|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.68 |
| Max. Negotiated Rate |
$192.02 |
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: BCBS Trust/PPO |
$174.16
|
| Rate for Payer: BCN Commercial |
$164.88
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$192.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health HMO/PPO |
$185.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.75
|
| Rate for Payer: UHC Core |
$178.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.92 |
| Max. Negotiated Rate |
$128.55 |
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: Aetna Medicare |
$37.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.63
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$35.71
|
| Rate for Payer: BCBS Trust/PPO |
$117.42
|
| Rate for Payer: BCN Commercial |
$111.05
|
| Rate for Payer: BCN Medicare Advantage |
$35.71
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.71
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.49
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PACE Senior Care Partners |
$33.92
|
| Rate for Payer: PACE SWMI |
$35.71
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: PHP Medicare Advantage |
$35.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO |
$124.26
|
| Rate for Payer: Priority Health Medicare |
$36.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.70
|
| Rate for Payer: Railroad Medicare Medicare |
$35.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.69
|
| Rate for Payer: UHC Core |
$119.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.71
|
| Rate for Payer: UHC Exchange |
$35.71
|
| Rate for Payer: UHC Medicare Advantage |
$35.71
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$35.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$128.55 |
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: BCBS Trust/PPO |
$116.59
|
| Rate for Payer: BCN Commercial |
$110.38
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO |
$124.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.69
|
| Rate for Payer: UHC Core |
$119.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.68 |
| Max. Negotiated Rate |
$192.02 |
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: BCBS Trust/PPO |
$174.16
|
| Rate for Payer: BCN Commercial |
$164.88
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$192.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health HMO/PPO |
$185.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.75
|
| Rate for Payer: UHC Core |
$178.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$213.35
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$192.02 |
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: Aetna Medicare |
$55.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.67
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$53.34
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$165.88
|
| Rate for Payer: BCN Medicare Advantage |
$53.34
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.34
|
| Rate for Payer: Healthscope Commercial |
$192.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.00
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: Nomi Health Commercial |
$174.95
|
| Rate for Payer: PACE Senior Care Partners |
$50.67
|
| Rate for Payer: PACE SWMI |
$53.34
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: PHP Medicare Advantage |
$53.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health HMO/PPO |
$185.61
|
| Rate for Payer: Priority Health Medicare |
$53.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.94
|
| Rate for Payer: Railroad Medicare Medicare |
$53.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.75
|
| Rate for Payer: UHC Core |
$178.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.34
|
| Rate for Payer: UHC Exchange |
$53.34
|
| Rate for Payer: UHC Medicare Advantage |
$53.34
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$53.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$142.83
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.92 |
| Max. Negotiated Rate |
$128.55 |
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: Aetna Medicare |
$37.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.63
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$35.71
|
| Rate for Payer: BCBS Trust/PPO |
$117.42
|
| Rate for Payer: BCN Commercial |
$111.05
|
| Rate for Payer: BCN Medicare Advantage |
$35.71
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.71
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.49
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PACE Senior Care Partners |
$33.92
|
| Rate for Payer: PACE SWMI |
$35.71
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: PHP Medicare Advantage |
$35.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO |
$124.26
|
| Rate for Payer: Priority Health Medicare |
$36.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.70
|
| Rate for Payer: Railroad Medicare Medicare |
$35.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.69
|
| Rate for Payer: UHC Core |
$119.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.71
|
| Rate for Payer: UHC Exchange |
$35.71
|
| Rate for Payer: UHC Medicare Advantage |
$35.71
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$35.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$142.83
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.84 |
| Max. Negotiated Rate |
$128.55 |
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: BCBS Trust/PPO |
$116.59
|
| Rate for Payer: BCN Commercial |
$110.38
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: Nomi Health Commercial |
$117.12
