|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,695.85
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,180.31 |
| Max. Negotiated Rate |
$1,526.27 |
| Rate for Payer: Aetna Commercial |
$1,441.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,400.60
|
| Rate for Payer: BCN Commercial |
$1,400.60
|
| 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: Healthscope Commercial |
$1,526.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,271.89
|
| 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: PHP Commercial |
$1,441.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,475.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,180.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,492.35
|
| Rate for Payer: UHC Core |
$1,416.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,271.89
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM
|
Facility
|
OP
|
$1,927.80
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
76100531
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$339.87 |
| Max. Negotiated Rate |
$1,735.02 |
| Rate for Payer: Aetna Commercial |
$1,638.63
|
| Rate for Payer: Aetna Medicare |
$501.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$602.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$602.44
|
| Rate for Payer: BCBS Complete |
$356.84
|
| Rate for Payer: BCBS MAPPO |
$481.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,584.84
|
| Rate for Payer: BCN Commercial |
$1,584.84
|
| Rate for Payer: BCN Medicare Advantage |
$481.95
|
| Rate for Payer: Cash Price |
$1,542.24
|
| Rate for Payer: Cofinity Commercial |
$1,657.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,542.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.95
|
| Rate for Payer: Healthscope Commercial |
$1,735.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,445.85
|
| Rate for Payer: Mclaren Medicaid |
$339.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.05
|
| Rate for Payer: Meridian Medicaid |
$356.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$554.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,638.63
|
| Rate for Payer: Nomi Health Commercial |
$1,580.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.85
|
| Rate for Payer: PACE Senior Care Partners |
$457.85
|
| Rate for Payer: PACE SWMI |
$481.95
|
| Rate for Payer: PHP Commercial |
$1,638.63
|
| Rate for Payer: PHP Medicare Advantage |
$481.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$339.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,677.19
|
| Rate for Payer: Priority Health Medicare |
$486.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,341.75
|
| Rate for Payer: Railroad Medicare Medicare |
$481.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,696.46
|
| Rate for Payer: UHC Core |
$1,609.71
|
| Rate for Payer: UHC Exchange |
$481.95
|
| Rate for Payer: UHC Medicaid |
$339.87
|
| Rate for Payer: UHC Medicare Advantage |
$481.95
|
| Rate for Payer: UHCCP Medicaid |
$339.87
|
| Rate for Payer: VA VA |
$481.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,445.85
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM
|
Facility
|
IP
|
$1,927.80
|
|
|
Service Code
|
CPT 13120
|
| Hospital Charge Code |
76100531
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,341.75 |
| Max. Negotiated Rate |
$1,735.02 |
| Rate for Payer: Aetna Commercial |
$1,638.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,592.17
|
| Rate for Payer: BCN Commercial |
$1,592.17
|
| Rate for Payer: Cash Price |
$1,542.24
|
| Rate for Payer: Cofinity Commercial |
$1,657.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,542.24
|
| Rate for Payer: Healthscope Commercial |
$1,735.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,445.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,638.63
|
| Rate for Payer: Nomi Health Commercial |
$1,580.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,445.85
|
| Rate for Payer: PHP Commercial |
$1,638.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,677.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,341.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,696.46
|
| Rate for Payer: UHC Core |
$1,609.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,445.85
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5CM
|
Facility
|
IP
|
$1,603.27
|
|
|
Service Code
|
CPT 13121
|
| Hospital Charge Code |
76100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,115.88 |
| Max. Negotiated Rate |
$1,442.94 |
| Rate for Payer: Aetna Commercial |
$1,362.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,324.14
|
| Rate for Payer: BCN Commercial |
$1,324.14
|
| Rate for Payer: Cash Price |
$1,282.62
|
| Rate for Payer: Cofinity Commercial |
$1,378.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,282.62
|
| Rate for Payer: Healthscope Commercial |
$1,442.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,202.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,362.78
|
| Rate for Payer: Nomi Health Commercial |
$1,314.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,202.45
|
| Rate for Payer: PHP Commercial |
$1,362.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,394.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,410.88
|
| Rate for Payer: UHC Core |
$1,338.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,202.45
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5CM
|
Facility
|
OP
|
$1,603.27
|
|
|
Service Code
|
CPT 13121
|
