|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$74.59 |
| Max. Negotiated Rate |
$103.28 |
| Rate for Payer: Aetna Commercial |
$97.54
|
| Rate for Payer: BCBS Trust/PPO |
$93.67
|
| Rate for Payer: BCN Commercial |
$88.68
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$103.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$94.10
|
| Rate for Payer: PHP Commercial |
$97.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health HMO/PPO |
$99.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.98
|
| Rate for Payer: UHC Core |
$95.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.06
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$237.99 |
| Max. Negotiated Rate |
$329.53 |
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: BCBS Trust/PPO |
$298.88
|
| Rate for Payer: BCN Commercial |
$282.95
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health HMO/PPO |
$318.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.20
|
| Rate for Payer: UHC Core |
$305.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.60
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$86.96 |
| Max. Negotiated Rate |
$329.53 |
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: Aetna Medicare |
$95.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.42
|
| Rate for Payer: BCBS Complete |
$95.86
|
| Rate for Payer: BCBS MAPPO |
$91.54
|
| Rate for Payer: BCBS Trust/PPO |
$301.00
|
| Rate for Payer: BCN Commercial |
$284.67
|
| Rate for Payer: BCN Medicare Advantage |
$91.54
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.54
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.60
|
| Rate for Payer: Mclaren Medicaid |
$91.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.11
|
| Rate for Payer: Meridian Medicaid |
$95.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$300.23
|
| Rate for Payer: PACE Senior Care Partners |
$86.96
|
| Rate for Payer: PACE SWMI |
$91.54
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: PHP Medicare Advantage |
$91.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health HMO/PPO |
$318.54
|
| Rate for Payer: Priority Health Medicare |
$92.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.31
|
| Rate for Payer: Railroad Medicare Medicare |
$91.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.20
|
| Rate for Payer: UHC Core |
$305.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.54
|
| Rate for Payer: UHC Exchange |
$91.54
|
| Rate for Payer: UHC Medicare Advantage |
$91.54
|
| Rate for Payer: UHCCP Medicaid |
$91.29
|
| Rate for Payer: VA VA |
$91.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.60
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$430.57 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: BCBS Trust/PPO |
$540.73
|
| Rate for Payer: BCN Commercial |
$511.91
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO |
$576.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$443.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.92
|
| Rate for Payer: UHC Core |
$553.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.81
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$157.32 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna Medicare |
$172.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.00
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: BCBS MAPPO |
$165.60
|
| Rate for Payer: BCBS Trust/PPO |
$544.57
|
| Rate for Payer: BCN Commercial |
$515.02
|
| Rate for Payer: BCN Medicare Advantage |
$165.60
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.60
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: Nomi Health Commercial |
$543.18
|
| Rate for Payer: PACE Senior Care Partners |
$157.32
|
| Rate for Payer: PACE SWMI |
$165.60
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: PHP Medicare Advantage |
$165.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health HMO/PPO |
$576.30
|
| Rate for Payer: Priority Health Medicare |
$167.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$443.81
|
| Rate for Payer: Railroad Medicare Medicare |
$165.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.92
|
| Rate for Payer: UHC Core |
$553.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.60
|
| Rate for Payer: UHC Exchange |
$165.60
|
| Rate for Payer: UHC Medicare Advantage |
$165.60
|
| Rate for Payer: VA VA |
$165.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.81
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,417.37 |
| Max. Negotiated Rate |
$1,962.51 |
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.00
|
| Rate for Payer: BCN Commercial |
$1,685.14
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,635.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: Nomi Health Commercial |
$1,788.07
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,897.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,460.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,918.90
|
| Rate for Payer: UHC Core |
$1,820.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,635.43
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$517.89 |
| Max. Negotiated Rate |
$1,962.51 |
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: Aetna Medicare |
$566.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$681.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$681.43
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$545.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.65
|
| Rate for Payer: BCN Commercial |
$1,695.39
|
| Rate for Payer: BCN Medicare Advantage |
$545.14
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.14
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,635.43
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.40
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: Nomi Health Commercial |
$1,788.07
|
| Rate for Payer: PACE Senior Care Partners |
$517.89
|
| Rate for Payer: PACE SWMI |
$545.14
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: PHP Medicare Advantage |
$545.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,897.10
|
| Rate for Payer: Priority Health Medicare |
$550.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,460.98
|
| Rate for Payer: Railroad Medicare Medicare |
$545.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,918.90
|
| Rate for Payer: UHC Core |
$1,820.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.14
|
| Rate for Payer: UHC Exchange |
$545.14
|
| Rate for Payer: UHC Medicare Advantage |
$545.14
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$545.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,635.43
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.16 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: BCBS Trust/PPO |
$280.26
|
| Rate for Payer: BCN Commercial |
$265.33
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$281.53
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health HMO/PPO |
$298.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.13
|
| Rate for Payer: UHC Core |
$286.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.50
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.54 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: Aetna Medicare |
$89.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.29
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$85.83
|
| Rate for Payer: BCBS Trust/PPO |
$282.25
|
| Rate for Payer: BCN Commercial |
$266.94
|
| Rate for Payer: BCN Medicare Advantage |
$85.83
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.83
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.50
|
| Rate for Payer: Mclaren Medicaid |
$282.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.12
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$281.53
|
| Rate for Payer: PACE Senior Care Partners |
