|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
IP
|
$91.58
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$63.74 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna Commercial |
$77.84
|
| Rate for Payer: BCBS Trust/PPO |
$75.64
|
| Rate for Payer: BCN Commercial |
$75.64
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cofinity Commercial |
$78.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.26
|
| Rate for Payer: Healthscope Commercial |
$82.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.84
|
| Rate for Payer: Nomi Health Commercial |
$75.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.69
|
| Rate for Payer: PHP Commercial |
$77.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.59
|
| Rate for Payer: UHC Core |
$76.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.69
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
OP
|
$91.58
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna Commercial |
$77.84
|
| Rate for Payer: Aetna Medicare |
$23.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.62
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$75.29
|
| Rate for Payer: BCN Commercial |
$75.29
|
| Rate for Payer: BCN Medicare Advantage |
$22.89
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cofinity Commercial |
$78.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.89
|
| Rate for Payer: Healthscope Commercial |
$82.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.69
|
| Rate for Payer: Mclaren Medicaid |
$16.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.04
|
| Rate for Payer: Meridian Medicaid |
$16.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.84
|
| Rate for Payer: Nomi Health Commercial |
$75.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.69
|
| Rate for Payer: PACE Senior Care Partners |
$21.75
|
| Rate for Payer: PACE SWMI |
$22.89
|
| Rate for Payer: PHP Commercial |
$77.84
|
| Rate for Payer: PHP Medicare Advantage |
$22.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.67
|
| Rate for Payer: Priority Health Medicare |
$23.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.59
|
| Rate for Payer: UHC Core |
$76.47
|
| Rate for Payer: UHC Exchange |
$22.89
|
| Rate for Payer: UHC Medicaid |
$16.15
|
| Rate for Payer: UHC Medicare Advantage |
$22.89
|
| Rate for Payer: UHCCP Medicaid |
$16.15
|
| Rate for Payer: VA VA |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.69
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
OP
|
$116.73
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.58 |
| Max. Negotiated Rate |
$105.06 |
| Rate for Payer: Aetna Commercial |
$99.22
|
| Rate for Payer: Aetna Medicare |
$30.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.48
|
| Rate for Payer: BCBS Complete |
$21.61
|
| Rate for Payer: BCBS MAPPO |
$29.18
|
| Rate for Payer: BCBS Trust/PPO |
$95.96
|
| Rate for Payer: BCN Commercial |
$95.96
|
| Rate for Payer: BCN Medicare Advantage |
$29.18
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cofinity Commercial |
$100.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.18
|
| Rate for Payer: Healthscope Commercial |
$105.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.55
|
| Rate for Payer: Mclaren Medicaid |
$20.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.64
|
| Rate for Payer: Meridian Medicaid |
$21.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.22
|
| Rate for Payer: Nomi Health Commercial |
$95.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.55
|
| Rate for Payer: PACE Senior Care Partners |
$27.72
|
| Rate for Payer: PACE SWMI |
$29.18
|
| Rate for Payer: PHP Commercial |
$99.22
|
| Rate for Payer: PHP Medicare Advantage |
$29.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.56
|
| Rate for Payer: Priority Health Medicare |
$29.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.24
|
| Rate for Payer: Railroad Medicare Medicare |
$29.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.72
|
| Rate for Payer: UHC Core |
$97.47
|
| Rate for Payer: UHC Exchange |
$29.18
|
| Rate for Payer: UHC Medicaid |
$20.58
|
| Rate for Payer: UHC Medicare Advantage |
$29.18
|
| Rate for Payer: UHCCP Medicaid |
$20.58
|
| Rate for Payer: VA VA |
$29.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.55
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
IP
|
$116.73
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.24 |
| Max. Negotiated Rate |
$105.06 |
| Rate for Payer: Aetna Commercial |
$99.22
|
| Rate for Payer: BCBS Trust/PPO |
$96.41
|
| Rate for Payer: BCN Commercial |
$96.41
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cofinity Commercial |
$100.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.38
|
| Rate for Payer: Healthscope Commercial |
$105.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.22
|
| Rate for Payer: Nomi Health Commercial |
$95.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.55
|
| Rate for Payer: PHP Commercial |
$99.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.72
|
| Rate for Payer: UHC Core |
$97.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.55
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
OP
|
$2,859.96
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$504.21 |
| Max. Negotiated Rate |
$2,573.96 |
| Rate for Payer: Aetna Commercial |
$2,430.97
|
| Rate for Payer: Aetna Medicare |
$743.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$893.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$893.74
|
| Rate for Payer: BCBS Complete |
$529.38
|