| Hospital Charge Code |
76100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$282.66 |
| Max. Negotiated Rate |
$1,442.94 |
| Rate for Payer: Aetna Commercial |
$1,362.78
|
| Rate for Payer: Aetna Medicare |
$416.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$501.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$501.02
|
| Rate for Payer: BCBS Complete |
$296.77
|
| Rate for Payer: BCBS MAPPO |
$400.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,318.05
|
| Rate for Payer: BCN Commercial |
$1,318.05
|
| Rate for Payer: BCN Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$1,282.62
|
| Rate for Payer: Cofinity Commercial |
$1,378.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,282.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.82
|
| Rate for Payer: Healthscope Commercial |
$1,442.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,202.45
|
| Rate for Payer: Mclaren Medicaid |
$282.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.86
|
| Rate for Payer: Meridian Medicaid |
$296.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,362.78
|
| Rate for Payer: Nomi Health Commercial |
$1,314.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,202.45
|
| Rate for Payer: PACE Senior Care Partners |
$380.78
|
| Rate for Payer: PACE SWMI |
$400.82
|
| Rate for Payer: PHP Commercial |
$1,362.78
|
| Rate for Payer: PHP Medicare Advantage |
$400.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,394.84
|
| Rate for Payer: Priority Health Medicare |
$404.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.88
|
| Rate for Payer: Railroad Medicare Medicare |
$400.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,410.88
|
| Rate for Payer: UHC Core |
$1,338.73
|
| Rate for Payer: UHC Exchange |
$400.82
|
| Rate for Payer: UHC Medicaid |
$282.66
|
| Rate for Payer: UHC Medicare Advantage |
$400.82
|
| Rate for Payer: UHCCP Medicaid |
$282.66
|
| Rate for Payer: VA VA |
$400.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,202.45
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<
|
Facility
|
OP
|
$3,431.75
|
|
|
Service Code
|
CPT 13122
|
| Hospital Charge Code |
76100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$605.02 |
| Max. Negotiated Rate |
$3,088.57 |
| Rate for Payer: Aetna Commercial |
$2,916.99
|
| Rate for Payer: Aetna Medicare |
$892.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,072.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,072.42
|
| Rate for Payer: BCBS Complete |
$635.22
|
| Rate for Payer: BCBS MAPPO |
$857.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,821.24
|
| Rate for Payer: BCN Commercial |
$2,821.24
|
| Rate for Payer: BCN Medicare Advantage |
$857.94
|
| Rate for Payer: Cash Price |
$2,745.40
|
| Rate for Payer: Cofinity Commercial |
$2,951.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,745.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.94
|
| Rate for Payer: Healthscope Commercial |
$3,088.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,573.81
|
| Rate for Payer: Mclaren Medicaid |
$605.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$900.83
|
| Rate for Payer: Meridian Medicaid |
$635.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$986.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$943.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,916.99
|
| Rate for Payer: Nomi Health Commercial |
$2,814.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,573.81
|
| Rate for Payer: PACE Senior Care Partners |
$815.04
|
| Rate for Payer: PACE SWMI |
$857.94
|
| Rate for Payer: PHP Commercial |
$2,916.99
|
| Rate for Payer: PHP Medicare Advantage |
$857.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$605.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,985.62
|
| Rate for Payer: Priority Health Medicare |
$866.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,388.50
|
| Rate for Payer: Railroad Medicare Medicare |
$857.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,019.94
|
| Rate for Payer: UHC Core |
$2,865.51
|
| Rate for Payer: UHC Exchange |
$857.94
|
| Rate for Payer: UHC Medicaid |
$605.02
|
| Rate for Payer: UHC Medicare Advantage |
$857.94
|
| Rate for Payer: UHCCP Medicaid |
$605.02
|
| Rate for Payer: VA VA |
$857.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,573.81
|
|
|
HC REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<
|
Facility
|
IP
|
$3,431.75
|
|
|
Service Code
|
CPT 13122
|
| Hospital Charge Code |
76100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,388.50 |
| Max. Negotiated Rate |
$3,088.57 |
| Rate for Payer: Aetna Commercial |
$2,916.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,834.28
|
| Rate for Payer: BCN Commercial |
$2,834.28
|
| Rate for Payer: Cash Price |
$2,745.40
|
| Rate for Payer: Cofinity Commercial |
$2,951.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,745.40
|
| Rate for Payer: Healthscope Commercial |
$3,088.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,573.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,916.99
|
| Rate for Payer: Nomi Health Commercial |
$2,814.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,573.81
|
| Rate for Payer: PHP Commercial |
$2,916.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,985.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,388.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,019.94
|
| Rate for Payer: UHC Core |
$2,865.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,573.81
