|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
OP
|
$563.37
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$99.32 |
| Max. Negotiated Rate |
$507.03 |
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna Medicare |
$146.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.05
|
| Rate for Payer: BCBS Complete |
$104.28
|
| Rate for Payer: BCBS MAPPO |
$140.84
|
| Rate for Payer: BCBS Trust/PPO |
$463.15
|
| Rate for Payer: BCN Commercial |
$463.15
|
| Rate for Payer: BCN Medicare Advantage |
$140.84
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cofinity Commercial |
$484.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.84
|
| Rate for Payer: Healthscope Commercial |
$507.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.53
|
| Rate for Payer: Mclaren Medicaid |
$99.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.88
|
| Rate for Payer: Meridian Medicaid |
$104.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: Nomi Health Commercial |
$461.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.53
|
| Rate for Payer: PACE Senior Care Partners |
$133.80
|
| Rate for Payer: PACE SWMI |
$140.84
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: PHP Medicare Advantage |
$140.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$490.13
|
| Rate for Payer: Priority Health Medicare |
$142.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.11
|
| Rate for Payer: Railroad Medicare Medicare |
$140.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.77
|
| Rate for Payer: UHC Core |
$470.41
|
| Rate for Payer: UHC Exchange |
$140.84
|
| Rate for Payer: UHC Medicaid |
$99.32
|
| Rate for Payer: UHC Medicare Advantage |
$140.84
|
| Rate for Payer: UHCCP Medicaid |
$99.32
|
| Rate for Payer: VA VA |
$140.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.53
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
IP
|
$244.08
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$169.88 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Aetna Commercial |
$207.47
|
| Rate for Payer: BCBS Trust/PPO |
$201.59
|
| Rate for Payer: BCN Commercial |
$201.59
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cofinity Commercial |
$209.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.26
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.47
|
| Rate for Payer: Nomi Health Commercial |
$200.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.06
|
| Rate for Payer: PHP Commercial |
$207.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.79
|
| Rate for Payer: UHC Core |
$203.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.06
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
OP
|
$244.08
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Aetna Commercial |
$207.47
|
| Rate for Payer: Aetna Medicare |
$63.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.28
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$61.02
|
| Rate for Payer: BCBS Trust/PPO |
$200.66
|
| Rate for Payer: BCN Commercial |
$200.66
|
| Rate for Payer: BCN Medicare Advantage |
$61.02
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cofinity Commercial |
$209.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.02
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.06
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.07
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.47
|
| Rate for Payer: Nomi Health Commercial |
$200.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.06
|
| Rate for Payer: PACE Senior Care Partners |
$57.97
|
| Rate for Payer: PACE SWMI |
$61.02
|
| Rate for Payer: PHP Commercial |
$207.47
|
| Rate for Payer: PHP Medicare Advantage |
$61.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.35
|
| Rate for Payer: Priority Health Medicare |
$61.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.88
|
| Rate for Payer: Railroad Medicare Medicare |
$61.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.79
|
| Rate for Payer: UHC Core |
$203.81
|
| Rate for Payer: UHC Exchange |
$61.02
|
| Rate for Payer: UHC Medicaid |
$43.03
|
| Rate for Payer: UHC Medicare Advantage |
$61.02
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
| Rate for Payer: VA VA |
$61.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.06
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
IP
|
$385.31
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$268.18 |
| Max. Negotiated Rate |
$346.78 |
| Rate for Payer: Aetna Commercial |
$327.51
|
| Rate for Payer: BCBS Trust/PPO |
$318.23
|
| Rate for Payer: BCN Commercial |
$318.23
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cofinity Commercial |
$331.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.25
|
| Rate for Payer: Healthscope Commercial |
$346.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.51
|
| Rate for Payer: Nomi Health Commercial |
$315.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.98
|
| Rate for Payer: PHP Commercial |
$327.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.07
|
| Rate for Payer: UHC Core |
$321.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.98
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
OP
|
$385.31
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$67.93 |
| Max. Negotiated Rate |
$346.78 |
| Rate for Payer: Aetna Commercial |
$327.51
|
| Rate for Payer: Aetna Medicare |
$100.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.41
|
