mclaren Medicaid |
$1,504.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.46
|
| Rate for Payer: Meridian Medicaid |
$1,579.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,452.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,346.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,026.18
|
| Rate for Payer: PACE SWMI |
$2,132.82
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,504.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Medicare |
$2,154.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,132.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: UHC Exchange |
$2,132.82
|
| Rate for Payer: UHC Medicaid |
$1,504.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.82
|
| Rate for Payer: UHCCP Medicaid |
$1,504.06
|
| Rate for Payer: VA VA |
$2,132.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,654.45
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,239.50 |
| Max. Negotiated Rate |
$4,189.01 |
| Rate for Payer: Aetna Commercial |
$3,956.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,844.11
|
| Rate for Payer: BCN Commercial |
$3,844.11
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cofinity Commercial |
$4,002.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,723.56
|
| Rate for Payer: Healthscope Commercial |
$4,189.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,490.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,956.28
|
| Rate for Payer: Nomi Health Commercial |
$3,816.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,490.84
|
| Rate for Payer: PHP Commercial |
$3,956.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,049.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,239.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,095.92
|
| Rate for Payer: UHC Core |
$3,886.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,490.84
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,654.45
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$820.58 |
| Max. Negotiated Rate |
$4,189.01 |
| Rate for Payer: Aetna Commercial |
$3,956.28
|
| Rate for Payer: Aetna Medicare |
$1,210.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,454.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,454.52
|
| Rate for Payer: BCBS Complete |
$861.54
|
| Rate for Payer: BCBS MAPPO |
$1,163.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,826.42
|
| Rate for Payer: BCN Commercial |
$3,826.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,163.61
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cofinity Commercial |
$4,002.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,723.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,163.61
|
| Rate for Payer: Healthscope Commercial |
$4,189.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,490.84
|
| Rate for Payer: Mclaren Medicaid |
$820.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,221.79
|
| Rate for Payer: Meridian Medicaid |
$861.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,338.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,279.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,956.28
|
| Rate for Payer: Nomi Health Commercial |
$3,816.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,490.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,105.43
|
| Rate for Payer: PACE SWMI |
$1,163.61
|
| Rate for Payer: PHP Commercial |
$3,956.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,163.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,049.37
|
| Rate for Payer: Priority Health Medicare |
$1,175.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,239.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,163.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,095.92
|
| Rate for Payer: UHC Core |
$3,886.47
|
| Rate for Payer: UHC Exchange |
$1,163.61
|
| Rate for Payer: UHC Medicaid |
$820.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,163.61
|
| Rate for Payer: UHCCP Medicaid |
$820.58
|
| Rate for Payer: VA VA |
$1,163.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,490.84
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.81
|
| Rate for Payer: BCN Commercial |
$37.81
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$11.45
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$37.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.45
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.45
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.45
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.86
|
| Rate for Payer: Railroad Medicare Medicare |
$11.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Exchange |
$11.45
|
| Rate for Payer: UHC Medicaid |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$11.45
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$11.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.08
|
| Rate for Payer: BCBS Complete |
$5.97
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Mclaren Medicaid |
$5.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$5.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PACE Senior Care Partners |
$7.66
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Medicare |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: UHC Exchange |
$8.06
|
| Rate for Payer: UHC Medicaid |
$5.69
|
| Rate for Payer: UHC Medicare Advantage |
$8.06
|
| Rate for Payer: UHCCP Medicaid |
$5.69
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: BCBS Trust/PPO |
$26.64
|
| Rate for Payer: BCN Commercial |
$26.64
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,207.19
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$918.03 |
| Max. Negotiated Rate |
$4,686.47 |
| Rate for Payer: Aetna Commercial |
$4,426.11
|
| Rate for Payer: Aetna Medicare |
$1,353.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,627.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,627.25
|
| Rate for Payer: BCBS Complete |
$963.85
|
| Rate for Payer: BCBS MAPPO |
$1,301.80
|
| Rate for Payer: BCBS Trust/PPO |
$4,280.83
|
| Rate for Payer: BCN Commercial |
$4,280.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,301.80
|
| Rate for Payer: Cash Price |
$4,165.75
|
| Rate for Payer: Cofinity Commercial |
$4,478.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,165.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,301.80