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,090.74
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$759.16 |
| Max. Negotiated Rate |
$981.67 |
| Rate for Payer: Aetna Commercial |
$927.13
|
| Rate for Payer: BCBS Trust/PPO |
$900.84
|
| Rate for Payer: BCN Commercial |
$900.84
|
| Rate for Payer: Cash Price |
$872.59
|
| Rate for Payer: Cofinity Commercial |
$938.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.59
|
| Rate for Payer: Healthscope Commercial |
$981.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$927.13
|
| Rate for Payer: Nomi Health Commercial |
$894.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.05
|
| Rate for Payer: PHP Commercial |
$927.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$948.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$759.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.85
|
| Rate for Payer: UHC Core |
$910.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.05
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,090.74
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.30 |
| Max. Negotiated Rate |
$981.67 |
| Rate for Payer: Aetna Commercial |
$927.13
|
| Rate for Payer: Aetna Medicare |
$283.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$340.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$340.86
|
| Rate for Payer: BCBS Complete |
$201.90
|
| Rate for Payer: BCBS MAPPO |
$272.69
|
| Rate for Payer: BCBS Trust/PPO |
$896.70
|
| Rate for Payer: BCN Commercial |
$896.70
|
| Rate for Payer: BCN Medicare Advantage |
$272.69
|
| Rate for Payer: Cash Price |
$872.59
|
| Rate for Payer: Cofinity Commercial |
$938.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$872.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.69
|
| Rate for Payer: Healthscope Commercial |
$981.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.05
|
| Rate for Payer: Mclaren Medicaid |
$192.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.32
|
| Rate for Payer: Meridian Medicaid |
$201.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$313.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$299.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$927.13
|
| Rate for Payer: Nomi Health Commercial |
$894.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.05
|
| Rate for Payer: PACE Senior Care Partners |
$259.05
|
| Rate for Payer: PACE SWMI |
$272.69
|
| Rate for Payer: PHP Commercial |
$927.13
|
| Rate for Payer: PHP Medicare Advantage |
$272.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$948.94
|
| Rate for Payer: Priority Health Medicare |
$275.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$759.16
|
| Rate for Payer: Railroad Medicare Medicare |
$272.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$959.85
|
| Rate for Payer: UHC Core |
$910.77
|
| Rate for Payer: UHC Exchange |
$272.69
|
| Rate for Payer: UHC Medicaid |
$192.30
|
| Rate for Payer: UHC Medicare Advantage |
$272.69
|
| Rate for Payer: UHCCP Medicaid |
$192.30
|
| Rate for Payer: VA VA |
$272.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.05
|
|
|
HC REPAIR ECTROPION EXTENSIVE
|
Facility
|
OP
|
$4,403.39
|
|
|
Service Code
|
CPT 67917
|
| Hospital Charge Code |
76100568
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$776.32 |
| Max. Negotiated Rate |
$3,963.05 |
| Rate for Payer: Aetna Commercial |
$3,742.88
|
| Rate for Payer: Aetna Medicare |
$1,144.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,376.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,376.06
|
| Rate for Payer: BCBS Complete |
$815.07
|
| Rate for Payer: BCBS MAPPO |
$1,100.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,620.03
|
| Rate for Payer: BCN Commercial |
$3,620.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,100.85
|
| Rate for Payer: Cash Price |
$3,522.71
|
| Rate for Payer: Cofinity Commercial |
$3,786.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,522.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,100.85
|
| Rate for Payer: Healthscope Commercial |
$3,963.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,302.54
|
| Rate for Payer: Mclaren Medicaid |
$776.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,155.89
|
| Rate for Payer: Meridian Medicaid |
$815.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,265.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,210.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,742.88
|
| Rate for Payer: Nomi Health Commercial |
$3,610.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,302.54
|
| Rate for Payer: PACE Senior Care Partners |
$1,045.81
|
| Rate for Payer: PACE SWMI |
$1,100.85
|
| Rate for Payer: PHP Commercial |
$3,742.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,100.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$776.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,830.95
|
| Rate for Payer: Priority Health Medicare |
$1,111.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,064.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,100.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,874.98
|
| Rate for Payer: UHC Core |
$3,676.83
|
| Rate for Payer: UHC Exchange |
$1,100.85
|
| Rate for Payer: UHC Medicaid |
$776.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,100.85
|
| Rate for Payer: UHCCP Medicaid |
$776.32
|
| Rate for Payer: VA VA |
$1,100.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,302.54
|
|
|
HC REPAIR ECTROPION EXTENSIVE