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health HMO/PPO |
$124.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.69
|
| Rate for Payer: UHC Core |
$119.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$7,039.02
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,671.77 |
| Max. Negotiated Rate |
$6,335.12 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: Aetna Medicare |
$1,830.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,199.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,199.69
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$1,759.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,786.78
|
| Rate for Payer: BCN Commercial |
$5,472.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,759.76
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,759.76
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,279.26
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,847.74
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,023.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,983.17
|
| Rate for Payer: Nomi Health Commercial |
$5,772.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,671.77
|
| Rate for Payer: PACE SWMI |
$1,759.76
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,759.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,575.36
|
| Rate for Payer: Priority Health HMO/PPO |
$6,123.95
|
| Rate for Payer: Priority Health Medicare |
$1,777.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,716.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,759.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,194.34
|
| Rate for Payer: UHC Core |
$5,877.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,759.76
|
| Rate for Payer: UHC Exchange |
$1,759.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,759.76
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$1,759.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,279.26
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$7,039.02
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,575.36 |
| Max. Negotiated Rate |
$6,335.12 |
| Rate for Payer: Aetna Commercial |
$5,983.17
|
| Rate for Payer: BCBS Trust/PPO |
$5,745.95
|
| Rate for Payer: BCN Commercial |
$5,439.75
|
| Rate for Payer: Cash Price |
$5,631.22
|
| Rate for Payer: Cofinity Commercial |
$6,053.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,631.22
|
| Rate for Payer: Healthscope Commercial |
$6,335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,279.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,983.17
|
| Rate for Payer: Nomi Health Commercial |
$5,772.00
|
| Rate for Payer: PHP Commercial |
$5,983.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,575.36
|
| Rate for Payer: Priority Health HMO/PPO |
$6,123.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,716.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,194.34
|
| Rate for Payer: UHC Core |
$5,877.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,279.26
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,551.45
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,658.44 |
| Max. Negotiated Rate |
$2,296.30 |
| Rate for Payer: Aetna Commercial |
$2,168.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.75
|
| Rate for Payer: BCN Commercial |
$1,971.76
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cofinity Commercial |
$2,194.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.16
|
| Rate for Payer: Healthscope Commercial |
$2,296.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.73
|
| Rate for Payer: Nomi Health Commercial |
$2,092.19
|
| Rate for Payer: PHP Commercial |
$2,168.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.44
|
| Rate for Payer: Priority Health HMO/PPO |
$2,219.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,709.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.28
|
| Rate for Payer: UHC Core |
$2,130.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.59
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,551.45
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$605.97 |
| Max. Negotiated Rate |
$2,296.30 |
| Rate for Payer: Aetna Commercial |
$2,168.73
|
| Rate for Payer: Aetna Medicare |
$663.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.33
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$637.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,097.55
|
| Rate for Payer: BCN Commercial |
$1,983.75
|
| Rate for Payer: BCN Medicare Advantage |
$637.86
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cash Price |
$2,041.16
|
| Rate for Payer: Cofinity Commercial |
$2,194.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.86
|
| Rate for Payer: Healthscope Commercial |
$2,296.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.59
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.76
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.73
|
| Rate for Payer: Nomi Health Commercial |
$2,092.19
|
| Rate for Payer: PACE Senior Care Partners |
$605.97
|
| Rate for Payer: PACE SWMI |
$637.86
|
| Rate for Payer: PHP Commercial |
$2,168.73
|
| Rate for Payer: PHP Medicare Advantage |
$637.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.44
|
| Rate for Payer: Priority Health HMO/PPO |
$2,219.76
|
| Rate for Payer: Priority Health Medicare |
$644.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,709.47
|
| Rate for Payer: Railroad Medicare Medicare |
$637.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.28
|
| Rate for Payer: UHC Core |
$2,130.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.86
|
| Rate for Payer: UHC Exchange |
$637.86
|
| Rate for Payer: UHC Medicare Advantage |
