|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
OP
|
$0.52
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: Aetna Medicare |
$0.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.16
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.43
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: PACE Senior Care Partners |
$0.12
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Commercial |
$0.44
|
| Rate for Payer: PHP Medicare Advantage |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health HMO/PPO |
$0.45
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.35
|
| Rate for Payer: Railroad Medicare Medicare |
$0.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.13
|
| Rate for Payer: UHC Exchange |
$0.13
|
| Rate for Payer: UHC Medicare Advantage |
$0.13
|
| Rate for Payer: VA VA |
$0.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.39
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
IP
|
$0.52
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.42
|
| Rate for Payer: BCN Commercial |
$0.40
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: Nomi Health Commercial |
$0.43
|
| Rate for Payer: PHP Commercial |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health HMO/PPO |
$0.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.46
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.39
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$19.18
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$12.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: BCBS Trust/PPO |
$94.09
|
| Rate for Payer: BCN Commercial |
$89.07
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$94.76
|
| Rate for Payer: BCN Commercial |
$89.61
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$8.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$9.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PACE Senior Care Partners |
$27.37
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Medicare |
$29.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.82
|
| Rate for Payer: UHC Exchange |
$28.82
|
| Rate for Payer: UHC Medicare Advantage |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$8.90
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC SENSOR CDI 550 ART SHUNT
|
Facility
|
OP
|
$382.50
|
|
| Hospital Charge Code |
27000655
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.84 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.53
|
| Rate for Payer: BCBS Complete |
$153.00
|
| Rate for Payer: BCBS MAPPO |
$95.62
|
| Rate for Payer: BCBS Trust/PPO |
$314.45
|
| Rate for Payer: BCN Commercial |
$297.39
|
| Rate for Payer: BCN Medicare Advantage |
$95.62
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.62
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: PACE Senior Care Partners |
$90.84
|
| Rate for Payer: PACE SWMI |
$95.62
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: PHP Medicare Advantage |
$95.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO |
$332.77
|
| Rate for Payer: Priority Health Medicare |
$96.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.27
|
| Rate for Payer: Railroad Medicare Medicare |
$95.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.62
|
| Rate for Payer: UHC Exchange |
$95.62
|
| Rate for Payer: UHC Medicare Advantage |
$95.62
|
| Rate for Payer: VA VA |
$95.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC SENSOR CDI 550 ART SHUNT
|
Facility
|
IP
|
$382.50
|
|
| Hospital Charge Code |
27000655
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$248.62 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: BCN Commercial |
$295.60
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO |
$332.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC SENSOR PAD LEVEL DETECTOR
|
Facility
|
OP
|
$17.60
|
|
| Hospital Charge Code |
27000656
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$15.84 |
| Rate for Payer: Aetna Commercial |
$14.96
|
| Rate for Payer: Aetna Medicare |
$4.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.50
|
| Rate for Payer: BCBS Complete |
$7.04
|
| Rate for Payer: BCBS MAPPO |
$4.40
|
| Rate for Payer: BCBS Trust/PPO |
$14.47
|
| Rate for Payer: BCN Commercial |
$13.68
|
| Rate for Payer: BCN Medicare Advantage |
$4.40
|
| Rate for Payer: Cash Price |
$14.08
|
| Rate for Payer: Cofinity Commercial |
$15.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.40
|
| Rate for Payer: Healthscope Commercial |
$15.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.96
|
| Rate for Payer: Nomi Health Commercial |
$14.43
|
| Rate for Payer: PACE Senior Care Partners |
$4.18
|
| Rate for Payer: PACE SWMI |
$4.40
|
| Rate for Payer: PHP Commercial |
$14.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.44
|
| Rate for Payer: Priority Health HMO/PPO |
$15.31
|
| Rate for Payer: Priority Health Medicare |
$4.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.79
|
| Rate for Payer: Railroad Medicare Medicare |
$4.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.49
|
| Rate for Payer: UHC Core |
$14.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.40
|
| Rate for Payer: UHC Exchange |
$4.40
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: VA VA |
$4.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.20
|
|
|
HC SENSOR PAD LEVEL DETECTOR
|
Facility
|
IP
|
$17.60
|
|
| Hospital Charge Code |
27000656
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$15.84 |
| Rate for Payer: Aetna Commercial |
$14.96
|
| Rate for Payer: BCBS Trust/PPO |
$14.37
|
| Rate for Payer: BCN Commercial |
$13.60
|
| Rate for Payer: Cash Price |
$14.08
|
| Rate for Payer: Cofinity Commercial |
$15.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$15.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.96
|
| Rate for Payer: Nomi Health Commercial |
$14.43
|
| Rate for Payer: PHP Commercial |
$14.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.44
|
| Rate for Payer: Priority Health HMO/PPO |
$15.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.49
|
| Rate for Payer: UHC Core |
$14.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.20
|
|
|
HC SENSORS CEREBRAL OXIMETER
|
Facility
|
OP
|
$244.80
|