|
| Rate for Payer: Healthscope Commercial |
$4,686.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,905.39
|
| Rate for Payer: Mclaren Medicaid |
$918.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,366.89
|
| Rate for Payer: Meridian Medicaid |
$963.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,497.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,431.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,426.11
|
| Rate for Payer: Nomi Health Commercial |
$4,269.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,905.39
|
| Rate for Payer: PACE Senior Care Partners |
$1,236.71
|
| Rate for Payer: PACE SWMI |
$1,301.80
|
| Rate for Payer: PHP Commercial |
$4,426.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,301.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$918.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,530.26
|
| Rate for Payer: Priority Health Medicare |
$1,314.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,624.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,301.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,582.33
|
| Rate for Payer: UHC Core |
$4,348.00
|
| Rate for Payer: UHC Exchange |
$1,301.80
|
| Rate for Payer: UHC Medicaid |
$918.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,301.80
|
| Rate for Payer: UHCCP Medicaid |
$918.03
|
| Rate for Payer: VA VA |
$1,301.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,905.39
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,207.19
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,624.20 |
| Max. Negotiated Rate |
$4,686.47 |
| Rate for Payer: Aetna Commercial |
$4,426.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,300.62
|
| Rate for Payer: BCN Commercial |
$4,300.62
|
| Rate for Payer: Cash Price |
$4,165.75
|
| Rate for Payer: Cofinity Commercial |
$4,478.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,165.75
|
| Rate for Payer: Healthscope Commercial |
$4,686.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,905.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,426.11
|
| Rate for Payer: Nomi Health Commercial |
$4,269.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,905.39
|
| Rate for Payer: PHP Commercial |
$4,426.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,530.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,624.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,582.33
|
| Rate for Payer: UHC Core |
$4,348.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,905.39
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.11 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.80
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$29.66
|
| Rate for Payer: BCN Commercial |
$29.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Senior Care Partners |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicaid |
$6.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.02
|
| Rate for Payer: UHCCP Medicaid |
$6.36
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC RENIN
|
Facility
|
OP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$11.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.23
|
| Rate for Payer: BCBS Complete |
$7.84
|
| Rate for Payer: BCBS MAPPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$34.81
|
| Rate for Payer: BCN Commercial |
$34.81
|
| Rate for Payer: BCN Medicare Advantage |
$10.59
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.59
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$7.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PACE Senior Care Partners |
$10.06
|
| Rate for Payer: PACE SWMI |
$10.59
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$10.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.84
|
| Rate for Payer: Priority Health Medicare |
$10.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.47
|
| Rate for Payer: Railroad Medicare Medicare |
$10.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.26
|
| Rate for Payer: UHC Core |
$35.35
|
| Rate for Payer: UHC Exchange |
$10.59
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.59
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
|
HC RENIN
|
Facility
|
IP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.47 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: BCBS Trust/PPO |
$34.97
|
| Rate for Payer: BCN Commercial |
$34.97
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$34.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.26
|
| Rate for Payer: UHC Core |
$35.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.41
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Aetna Commercial |
$0.35
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: Cash Price |
$0.33
|
| Rate for Payer: Cofinity Commercial |
$0.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.35
|
| Rate for Payer: Nomi Health Commercial |
$0.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.31
|
| Rate for Payer: PHP Commercial |
$0.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.36
|
| Rate for Payer: UHC Core |
$0.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.31
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.41
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Aetna Commercial |
$0.35
|
| Rate for Payer: Aetna Medicare |
$0.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.13
|
| Rate for Payer: BCBS Complete |
$0.08
|
| Rate for Payer: BCBS MAPPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.34
|
| Rate for Payer: BCN Commercial |
$0.34
|
| Rate for Payer: BCN Medicare Advantage |
$0.10
|
| Rate for Payer: Cash Price |
$0.33
|
| Rate for Payer: Cofinity Commercial |
$0.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.10
|
| Rate for Payer: Healthscope Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.31
|
| Rate for Payer: Mclaren Medicaid |
$0.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.11
|
| Rate for Payer: Meridian Medicaid |
$0.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.35
|
| Rate for Payer: Nomi Health Commercial |
$0.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.31
|
| Rate for Payer: PACE Senior Care Partners |
$0.10
|
| Rate for Payer: PACE SWMI |
$0.10
|
| Rate for Payer: PHP Commercial |
$0.35
|
| Rate for Payer: PHP Medicare Advantage |
$0.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.36