|
Facility
|
IP
|
$4,403.39
|
|
|
Service Code
|
CPT 67917
|
| Hospital Charge Code |
76100568
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,064.76 |
| Max. Negotiated Rate |
$3,963.05 |
| Rate for Payer: Aetna Commercial |
$3,742.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,636.76
|
| Rate for Payer: BCN Commercial |
$3,636.76
|
| Rate for Payer: Cash Price |
$3,522.71
|
| Rate for Payer: Cofinity Commercial |
$3,786.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,522.71
|
| Rate for Payer: Healthscope Commercial |
$3,963.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,302.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,742.88
|
| Rate for Payer: Nomi Health Commercial |
$3,610.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,302.54
|
| Rate for Payer: PHP Commercial |
$3,742.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,830.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,064.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,874.98
|
| Rate for Payer: UHC Core |
$3,676.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,302.54
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,729.92
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$4,256.93 |
| Rate for Payer: Aetna Commercial |
$4,020.43
|
| Rate for Payer: Aetna Medicare |
$1,229.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,478.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,478.10
|
| Rate for Payer: BCBS Complete |
$875.51
|
| Rate for Payer: BCBS MAPPO |
$1,182.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,888.47
|
| Rate for Payer: BCN Commercial |
$3,888.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,182.48
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cofinity Commercial |
$4,067.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,783.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,182.48
|
| Rate for Payer: Healthscope Commercial |
$4,256.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,547.44
|
| Rate for Payer: Mclaren Medicaid |
$833.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,241.60
|
| Rate for Payer: Meridian Medicaid |
$875.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,359.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,300.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,020.43
|
| Rate for Payer: Nomi Health Commercial |
$3,878.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,123.36
|
| Rate for Payer: PACE SWMI |
$1,182.48
|
| Rate for Payer: PHP Commercial |
$4,020.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,182.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$833.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,115.03
|
| Rate for Payer: Priority Health Medicare |
$1,194.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,292.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,182.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,162.33
|
| Rate for Payer: UHC Core |
$3,949.48
|
| Rate for Payer: UHC Exchange |
$1,182.48
|
| Rate for Payer: UHC Medicaid |
$833.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,182.48
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$1,182.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,547.44
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,729.92
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,292.02 |
| Max. Negotiated Rate |
$4,256.93 |
| Rate for Payer: Aetna Commercial |
$4,020.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,906.44
|
| Rate for Payer: BCN Commercial |
$3,906.44
|
| Rate for Payer: Cash Price |
$3,783.94
|
| Rate for Payer: Cofinity Commercial |
$4,067.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,783.94
|
| Rate for Payer: Healthscope Commercial |
$4,256.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,547.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,020.43
|
| Rate for Payer: Nomi Health Commercial |
$3,878.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,547.44
|
| Rate for Payer: PHP Commercial |
$4,020.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,115.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,292.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,162.33
|
| Rate for Payer: UHC Core |
$3,949.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,547.44
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,377.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,046.94 |
| Max. Negotiated Rate |
$3,940.01 |
| Rate for Payer: Aetna Commercial |
$3,721.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,615.62
|
| Rate for Payer: BCN Commercial |
$3,615.62
|
| Rate for Payer: Cash Price |
$3,502.23
|
| Rate for Payer: Cofinity Commercial |
$3,764.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,502.23
|
| Rate for Payer: Healthscope Commercial |
$3,940.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,283.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,721.12
|
| Rate for Payer: Nomi Health Commercial |
$3,589.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,283.34
|
| Rate for Payer: PHP Commercial |
$3,721.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,808.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,046.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,852.46
|
| Rate for Payer: UHC Core |
$3,655.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,283.34
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,377.79
