|
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 |
$2,082.98
|
| 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 |
$2,082.98
|
|
|
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 |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$694.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,283.22
|
| Rate for Payer: BCN Commercial |
$2,159.35
|
| Rate for Payer: BCN Medicare Advantage |
$694.32
|
| 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 |
$694.32
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.98
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.04
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| 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 |
$694.32
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: PHP Medicare Advantage |
$694.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| 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 |
$694.32
|
| 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 |
$694.32
|
| Rate for Payer: UHC Exchange |
$694.32
|
| Rate for Payer: UHC Medicare Advantage |
$694.32
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$694.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.98
|
|
|
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 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 |
$1,523.78 |
| 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 |
$1,523.78
|
| 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 |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.01
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| 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 |
$1,451.13
|
| 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 |
$1,451.13
|
| Rate for Payer: VA VA |
$242.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.61
|
|
|
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 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 |
$496.49
|
| 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 |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.72
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| 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 |
$472.82
|
| 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 |
$472.82
|
| Rate for Payer: VA VA |
$231.16
|
| 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 |
$1,891.04 |
| Max. Negotiated Rate |
$2,618.37 |
| Rate for Payer: Aetna Commercial |
$2,472.90
|
| 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 |
$2,181.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.90
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| Rate for Payer: PHP Commercial |
$2,472.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.04
|
| 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 |
$2,181.98
|
|
|
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 |
$2,472.90
|
| 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 |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$727.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.74
|
| Rate for Payer: BCN Commercial |
$2,261.98
|
| Rate for Payer: BCN Medicare Advantage |
$727.32
|
| 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 |
$727.32
|
| Rate for Payer: Healthscope Commercial |
$2,618.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.98
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.69
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$836.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.90
|
| Rate for Payer: Nomi Health Commercial |
$2,385.63
|
| Rate for Payer: PACE Senior Care Partners |
$690.96
|
| Rate for Payer: PACE SWMI |
$727.32
|
| Rate for Payer: PHP Commercial |
$2,472.90
|
| Rate for Payer: PHP Medicare Advantage |
$727.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.04
|
| 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 |
$727.32
|
| 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 |
$727.32
|
| Rate for Payer: UHC Exchange |
$727.32
|
| Rate for Payer: UHC Medicare Advantage |
$727.32
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$727.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.98
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,986.45 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$2,174.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,613.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,613.75
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$2,091.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,876.04
|
| Rate for Payer: BCN Commercial |
$6,503.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,091.00
|
| Rate for Payer: Cash Price |
$6,691.20
|
| 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: Health Alliance Plan Medicare Advantage |
$2,091.00
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,195.55
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,404.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,986.45
|
| Rate for Payer: PACE SWMI |
$2,091.00
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,091.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| 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 Medicare |
$2,111.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,091.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,091.00
|
| Rate for Payer: UHC Exchange |
$2,091.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,091.00
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$2,091.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
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
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,966.07 |
| Max. Negotiated Rate |
$4,106.87 |
| Rate for Payer: Aetna Commercial |
$3,878.71
|
| Rate for Payer: BCBS Trust/PPO |
$3,724.93
|
| Rate for Payer: BCN Commercial |
$3,526.43
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$3,924.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Healthscope Commercial |
$4,106.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,422.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: Nomi Health Commercial |
$3,741.82
|
| Rate for Payer: PHP Commercial |
$3,878.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,969.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,057.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,015.61
|
| Rate for Payer: UHC Core |
$3,810.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,422.39
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,083.76 |
| Max. Negotiated Rate |
$4,106.87 |
| Rate for Payer: Aetna Commercial |
$3,878.71
|
| Rate for Payer: Aetna Medicare |
$1,186.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,426.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,426.00
|
| Rate for Payer: BCBS Complete |
$1,452.56
|
| Rate for Payer: BCBS MAPPO |
$1,140.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,751.40
|
| Rate for Payer: BCN Commercial |
$3,547.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,140.80
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$3,924.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,140.80
|
| Rate for Payer: Healthscope Commercial |
$4,106.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,422.39
|
| Rate for Payer: Mclaren Medicaid |
$1,383.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,197.84
|
| Rate for Payer: Meridian Medicaid |
$1,452.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,311.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: Nomi Health Commercial |
$3,741.82
|
| Rate for Payer: PACE Senior Care Partners |
$1,083.76
|
| Rate for Payer: PACE SWMI |
$1,140.80
|
| Rate for Payer: PHP Commercial |
$3,878.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,140.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,969.98
|
| Rate for Payer: Priority Health Medicare |
$1,152.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,057.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,140.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,015.61
|
| Rate for Payer: UHC Core |
$3,810.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,140.80
|
| Rate for Payer: UHC Exchange |
$1,140.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,140.80
|
| Rate for Payer: UHCCP Medicaid |
$1,383.30
|
| Rate for Payer: VA VA |
$1,140.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,422.39
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$17.95