$637.86
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$637.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.59
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$377.89
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: BCBS Trust/PPO |
$308.47
|
| Rate for Payer: BCN Commercial |
$292.03
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$377.89
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.75 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: Aetna Medicare |
$98.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.09
|
| Rate for Payer: BCBS Complete |
$151.16
|
| Rate for Payer: BCBS MAPPO |
$94.47
|
| Rate for Payer: BCBS Trust/PPO |
$310.66
|
| Rate for Payer: BCN Commercial |
$293.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.47
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.47
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PACE Senior Care Partners |
$89.75
|
| Rate for Payer: PACE SWMI |
$94.47
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: PHP Medicare Advantage |
$94.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Medicare |
$95.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: Railroad Medicare Medicare |
$94.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.47
|
| Rate for Payer: UHC Exchange |
$94.47
|
| Rate for Payer: UHC Medicare Advantage |
$94.47
|
| Rate for Payer: VA VA |
$94.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$951.99
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.10 |
| Max. Negotiated Rate |
$856.79 |
| Rate for Payer: Aetna Commercial |
$809.19
|
| Rate for Payer: Aetna Medicare |
$247.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.50
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$238.00
|
| Rate for Payer: BCBS Trust/PPO |
$782.63
|
| Rate for Payer: BCN Commercial |
$740.17
|
| Rate for Payer: BCN Medicare Advantage |
$238.00
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$818.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.00
|
| Rate for Payer: Healthscope Commercial |
$856.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.99
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.90
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: PACE Senior Care Partners |
$226.10
|
| Rate for Payer: PACE SWMI |
$238.00
|
| Rate for Payer: PHP Commercial |
$809.19
|
| Rate for Payer: PHP Medicare Advantage |
$238.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO |
$828.23
|
| Rate for Payer: Priority Health Medicare |
$240.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.83
|
| Rate for Payer: Railroad Medicare Medicare |
$238.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.75
|
| Rate for Payer: UHC Core |
$794.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.00
|
| Rate for Payer: UHC Exchange |
$238.00
|
| Rate for Payer: UHC Medicare Advantage |
$238.00
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$238.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.99
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$951.99
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.79 |
| Max. Negotiated Rate |
$856.79 |
| Rate for Payer: Aetna Commercial |
$809.19
|
| Rate for Payer: BCBS Trust/PPO |
$777.11
|
| Rate for Payer: BCN Commercial |
$735.70
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$818.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Healthscope Commercial |
$856.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: Nomi Health Commercial |
$780.63
|
| Rate for Payer: PHP Commercial |
$809.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health HMO/PPO |
$828.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.75
|
| Rate for Payer: UHC Core |
$794.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.99
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$247.45
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.84 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: Aetna Commercial |
$210.33
|
| Rate for Payer: BCBS Trust/PPO |
$201.99
|
| Rate for Payer: BCN Commercial |
$191.23
|
| Rate for Payer: Cash Price |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$212.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.96
|
| Rate for Payer: Healthscope Commercial |
$222.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.33
|
| Rate for Payer: Nomi Health Commercial |
$202.91
|
| Rate for Payer: PHP Commercial |
$210.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.84
|
| Rate for Payer: Priority Health HMO/PPO |
$215.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.76
|
| Rate for Payer: UHC Core |
$206.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.59
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$247.45
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.77 |
| Max. Negotiated Rate |
$222.70 |
| Rate for Payer: Aetna Commercial |
$210.33
|
| Rate for Payer: Aetna Medicare |
$64.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.33
|
| Rate for Payer: BCBS Complete |
$98.98
|
| Rate for Payer: BCBS MAPPO |
$61.86
|
| Rate for Payer: BCBS Trust/PPO |
$203.43
|
| Rate for Payer: BCN Commercial |
$192.39
|
| Rate for Payer: BCN Medicare Advantage |
$61.86
|
| Rate for Payer: Cash Price |
$197.96
|
| Rate for Payer: Cofinity Commercial |
$212.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.86
|
| Rate for Payer: Healthscope Commercial |
$222.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.33
|
| Rate for Payer: Nomi Health Commercial |
$202.91
|
| Rate for Payer: PACE Senior Care Partners |
$58.77
|
| Rate for Payer: PACE SWMI |
$61.86
|
| Rate for Payer: PHP Commercial |