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$771.80 |
| Max. Negotiated Rate |
$3,940.01 |
| Rate for Payer: Aetna Commercial |
$3,721.12
|
| Rate for Payer: Aetna Medicare |
$1,138.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,368.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,368.06
|
| Rate for Payer: BCBS Complete |
$810.33
|
| Rate for Payer: BCBS MAPPO |
$1,094.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,598.98
|
| Rate for Payer: BCN Commercial |
$3,598.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,094.45
|
| Rate for Payer: Cash Price |
$3,502.23
|
| Rate for Payer: Cofinity Commercial |
$3,764.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,502.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,094.45
|
| Rate for Payer: Healthscope Commercial |
$3,940.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,283.34
|
| Rate for Payer: Mclaren Medicaid |
$771.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,149.17
|
| Rate for Payer: Meridian Medicaid |
$810.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,258.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,203.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,721.12
|
| Rate for Payer: Nomi Health Commercial |
$3,589.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,283.34
|
| Rate for Payer: PACE Senior Care Partners |
$1,039.73
|
| Rate for Payer: PACE SWMI |
$1,094.45
|
| Rate for Payer: PHP Commercial |
$3,721.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,094.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$771.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,808.68
|
| Rate for Payer: Priority Health Medicare |
$1,105.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,046.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,094.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,852.46
|
| Rate for Payer: UHC Core |
$3,655.45
|
| Rate for Payer: UHC Exchange |
$1,094.45
|
| Rate for Payer: UHC Medicaid |
$771.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.45
|
| Rate for Payer: UHCCP Medicaid |
$771.80
|
| Rate for Payer: VA VA |
$1,094.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,283.34
|
|
|
HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20CM
|
Facility
|
IP
|
$1,054.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
76100567
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$733.58 |
| Max. Negotiated Rate |
$948.60 |
| Rate for Payer: Aetna Commercial |
$895.90
|
| Rate for Payer: BCBS Trust/PPO |
$870.50
|
| Rate for Payer: BCN Commercial |
$870.50
|
| Rate for Payer: Cash Price |
$843.20
|
| Rate for Payer: Cofinity Commercial |
$906.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.20
|
| Rate for Payer: Healthscope Commercial |
$948.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.90
|
| Rate for Payer: Nomi Health Commercial |
$864.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$790.50
|
| Rate for Payer: PHP Commercial |
$895.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$916.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$927.52
|
| Rate for Payer: UHC Core |
$880.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.50
|
|
|
HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20CM
|
Facility
|
OP
|
$1,054.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
76100567
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.82 |
| Max. Negotiated Rate |
$948.60 |
| Rate for Payer: Aetna Commercial |
$895.90
|
| Rate for Payer: Aetna Medicare |
$274.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.38
|
| Rate for Payer: BCBS Complete |
$195.10
|
| Rate for Payer: BCBS MAPPO |
$263.50
|
| Rate for Payer: BCBS Trust/PPO |
$866.49
|
| Rate for Payer: BCN Commercial |
$866.49
|
| Rate for Payer: BCN Medicare Advantage |
$263.50
|
| Rate for Payer: Cash Price |
$843.20
|
| Rate for Payer: Cofinity Commercial |
$906.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.50
|
| Rate for Payer: Healthscope Commercial |
$948.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.50
|
| Rate for Payer: Mclaren Medicaid |
$185.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.68
|
| Rate for Payer: Meridian Medicaid |
$195.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.90
|
| Rate for Payer: Nomi Health Commercial |
$864.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$790.50
|
| Rate for Payer: PACE Senior Care Partners |
$250.32
|
| Rate for Payer: PACE SWMI |
$263.50
|
| Rate for Payer: PHP Commercial |
$895.90
|
| Rate for Payer: PHP Medicare Advantage |
$263.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$916.98
|
| Rate for Payer: Priority Health Medicare |
$266.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.58
|
| Rate for Payer: Railroad Medicare Medicare |
$263.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$927.52
|
| Rate for Payer: UHC Core |
$880.09
|
| Rate for Payer: UHC Exchange |
$263.50
|
| Rate for Payer: UHC Medicaid |
$185.82
|
| Rate for Payer: UHC Medicare Advantage |
$263.50
|
| Rate for Payer: UHCCP Medicaid |
$185.82
|
| Rate for Payer: VA VA |
$263.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.50
|
|
|
HC REPAIR LIP AND BORDER
|
Facility
|
OP
|
$1,569.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
76100539
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.61 |
| Max. Negotiated Rate |
$1,412.10 |
| Rate for Payer: Aetna Commercial |
$1,333.65
|
| Rate for Payer: Aetna Medicare |