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$36.90
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Exchange |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.22
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$25.81
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$25.99
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$25.93
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.19
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Exchange |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$7.90
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,212.46 |
| Max. Negotiated Rate |
$4,594.58 |
| Rate for Payer: Aetna Commercial |
$4,339.33
|
| Rate for Payer: Aetna Medicare |
$1,327.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,595.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,595.34
|
| Rate for Payer: BCBS Complete |
$1,360.67
|
| Rate for Payer: BCBS MAPPO |
$1,276.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,196.89
|
| Rate for Payer: BCN Commercial |
$3,969.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.27
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$4,390.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.27
|
| Rate for Payer: Healthscope Commercial |
$4,594.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,828.82
|
| Rate for Payer: Mclaren Medicaid |
$1,295.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.09
|
| Rate for Payer: Meridian Medicaid |
$1,360.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,467.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: Nomi Health Commercial |
$4,186.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,212.46
|
| Rate for Payer: PACE SWMI |
$1,276.27
|
| Rate for Payer: PHP Commercial |
$4,339.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,295.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: Priority Health HMO/PPO |
$4,441.43
|
| Rate for Payer: Priority Health Medicare |
$1,289.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,420.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,276.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,492.48
|
| Rate for Payer: UHC Core |
$4,262.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.27
|
| Rate for Payer: UHC Exchange |
$1,276.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.27
|
| Rate for Payer: UHCCP Medicaid |
$1,295.79
|
| Rate for Payer: VA VA |
$1,276.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,828.82
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,318.31 |
| Max. Negotiated Rate |
$4,594.58 |
| Rate for Payer: Aetna Commercial |
$4,339.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,167.28
|
| Rate for Payer: BCN Commercial |
$3,945.21
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$4,390.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Healthscope Commercial |
$4,594.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,828.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: Nomi Health Commercial |
$4,186.17
|
| Rate for Payer: PHP Commercial |
$4,339.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: Priority Health HMO/PPO |
$4,441.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,420.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,492.48
|
| Rate for Payer: UHC Core |
$4,262.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,828.82
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$27.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$6.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$6.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$6.28
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC RENIN
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna Medicare |
$10.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.97
|
| Rate for Payer: BCBS Complete |
$16.69
|
| Rate for Payer: BCBS MAPPO |
$10.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.13
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.38
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.38
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Mclaren Medicaid |
$15.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.90
|
| Rate for Payer: Meridian Medicaid |
$16.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE Senior Care Partners |
$9.86
|
| Rate for Payer: PACE SWMI |
$10.38
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: Railroad Medicare Medicare |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.38
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$10.38
|
| Rate for Payer: UHCCP Medicaid |
$15.90
|
| Rate for Payer: VA VA |
$10.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC RENIN
|
Facility
|
IP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.88
|
| Rate for Payer: BCN Commercial |
$32.08
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Aetna Commercial |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.13
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: BCBS MAPPO |
$0.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.33
|
| Rate for Payer: BCN Commercial |
$0.31
|
| Rate for Payer: BCN Medicare Advantage |
$0.10
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.10
|
| Rate for Payer: Healthscope Commercial |
$0.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: Nomi Health Commercial |
$0.33
|
| Rate for Payer: PACE Senior Care Partners |
$0.10
|
| Rate for Payer: PACE SWMI |
$0.10
|
| Rate for Payer: PHP Commercial |
$0.34
|
| Rate for Payer: PHP Medicare Advantage |
$0.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: Priority Health HMO/PPO |
$0.35
|
| Rate for Payer: Priority Health Medicare |
$0.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.27
|
| Rate for Payer: Railroad Medicare Medicare |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.35
|
| Rate for Payer: UHC Core |
$0.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.10
|
| Rate for Payer: UHC Exchange |
$0.10
|
| Rate for Payer: UHC Medicare Advantage |
$0.10
|
| Rate for Payer: VA VA |
$0.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.30
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Aetna Commercial |
$0.34
|
| Rate for Payer: BCBS Trust/PPO |
$0.33
|
| Rate for Payer: BCN Commercial |
$0.31
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Healthscope Commercial |
$0.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: Nomi Health Commercial |
$0.33
|
| Rate for Payer: PHP Commercial |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: Priority Health HMO/PPO |
$0.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.35
|
| Rate for Payer: UHC Core |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.30
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.49 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna Medicare |
$411.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$494.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$494.06
|
| Rate for Payer: BCBS Complete |
$455.33
|
| Rate for Payer: BCBS MAPPO |
$395.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,299.74
|
| Rate for Payer: BCN Commercial |
$1,229.23
|
| Rate for Payer: BCN Medicare Advantage |
$395.25
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.25
|
| Rate for Payer: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Mclaren Medicaid |
$433.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.01
|
| Rate for Payer: Meridian Medicaid |
$455.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$454.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: PACE Senior Care Partners |
$375.49
|
| Rate for Payer: PACE SWMI |
$395.25
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: PHP Medicare Advantage |
$395.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,375.47
|
| Rate for Payer: Priority Health Medicare |
$399.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.27
|
| Rate for Payer: Railroad Medicare Medicare |
$395.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,391.28
|
| Rate for Payer: UHC Core |
$1,320.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.25
|
| Rate for Payer: UHC Exchange |
$395.25
|
| Rate for Payer: UHC Medicare Advantage |
$395.25
|
| Rate for Payer: UHCCP Medicaid |
$433.62
|
| Rate for Payer: VA VA |
$395.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