| Rate for Payer: BCBS MAPPO |
$714.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,351.17
|
| Rate for Payer: BCN Commercial |
$2,351.17
|
| Rate for Payer: BCN Medicare Advantage |
$714.99
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cofinity Commercial |
$2,459.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,287.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$714.99
|
| Rate for Payer: Healthscope Commercial |
$2,573.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,144.97
|
| Rate for Payer: Mclaren Medicaid |
$504.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$750.74
|
| Rate for Payer: Meridian Medicaid |
$529.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$822.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$786.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,430.97
|
| Rate for Payer: Nomi Health Commercial |
$2,345.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,144.97
|
| Rate for Payer: PACE Senior Care Partners |
$679.24
|
| Rate for Payer: PACE SWMI |
$714.99
|
| Rate for Payer: PHP Commercial |
$2,430.97
|
| Rate for Payer: PHP Medicare Advantage |
$714.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,488.17
|
| Rate for Payer: Priority Health Medicare |
$722.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,990.53
|
| Rate for Payer: Railroad Medicare Medicare |
$714.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,516.76
|
| Rate for Payer: UHC Core |
$2,388.07
|
| Rate for Payer: UHC Exchange |
$714.99
|
| Rate for Payer: UHC Medicaid |
$504.21
|
| Rate for Payer: UHC Medicare Advantage |
$714.99
|
| Rate for Payer: UHCCP Medicaid |
$504.21
|
| Rate for Payer: VA VA |
$714.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,144.97
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
IP
|
$2,859.96
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,990.53 |
| Max. Negotiated Rate |
$2,573.96 |
| Rate for Payer: Aetna Commercial |
$2,430.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,362.04
|
| Rate for Payer: BCN Commercial |
$2,362.04
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cofinity Commercial |
$2,459.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,287.97
|
| Rate for Payer: Healthscope Commercial |
$2,573.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,144.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,430.97
|
| Rate for Payer: Nomi Health Commercial |
$2,345.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,144.97
|
| Rate for Payer: PHP Commercial |
$2,430.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,488.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,990.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,516.76
|
| Rate for Payer: UHC Core |
$2,388.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,144.97
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
IP
|
$702.06
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$488.63 |
| Max. Negotiated Rate |
$631.85 |
| Rate for Payer: Aetna Commercial |
$596.75
|
| Rate for Payer: BCBS Trust/PPO |
$579.83
|
| Rate for Payer: BCN Commercial |
$579.83
|
| Rate for Payer: Cash Price |
$561.65
|
| Rate for Payer: Cofinity Commercial |
$603.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.65
|
| Rate for Payer: Healthscope Commercial |
$631.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.75
|
| Rate for Payer: Nomi Health Commercial |
$575.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.54
|
| Rate for Payer: PHP Commercial |
$596.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.81
|
| Rate for Payer: UHC Core |
$586.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.54
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
OP
|
$702.06
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.77 |
| Max. Negotiated Rate |
$631.85 |
| Rate for Payer: Aetna Commercial |
$596.75
|
| Rate for Payer: Aetna Medicare |
$182.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.39
|
| Rate for Payer: BCBS Complete |
$129.95
|
| Rate for Payer: BCBS MAPPO |
$175.51
|
| Rate for Payer: BCBS Trust/PPO |
$577.16
|
| Rate for Payer: BCN Commercial |
$577.16
|
| Rate for Payer: BCN Medicare Advantage |
$175.51
|
| Rate for Payer: Cash Price |
$561.65
|
| Rate for Payer: Cofinity Commercial |
$603.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.51
|
| Rate for Payer: Healthscope Commercial |
$631.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.54
|
| Rate for Payer: Mclaren Medicaid |
$123.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.29
|
| Rate for Payer: Meridian Medicaid |
$129.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.75
|
| Rate for Payer: Nomi Health Commercial |
$575.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.54
|
| Rate for Payer: PACE Senior Care Partners |
$166.74
|
| Rate for Payer: PACE SWMI |
$175.51
|
| Rate for Payer: PHP Commercial |
$596.75
|
| Rate for Payer: PHP Medicare Advantage |
$175.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.79
|
| Rate for Payer: Priority Health Medicare |
$177.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.63
|
| Rate for Payer: Railroad Medicare Medicare |
$175.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.81
|
| Rate for Payer: UHC Core |
$586.22
|
| Rate for Payer: UHC Exchange |
$175.51
|
| Rate for Payer: UHC Medicaid |
$123.77
|
| Rate for Payer: UHC Medicare Advantage |
$175.51
|
| Rate for Payer: UHCCP Medicaid |
$123.77
|
| Rate for Payer: VA VA |
$175.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.54