$81.54
|
| Rate for Payer: PACE SWMI |
$85.83
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$85.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health HMO/PPO |
$298.70
|
| Rate for Payer: Priority Health Medicare |
$86.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.03
|
| Rate for Payer: Railroad Medicare Medicare |
$85.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.13
|
| Rate for Payer: UHC Core |
$286.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.83
|
| Rate for Payer: UHC Exchange |
$85.83
|
| Rate for Payer: UHC Medicare Advantage |
$85.83
|
| Rate for Payer: UHCCP Medicaid |
$282.67
|
| Rate for Payer: VA VA |
$85.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.50
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.48 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$291.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.62
|
| Rate for Payer: BCBS Complete |
$296.82
|
| Rate for Payer: BCBS MAPPO |
$280.50
|
| Rate for Payer: BCBS Trust/PPO |
$922.40
|
| Rate for Payer: BCN Commercial |
$872.36
|
| Rate for Payer: BCN Medicare Advantage |
$280.50
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.50
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$282.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.52
|
| Rate for Payer: Meridian Medicaid |
$296.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: PACE Senior Care Partners |
$266.48
|
| Rate for Payer: PACE SWMI |
$280.50
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$280.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO |
$976.14
|
| Rate for Payer: Priority Health Medicare |
$283.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.74
|
| Rate for Payer: Railroad Medicare Medicare |
$280.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.50
|
| Rate for Payer: UHC Exchange |
$280.50
|
| Rate for Payer: UHC Medicare Advantage |
$280.50
|
| Rate for Payer: UHCCP Medicaid |
$282.67
|
| Rate for Payer: VA VA |
$280.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$729.30 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: BCBS Trust/PPO |
$915.89
|
| Rate for Payer: BCN Commercial |
$867.08
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$920.04
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO |
$976.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.36
|
| Rate for Payer: UHC Core |
$936.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.05 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: BCBS Trust/PPO |
$291.42
|
| Rate for Payer: BCN Commercial |
$275.89
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$310.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.16
|
| Rate for Payer: UHC Core |
$298.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.79 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna Medicare |
$92.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.56
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$89.25
|
| Rate for Payer: BCBS Trust/PPO |
$293.49
|
| Rate for Payer: BCN Commercial |
$277.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.25
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.25
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.71
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$292.74
|
| Rate for Payer: PACE Senior Care Partners |
$84.79
|
| Rate for Payer: PACE SWMI |
$89.25
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: PHP Medicare Advantage |
$89.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO |
$310.59
|
| Rate for Payer: Priority Health Medicare |
$90.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.19
|
| Rate for Payer: Railroad Medicare Medicare |
$89.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.16
|
| Rate for Payer: UHC Core |
$298.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.25
|
| Rate for Payer: UHC Exchange |
$89.25
|
| Rate for Payer: UHC Medicare Advantage |
$89.25
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$89.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.74 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$556.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.40
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$535.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,761.00
|
| Rate for Payer: BCN Commercial |
$1,665.47
|
| Rate for Payer: BCN Medicare Advantage |
$535.52
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.52
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.30
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PACE Senior Care Partners |
$508.74
|
| Rate for Payer: PACE SWMI |
$535.52
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$535.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Medicare |
$540.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: Railroad Medicare Medicare |
$535.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.52
|
| Rate for Payer: UHC Exchange |
$535.52
|
| Rate for Payer: UHC Medicare Advantage |
$535.52
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$535.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.35 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.58
|
| Rate for Payer: BCN Commercial |
$1,655.40
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$1,756.51
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.03
|
| Rate for Payer: UHC Core |
$1,788.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,304.74 |
| Max. Negotiated Rate |
$4,575.79 |
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,150.24
|
| Rate for Payer: BCN Commercial |
$3,929.08
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: Nomi Health Commercial |
$4,169.05
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,423.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,406.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,474.10
|
| Rate for Payer: UHC Core |
$4,245.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.16
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,207.50 |
| Max. Negotiated Rate |
$4,575.79 |
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: Aetna Medicare |
$1,321.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,588.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,588.82
|
| Rate for Payer: BCBS Complete |
$2,039.92
|
| Rate for Payer: BCBS MAPPO |
$1,271.05
|
| Rate for Payer: BCBS Trust/PPO |
$4,179.73
|
| Rate for Payer: BCN Commercial |
$3,952.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,271.05
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,271.05
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.16
|
| Rate for Payer: Mclaren Medicaid |
$1,942.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,334.61
|
| Rate for Payer: Meridian Medicaid |
$2,039.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,461.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: Nomi Health Commercial |
$4,169.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,207.50
|
| Rate for Payer: PACE SWMI |
$1,271.05
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,271.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,942.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,423.26
|
| Rate for Payer: Priority Health Medicare |
$1,283.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,406.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,271.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,474.10
|
| Rate for Payer: UHC Core |
$4,245.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,271.05
|
| Rate for Payer: UHC Exchange |
$1,271.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,271.05
|
| Rate for Payer: UHCCP Medicaid |
$1,942.66
|
| Rate for Payer: VA VA |
$1,271.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.16
