|
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
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.04 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna Medicare |
$141.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.79
|
| Rate for Payer: BCBS Complete |
$302.95
|
| Rate for Payer: BCBS MAPPO |
$135.83
|
| Rate for Payer: BCBS Trust/PPO |
$446.67
|
| Rate for Payer: BCN Commercial |
$422.44
|
| Rate for Payer: BCN Medicare Advantage |
$135.83
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.62
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: Nomi Health Commercial |
$445.53
|
| Rate for Payer: PACE Senior Care Partners |
$129.04
|
| Rate for Payer: PACE SWMI |
$135.83
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: PHP Medicare Advantage |
$135.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health HMO/PPO |
$472.70
|
| Rate for Payer: Priority Health Medicare |
$137.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.03
|
| Rate for Payer: Railroad Medicare Medicare |
$135.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.13
|
| Rate for Payer: UHC Core |
$453.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.83
|
| Rate for Payer: UHC Exchange |
$135.83
|
| Rate for Payer: UHC Medicare Advantage |
$135.83
|
| Rate for Payer: UHCCP Medicaid |
$288.51
|
| Rate for Payer: VA VA |
$135.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$353.16 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: BCBS Trust/PPO |
$443.52
|
| Rate for Payer: BCN Commercial |
$419.89
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: Nomi Health Commercial |
$445.53
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health HMO/PPO |
$472.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$364.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$478.13
|
| Rate for Payer: UHC Core |
$453.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$212.32
|
| Rate for Payer: BCN Commercial |
$201.01
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$104.04
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.03
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$659.61 |
| Max. Negotiated Rate |
$2,499.57 |
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: Aetna Medicare |
$722.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$867.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$867.91
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$694.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,283.22
|
| Rate for Payer: BCN Commercial |
$2,159.35
|
| Rate for Payer: BCN Medicare Advantage |
$694.33
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.33
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.97
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.04
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$798.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: Nomi Health Commercial |
$2,277.39
|
| Rate for Payer: PACE Senior Care Partners |
$659.61
|
| Rate for Payer: PACE SWMI |
$694.33
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: PHP Medicare Advantage |
$694.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: Priority Health HMO/PPO |
$2,416.25
|
| Rate for Payer: Priority Health Medicare |
$701.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,860.79
|
| Rate for Payer: Railroad Medicare Medicare |
$694.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.02
|
| Rate for Payer: UHC Core |
$2,319.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$694.33
|
| Rate for Payer: UHC Exchange |
$694.33
|
| Rate for Payer: UHC Medicare Advantage |
$694.33
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$694.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.97
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,805.24 |
| Max. Negotiated Rate |
$2,499.57 |
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,267.11
|
| Rate for Payer: BCN Commercial |
$2,146.30
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: Nomi Health Commercial |
$2,277.39
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: Priority Health HMO/PPO |
$2,416.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,860.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.02
|
| Rate for Payer: UHC Core |
$2,319.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.97
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$559.75 |
| Max. Negotiated Rate |
$775.03 |
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: BCBS Trust/PPO |
$702.96
|
| Rate for Payer: BCN Commercial |
$665.50
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Healthscope Commercial |
$775.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: Nomi Health Commercial |
$706.14
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health HMO/PPO |
$749.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$576.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.81
|
| Rate for Payer: UHC Core |
$719.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.52 |
| Max. Negotiated Rate |
$775.03 |
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: Aetna Medicare |
$223.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.11
|
| Rate for Payer: BCBS Complete |
$711.80
|
| Rate for Payer: BCBS MAPPO |
$215.29
|
| Rate for Payer: BCBS Trust/PPO |
$707.95
|
| Rate for Payer: BCN Commercial |
$669.54
|
| Rate for Payer: BCN Medicare Advantage |
$215.29
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.29
|
| Rate for Payer: Healthscope Commercial |
$775.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Mclaren Medicaid |
$677.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.05
|
| Rate for Payer: Meridian Medicaid |
$711.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: Nomi Health Commercial |
$706.14
|
| Rate for Payer: PACE Senior Care Partners |
$204.52
|
| Rate for Payer: PACE SWMI |
$215.29
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: PHP Medicare Advantage |
$215.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health HMO/PPO |
$749.20
|
| Rate for Payer: Priority Health Medicare |
$217.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$576.97
|
| Rate for Payer: Railroad Medicare Medicare |
$215.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$757.81
|
| Rate for Payer: UHC Core |
$719.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.29
|
| Rate for Payer: UHC Exchange |
$215.29
|
| Rate for Payer: UHC Medicare Advantage |
$215.29
|
| Rate for Payer: UHCCP Medicaid |
$677.86
|
| Rate for Payer: VA VA |
$215.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$201.63 |
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna Medicare |
$45.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.31
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$43.45
|
| Rate for Payer: BCBS Trust/PPO |
$142.86
|
| Rate for Payer: BCN Commercial |
$135.11
|
| Rate for Payer: BCN Medicare Advantage |
$43.45
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.45
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.62
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: Nomi Health Commercial |
$142.50
|
| Rate for Payer: PACE Senior Care Partners |
$41.27
|
| Rate for Payer: PACE SWMI |
$43.45
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: PHP Medicare Advantage |
$43.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health HMO/PPO |
$151.19
|
| Rate for Payer: Priority Health Medicare |
$43.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.43
|