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
OP
|
$108.24
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna Medicare |
$28.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.83
|
| Rate for Payer: BCBS Complete |
$20.04
|
| Rate for Payer: BCBS MAPPO |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$88.98
|
| Rate for Payer: BCN Commercial |
$88.98
|
| Rate for Payer: BCN Medicare Advantage |
$27.06
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.06
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Mclaren Medicaid |
$19.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.41
|
| Rate for Payer: Meridian Medicaid |
$20.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PACE Senior Care Partners |
$25.71
|
| Rate for Payer: PACE SWMI |
$27.06
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: PHP Medicare Advantage |
$27.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Medicare |
$27.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: Railroad Medicare Medicare |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: UHC Exchange |
$27.06
|
| Rate for Payer: UHC Medicaid |
$19.08
|
| Rate for Payer: UHC Medicare Advantage |
$27.06
|
| Rate for Payer: UHCCP Medicaid |
$19.08
|
| Rate for Payer: VA VA |
$27.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
IP
|
$108.24
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$75.34 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: BCBS Trust/PPO |
$89.40
|
| Rate for Payer: BCN Commercial |
$89.40
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC TENOTOMY
|
Facility
|
OP
|
$2,950.53
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.18 |
| Max. Negotiated Rate |
$2,655.48 |
| Rate for Payer: Aetna Commercial |
$2,507.95
|
| Rate for Payer: Aetna Medicare |
$767.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$922.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$922.04
|
| Rate for Payer: BCBS Complete |
$546.14
|
| Rate for Payer: BCBS MAPPO |
$737.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.63
|
| Rate for Payer: BCN Commercial |
$2,425.63
|
| Rate for Payer: BCN Medicare Advantage |
$737.63
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cofinity Commercial |
$2,537.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$737.63
|
| Rate for Payer: Healthscope Commercial |
$2,655.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.90
|
| Rate for Payer: Mclaren Medicaid |
$520.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$774.51
|
| Rate for Payer: Meridian Medicaid |
$546.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$848.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$811.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,507.95
|
| Rate for Payer: Nomi Health Commercial |
$2,419.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,212.90
|
| Rate for Payer: PACE Senior Care Partners |
$700.75
|
| Rate for Payer: PACE SWMI |
$737.63
|
| Rate for Payer: PHP Commercial |
$2,507.95
|
| Rate for Payer: PHP Medicare Advantage |
$737.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,566.96
|
| Rate for Payer: Priority Health Medicare |
$745.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,053.57
|
| Rate for Payer: Railroad Medicare Medicare |
$737.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,596.47
|
| Rate for Payer: UHC Core |
$2,463.69
|
| Rate for Payer: UHC Exchange |
$737.63
|
| Rate for Payer: UHC Medicaid |
$520.18
|
| Rate for Payer: UHC Medicare Advantage |
$737.63
|
| Rate for Payer: UHCCP Medicaid |
$520.18
|
| Rate for Payer: VA VA |
$737.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.90
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,950.53
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,053.57 |
| Max. Negotiated Rate |
$2,655.48 |
| Rate for Payer: Aetna Commercial |
$2,507.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,436.84
|
| Rate for Payer: BCN Commercial |
$2,436.84
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cofinity Commercial |
$2,537.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.42
|
| Rate for Payer: Healthscope Commercial |
$2,655.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,507.95
|
| Rate for Payer: Nomi Health Commercial |
$2,419.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,212.90
|
| Rate for Payer: PHP Commercial |
$2,507.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,566.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,053.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,596.47
|
| Rate for Payer: UHC Core |
$2,463.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.90
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$769.28 |
| Max. Negotiated Rate |
$3,927.13 |
| Rate for Payer: Aetna Commercial |
$3,708.96
|
| Rate for Payer: Aetna Medicare |
$1,134.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,363.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,363.59
|
| Rate for Payer: BCBS Complete |
$807.68
|
| Rate for Payer: BCBS MAPPO |
$1,090.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,587.22
|
| Rate for Payer: BCN Commercial |
$3,587.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.87
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Commercial |
$3,752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.87
|
| Rate for Payer: Healthscope Commercial |
$3,927.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,272.61
|
| Rate for Payer: Mclaren Medicaid |
$769.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,145.41
