|
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 |
$1,555.23
|
| 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 |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.76
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| 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 |
$1,481.07
|
| 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 |
$1,481.07
|
| 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 |
$534.17
|
| 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 |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.90
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| 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 |
$508.70
|
| 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 |
$508.70
|
| 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
|
OP
|
$247.45
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.77 |
| Max. Negotiated Rate |
$222.71 |
| 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 |
$222.71
|
| 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 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 |
$222.71 |
| 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 |
$222.71
|
| 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 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 |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$429.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,411.27
|
| Rate for Payer: BCN Commercial |
$1,334.70
|
| Rate for Payer: BCN Medicare Advantage |
$429.17
|
| 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 |
$429.17
|
| Rate for Payer: Healthscope Commercial |
$1,544.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,287.49
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$450.62
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$429.17
|
| Rate for Payer: PHP Commercial |
$1,459.16
|
| Rate for Payer: PHP Medicare Advantage |
$429.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| 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 |
$429.17
|
| 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 |
$429.17
|
| Rate for Payer: UHC Exchange |
$429.17
|
| Rate for Payer: UHC Medicare Advantage |
$429.17
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$429.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,287.49
|
|
|
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 |
$1,287.49
|
| 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 |
$1,287.49
|
|
|
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 |
$2,714.99 |
| 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 |
$2,714.99
|
| 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 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.44
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.99
|
| 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 |
$1,171.43
|
| Rate for Payer: VA VA |
$1,044.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,132.68
|
|
|
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 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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$562.24
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| Rate for Payer: VA VA |
$535.46
|
| 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 |
$97.86
|
| 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 |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| 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 |
$93.19
|
| 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 |
$93.19
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.38
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETERAL STENT
|
Facility
|
IP
|
$2,777.30
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$971.48
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$230.73 |
| Max. Negotiated Rate |
$1,555.23 |
| Rate for Payer: Aetna Commercial |
$825.76
|
| Rate for Payer: Aetna Medicare |
$252.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.59
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$242.87
|
| Rate for Payer: BCBS Trust/PPO |
$798.65
|
| Rate for Payer: BCN Commercial |
$755.33
|
| Rate for Payer: BCN Medicare Advantage |
$242.87
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cofinity Commercial |
$835.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.87
|
| Rate for Payer: Healthscope Commercial |
$874.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.61
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.01
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.76
|
| Rate for Payer: Nomi Health Commercial |
$796.61
|
| Rate for Payer: PACE Senior Care Partners |
$230.73
|
| Rate for Payer: PACE SWMI |
$242.87
|
| Rate for Payer: PHP Commercial |
$825.76
|
| Rate for Payer: PHP Medicare Advantage |
$242.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.46
|
| Rate for Payer: Priority Health HMO/PPO |
$845.19
|
| Rate for Payer: Priority Health Medicare |
$245.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.89
|
| Rate for Payer: Railroad Medicare Medicare |
$242.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.90
|
| Rate for Payer: UHC Core |
$811.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.87
|
| Rate for Payer: UHC Exchange |
$242.87
|
| Rate for Payer: UHC Medicare Advantage |
$242.87
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$242.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.61
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$971.48
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$631.46 |
| Max. Negotiated Rate |
$874.33 |
| Rate for Payer: Aetna Commercial |
$825.76
|
| Rate for Payer: BCBS Trust/PPO |
$793.02
|
| Rate for Payer: BCN Commercial |
$750.76
|
| Rate for Payer: Cash Price |
$777.18
|
| Rate for Payer: Cofinity Commercial |
$835.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.18