| Rate for Payer: Railroad Medicare Medicare |
$43.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.93
|
| Rate for Payer: UHC Core |
$145.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.45
|
| Rate for Payer: UHC Exchange |
$43.45
|
| Rate for Payer: UHC Medicare Advantage |
$43.45
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$43.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$112.96 |
| Max. Negotiated Rate |
$156.40 |
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: BCBS Trust/PPO |
$141.86
|
| Rate for Payer: BCN Commercial |
$134.30
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: Nomi Health Commercial |
$142.50
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health HMO/PPO |
$151.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.93
|
| Rate for Payer: UHC Core |
$145.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$46.05 |
| Max. Negotiated Rate |
$201.63 |
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna Medicare |
$50.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.60
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$159.41
|
| Rate for Payer: BCN Commercial |
$150.77
|
| Rate for Payer: BCN Medicare Advantage |
$48.48
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.48
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.90
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PACE Senior Care Partners |
$46.05
|
| Rate for Payer: PACE SWMI |
$48.48
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$48.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO |
$168.70
|
| Rate for Payer: Priority Health Medicare |
$48.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.92
|
| Rate for Payer: Railroad Medicare Medicare |
$48.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.64
|
| Rate for Payer: UHC Core |
$161.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.48
|
| Rate for Payer: UHC Exchange |
$48.48
|
| Rate for Payer: UHC Medicare Advantage |
$48.48
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$48.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$126.04 |
| Max. Negotiated Rate |
$174.52 |
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: BCBS Trust/PPO |
$158.29
|
| Rate for Payer: BCN Commercial |
$149.85
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$159.01
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO |
$168.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.64
|
| Rate for Payer: UHC Core |
$161.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$228.86 |
| Max. Negotiated Rate |
$316.88 |
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: BCBS Trust/PPO |
$287.41
|
| Rate for Payer: BCN Commercial |
$272.10
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: Nomi Health Commercial |
$288.71
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health HMO/PPO |
$306.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.84
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$83.62 |
| Max. Negotiated Rate |
$316.88 |
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: Aetna Medicare |
$91.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.03
|
| Rate for Payer: BCBS Complete |
$201.63
|
| Rate for Payer: BCBS MAPPO |
$88.02
|
| Rate for Payer: BCBS Trust/PPO |
$289.45
|
| Rate for Payer: BCN Commercial |
$273.75
|
| Rate for Payer: BCN Medicare Advantage |
$88.02
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.02
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Mclaren Medicaid |
$192.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.42
|
| Rate for Payer: Meridian Medicaid |
$201.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: Nomi Health Commercial |
$288.71
|
| Rate for Payer: PACE Senior Care Partners |
$83.62
|
| Rate for Payer: PACE SWMI |
$88.02
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: PHP Medicare Advantage |
$88.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health HMO/PPO |
$306.32
|
| Rate for Payer: Priority Health Medicare |
$88.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.90
|
| Rate for Payer: Railroad Medicare Medicare |
$88.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.84
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.02
|
| Rate for Payer: UHC Exchange |
$88.02
|
| Rate for Payer: UHC Medicare Advantage |
$88.02
|
| Rate for Payer: UHCCP Medicaid |
$192.01
|
| Rate for Payer: VA VA |
$88.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
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 |
$192.01 |
| 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 |
$192.01
|
| 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 BILAT
|
Facility
|
OP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$192.01 |
| 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 |
$45.10
|
| 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 |
$192.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.00
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| 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 |
$42.95
|
| 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 |
$42.95
|
| Rate for Payer: VA VA |
$53.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
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 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 |
$45.10
|
| 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 |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.49
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| 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 |
$42.95
|
| 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 |
$42.95
|
| Rate for Payer: VA VA |
$35.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
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 |
$42.95 |
| Max. Negotiated Rate |
$192.01 |
| 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 |
$45.10
|
| 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 |
$192.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.00
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| 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 |
$42.95
|
| 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 |
$42.95
|
| Rate for Payer: VA VA |
$53.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
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 |
$192.01 |
| 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 |
$192.01
|
| 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 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 |
$45.10
|
| 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 |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.49
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| 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 |
$42.95
|
| 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 |
$42.95
|
| 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
|
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 |
$5,279.27
|
| 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 |
$5,279.27
|
|
|
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 |
$2,172.87
|
| 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 |
$5,279.27
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,847.74
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| 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 |
$2,069.26
|
| 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 |
$2,069.26
|
| Rate for Payer: VA VA |
$1,759.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,279.27
|
|