|
| Rate for Payer: Meridian Medicaid |
$807.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,254.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,199.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Nomi Health Commercial |
$3,578.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,036.33
|
| Rate for Payer: PACE SWMI |
$1,090.87
|
| Rate for Payer: PHP Commercial |
$3,708.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$769.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,796.23
|
| Rate for Payer: Priority Health Medicare |
$1,101.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,036.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,090.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,839.86
|
| Rate for Payer: UHC Core |
$3,643.51
|
| Rate for Payer: UHC Exchange |
$1,090.87
|
| Rate for Payer: UHC Medicaid |
$769.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.87
|
| Rate for Payer: UHCCP Medicaid |
$769.28
|
| Rate for Payer: VA VA |
$1,090.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,272.61
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,036.98 |
| Max. Negotiated Rate |
$3,927.13 |
| Rate for Payer: Aetna Commercial |
$3,708.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,603.80
|
| Rate for Payer: BCN Commercial |
$3,603.80
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Commercial |
$3,752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Healthscope Commercial |
$3,927.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,272.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Nomi Health Commercial |
$3,578.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: PHP Commercial |
$3,708.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,796.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,036.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,839.86
|
| Rate for Payer: UHC Core |
$3,643.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,272.61
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$808.18 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna Medicare |
$1,191.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,432.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,432.53
|
| Rate for Payer: BCBS Complete |
$848.52
|
| Rate for Payer: BCBS MAPPO |
$1,146.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,768.58
|
| Rate for Payer: BCN Commercial |
$3,768.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,146.02
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,146.02
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Mclaren Medicaid |
$808.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.32
|
| Rate for Payer: Meridian Medicaid |
$848.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,317.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,088.72
|
| Rate for Payer: PACE SWMI |
$1,146.02
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,146.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,988.16
|
| Rate for Payer: Priority Health Medicare |
$1,157.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,190.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,146.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,034.00
|
| Rate for Payer: UHC Core |
$3,827.72
|
| Rate for Payer: UHC Exchange |
$1,146.02
|
| Rate for Payer: UHC Medicaid |
$808.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,146.02
|
| Rate for Payer: UHCCP Medicaid |
$808.18
|
| Rate for Payer: VA VA |
$1,146.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,190.53 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,786.00
|
| Rate for Payer: BCN Commercial |
$3,786.00
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,988.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,190.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,034.00
|
| Rate for Payer: UHC Core |
$3,827.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$808.18 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna Medicare |
$1,191.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,432.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,432.53
|
| Rate for Payer: BCBS Complete |
$848.52
|
| Rate for Payer: BCBS MAPPO |
$1,146.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,768.58
|
| Rate for Payer: BCN Commercial |
$3,768.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,146.02
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,146.02
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Mclaren Medicaid |
$808.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,203.32
|
| Rate for Payer: Meridian Medicaid |
$848.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,317.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,260.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,088.72
|
| Rate for Payer: PACE SWMI |
$1,146.02
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,146.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,988.16
|
| Rate for Payer: Priority Health Medicare |
$1,157.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,190.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,146.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,034.00
|
| Rate for Payer: UHC Core |
$3,827.72
|
| Rate for Payer: UHC Exchange |
$1,146.02
|
| Rate for Payer: UHC Medicaid |
$808.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,146.02
|
| Rate for Payer: UHCCP Medicaid |
$808.18
|
| Rate for Payer: VA VA |