| Rate for Payer: BCBS Complete |
$71.32
|
| Rate for Payer: BCBS MAPPO |
$96.33
|
| Rate for Payer: BCBS Trust/PPO |
$316.76
|
| Rate for Payer: BCN Commercial |
$316.76
|
| Rate for Payer: BCN Medicare Advantage |
$96.33
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cofinity Commercial |
$331.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.33
|
| Rate for Payer: Healthscope Commercial |
$346.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.98
|
| Rate for Payer: Mclaren Medicaid |
$67.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.14
|
| Rate for Payer: Meridian Medicaid |
$71.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.51
|
| Rate for Payer: Nomi Health Commercial |
$315.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.98
|
| Rate for Payer: PACE Senior Care Partners |
$91.51
|
| Rate for Payer: PACE SWMI |
$96.33
|
| Rate for Payer: PHP Commercial |
$327.51
|
| Rate for Payer: PHP Medicare Advantage |
$96.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.22
|
| Rate for Payer: Priority Health Medicare |
$97.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.18
|
| Rate for Payer: Railroad Medicare Medicare |
$96.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.07
|
| Rate for Payer: UHC Core |
$321.73
|
| Rate for Payer: UHC Exchange |
$96.33
|
| Rate for Payer: UHC Medicaid |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$96.33
|
| Rate for Payer: UHCCP Medicaid |
$67.93
|
| Rate for Payer: VA VA |
$96.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.98
|
|
|
HC SPLINT SUPPLIES MISC
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27200394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$14.16
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$62.89
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$13.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$14.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.24
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicaid |
$13.49
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$13.49
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC SPLINT SUPPLIES MISC
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27200394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.24 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$63.18
|
| Rate for Payer: BCN Commercial |
$63.18
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
IP
|
$99.04
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$68.93 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: BCBS Trust/PPO |
$81.80
|
| Rate for Payer: BCN Commercial |
$81.80
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
OP
|
$99.04
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: Aetna Medicare |
$25.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.95
|
| Rate for Payer: BCBS Complete |
$18.33
|
| Rate for Payer: BCBS MAPPO |
$24.76
|
| Rate for Payer: BCBS Trust/PPO |
$81.42
|
| Rate for Payer: BCN Commercial |
$81.42
|
| Rate for Payer: BCN Medicare Advantage |
$24.76
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.76
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Mclaren Medicaid |
$17.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.00
|
| Rate for Payer: Meridian Medicaid |
$18.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PACE Senior Care Partners |
$23.52
|
| Rate for Payer: PACE SWMI |
$24.76
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Medicare |
$25.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: UHC Exchange |
$24.76
|
| Rate for Payer: UHC Medicaid |
$17.46
|
| Rate for Payer: UHC Medicare Advantage |
$24.76
|
| Rate for Payer: UHCCP Medicaid |
$17.46
|
| Rate for Payer: VA VA |
$24.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC SPORE CHECK
|
Facility
|
IP
|
$23.73
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.52 |
| Max. Negotiated Rate |
$21.36 |
| Rate for Payer: Aetna Commercial |
$20.17
|
| Rate for Payer: BCBS Trust/PPO |
$19.60
|
| Rate for Payer: BCN Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$21.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.17
|
| Rate for Payer: Nomi Health Commercial |
$19.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: PHP Commercial |
$20.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.88
|
| Rate for Payer: UHC Core |
$19.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
|
|
HC SPORE CHECK
|
Facility
|
OP
|
$23.73
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$21.36 |
| Rate for Payer: Aetna Commercial |
$20.17
|
| Rate for Payer: Aetna Medicare |
$6.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.42
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$5.93
|
| Rate for Payer: BCBS Trust/PPO |
$19.51
|
| Rate for Payer: BCN Commercial |
$19.51
|
| Rate for Payer: BCN Medicare Advantage |
$5.93
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.93
|
| Rate for Payer: Healthscope Commercial |
$21.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.23
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.17
|
| Rate for Payer: Nomi Health Commercial |
$19.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: PACE Senior Care Partners |
$5.64
|
| Rate for Payer: PACE SWMI |
$5.93
|
| Rate for Payer: PHP Commercial |
$20.17
|
| Rate for Payer: PHP Medicare Advantage |
$5.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.65
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.88
