|
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 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 |
$302.95
|
| 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 |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.52
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.57
|
| 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 |
$288.51
|
| 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 |
$283.31
|
| 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 |
$288.51
|
| Rate for Payer: VA VA |
$280.50
|
| 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 |
$97.86
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.71
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$93.19
|
| 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.30
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| 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 |
$2,082.02
|
| 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 |
$1,982.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,334.61
|
| Rate for Payer: Meridian Medicaid |
$2,082.02
|
| 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 |
$1,982.75
|
| 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 |
$1,982.75
|
| 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
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.23 |
| Max. Negotiated Rate |
$2,762.96 |
| 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 |
$2,762.96
|
| 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 |
$2,631.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.78
|
| Rate for Payer: Meridian Medicaid |
$2,762.96
|
| 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 |
$2,631.21
|
| 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 |
$2,631.21
|
| Rate for Payer: VA VA |
$765.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
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 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 |
$6,283.12 |
| 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 |
$6,283.12
|
| 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 |
$5,983.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$884.16
|
| Rate for Payer: Meridian Medicaid |
$6,283.12
|
| 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 |
$5,983.53
|
| 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 |
$5,983.53
|
| Rate for Payer: VA VA |
$842.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,526.17
|
|
|
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 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 |
$2,462.14
|
| 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 |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| 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 |
$2,344.74
|
| 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 |
$2,344.74
|
| 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
|
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 |
$1,555.23
|
| 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 |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$712.70
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| 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 |
$1,481.07
|
| 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 |
$1,481.07
|
| Rate for Payer: VA VA |
$678.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
|
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 SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
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 SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
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 |
$2,462.14
|
| 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 |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,115.22
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| 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 |
$2,344.74
|
| 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 |
$2,344.74
|
| Rate for Payer: VA VA |
$2,014.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,315.00 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Aetna Commercial |
$4,335.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,163.13
|
| Rate for Payer: BCN Commercial |
$3,941.28
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$4,386.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,825.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: Nomi Health Commercial |
$4,182.00
|
| Rate for Payer: PHP Commercial |
$4,335.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,437.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,417.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,488.00
|
| Rate for Payer: UHC Core |
$4,258.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,825.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,211.25 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Aetna Commercial |
$4,335.00
|
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,593.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,593.75
|
| Rate for Payer: BCBS Complete |
$1,388.75
|
| Rate for Payer: BCBS MAPPO |
$1,275.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,192.71
|
| Rate for Payer: BCN Commercial |
$3,965.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,275.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$4,386.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,275.00
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,825.00
|
| Rate for Payer: Mclaren Medicaid |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,338.75
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,466.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: Nomi Health Commercial |
$4,182.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,211.25
|
| Rate for Payer: PACE SWMI |
$1,275.00
|
| Rate for Payer: PHP Commercial |
$4,335.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,275.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,322.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: Priority Health HMO/PPO |
$4,437.00
|
| Rate for Payer: Priority Health Medicare |
$1,287.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,417.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,275.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,488.00
|
| Rate for Payer: UHC Core |
$4,258.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,275.00
|
| Rate for Payer: UHC Exchange |
$1,275.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,275.00
|
| Rate for Payer: UHCCP Medicaid |
$1,322.53
|
| Rate for Payer: VA VA |
$1,275.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,825.00
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$731.26 |
| Max. Negotiated Rate |
$1,012.51 |
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: BCBS Trust/PPO |
$918.35
|
| Rate for Payer: BCN Commercial |
$869.41
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: Nomi Health Commercial |
$922.51
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health HMO/PPO |
$978.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$753.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.01
|
| Rate for Payer: UHC Core |
$939.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$267.19 |
| Max. Negotiated Rate |
$1,012.51 |
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$351.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$351.57
|
| Rate for Payer: BCBS Complete |
$469.38
|
| Rate for Payer: BCBS MAPPO |
$281.25
|
| Rate for Payer: BCBS Trust/PPO |
$924.87
|
| Rate for Payer: BCN Commercial |
$874.70
|
| Rate for Payer: BCN Medicare Advantage |
$281.25
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.25
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Mclaren Medicaid |
$447.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.32
|
| Rate for Payer: Meridian Medicaid |
$469.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$323.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: Nomi Health Commercial |
$922.51
|
| Rate for Payer: PACE Senior Care Partners |
$267.19
|
| Rate for Payer: PACE SWMI |
$281.25
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: PHP Medicare Advantage |
$281.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health HMO/PPO |
$978.76
|
| Rate for Payer: Priority Health Medicare |
$284.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$753.76
|
| Rate for Payer: Railroad Medicare Medicare |
$281.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.01
|
| Rate for Payer: UHC Core |
$939.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.25
|
| Rate for Payer: UHC Exchange |
$281.25
|
| Rate for Payer: UHC Medicare Advantage |
$281.25
|
| Rate for Payer: UHCCP Medicaid |
$447.00
|
| Rate for Payer: VA VA |
$281.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.05 |
| Max. Negotiated Rate |
$2,963.56 |
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: Aetna Medicare |
$856.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,029.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,029.01
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$823.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,707.04
|
| Rate for Payer: BCN Commercial |
$2,560.18
|
| Rate for Payer: BCN Medicare Advantage |
$823.21
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$823.21
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$864.37
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$946.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: Nomi Health Commercial |
$2,700.13
|
| Rate for Payer: PACE Senior Care Partners |
$782.05
|
| Rate for Payer: PACE SWMI |
$823.21
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: PHP Medicare Advantage |
$823.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,864.77
|
| Rate for Payer: Priority Health Medicare |
$831.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,206.20
|
| Rate for Payer: Railroad Medicare Medicare |
$823.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,897.70
|
| Rate for Payer: UHC Core |
$2,749.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$823.21
|
| Rate for Payer: UHC Exchange |
$823.21
|
| Rate for Payer: UHC Medicare Advantage |
$823.21
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$823.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,140.35 |
| Max. Negotiated Rate |
$2,963.56 |
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,687.95
|
| Rate for Payer: BCN Commercial |
$2,544.71
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: Nomi Health Commercial |
$2,700.13
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health HMO/PPO |
$2,864.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,206.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,897.70
|
| Rate for Payer: UHC Core |
$2,749.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.59 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: BCBS Trust/PPO |
$803.22
|
| Rate for Payer: BCN Commercial |
$760.42
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$806.86
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO |
$856.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.90
|
| Rate for Payer: UHC Core |
$821.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