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,990.32 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.54
|
| Rate for Payer: BCN Commercial |
$2,366.34
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.23 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna Medicare |
$796.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.88
|
| Rate for Payer: BCBS Complete |
$2,707.09
|
| Rate for Payer: BCBS MAPPO |
$765.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.29
|
| Rate for Payer: BCN Commercial |
$2,380.73
|
| Rate for Payer: BCN Medicare Advantage |
$765.51
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.51
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Mclaren Medicaid |
$2,578.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.78
|
| Rate for Payer: Meridian Medicaid |
$2,707.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$880.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PACE Senior Care Partners |
$727.23
|
| Rate for Payer: PACE SWMI |
$765.51
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: PHP Medicare Advantage |
$765.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,578.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Medicare |
$773.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: Railroad Medicare Medicare |
$765.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.51
|
| Rate for Payer: UHC Exchange |
$765.51
|
| Rate for Payer: UHC Medicare Advantage |
$765.51
|
| Rate for Payer: UHCCP Medicaid |
$2,578.01
|
| Rate for Payer: VA VA |
$765.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,189.35 |
| Max. Negotiated Rate |
$3,031.41 |
| Rate for Payer: Aetna Commercial |
$2,863.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,749.49
|
| Rate for Payer: BCN Commercial |
$2,602.97
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$2,896.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Healthscope Commercial |
$3,031.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,526.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: Nomi Health Commercial |
$2,761.95
|
| Rate for Payer: PHP Commercial |
$2,863.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,930.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,256.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,964.04
|
| Rate for Payer: UHC Core |
$2,812.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,526.17
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$799.95 |
| Max. Negotiated Rate |
$6,156.08 |
| Rate for Payer: Aetna Commercial |
$2,863.00
|
| Rate for Payer: Aetna Medicare |
$875.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,052.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,052.57
|
| Rate for Payer: BCBS Complete |
$6,156.08
|
| Rate for Payer: BCBS MAPPO |
$842.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,769.02
|
| Rate for Payer: BCN Commercial |
$2,618.80
|
| Rate for Payer: BCN Medicare Advantage |
$842.06
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$2,896.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$842.06
|
| Rate for Payer: Healthscope Commercial |
$3,031.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,526.17
|
| Rate for Payer: Mclaren Medicaid |
$5,862.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.16
|
| Rate for Payer: Meridian Medicaid |
$6,156.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$968.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: Nomi Health Commercial |
$2,761.95
|
| Rate for Payer: PACE Senior Care Partners |
$799.95
|
| Rate for Payer: PACE SWMI |
$842.06
|
| Rate for Payer: PHP Commercial |
$2,863.00
|
| Rate for Payer: PHP Medicare Advantage |
$842.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,862.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,930.36
|
| Rate for Payer: Priority Health Medicare |
$850.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,256.71
|
| Rate for Payer: Railroad Medicare Medicare |
$842.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,964.04
|
| Rate for Payer: UHC Core |
$2,812.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$842.06
|
| Rate for Payer: UHC Exchange |
$842.06
|
| Rate for Payer: UHC Medicare Advantage |
$842.06
|
| Rate for Payer: UHCCP Medicaid |
$5,862.55
|
| Rate for Payer: VA VA |
$842.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,526.17
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,913.78 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$2,095.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,518.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,518.12
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$2,014.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,624.48
|
| Rate for Payer: BCN Commercial |
$6,265.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,014.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,014.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,316.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,913.78
|
| Rate for Payer: PACE SWMI |
$2,014.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,014.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Medicare |
$2,034.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,014.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,014.50
|
| Rate for Payer: UHC Exchange |
$2,014.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,014.50
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,237.70 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: BCBS Trust/PPO |
$6,577.75
|
| Rate for Payer: BCN Commercial |
$6,227.22
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,607.56
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,010.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,398.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,091.04
|
| Rate for Payer: UHC Core |
$6,728.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,764.79 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,216.30
|
| Rate for Payer: BCN Commercial |
$2,098.20
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,362.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,819.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,389.25
|
| Rate for Payer: UHC Core |
$2,267.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$644.83 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna Medicare |
$705.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$848.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$848.46
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$678.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.05
|
| Rate for Payer: BCN Commercial |
$2,110.96
|
| Rate for Payer: BCN Medicare Advantage |
$678.76
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$678.76
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.70
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$780.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$2,226.35
|
| Rate for Payer: PACE Senior Care Partners |
$644.83
|
| Rate for Payer: PACE SWMI |
$678.76
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: PHP Medicare Advantage |
$678.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO |
$2,362.10
|
| Rate for Payer: Priority Health Medicare |
$685.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,819.09
|
| Rate for Payer: Railroad Medicare Medicare |
$678.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,389.25
|
| Rate for Payer: UHC Core |
$2,267.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$678.76
|
| Rate for Payer: UHC Exchange |
$678.76
|
| Rate for Payer: UHC Medicare Advantage |
$678.76
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$678.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