|
| Rate for Payer: UHC Core |
$19.81
|
| Rate for Payer: UHC Exchange |
$5.93
|
| Rate for Payer: UHC Medicaid |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.93
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: VA VA |
$5.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,942.72
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,440.13 |
| Max. Negotiated Rate |
$4,448.45 |
| Rate for Payer: Aetna Commercial |
$4,201.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,082.19
|
| Rate for Payer: BCN Commercial |
$4,082.19
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cofinity Commercial |
$4,250.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.18
|
| Rate for Payer: Healthscope Commercial |
$4,448.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,707.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.31
|
| Rate for Payer: Nomi Health Commercial |
$4,053.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.04
|
| Rate for Payer: PHP Commercial |
$4,201.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,300.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,440.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,349.59
|
| Rate for Payer: UHC Core |
$4,127.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,707.04
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,942.72
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$871.40 |
| Max. Negotiated Rate |
$4,448.45 |
| Rate for Payer: Aetna Commercial |
$4,201.31
|
| Rate for Payer: Aetna Medicare |
$1,285.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,544.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,544.60
|
| Rate for Payer: BCBS Complete |
$914.90
|
| Rate for Payer: BCBS MAPPO |
$1,235.68
|
| Rate for Payer: BCBS Trust/PPO |
$4,063.41
|
| Rate for Payer: BCN Commercial |
$4,063.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,235.68
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cofinity Commercial |
$4,250.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,235.68
|
| Rate for Payer: Healthscope Commercial |
$4,448.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,707.04
|
| Rate for Payer: Mclaren Medicaid |
$871.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,297.46
|
| Rate for Payer: Meridian Medicaid |
$914.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,421.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,359.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.31
|
| Rate for Payer: Nomi Health Commercial |
$4,053.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.04
|
| Rate for Payer: PACE Senior Care Partners |
$1,173.90
|
| Rate for Payer: PACE SWMI |
$1,235.68
|
| Rate for Payer: PHP Commercial |
$4,201.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,235.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$871.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,300.17
|
| Rate for Payer: Priority Health Medicare |
$1,248.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,440.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,235.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,349.59
|
| Rate for Payer: UHC Core |
$4,127.17
|
| Rate for Payer: UHC Exchange |
$1,235.68
|
| Rate for Payer: UHC Medicaid |
$871.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,235.68
|
| Rate for Payer: UHCCP Medicaid |
$871.40
|
| Rate for Payer: VA VA |
$1,235.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,707.04
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,842.80
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$677.49 |
| Max. Negotiated Rate |
$3,458.52 |
| Rate for Payer: Aetna Commercial |
$3,266.38
|
| Rate for Payer: Aetna Medicare |
$999.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,200.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,200.88
|
| Rate for Payer: BCBS Complete |
$711.30
|
| Rate for Payer: BCBS MAPPO |
$960.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,159.17
|
| Rate for Payer: BCN Commercial |
$3,159.17
|
| Rate for Payer: BCN Medicare Advantage |
$960.70
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cofinity Commercial |
$3,304.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.70
|
| Rate for Payer: Healthscope Commercial |
$3,458.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.10
|
| Rate for Payer: Mclaren Medicaid |
$677.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,008.74
|
| Rate for Payer: Meridian Medicaid |
$711.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,104.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,056.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.38
|
| Rate for Payer: Nomi Health Commercial |
$3,151.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,882.10
|
| Rate for Payer: PACE Senior Care Partners |
$912.66
|
| Rate for Payer: PACE SWMI |
$960.70
|
| Rate for Payer: PHP Commercial |
$3,266.38
|
| Rate for Payer: PHP Medicare Advantage |
$960.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,343.24
|
| Rate for Payer: Priority Health Medicare |
$970.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,674.59
|
| Rate for Payer: Railroad Medicare Medicare |
$960.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.66
|
| Rate for Payer: UHC Core |
$3,208.74
|
| Rate for Payer: UHC Exchange |
$960.70
|
| Rate for Payer: UHC Medicaid |
$677.49
|
| Rate for Payer: UHC Medicare Advantage |
$960.70