$407.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.31
|
| Rate for Payer: BCBS Complete |
$290.42
|
| Rate for Payer: BCBS MAPPO |
$392.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.87
|
| Rate for Payer: BCN Commercial |
$1,289.87
|
| Rate for Payer: BCN Medicare Advantage |
$392.25
|
| Rate for Payer: Cash Price |
$1,255.20
|
| Rate for Payer: Cofinity Commercial |
$1,349.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.25
|
| Rate for Payer: Healthscope Commercial |
$1,412.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.75
|
| Rate for Payer: Mclaren Medicaid |
$276.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.86
|
| Rate for Payer: Meridian Medicaid |
$290.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$431.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.65
|
| Rate for Payer: Nomi Health Commercial |
$1,286.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,176.75
|
| Rate for Payer: PACE Senior Care Partners |
$372.64
|
| Rate for Payer: PACE SWMI |
$392.25
|
| Rate for Payer: PHP Commercial |
$1,333.65
|
| Rate for Payer: PHP Medicare Advantage |
$392.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$276.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,365.03
|
| Rate for Payer: Priority Health Medicare |
$396.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,092.02
|
| Rate for Payer: Railroad Medicare Medicare |
$392.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.72
|
| Rate for Payer: UHC Core |
$1,310.12
|
| Rate for Payer: UHC Exchange |
$392.25
|
| Rate for Payer: UHC Medicaid |
$276.61
|
| Rate for Payer: UHC Medicare Advantage |
$392.25
|
| Rate for Payer: UHCCP Medicaid |
$276.61
|
| Rate for Payer: VA VA |
$392.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.75
|
|
|
HC REPAIR LIP AND BORDER
|
Facility
|
IP
|
$1,569.00
|
|
|
Service Code
|
CPT 40650
|
| Hospital Charge Code |
76100539
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,092.02 |
| Max. Negotiated Rate |
$1,412.10 |
| Rate for Payer: Aetna Commercial |
$1,333.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,295.84
|
| Rate for Payer: BCN Commercial |
$1,295.84
|
| Rate for Payer: Cash Price |
$1,255.20
|
| Rate for Payer: Cofinity Commercial |
$1,349.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.20
|
| Rate for Payer: Healthscope Commercial |
$1,412.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.65
|
| Rate for Payer: Nomi Health Commercial |
$1,286.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,176.75
|
| Rate for Payer: PHP Commercial |
$1,333.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,365.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,092.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.72
|
| Rate for Payer: UHC Core |
$1,310.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.75
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$5,930.28
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,127.47 |
| Max. Negotiated Rate |
$5,337.25 |
| Rate for Payer: Aetna Commercial |
$5,040.74
|
| Rate for Payer: BCBS Trust/PPO |
$4,897.82
|
| Rate for Payer: BCN Commercial |
$4,897.82
|
| Rate for Payer: Cash Price |
$4,744.22
|
| Rate for Payer: Cofinity Commercial |
$5,100.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.22
|
| Rate for Payer: Healthscope Commercial |
$5,337.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,040.74
|
| Rate for Payer: Nomi Health Commercial |
$4,862.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,447.71
|
| Rate for Payer: PHP Commercial |
$5,040.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,159.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,127.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,218.65
|
| Rate for Payer: UHC Core |
$4,951.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.71
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$5,930.28
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,045.51 |
| Max. Negotiated Rate |
$5,337.25 |
| Rate for Payer: Aetna Commercial |
$5,040.74
|
| Rate for Payer: Aetna Medicare |
$1,541.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,853.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,853.21
|
| Rate for Payer: BCBS Complete |
$1,097.69
|
| Rate for Payer: BCBS MAPPO |
$1,482.57
|
| Rate for Payer: BCBS Trust/PPO |
$4,875.28
|
| Rate for Payer: BCN Commercial |
$4,875.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,482.57
|
| Rate for Payer: Cash Price |
$4,744.22
|
| Rate for Payer: Cofinity Commercial |
$5,100.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,482.57
|
| Rate for Payer: Healthscope Commercial |
$5,337.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.71
|
| Rate for Payer: Mclaren Medicaid |
$1,045.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,556.70
|
| Rate for Payer: Meridian Medicaid |
$1,097.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,704.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,630.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,040.74
|
| Rate for Payer: Nomi Health Commercial |
$4,862.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,447.71
|
| Rate for Payer: PACE Senior Care Partners |
$1,408.44
|
| Rate for Payer: PACE SWMI |
$1,482.57
|
| Rate for Payer: PHP Commercial |
$5,040.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,482.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,045.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,159.34