|
| Rate for Payer: Healthscope Commercial |
$874.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.76
|
| Rate for Payer: Nomi Health Commercial |
$796.61
|
| Rate for Payer: PHP Commercial |
$825.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.46
|
| Rate for Payer: Priority Health HMO/PPO |
$845.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.90
|
| Rate for Payer: UHC Core |
$811.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.61
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$219.61 |
| Max. Negotiated Rate |
$832.19 |
| Rate for Payer: Aetna Commercial |
$785.96
|
| Rate for Payer: Aetna Medicare |
$240.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.96
|
| Rate for Payer: BCBS Complete |
$506.74
|
| Rate for Payer: BCBS MAPPO |
$231.16
|
| Rate for Payer: BCBS Trust/PPO |
$760.16
|
| Rate for Payer: BCN Commercial |
$718.92
|
| Rate for Payer: BCN Medicare Advantage |
$231.16
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$795.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.16
|
| Rate for Payer: Healthscope Commercial |
$832.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.50
|
| Rate for Payer: Mclaren Medicaid |
$482.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.72
|
| Rate for Payer: Meridian Medicaid |
$506.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: Nomi Health Commercial |
$758.22
|
| Rate for Payer: PACE Senior Care Partners |
$219.61
|
| Rate for Payer: PACE SWMI |
$231.16
|
| Rate for Payer: PHP Commercial |
$785.96
|
| Rate for Payer: PHP Medicare Advantage |
$231.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: Priority Health HMO/PPO |
$804.45
|
| Rate for Payer: Priority Health Medicare |
$233.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.52
|
| Rate for Payer: Railroad Medicare Medicare |
$231.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.70
|
| Rate for Payer: UHC Core |
$772.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.16
|
| Rate for Payer: UHC Exchange |
$231.16
|
| Rate for Payer: UHC Medicare Advantage |
$231.16
|
| Rate for Payer: UHCCP Medicaid |
$482.58
|
| Rate for Payer: VA VA |
$231.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.50
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$601.03 |
| Max. Negotiated Rate |
$832.19 |
| Rate for Payer: Aetna Commercial |
$785.96
|
| Rate for Payer: BCBS Trust/PPO |
$754.80
|
| Rate for Payer: BCN Commercial |
$714.58
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$795.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Healthscope Commercial |
$832.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: Nomi Health Commercial |
$758.22
|
| Rate for Payer: PHP Commercial |
$785.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: Priority Health HMO/PPO |
$804.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$619.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$813.70
|
| Rate for Payer: UHC Core |
$772.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.50
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,891.05 |
| Max. Negotiated Rate |
$2,618.37 |
| Rate for Payer: Aetna Commercial |
$2,472.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,374.86
|
| Rate for Payer: BCN Commercial |
$2,248.31
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,502.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Healthscope Commercial |
$2,618.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.91
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| Rate for Payer: PHP Commercial |
$2,472.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,531.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,949.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,560.18
|
| Rate for Payer: UHC Core |
$2,429.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.97
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$690.96 |
| Max. Negotiated Rate |
$2,618.37 |
| Rate for Payer: Aetna Commercial |
$2,472.91
|
| Rate for Payer: Aetna Medicare |
$756.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$909.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$909.16
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$727.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.74
|
| Rate for Payer: BCN Commercial |
$2,261.98
|
| Rate for Payer: BCN Medicare Advantage |
$727.33
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,502.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.33
|
| Rate for Payer: Healthscope Commercial |
$2,618.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.97
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.69
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$836.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.91
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| Rate for Payer: PACE Senior Care Partners |
$690.96
|
| Rate for Payer: PACE SWMI |
$727.33
|
| Rate for Payer: PHP Commercial |
$2,472.91
|
| Rate for Payer: PHP Medicare Advantage |
$727.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,531.09
|
| Rate for Payer: Priority Health Medicare |
$734.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,949.23
|
| Rate for Payer: Railroad Medicare Medicare |
$727.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,560.18
|
| Rate for Payer: UHC Core |
$2,429.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$727.33
|
| Rate for Payer: UHC Exchange |
$727.33
|
| Rate for Payer: UHC Medicare Advantage |
$727.33
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$727.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.97
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,827.53
|
| Rate for Payer: BCN Commercial |
$6,463.70
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO |
$7,276.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