$210.33
|
| Rate for Payer: PHP Medicare Advantage |
$61.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.84
|
| Rate for Payer: Priority Health HMO/PPO |
$215.28
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.79
|
| Rate for Payer: Railroad Medicare Medicare |
$61.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.76
|
| Rate for Payer: UHC Core |
$206.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.86
|
| Rate for Payer: UHC Exchange |
$61.86
|
| Rate for Payer: UHC Medicare Advantage |
$61.86
|
| Rate for Payer: VA VA |
$61.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.59
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,716.66
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$407.71 |
| Max. Negotiated Rate |
$1,544.99 |
| Rate for Payer: Aetna Commercial |
$1,459.16
|
| Rate for Payer: Aetna Medicare |
$446.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$536.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$536.46
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$429.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,411.27
|
| Rate for Payer: BCN Commercial |
$1,334.70
|
| Rate for Payer: BCN Medicare Advantage |
$429.16
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cofinity Commercial |
$1,476.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$429.16
|
| Rate for Payer: Healthscope Commercial |
$1,544.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,287.50
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.62
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$493.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.16
|
| Rate for Payer: Nomi Health Commercial |
$1,407.66
|
| Rate for Payer: PACE Senior Care Partners |
$407.71
|
| Rate for Payer: PACE SWMI |
$429.16
|
| Rate for Payer: PHP Commercial |
$1,459.16
|
| Rate for Payer: PHP Medicare Advantage |
$429.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.49
|
| Rate for Payer: Priority Health Medicare |
$433.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.16
|
| Rate for Payer: Railroad Medicare Medicare |
$429.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.66
|
| Rate for Payer: UHC Core |
$1,433.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$429.16
|
| Rate for Payer: UHC Exchange |
$429.16
|
| Rate for Payer: UHC Medicare Advantage |
$429.16
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$429.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,287.50
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,716.66
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,115.83 |
| Max. Negotiated Rate |
$1,544.99 |
| Rate for Payer: Aetna Commercial |
$1,459.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.31
|
| Rate for Payer: BCN Commercial |
$1,326.63
|
| Rate for Payer: Cash Price |
$1,373.33
|
| Rate for Payer: Cofinity Commercial |
$1,476.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,373.33
|
| Rate for Payer: Healthscope Commercial |
$1,544.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,287.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,459.16
|
| Rate for Payer: Nomi Health Commercial |
$1,407.66
|
| Rate for Payer: PHP Commercial |
$1,459.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,115.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,493.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,510.66
|
| Rate for Payer: UHC Core |
$1,433.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,287.50
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,176.90
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$992.01 |
| Max. Negotiated Rate |
$3,759.21 |
| Rate for Payer: Aetna Commercial |
$3,550.36
|
| Rate for Payer: Aetna Medicare |
$1,085.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,305.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,305.28
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$1,044.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,433.83
|
| Rate for Payer: BCN Commercial |
$3,247.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,044.22
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cofinity Commercial |
$3,592.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,044.22
|
| Rate for Payer: Healthscope Commercial |
$3,759.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,132.68
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.44
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,200.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,550.36
|
| Rate for Payer: Nomi Health Commercial |
$3,425.06
|
| Rate for Payer: PACE Senior Care Partners |
$992.01
|
| Rate for Payer: PACE SWMI |
$1,044.22
|
| Rate for Payer: PHP Commercial |
$3,550.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,044.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,633.90
|
| Rate for Payer: Priority Health Medicare |
$1,054.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,798.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,044.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,675.67
|
| Rate for Payer: UHC Core |
$3,487.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,044.22
|
| Rate for Payer: UHC Exchange |
$1,044.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,044.22
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$1,044.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,132.68
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,176.90
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,714.98 |
| Max. Negotiated Rate |
$3,759.21 |
| Rate for Payer: Aetna Commercial |
$3,550.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,409.60