|
| Rate for Payer: Priority Health Medicare |
$1,497.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,482.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,218.65
|
| Rate for Payer: UHC Core |
$4,951.78
|
| Rate for Payer: UHC Exchange |
$1,482.57
|
| Rate for Payer: UHC Medicaid |
$1,045.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,482.57
|
| Rate for Payer: UHCCP Medicaid |
$1,045.51
|
| Rate for Payer: VA VA |
$1,482.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.71
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,983.22
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,468.32 |
| Max. Negotiated Rate |
$4,484.90 |
| Rate for Payer: Aetna Commercial |
$4,235.74
|
| Rate for Payer: BCBS Trust/PPO |
$4,115.64
|
| Rate for Payer: BCN Commercial |
$4,115.64
|
| Rate for Payer: Cash Price |
$3,986.58
|
| Rate for Payer: Cofinity Commercial |
$4,285.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,986.58
|
| Rate for Payer: Healthscope Commercial |
$4,484.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,737.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,235.74
|
| Rate for Payer: Nomi Health Commercial |
$4,086.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,737.41
|
| Rate for Payer: PHP Commercial |
$4,235.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,335.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,468.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,385.23
|
| Rate for Payer: UHC Core |
$4,160.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,737.41
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,983.22
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$878.54 |
| Max. Negotiated Rate |
$4,484.90 |
| Rate for Payer: Aetna Commercial |
$4,235.74
|
| Rate for Payer: Aetna Medicare |
$1,295.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,557.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,557.26
|
| Rate for Payer: BCBS Complete |
$922.39
|
| Rate for Payer: BCBS MAPPO |
$1,245.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,096.71
|
| Rate for Payer: BCN Commercial |
$4,096.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,245.81
|
| Rate for Payer: Cash Price |
$3,986.58
|
| Rate for Payer: Cofinity Commercial |
$4,285.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,986.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,245.81
|
| Rate for Payer: Healthscope Commercial |
$4,484.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,737.41
|
| Rate for Payer: Mclaren Medicaid |
$878.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,308.10
|
| Rate for Payer: Meridian Medicaid |
$922.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,432.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,370.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,235.74
|
| Rate for Payer: Nomi Health Commercial |
$4,086.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,737.41
|
| Rate for Payer: PACE Senior Care Partners |
$1,183.51
|
| Rate for Payer: PACE SWMI |
$1,245.81
|
| Rate for Payer: PHP Commercial |
$4,235.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,245.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,335.40
|
| Rate for Payer: Priority Health Medicare |
$1,258.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,468.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,245.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,385.23
|
| Rate for Payer: UHC Core |
$4,160.99
|
| Rate for Payer: UHC Exchange |
$1,245.81
|
| Rate for Payer: UHC Medicaid |
$878.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,245.81
|
| Rate for Payer: UHCCP Medicaid |
$878.54
|
| Rate for Payer: VA VA |
$1,245.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,737.41
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$137.66 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: BCBS Trust/PPO |
$163.35
|
| Rate for Payer: BCN Commercial |
$163.35
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$34.87 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna Medicare |
$51.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.81
|
| Rate for Payer: BCBS Complete |
$36.61
|
| Rate for Payer: BCBS MAPPO |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$162.60
|
| Rate for Payer: BCN Commercial |
$162.60
|
| Rate for Payer: BCN Medicare Advantage |
$49.45
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.45
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Mclaren Medicaid |
$34.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.92
|
| Rate for Payer: Meridian Medicaid |
$36.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$162.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Senior Care Partners |
$46.98
|
| Rate for Payer: PACE SWMI |
$49.45
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: PHP Medicare Advantage |
$49.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.08
|
| Rate for Payer: Priority Health Medicare |
$49.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.66
|
| Rate for Payer: Railroad Medicare Medicare |
$49.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.06
|
| Rate for Payer: UHC Core |
$165.15
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHC Medicaid |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$49.45
|
| Rate for Payer: UHCCP Medicaid |
$34.87
|
| Rate for Payer: VA VA |
$49.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
