|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
IP
|
$145.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.38 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna Commercial |
$123.81
|
| Rate for Payer: BCBS Trust/PPO |
$120.30
|
| Rate for Payer: BCN Commercial |
$120.30
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cofinity Commercial |
$125.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.53
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Nomi Health Commercial |
$119.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.25
|
| Rate for Payer: PHP Commercial |
$123.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.18
|
| Rate for Payer: UHC Core |
$121.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.25
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
OP
|
$145.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna Commercial |
$123.81
|
| Rate for Payer: Aetna Medicare |
$37.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.52
|
| Rate for Payer: BCBS Complete |
$26.96
|
| Rate for Payer: BCBS MAPPO |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$119.75
|
| Rate for Payer: BCN Commercial |
$119.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.41
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cofinity Commercial |
$125.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.41
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.25
|
| Rate for Payer: Mclaren Medicaid |
$25.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$26.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Nomi Health Commercial |
$119.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.25
|
| Rate for Payer: PACE Senior Care Partners |
$34.59
|
| Rate for Payer: PACE SWMI |
$36.41
|
| Rate for Payer: PHP Commercial |
$123.81
|
| Rate for Payer: PHP Medicare Advantage |
$36.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.72
|
| Rate for Payer: Priority Health Medicare |
$36.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.38
|
| Rate for Payer: Railroad Medicare Medicare |
$36.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.18
|
| Rate for Payer: UHC Core |
$121.63
|
| Rate for Payer: UHC Exchange |
$36.41
|
| Rate for Payer: UHC Medicaid |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$36.41
|
| Rate for Payer: UHCCP Medicaid |
$25.68
|
| Rate for Payer: VA VA |
$36.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.25
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
IP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$49.55 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: BCBS Trust/PPO |
$58.80
|
| Rate for Payer: BCN Commercial |
$58.80
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Nomi Health Commercial |
$58.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.65
|
| Rate for Payer: UHC Core |
$59.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.39
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
OP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.55 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$18.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.25
|
| Rate for Payer: BCBS Complete |
$13.18
|
| Rate for Payer: BCBS MAPPO |
$17.80
|
| Rate for Payer: BCBS Trust/PPO |
$58.53
|
| Rate for Payer: BCN Commercial |
$58.53
|
| Rate for Payer: BCN Medicare Advantage |
$17.80
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.80
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.39
|
| Rate for Payer: Mclaren Medicaid |
$12.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.69
|
| Rate for Payer: Meridian Medicaid |
$13.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Nomi Health Commercial |
$58.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PACE Senior Care Partners |
$16.91
|
| Rate for Payer: PACE SWMI |
$17.80
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: PHP Medicare Advantage |
$17.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.94
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.55
|
| Rate for Payer: Railroad Medicare Medicare |
$17.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.65
|
| Rate for Payer: UHC Core |
$59.44
|
| Rate for Payer: UHC Exchange |
$17.80
|
| Rate for Payer: UHC Medicaid |
$12.55
|
| Rate for Payer: UHC Medicare Advantage |
$17.80
|
| Rate for Payer: UHCCP Medicaid |
$12.55
|
| Rate for Payer: VA VA |
$17.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.39
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
OP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$336.73 |
| Max. Negotiated Rate |
$1,719.00 |
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: Aetna Medicare |
$496.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$596.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$596.88
|
| Rate for Payer: BCBS Complete |
$353.54
|
| Rate for Payer: BCBS MAPPO |
$477.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.21
|
| Rate for Payer: BCN Commercial |
$1,570.21
|
| Rate for Payer: BCN Medicare Advantage |
$477.50
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.50
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,432.50
|
| Rate for Payer: Mclaren Medicaid |
$336.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$501.38
|
| Rate for Payer: Meridian Medicaid |
$353.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$525.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Nomi Health Commercial |
$1,566.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PACE Senior Care Partners |
$453.62
|
| Rate for Payer: PACE SWMI |
$477.50
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: PHP Medicare Advantage |
