|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,027.65 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.57
|
| Rate for Payer: BCN Commercial |
$1,221.80
|
| 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: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| 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 Narrow/Tiered Network |
$1,059.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,391.28
|
| Rate for Payer: UHC Core |
$1,320.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
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
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,027.65 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.57
|
| Rate for Payer: BCN Commercial |
$1,221.80
|
| 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: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,296.42
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| 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 Narrow/Tiered Network |
$1,059.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,391.28
|
| Rate for Payer: UHC Core |
$1,320.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$394.87 |
| Max. Negotiated Rate |
$1,496.34 |
| Rate for Payer: Aetna Commercial |
$1,413.21
|
| Rate for Payer: Aetna Medicare |
$432.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.56
|
| Rate for Payer: BCBS Complete |
$455.33
|
| Rate for Payer: BCBS MAPPO |
$415.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,366.82
|
| Rate for Payer: BCN Commercial |
$1,292.67
|
| Rate for Payer: BCN Medicare Advantage |
$415.65
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,429.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.65
|
| Rate for Payer: Healthscope Commercial |
$1,496.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.95
|
| Rate for Payer: Mclaren Medicaid |
$433.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.43
|
| Rate for Payer: Meridian Medicaid |
$455.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$478.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: Nomi Health Commercial |
$1,363.33
|
| Rate for Payer: PACE Senior Care Partners |
$394.87
|
| Rate for Payer: PACE SWMI |
$415.65
|
| Rate for Payer: PHP Commercial |
$1,413.21
|
| Rate for Payer: PHP Medicare Advantage |
$415.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,446.46
|
| Rate for Payer: Priority Health Medicare |
$419.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.94
|
| Rate for Payer: Railroad Medicare Medicare |
$415.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,463.09
|
| Rate for Payer: UHC Core |
$1,388.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.65
|
| Rate for Payer: UHC Exchange |
$415.65
|
| Rate for Payer: UHC Medicare Advantage |
$415.65
|
| Rate for Payer: UHCCP Medicaid |
$433.62
|
| Rate for Payer: VA VA |
$415.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.95
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,080.69 |
| Max. Negotiated Rate |
$1,496.34 |
| Rate for Payer: Aetna Commercial |
$1,413.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,357.18
|
| Rate for Payer: BCN Commercial |
$1,284.86
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,429.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| Rate for Payer: Healthscope Commercial |
$1,496.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: Nomi Health Commercial |
$1,363.33
|
| Rate for Payer: PHP Commercial |
$1,413.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,446.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,463.09
|
| Rate for Payer: UHC Core |
$1,388.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.95
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.97 |
| Max. Negotiated Rate |
$962.42 |
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna Medicare |
$278.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.17
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$267.34
|
| Rate for Payer: BCBS Trust/PPO |
$879.11
|
| Rate for Payer: BCN Commercial |
$831.42
|
| Rate for Payer: BCN Medicare Advantage |
$267.34
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.34
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.70
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: PACE Senior Care Partners |
$253.97
|
| Rate for Payer: PACE SWMI |
$267.34
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: PHP Medicare Advantage |
$267.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO |
$930.33
|
| Rate for Payer: Priority Health Medicare |
$270.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.46
|
| Rate for Payer: Railroad Medicare Medicare |
$267.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.03
|
| Rate for Payer: UHC Core |
$892.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.34
|
| Rate for Payer: UHC Exchange |
$267.34
|
| Rate for Payer: UHC Medicare Advantage |
$267.34
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$267.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$695.08 |
| Max. Negotiated Rate |
$962.42 |
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: BCBS Trust/PPO |
$872.91
|
| Rate for Payer: BCN Commercial |
$826.39
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO |
$930.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.03
|
| Rate for Payer: UHC Core |
$892.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,014.17 |
| Max. Negotiated Rate |
$4,173.46 |
| Rate for Payer: Aetna Commercial |
$3,941.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,785.33
|
| Rate for Payer: BCN Commercial |
$3,583.61
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$3,987.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Healthscope Commercial |
$4,173.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,477.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: Nomi Health Commercial |
$3,802.49
|
| Rate for Payer: PHP Commercial |
$3,941.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,034.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,106.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,080.72
|
| Rate for Payer: UHC Core |
$3,872.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,477.88
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,101.33 |
| Max. Negotiated Rate |
$4,173.46 |
| Rate for Payer: Aetna Commercial |
$3,941.60
|
| Rate for Payer: Aetna Medicare |
$1,205.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,449.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,449.12
|
| Rate for Payer: BCBS Complete |
$1,190.46
|
| Rate for Payer: BCBS MAPPO |
$1,159.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,812.23
|
| Rate for Payer: BCN Commercial |
$3,605.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,159.30
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$3,987.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,159.30
|
| Rate for Payer: Healthscope Commercial |
$4,173.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,477.88
|
| Rate for Payer: Mclaren Medicaid |
$1,133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,217.26
|
| Rate for Payer: Meridian Medicaid |
$1,190.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,333.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: Nomi Health Commercial |
$3,802.49
|
| Rate for Payer: PACE Senior Care Partners |
$1,101.33
|
| Rate for Payer: PACE SWMI |
$1,159.30
|
| Rate for Payer: PHP Commercial |
$3,941.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,159.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,133.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: Priority Health HMO/PPO |
$4,034.35
|
| Rate for Payer: Priority Health Medicare |