|
| Rate for Payer: BCN Commercial |
$3,227.91
|
| Rate for Payer: Cash Price |
$3,341.52
|
| Rate for Payer: Cofinity Commercial |
$3,592.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,341.52
|
| Rate for Payer: Healthscope Commercial |
$3,759.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,132.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,550.36
|
| Rate for Payer: Nomi Health Commercial |
$3,425.06
|
| Rate for Payer: PHP Commercial |
$3,550.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,633.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,798.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,675.67
|
| Rate for Payer: UHC Core |
$3,487.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,132.68
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,141.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$508.69 |
| Max. Negotiated Rate |
$1,927.66 |
| Rate for Payer: Aetna Commercial |
$1,820.57
|
| Rate for Payer: Aetna Medicare |
$556.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$669.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$669.33
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$535.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,760.81
|
| Rate for Payer: BCN Commercial |
$1,665.29
|
| Rate for Payer: BCN Medicare Advantage |
$535.46
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cofinity Commercial |
$1,841.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.46
|
| Rate for Payer: Healthscope Commercial |
$1,927.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.39
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.24
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$615.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.57
|
| Rate for Payer: Nomi Health Commercial |
$1,756.32
|
| Rate for Payer: PACE Senior Care Partners |
$508.69
|
| Rate for Payer: PACE SWMI |
$535.46
|
| Rate for Payer: PHP Commercial |
$1,820.57
|
| Rate for Payer: PHP Medicare Advantage |
$535.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.41
|
| Rate for Payer: Priority Health Medicare |
$540.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.04
|
| Rate for Payer: Railroad Medicare Medicare |
$535.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.83
|
| Rate for Payer: UHC Core |
$1,788.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.46
|
| Rate for Payer: UHC Exchange |
$535.46
|
| Rate for Payer: UHC Medicare Advantage |
$535.46
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$535.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.39
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,141.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,392.20 |
| Max. Negotiated Rate |
$1,927.66 |
| Rate for Payer: Aetna Commercial |
$1,820.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,748.39
|
| Rate for Payer: BCN Commercial |
$1,655.22
|
| Rate for Payer: Cash Price |
$1,713.48
|
| Rate for Payer: Cofinity Commercial |
$1,841.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.48
|
| Rate for Payer: Healthscope Commercial |
$1,927.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.57
|
| Rate for Payer: Nomi Health Commercial |
$1,756.32
|
| Rate for Payer: PHP Commercial |
$1,820.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,863.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,884.83
|
| Rate for Payer: UHC Core |
$1,788.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.39
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
IP
|
$113.84
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$102.46 |
| Rate for Payer: Aetna Commercial |
$96.76
|
| Rate for Payer: BCBS Trust/PPO |
$92.93
|
| Rate for Payer: BCN Commercial |
$87.98
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cofinity Commercial |
$97.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.07
|
| Rate for Payer: Healthscope Commercial |
$102.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.35
|
| Rate for Payer: PHP Commercial |
$96.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.00
|
| Rate for Payer: Priority Health HMO/PPO |
$99.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.18
|
| Rate for Payer: UHC Core |
$95.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.38
|
|
|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$113.84
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$27.04 |
| Max. Negotiated Rate |
$102.46 |
| Rate for Payer: Aetna Commercial |
$96.76
|
| Rate for Payer: Aetna Medicare |
$29.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.58
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$93.59
|
| Rate for Payer: BCN Commercial |
$88.51
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cash Price |
$91.07
|
| Rate for Payer: Cofinity Commercial |
$97.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$102.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.38
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.76
|
| Rate for Payer: Nomi Health Commercial |
$93.35
|
| Rate for Payer: PACE Senior Care Partners |
$27.04
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$96.76
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.00
|
| Rate for Payer: Priority Health HMO/PPO |
$99.04
|
| Rate for Payer: Priority Health Medicare |
$28.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.27
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.18
|
| Rate for Payer: UHC Core |
$95.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.46
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicare Advantage |
$28.46
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.38
|
|
