|
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 |
$2,463.31
|
| 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 |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,195.55
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| 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 |
$2,345.85
|
| 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 |
$2,345.85
|
| Rate for Payer: VA VA |
$2,091.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
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 |
$1,482.54
|
| 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 |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,197.84
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| 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 |
$1,411.85
|
| 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 |
$1,411.85
|
| Rate for Payer: VA VA |
$1,140.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,422.39
|
|
|
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 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 |
$14.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.03
|
| 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
|
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 |
$7.91
|
| Rate for Payer: BCBS Trust/PPO |
$25.99
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.91
|
| 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 |
$7.91
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.71
|
| 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 |
$7.91
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.91
|
| 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 |
$7.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.91
|
| Rate for Payer: UHC Exchange |
$7.91
|
| Rate for Payer: UHC Medicare Advantage |
$7.91
|
| Rate for Payer: VA VA |
$7.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.71
|
|
|
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 |
$23.71
|
| 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 |
$23.71
|
|
|
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 |
$1,388.75
|
| 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 |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.09
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| 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 |
$1,322.53
|
| 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 |
$1,322.53
|
| 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
|
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 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 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
|
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 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 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 |
$464.73
|
| 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 |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.01
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| 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 |
$442.57
|
| 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 |
$1,320.13
|
| 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 |
$442.57
|
| 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 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 |
$1,320.13
|
| 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 |
$464.73
|
| 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 |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.01
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| 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 |
$442.57
|
| 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 |
$1,320.13
|
| 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 |
$442.57
|
| 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 |
$1,320.13
|
| 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 |
$464.73
|
| 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 |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.43
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| 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 |
$442.57
|
| 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 |
$442.57
|
| 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 |
$962.41 |
| 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 |
$469.38
|
| 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 |
$962.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Mclaren Medicaid |
$447.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.70
|
| Rate for Payer: Meridian Medicaid |
$469.38
|
| 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 |
$447.00
|
| 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 |
$447.00
|
| 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 |
$962.41 |
| 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 |
$962.41
|
| 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 |
$3,477.89
|
| 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 |
$3,477.89
|
|
|
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 |
$1,215.03
|
| 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 |
$3,477.89
|
| Rate for Payer: Mclaren Medicaid |
$1,157.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,217.26
|
| Rate for Payer: Meridian Medicaid |
$1,215.03
|
| 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 |
$1,157.10
|
| 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 |
$1,157.10
|
| Rate for Payer: VA VA |
$1,159.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,477.89
|
|