|
| Rate for Payer: UHCCP Medicaid |
$677.49
|
| Rate for Payer: VA VA |
$960.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.10
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,842.80
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,674.59 |
| Max. Negotiated Rate |
$3,458.52 |
| Rate for Payer: Aetna Commercial |
$3,266.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,173.77
|
| Rate for Payer: BCN Commercial |
$3,173.77
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cofinity Commercial |
$3,304.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.24
|
| Rate for Payer: Healthscope Commercial |
$3,458.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.38
|
| Rate for Payer: Nomi Health Commercial |
$3,151.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,882.10
|
| Rate for Payer: PHP Commercial |
$3,266.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,343.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,674.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.66
|
| Rate for Payer: UHC Core |
$3,208.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.10
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,365.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$769.55 |
| Max. Negotiated Rate |
$3,928.50 |
| Rate for Payer: Aetna Commercial |
$3,710.25
|
| Rate for Payer: Aetna Medicare |
$1,134.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,364.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,364.06
|
| Rate for Payer: BCBS Complete |
$807.96
|
| Rate for Payer: BCBS MAPPO |
$1,091.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,588.47
|
| Rate for Payer: BCN Commercial |
$3,588.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,091.25
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cofinity Commercial |
$3,753.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,492.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,091.25
|
| Rate for Payer: Healthscope Commercial |
$3,928.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,273.75
|
| Rate for Payer: Mclaren Medicaid |
$769.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.81
|
| Rate for Payer: Meridian Medicaid |
$807.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,254.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,200.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,710.25
|
| Rate for Payer: Nomi Health Commercial |
$3,579.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,273.75
|
| Rate for Payer: PACE Senior Care Partners |
$1,036.69
|
| Rate for Payer: PACE SWMI |
$1,091.25
|
| Rate for Payer: PHP Commercial |
$3,710.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,091.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$769.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,797.55
|
| Rate for Payer: Priority Health Medicare |
$1,102.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,038.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,091.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,841.20
|
| Rate for Payer: UHC Core |
$3,644.78
|
| Rate for Payer: UHC Exchange |
$1,091.25
|
| Rate for Payer: UHC Medicaid |
$769.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,091.25
|
| Rate for Payer: UHCCP Medicaid |
$769.55
|
| Rate for Payer: VA VA |
$1,091.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,273.75
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,365.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,038.04 |
| Max. Negotiated Rate |
$3,928.50 |
| Rate for Payer: Aetna Commercial |
$3,710.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,605.05
|
| Rate for Payer: BCN Commercial |
$3,605.05
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cofinity Commercial |
$3,753.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,492.00
|
| Rate for Payer: Healthscope Commercial |
$3,928.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,273.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,710.25
|
| Rate for Payer: Nomi Health Commercial |
$3,579.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,273.75
|
| Rate for Payer: PHP Commercial |
$3,710.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,797.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,038.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,841.20
|
| Rate for Payer: UHC Core |
$3,644.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,273.75
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$710.23
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$494.32 |
| Max. Negotiated Rate |
$639.21 |
| Rate for Payer: Aetna Commercial |
$603.70
|
| Rate for Payer: BCBS Trust/PPO |
$586.58
|
| Rate for Payer: BCN Commercial |
$586.58
|
| Rate for Payer: Cash Price |
$568.18
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.18
|
| Rate for Payer: Healthscope Commercial |
$639.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.70
|
| Rate for Payer: Nomi Health Commercial |
$582.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.67
|
| Rate for Payer: PHP Commercial |
$603.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$617.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.00
|
| Rate for Payer: UHC Core |
$593.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.67
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
OP
|
$710.23
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.21 |