$1,170.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,106.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,159.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,080.72
|
| Rate for Payer: UHC Core |
$3,872.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,159.30
|
| Rate for Payer: UHC Exchange |
$1,159.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,159.30
|
| Rate for Payer: UHCCP Medicaid |
$1,133.70
|
| Rate for Payer: VA VA |
$1,159.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,477.88
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,789.77 |
| Max. Negotiated Rate |
$3,862.76 |
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,503.52
|
| Rate for Payer: BCN Commercial |
$3,316.82
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO |
$3,734.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,776.92
|
| Rate for Payer: UHC Core |
$3,583.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,019.34 |
| Max. Negotiated Rate |
$3,862.76 |
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: Aetna Medicare |
$1,115.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,341.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,341.23
|
| Rate for Payer: BCBS Complete |
$1,190.46
|
| Rate for Payer: BCBS MAPPO |
$1,072.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,528.41
|
| Rate for Payer: BCN Commercial |
$3,336.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,072.99
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,072.99
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Mclaren Medicaid |
$1,133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,126.64
|
| Rate for Payer: Meridian Medicaid |
$1,190.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,233.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,519.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,019.34
|
| Rate for Payer: PACE SWMI |
$1,072.99
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,072.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,133.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO |
$3,734.00
|
| Rate for Payer: Priority Health Medicare |
$1,083.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,875.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,072.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,776.92
|
| Rate for Payer: UHC Core |
$3,583.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,072.99
|
| Rate for Payer: UHC Exchange |
$1,072.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,072.99
|
| Rate for Payer: UHCCP Medicaid |
$1,133.70
|
| Rate for Payer: VA VA |
$1,072.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,380.82 |
| Max. Negotiated Rate |
$5,232.60 |
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: Aetna Medicare |
$1,511.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,816.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,816.88
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$1,453.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,779.69
|
| Rate for Payer: BCN Commercial |
$4,520.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,453.50
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,453.50
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,526.18
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,671.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,380.82
|
| Rate for Payer: PACE SWMI |
$1,453.50
|
| Rate for Payer: PHP Commercial |
$4,941.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,453.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: Priority Health HMO/PPO |
$5,058.18
|
| Rate for Payer: Priority Health Medicare |
$1,468.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,895.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,453.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,116.32
|
| Rate for Payer: UHC Core |
$4,854.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,453.50
|
| Rate for Payer: UHC Exchange |
$1,453.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,453.50
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$1,453.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,779.10 |
| Max. Negotiated Rate |
$5,232.60 |
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: BCBS Trust/PPO |
$4,745.97
|
| Rate for Payer: BCN Commercial |
$4,493.06
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: Nomi Health Commercial |
$4,767.48
|
| Rate for Payer: PHP Commercial |
$4,941.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: Priority Health HMO/PPO |
$5,058.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,895.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,116.32
|
| Rate for Payer: UHC Core |
$4,854.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,175.58 |
| Max. Negotiated Rate |
$4,396.96 |
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,988.04
|
| Rate for Payer: BCN Commercial |
$3,775.52
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,250.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,273.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,299.25
|
| Rate for Payer: UHC Core |
$4,079.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,160.31 |
| Max. Negotiated Rate |
$4,396.96 |
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: Aetna Medicare |
$1,270.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,526.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,526.72
|
| Rate for Payer: BCBS Complete |
$2,707.09
|
| Rate for Payer: BCBS MAPPO |
$1,221.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,016.38
|
| Rate for Payer: BCN Commercial |
$3,798.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,221.38
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,221.38
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Mclaren Medicaid |
$2,578.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,282.45
|
| Rate for Payer: Meridian Medicaid |
$2,707.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,404.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$4,006.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,160.31
|
| Rate for Payer: PACE SWMI |
$1,221.38
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,221.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,578.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO |
$4,250.39
|
| Rate for Payer: Priority Health Medicare |
$1,233.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,273.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,221.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,299.25
|
| Rate for Payer: UHC Core |
$4,079.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,221.38
|
| Rate for Payer: UHC Exchange |
$1,221.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,221.38
|
| Rate for Payer: UHCCP Medicaid |
$2,578.01
|
| Rate for Payer: VA VA |
$1,221.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$46.05 |
| Max. Negotiated Rate |
$174.52 |
| 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 |
$117.37
|
| 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 |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.90
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| 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 |
$111.78
|
| 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 |
$111.78
|
| Rate for Payer: VA VA |
$48.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
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 REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,001.05 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: Aetna Medicare |
$1,095.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,317.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,317.18
|