$1,146.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,190.53 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,786.00
|
| Rate for Payer: BCN Commercial |
$3,786.00
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$3,758.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,988.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,190.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,034.00
|
| Rate for Payer: UHC Core |
$3,827.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$941.56 |
| Max. Negotiated Rate |
$4,806.62 |
| Rate for Payer: Aetna Commercial |
$4,539.59
|
| Rate for Payer: Aetna Medicare |
$1,388.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,668.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,668.97
|
| Rate for Payer: BCBS Complete |
$988.56
|
| Rate for Payer: BCBS MAPPO |
$1,335.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,390.58
|
| Rate for Payer: BCN Commercial |
$4,390.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,335.17
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Commercial |
$4,592.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,335.17
|
| Rate for Payer: Healthscope Commercial |
$4,806.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,005.52
|
| Rate for Payer: Mclaren Medicaid |
$941.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,401.93
|
| Rate for Payer: Meridian Medicaid |
$988.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,535.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,468.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Nomi Health Commercial |
$4,379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: PACE Senior Care Partners |
$1,268.41
|
| Rate for Payer: PACE SWMI |
$1,335.17
|
| Rate for Payer: PHP Commercial |
$4,539.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,335.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$941.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,646.40
|
| Rate for Payer: Priority Health Medicare |
$1,348.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,717.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,335.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,699.81
|
| Rate for Payer: UHC Core |
$4,459.48
|
| Rate for Payer: UHC Exchange |
$1,335.17
|
| Rate for Payer: UHC Medicaid |
$941.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,335.17
|
| Rate for Payer: UHCCP Medicaid |
$941.56
|
| Rate for Payer: VA VA |
$1,335.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,005.52
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,717.12 |
| Max. Negotiated Rate |
$4,806.62 |
| Rate for Payer: Aetna Commercial |
$4,539.59
|
| Rate for Payer: BCBS Trust/PPO |
$4,410.88
|
| Rate for Payer: BCN Commercial |
$4,410.88
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Commercial |
$4,592.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Healthscope Commercial |
$4,806.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,005.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Nomi Health Commercial |
$4,379.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: PHP Commercial |
$4,539.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,646.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,717.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,699.81
|
| Rate for Payer: UHC Core |
$4,459.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,005.52
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,812.64
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$672.17 |
| Max. Negotiated Rate |
$3,431.38 |
| Rate for Payer: Aetna Commercial |
$3,240.74
|
| Rate for Payer: Aetna Medicare |
$991.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,191.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,191.45
|
| Rate for Payer: BCBS Complete |
$705.72
|
| Rate for Payer: BCBS MAPPO |
$953.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.37
|
| Rate for Payer: BCN Commercial |
$3,134.37
|
| Rate for Payer: BCN Medicare Advantage |
$953.16
|
| Rate for Payer: Cash Price |
$3,050.11
|
| Rate for Payer: Cofinity Commercial |
$3,278.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,050.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.16
|
| Rate for Payer: Healthscope Commercial |
$3,431.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,859.48
|
| Rate for Payer: Mclaren Medicaid |
$672.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,000.82
|
| Rate for Payer: Meridian Medicaid |
$705.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,096.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,048.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,240.74
|
| Rate for Payer: Nomi Health Commercial |
$3,126.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,859.48
|
| Rate for Payer: PACE Senior Care Partners |
$905.50
|
| Rate for Payer: PACE SWMI |
$953.16
|
| Rate for Payer: PHP Commercial |
$3,240.74
|
| Rate for Payer: PHP Medicare Advantage |
$953.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,317.00
|
| Rate for Payer: Priority Health Medicare |
$962.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,653.60
|
| Rate for Payer: Railroad Medicare Medicare |
$953.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,355.12
|
| Rate for Payer: UHC Core |
$3,183.55
|
| Rate for Payer: UHC Exchange |
$953.16
|
| Rate for Payer: UHC Medicaid |
$672.17
|
| Rate for Payer: UHC Medicare Advantage |
$953.16
|
| Rate for Payer: UHCCP Medicaid |
$672.17
|
| Rate for Payer: VA VA |
$953.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,859.48
|
|