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.14 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$63.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.50
|
| Rate for Payer: BCBS Complete |
$97.92
|
| Rate for Payer: BCBS MAPPO |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$201.25
|
| Rate for Payer: BCN Commercial |
$190.33
|
| Rate for Payer: BCN Medicare Advantage |
$61.20
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Senior Care Partners |
$58.14
|
| Rate for Payer: PACE SWMI |
$61.20
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Medicare |
$61.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: Railroad Medicare Medicare |
$61.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.20
|
| Rate for Payer: UHC Exchange |
$61.20
|
| Rate for Payer: UHC Medicare Advantage |
$61.20
|
| Rate for Payer: VA VA |
$61.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC SENSORS CEREBRAL OXIMETER
|
Facility
|
IP
|
$244.80
|
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: BCBS Trust/PPO |
$199.83
|
| Rate for Payer: BCN Commercial |
$189.18
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC SENSORY INTEGRATION
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
42000029
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$23.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.37
|
| Rate for Payer: BCBS Complete |
$36.31
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$74.63
|
| Rate for Payer: BCN Commercial |
$70.58
|
| Rate for Payer: BCN Medicare Advantage |
$22.70
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.70
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: PACE Senior Care Partners |
$21.56
|
| Rate for Payer: PACE SWMI |
$22.70
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$22.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$78.98
|
| Rate for Payer: Priority Health Medicare |
$22.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.82
|
| Rate for Payer: Railroad Medicare Medicare |
$22.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.70
|
| Rate for Payer: UHC Exchange |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$22.70
|
| Rate for Payer: VA VA |
$22.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC SENSORY INTEGRATION
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
42000029
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: BCBS Trust/PPO |
$74.10
|
| Rate for Payer: BCN Commercial |
$70.15
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$78.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC SENTINEL NODE INJ NON RADIOACTIVE
|
Facility
|
OP
|
$991.36
|
|
|
Service Code
|
HCPCS 38900
|
| Hospital Charge Code |
36000090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$235.45 |
| Max. Negotiated Rate |
$892.22 |
| Rate for Payer: Aetna Commercial |
$842.66
|
| Rate for Payer: Aetna Medicare |
$257.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.80
|
| Rate for Payer: BCBS Complete |
$396.54
|
| Rate for Payer: BCBS MAPPO |
$247.84
|
| Rate for Payer: BCBS Trust/PPO |
$815.00
|
| Rate for Payer: BCN Commercial |
$770.78
|
| Rate for Payer: BCN Medicare Advantage |
$247.84
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.84
|
| Rate for Payer: Healthscope Commercial |
$892.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.66
|
| Rate for Payer: Nomi Health Commercial |
$812.92
|
| Rate for Payer: PACE Senior Care Partners |
$235.45
|
| Rate for Payer: PACE SWMI |
$247.84
|
| Rate for Payer: PHP Commercial |
$842.66
|
| Rate for Payer: PHP Medicare Advantage |
$247.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.38
|
| Rate for Payer: Priority Health HMO/PPO |
$862.48
|
| Rate for Payer: Priority Health Medicare |
$250.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$664.21
|
| Rate for Payer: Railroad Medicare Medicare |
$247.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.40
|
| Rate for Payer: UHC Core |
$827.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.84
|
| Rate for Payer: UHC Exchange |
$247.84
|
| Rate for Payer: UHC Medicare Advantage |
$247.84
|
| Rate for Payer: VA VA |
$247.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.52
|
|
|
HC SENTINEL NODE INJ NON RADIOACTIVE
|
Facility
|
IP
|
$991.36
|
|
|
Service Code
|
HCPCS 38900
|
| Hospital Charge Code |
36000090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$644.38 |
| Max. Negotiated Rate |
$892.22 |
| Rate for Payer: Aetna Commercial |
$842.66
|
| Rate for Payer: BCBS Trust/PPO |
$809.25
|
| Rate for Payer: BCN Commercial |
$766.12
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.09
|
| Rate for Payer: Healthscope Commercial |
$892.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.66
|
| Rate for Payer: Nomi Health Commercial |
$812.92
|
| Rate for Payer: PHP Commercial |
$842.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.38
|
| Rate for Payer: Priority Health HMO/PPO |
$862.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$664.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.40
|
| Rate for Payer: UHC Core |
$827.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.52
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 1
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 1
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 2
|
Facility
|
OP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.64 |
| Max. Negotiated Rate |
$225.99 |
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna Medicare |
$65.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.47
|
| Rate for Payer: BCBS Complete |
$116.54
|
| Rate for Payer: BCBS MAPPO |
$62.77
|
| Rate for Payer: BCBS Trust/PPO |
$206.43
|
| Rate for Payer: BCN Commercial |
$195.23
|
| Rate for Payer: BCN Medicare Advantage |
$62.77
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.77
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Mclaren Medicaid |
$110.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.91
|
| Rate for Payer: Meridian Medicaid |
$116.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: Nomi Health Commercial |
$205.90
|
| Rate for Payer: PACE Senior Care Partners |
$59.64
|
| Rate for Payer: PACE SWMI |
$62.77
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: PHP Medicare Advantage |