| Rate for Payer: BCBS Complete |
$1,685.98
|
| Rate for Payer: BCBS MAPPO |
$1,053.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,465.12
|
| Rate for Payer: BCN Commercial |
$3,277.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,053.74
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,053.74
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,106.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,211.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: PACE Senior Care Partners |
$1,001.05
|
| Rate for Payer: PACE SWMI |
$1,053.74
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,053.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,667.02
|
| Rate for Payer: Priority Health Medicare |
$1,064.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,824.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,053.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,709.16
|
| Rate for Payer: UHC Core |
$3,519.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,053.74
|
| Rate for Payer: UHC Exchange |
$1,053.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,053.74
|
| Rate for Payer: VA VA |
$1,053.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
IP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,739.72 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,440.67
|
| Rate for Payer: BCN Commercial |
$3,257.32
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: Nomi Health Commercial |
$3,456.27
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health HMO/PPO |
$3,667.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,824.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,709.16
|
| Rate for Payer: UHC Core |
$3,519.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.03 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna Medicare |
$426.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$513.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$513.20
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$410.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,350.09
|
| Rate for Payer: BCN Commercial |
$1,276.84
|
| Rate for Payer: BCN Medicare Advantage |
$410.56
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.56
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.09
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$472.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PACE Senior Care Partners |
$390.03
|
| Rate for Payer: PACE SWMI |
$410.56
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: PHP Medicare Advantage |
$410.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Medicare |
$414.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: Railroad Medicare Medicare |
$410.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.56
|
| Rate for Payer: UHC Exchange |
$410.56
|
| Rate for Payer: UHC Medicare Advantage |
$410.56
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$410.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,067.46 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,340.56
|
| Rate for Payer: BCN Commercial |
$1,269.12
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$1,346.64
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,428.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,100.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,445.17
|
| Rate for Payer: UHC Core |
$1,371.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
IP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$43,395.61 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: BCBS Trust/PPO |
$54,498.20
|
| Rate for Payer: BCN Commercial |
$51,594.04
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: Nomi Health Commercial |
$54,745.23
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health HMO/PPO |
$58,083.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44,730.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,750.97
|
| Rate for Payer: UHC Core |
$55,746.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
OP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,856.09 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna Medicare |
$17,358.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,863.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,863.27
|
| Rate for Payer: BCBS Complete |
$26,704.99
|
| Rate for Payer: BCBS MAPPO |
$16,690.62
|
| Rate for Payer: BCBS Trust/PPO |
$54,885.43
|
| Rate for Payer: BCN Commercial |
$51,907.82
|
| Rate for Payer: BCN Medicare Advantage |
$16,690.62
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,690.62
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,525.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,194.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: Nomi Health Commercial |
$54,745.23
|
| Rate for Payer: PACE Senior Care Partners |
$15,856.09
|
| Rate for Payer: PACE SWMI |
$16,690.62
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: PHP Medicare Advantage |
$16,690.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health HMO/PPO |
$58,083.35
|
| Rate for Payer: Priority Health Medicare |
$16,857.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44,730.85
|
| Rate for Payer: Railroad Medicare Medicare |
$16,690.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58,750.97
|
| Rate for Payer: UHC Core |
$55,746.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,690.62
|
| Rate for Payer: UHC Exchange |
$16,690.62
|
| Rate for Payer: UHC Medicare Advantage |
$16,690.62
|
| Rate for Payer: VA VA |
$16,690.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
OP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$15,114.80 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna Medicare |
$16,546.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,887.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,887.90
|
| Rate for Payer: BCBS Complete |
$25,456.51
|
| Rate for Payer: BCBS MAPPO |
$15,910.32
|
| Rate for Payer: BCBS Trust/PPO |
$52,319.49
|
| Rate for Payer: BCN Commercial |
$49,481.09
|
| Rate for Payer: BCN Medicare Advantage |
$15,910.32
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,910.32
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,705.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,296.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: Nomi Health Commercial |
$52,185.84
|
| Rate for Payer: PACE Senior Care Partners |
$15,114.80
|
| Rate for Payer: PACE SWMI |
$15,910.32
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: PHP Medicare Advantage |
$15,910.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health HMO/PPO |
$55,367.90
|
| Rate for Payer: Priority Health Medicare |
$16,069.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42,639.65
|
| Rate for Payer: Railroad Medicare Medicare |
$15,910.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,004.32
|
| Rate for Payer: UHC Core |
$53,140.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,910.32
|
| Rate for Payer: UHC Exchange |
$15,910.32
|
| Rate for Payer: UHC Medicare Advantage |
$15,910.32
|
| Rate for Payer: VA VA |
$15,910.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
IP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$41,366.83 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: BCBS Trust/PPO |
$51,950.37
|
| Rate for Payer: BCN Commercial |
$49,181.97
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: Nomi Health Commercial |
$52,185.84
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health HMO/PPO |
$55,367.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42,639.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,004.32
|
| Rate for Payer: UHC Core |
$53,140.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