| Max. Negotiated Rate |
$639.21 |
| Rate for Payer: Aetna Commercial |
$603.70
|
| Rate for Payer: Aetna Medicare |
$184.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.95
|
| Rate for Payer: BCBS Complete |
$131.46
|
| Rate for Payer: BCBS MAPPO |
$177.56
|
| Rate for Payer: BCBS Trust/PPO |
$583.88
|
| Rate for Payer: BCN Commercial |
$583.88
|
| Rate for Payer: BCN Medicare Advantage |
$177.56
|
| Rate for Payer: Cash Price |
$568.18
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.56
|
| Rate for Payer: Healthscope Commercial |
$639.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.67
|
| Rate for Payer: Mclaren Medicaid |
$125.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.44
|
| Rate for Payer: Meridian Medicaid |
$131.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.70
|
| Rate for Payer: Nomi Health Commercial |
$582.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.67
|
| Rate for Payer: PACE Senior Care Partners |
$168.68
|
| Rate for Payer: PACE SWMI |
$177.56
|
| Rate for Payer: PHP Commercial |
$603.70
|
| Rate for Payer: PHP Medicare Advantage |
$177.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$617.90
|
| Rate for Payer: Priority Health Medicare |
$179.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.32
|
| Rate for Payer: Railroad Medicare Medicare |
$177.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.00
|
| Rate for Payer: UHC Core |
$593.04
|
| Rate for Payer: UHC Exchange |
$177.56
|
| Rate for Payer: UHC Medicaid |
$125.21
|
| Rate for Payer: UHC Medicare Advantage |
$177.56
|
| Rate for Payer: UHCCP Medicaid |
$125.21
|
| Rate for Payer: VA VA |
$177.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.67
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
OP
|
$1,118.31
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.16 |
| Max. Negotiated Rate |
$1,006.48 |
| Rate for Payer: Aetna Commercial |
$950.56
|
| Rate for Payer: Aetna Medicare |
$290.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.47
|
| Rate for Payer: BCBS Complete |
$207.00
|
| Rate for Payer: BCBS MAPPO |
$279.58
|
| Rate for Payer: BCBS Trust/PPO |
$919.36
|
| Rate for Payer: BCN Commercial |
$919.36
|
| Rate for Payer: BCN Medicare Advantage |
$279.58
|
| Rate for Payer: Cash Price |
$894.65
|
| Rate for Payer: Cofinity Commercial |
$961.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.58
|
| Rate for Payer: Healthscope Commercial |
$1,006.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.73
|
| Rate for Payer: Mclaren Medicaid |
$197.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.56
|
| Rate for Payer: Meridian Medicaid |
$207.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.56
|
| Rate for Payer: Nomi Health Commercial |
$917.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.73
|
| Rate for Payer: PACE Senior Care Partners |
$265.60
|
| Rate for Payer: PACE SWMI |
$279.58
|
| Rate for Payer: PHP Commercial |
$950.56
|
| Rate for Payer: PHP Medicare Advantage |
$279.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$972.93
|
| Rate for Payer: Priority Health Medicare |
$282.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.34
|
| Rate for Payer: Railroad Medicare Medicare |
$279.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.11
|
| Rate for Payer: UHC Core |
$933.79
|
| Rate for Payer: UHC Exchange |
$279.58
|
| Rate for Payer: UHC Medicaid |
$197.16
|
| Rate for Payer: UHC Medicare Advantage |
$279.58
|
| Rate for Payer: UHCCP Medicaid |
$197.16
|
| Rate for Payer: VA VA |
$279.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.73
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
IP
|
$1,118.31
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.34 |
| Max. Negotiated Rate |
$1,006.48 |
| Rate for Payer: Aetna Commercial |
$950.56
|
| Rate for Payer: BCBS Trust/PPO |
$923.61
|
| Rate for Payer: BCN Commercial |
$923.61
|
| Rate for Payer: Cash Price |
$894.65
|
| Rate for Payer: Cofinity Commercial |
$961.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.65
|
| Rate for Payer: Healthscope Commercial |
$1,006.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.56
|
| Rate for Payer: Nomi Health Commercial |
$917.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$838.73
|
| Rate for Payer: PHP Commercial |
$950.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$972.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.11
|
| Rate for Payer: UHC Core |
$933.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.73
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
IP
|
$6,388.13
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,446.14 |
| Max. Negotiated Rate |
$5,749.32 |
| Rate for Payer: Aetna Commercial |
$5,429.91
|
| Rate for Payer: BCBS Trust/PPO |
$5,275.96
|
| Rate for Payer: BCN Commercial |
$5,275.96
|
| Rate for Payer: Cash Price |
$5,110.50
|
| Rate for Payer: Cofinity Commercial |
$5,493.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.50
|
| Rate for Payer: Healthscope Commercial |
$5,749.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,791.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.91
|
| Rate for Payer: Nomi Health Commercial |
$5,238.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.10
|
| Rate for Payer: PHP Commercial |
$5,429.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,557.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,446.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,621.55