$62.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health HMO/PPO |
$218.46
|
| Rate for Payer: Priority Health Medicare |
$63.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.24
|
| Rate for Payer: Railroad Medicare Medicare |
$62.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.97
|
| Rate for Payer: UHC Core |
$209.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.77
|
| Rate for Payer: UHC Exchange |
$62.77
|
| Rate for Payer: UHC Medicare Advantage |
$62.77
|
| Rate for Payer: UHCCP Medicaid |
$110.98
|
| Rate for Payer: VA VA |
$62.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 2
|
Facility
|
IP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$163.22 |
| Max. Negotiated Rate |
$225.99 |
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: BCBS Trust/PPO |
$204.97
|
| Rate for Payer: BCN Commercial |
$194.05
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: Nomi Health Commercial |
$205.90
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health HMO/PPO |
$218.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.97
|
| Rate for Payer: UHC Core |
$209.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC SERIAL LOOP EXPLANT
|
Facility
|
IP
|
$2,181.53
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
36100082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,417.99 |
| Max. Negotiated Rate |
$1,963.38 |
| Rate for Payer: Aetna Commercial |
$1,854.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.78
|
| Rate for Payer: BCN Commercial |
$1,685.89
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cofinity Commercial |
$1,876.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.22
|
| Rate for Payer: Healthscope Commercial |
$1,963.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.30
|
| Rate for Payer: Nomi Health Commercial |
$1,788.85
|
| Rate for Payer: PHP Commercial |
$1,854.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,897.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.75
|
| Rate for Payer: UHC Core |
$1,821.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.15
|
|
|
HC SERIAL LOOP EXPLANT
|
Facility
|
OP
|
$2,181.53
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
36100082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$508.70 |
| Max. Negotiated Rate |
$1,963.38 |
| Rate for Payer: Aetna Commercial |
$1,854.30
|
| Rate for Payer: Aetna Medicare |
$567.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$681.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$681.73
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$545.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.44
|
| Rate for Payer: BCN Commercial |
$1,696.14
|
| Rate for Payer: BCN Medicare Advantage |
$545.38
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cofinity Commercial |
$1,876.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.38
|
| Rate for Payer: Healthscope Commercial |
$1,963.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.15
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.65
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$627.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.30
|
| Rate for Payer: Nomi Health Commercial |
$1,788.85
|
| Rate for Payer: PACE Senior Care Partners |
$518.11
|
| Rate for Payer: PACE SWMI |
$545.38
|
| Rate for Payer: PHP Commercial |
$1,854.30
|
| Rate for Payer: PHP Medicare Advantage |
$545.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,897.93
|
| Rate for Payer: Priority Health Medicare |
$550.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.63
|
| Rate for Payer: Railroad Medicare Medicare |
$545.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.75
|
| Rate for Payer: UHC Core |
$1,821.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.38
|
| Rate for Payer: UHC Exchange |
$545.38
|
| Rate for Payer: UHC Medicare Advantage |
$545.38
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$545.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.15
|
|
|
HC SERIAL LOOP IMPLANT
|
Facility
|
OP
|
$4,281.51
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
36100081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,016.86 |
| Max. Negotiated Rate |
$6,283.12 |
| Rate for Payer: Aetna Commercial |
$3,639.28
|
| Rate for Payer: Aetna Medicare |
$1,113.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,337.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,337.97
|
| Rate for Payer: BCBS Complete |
$6,283.12
|
| Rate for Payer: BCBS MAPPO |
$1,070.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,519.83
|
| Rate for Payer: BCN Commercial |
$3,328.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,070.38
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cofinity Commercial |
$3,682.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,070.38
|
| Rate for Payer: Healthscope Commercial |
$3,853.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,211.13
|
| Rate for Payer: Mclaren Medicaid |
$5,983.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,123.90
|
| Rate for Payer: Meridian Medicaid |
$6,283.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,230.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,639.28
|
| Rate for Payer: Nomi Health Commercial |
$3,510.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,016.86
|
| Rate for Payer: PACE SWMI |
$1,070.38
|
| Rate for Payer: PHP Commercial |
$3,639.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,070.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,983.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,782.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,724.91
|
| Rate for Payer: Priority Health Medicare |
$1,081.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,868.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,070.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,767.73
|
| Rate for Payer: UHC Core |
$3,575.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,070.38
|
| Rate for Payer: UHC Exchange |
$1,070.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.38
|
| Rate for Payer: UHCCP Medicaid |
$5,983.53
|
| Rate for Payer: VA VA |
$1,070.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,211.13
|
|