|
| Rate for Payer: Priority Health Medicare |
$0.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.29
|
| Rate for Payer: Railroad Medicare Medicare |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.36
|
| Rate for Payer: UHC Core |
$0.34
|
| Rate for Payer: UHC Exchange |
$0.10
|
| Rate for Payer: UHC Medicaid |
$0.07
|
| Rate for Payer: UHC Medicare Advantage |
$0.10
|
| Rate for Payer: UHCCP Medicaid |
$0.07
|
| Rate for Payer: VA VA |
$0.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.31
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.30 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: Aetna Medicare |
$419.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.94
|
| Rate for Payer: BCBS Complete |
$298.50
|
| Rate for Payer: BCBS MAPPO |
$403.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.73
|
| Rate for Payer: BCN Commercial |
$1,325.73
|
| Rate for Payer: BCN Medicare Advantage |
$403.15
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.15
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Mclaren Medicaid |
$284.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.31
|
| Rate for Payer: Meridian Medicaid |
$298.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$463.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PACE Senior Care Partners |
$383.00
|
| Rate for Payer: PACE SWMI |
$403.15
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: PHP Medicare Advantage |
$403.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,402.98
|
| Rate for Payer: Priority Health Medicare |
$407.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,122.38
|
| Rate for Payer: Railroad Medicare Medicare |
$403.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: UHC Exchange |
$403.15
|
| Rate for Payer: UHC Medicaid |
$284.30
|
| Rate for Payer: UHC Medicare Advantage |
$403.15
|
| Rate for Payer: UHCCP Medicaid |
$284.30
|
| Rate for Payer: VA VA |
$403.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,122.38 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.86
|
| Rate for Payer: BCN Commercial |
$1,331.86
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,402.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,122.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,122.38 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.86
|
| Rate for Payer: BCN Commercial |
$1,331.86
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,402.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,122.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.30 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: Aetna Medicare |
$419.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.94
|
| Rate for Payer: BCBS Complete |
$298.50
|
| Rate for Payer: BCBS MAPPO |
$403.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.73
|
| Rate for Payer: BCN Commercial |
$1,325.73
|
| Rate for Payer: BCN Medicare Advantage |
$403.15
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.15
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Mclaren Medicaid |
$284.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.31
|
| Rate for Payer: Meridian Medicaid |
$298.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$463.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,370.73
|
| Rate for Payer: Nomi Health Commercial |
$1,322.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,209.46
|
| Rate for Payer: PACE Senior Care Partners |
$383.00
|
| Rate for Payer: PACE SWMI |
$403.15
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: PHP Medicare Advantage |
$403.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,402.98
|
| Rate for Payer: Priority Health Medicare |
$407.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,122.38
|
| Rate for Payer: Railroad Medicare Medicare |
$403.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: UHC Exchange |
$403.15
|
| Rate for Payer: UHC Medicaid |
$284.30
|
| Rate for Payer: UHC Medicare Advantage |
$403.15
|
| Rate for Payer: UHCCP Medicaid |
$284.30
|
| Rate for Payer: VA VA |
$403.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,695.85
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.98 |
| Max. Negotiated Rate |
$1,526.27 |
| Rate for Payer: Aetna Commercial |
$1,441.47
|
| Rate for Payer: Aetna Medicare |
$440.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$529.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$529.95
|
| Rate for Payer: BCBS Complete |
$313.90
|
| Rate for Payer: BCBS MAPPO |
$423.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,394.16
|
| Rate for Payer: BCN Commercial |
$1,394.16
|
| Rate for Payer: BCN Medicare Advantage |
$423.96
|
| Rate for Payer: Cash Price |
$1,356.68
|
| Rate for Payer: Cofinity Commercial |
$1,458.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,356.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.96
|
| Rate for Payer: Healthscope Commercial |
$1,526.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,271.89
|
| Rate for Payer: Mclaren Medicaid |
$298.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$445.16
|
| Rate for Payer: Meridian Medicaid |
$313.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$487.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$466.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,441.47
|
| Rate for Payer: Nomi Health Commercial |
$1,390.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,271.89
|
| Rate for Payer: PACE Senior Care Partners |
$402.76
|
| Rate for Payer: PACE SWMI |
$423.96
|
| Rate for Payer: PHP Commercial |
$1,441.47
|
| Rate for Payer: PHP Medicare Advantage |
$423.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$298.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,475.39
|
| Rate for Payer: Priority Health Medicare |
$428.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,180.31
|
| Rate for Payer: Railroad Medicare Medicare |
$423.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.35
|
| Rate for Payer: UHC Core |
$1,416.03
|
| Rate for Payer: UHC Exchange |
$423.96
|
| Rate for Payer: UHC Medicaid |
$298.98
|
| Rate for Payer: UHC Medicare Advantage |
$423.96
|
| Rate for Payer: UHCCP Medicaid |
$298.98
|
| Rate for Payer: VA VA |
$423.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,271.89
|
|