|
| Rate for Payer: UHC Core |
$5,334.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,791.10
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
OP
|
$6,388.13
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,126.23 |
| Max. Negotiated Rate |
$5,749.32 |
| Rate for Payer: Aetna Commercial |
$5,429.91
|
| Rate for Payer: Aetna Medicare |
$1,660.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,996.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,996.29
|
| Rate for Payer: BCBS Complete |
$1,182.44
|
| Rate for Payer: BCBS MAPPO |
$1,597.03
|
| Rate for Payer: BCBS Trust/PPO |
$5,251.68
|
| Rate for Payer: BCN Commercial |
$5,251.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,597.03
|
| Rate for Payer: Cash Price |
$5,110.50
|
| Rate for Payer: Cofinity Commercial |
$5,493.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,597.03
|
| Rate for Payer: Healthscope Commercial |
$5,749.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,791.10
|
| Rate for Payer: Mclaren Medicaid |
$1,126.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,676.88
|
| Rate for Payer: Meridian Medicaid |
$1,182.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,836.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,756.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.91
|
| Rate for Payer: Nomi Health Commercial |
$5,238.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.10
|
| Rate for Payer: PACE Senior Care Partners |
$1,517.18
|
| Rate for Payer: PACE SWMI |
$1,597.03
|
| Rate for Payer: PHP Commercial |
$5,429.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,597.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,126.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,557.67
|
| Rate for Payer: Priority Health Medicare |
$1,613.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,446.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,597.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,621.55
|
| Rate for Payer: UHC Core |
$5,334.09
|
| Rate for Payer: UHC Exchange |
$1,597.03
|
| Rate for Payer: UHC Medicaid |
$1,126.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,597.03
|
| Rate for Payer: UHCCP Medicaid |
$1,126.23
|
| Rate for Payer: VA VA |
$1,597.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,791.10
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
IP
|
$2,493.73
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,735.64 |
| Max. Negotiated Rate |
$2,244.36 |
| Rate for Payer: Aetna Commercial |
$2,119.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,059.57
|
| Rate for Payer: BCN Commercial |
$2,059.57
|
| Rate for Payer: Cash Price |
$1,994.98
|
| Rate for Payer: Cofinity Commercial |
$2,144.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,994.98
|
| Rate for Payer: Healthscope Commercial |
$2,244.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,119.67
|
| Rate for Payer: Nomi Health Commercial |
$2,044.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,870.30
|
| Rate for Payer: PHP Commercial |
$2,119.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,169.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,735.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,194.48
|
| Rate for Payer: UHC Core |
$2,082.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.30
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
OP
|
$2,493.73
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$439.64 |
| Max. Negotiated Rate |
$2,244.36 |
| Rate for Payer: Aetna Commercial |
$2,119.67
|
| Rate for Payer: Aetna Medicare |
$648.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$779.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$779.29
|
| Rate for Payer: BCBS Complete |
$461.59
|
| Rate for Payer: BCBS MAPPO |
$623.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,050.10
|
| Rate for Payer: BCN Commercial |
$2,050.10
|
| Rate for Payer: BCN Medicare Advantage |
$623.43
|
| Rate for Payer: Cash Price |
$1,994.98
|
| Rate for Payer: Cofinity Commercial |
$2,144.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,994.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.43
|
| Rate for Payer: Healthscope Commercial |
$2,244.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.30
|
| Rate for Payer: Mclaren Medicaid |
$439.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.60
|
| Rate for Payer: Meridian Medicaid |
$461.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,119.67
|
| Rate for Payer: Nomi Health Commercial |
$2,044.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,870.30
|
| Rate for Payer: PACE Senior Care Partners |
$592.26
|
| Rate for Payer: PACE SWMI |
$623.43
|
| Rate for Payer: PHP Commercial |
$2,119.67
|
| Rate for Payer: PHP Medicare Advantage |
$623.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,169.55
|
| Rate for Payer: Priority Health Medicare |
$629.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,735.64
|
| Rate for Payer: Railroad Medicare Medicare |
$623.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,194.48
|
| Rate for Payer: UHC Core |
$2,082.26
|
| Rate for Payer: UHC Exchange |
$623.43
|
| Rate for Payer: UHC Medicaid |
$439.64
|
| Rate for Payer: UHC Medicare Advantage |
$623.43
|
| Rate for Payer: UHCCP Medicaid |
$439.64
|
| Rate for Payer: VA VA |
$623.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.30
|
|