$477.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,661.70
|
| Rate for Payer: Priority Health Medicare |
$482.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,329.36
|
| Rate for Payer: Railroad Medicare Medicare |
$477.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.80
|
| Rate for Payer: UHC Core |
$1,594.85
|
| Rate for Payer: UHC Exchange |
$477.50
|
| Rate for Payer: UHC Medicaid |
$336.73
|
| Rate for Payer: UHC Medicare Advantage |
$477.50
|
| Rate for Payer: UHCCP Medicaid |
$336.73
|
| Rate for Payer: VA VA |
$477.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,432.50
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
IP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,329.36 |
| Max. Negotiated Rate |
$1,719.00 |
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,577.47
|
| Rate for Payer: BCN Commercial |
$1,577.47
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,432.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Nomi Health Commercial |
$1,566.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,661.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,329.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.80
|
| Rate for Payer: UHC Core |
$1,594.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,432.50
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: Aetna Medicare |
$224.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.27
|
| Rate for Payer: BCBS Complete |
$160.09
|
| Rate for Payer: BCBS MAPPO |
$216.22
|
| Rate for Payer: BCBS Trust/PPO |
$711.00
|
| Rate for Payer: BCN Commercial |
$711.00
|
| Rate for Payer: BCN Medicare Advantage |
$216.22
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.22
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.64
|
| Rate for Payer: Mclaren Medicaid |
$152.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.03
|
| Rate for Payer: Meridian Medicaid |
$160.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Nomi Health Commercial |
$709.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PACE Senior Care Partners |
$205.40
|
| Rate for Payer: PACE SWMI |
$216.22
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: PHP Medicare Advantage |
$216.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$752.43
|
| Rate for Payer: Priority Health Medicare |
$218.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$601.94
|
| Rate for Payer: Railroad Medicare Medicare |
$216.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.08
|
| Rate for Payer: UHC Core |
$722.16
|
| Rate for Payer: UHC Exchange |
$216.22
|
| Rate for Payer: UHC Medicaid |
$152.47
|
| Rate for Payer: UHC Medicare Advantage |
$216.22
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$216.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.64
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$601.94 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: BCBS Trust/PPO |
$714.29
|
| Rate for Payer: BCN Commercial |
$714.29
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Nomi Health Commercial |
$709.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$752.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$601.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$761.08
|
| Rate for Payer: UHC Core |
$722.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.64
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$927.04 |
| Max. Negotiated Rate |
$1,198.76 |
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.06
|
| Rate for Payer: BCN Commercial |
$1,100.06
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Nomi Health Commercial |
$1,092.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,158.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$927.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.12
|
| Rate for Payer: UHC Core |
$1,112.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.96
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.82 |
| Max. Negotiated Rate |
$1,198.76 |
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: Aetna Medicare |
$346.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.23
|
| Rate for Payer: BCBS Complete |
$246.54
|
| Rate for Payer: BCBS MAPPO |
$332.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.00
|
| Rate for Payer: BCN Commercial |
$1,095.00
|
| Rate for Payer: BCN Medicare Advantage |
$332.99
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.99
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.96
|
| Rate for Payer: Mclaren Medicaid |
$234.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.64
|
| Rate for Payer: Meridian Medicaid |
$246.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Nomi Health Commercial |
$1,092.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PACE Senior Care Partners |
$316.34
|
| Rate for Payer: PACE SWMI |
$332.99
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: PHP Medicare Advantage |
$332.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,158.80
|
| Rate for Payer: Priority Health Medicare |
$336.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$927.04
|
| Rate for Payer: Railroad Medicare Medicare |
$332.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.12
|
| Rate for Payer: UHC Core |
$1,112.18
|
| Rate for Payer: UHC Exchange |
$332.99
|
| Rate for Payer: UHC Medicaid |
$234.82
|
| Rate for Payer: UHC Medicare Advantage |
$332.99
|
| Rate for Payer: UHCCP Medicaid |
$234.82
|
| Rate for Payer: VA VA |
$332.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.96
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.36 |
| Max. Negotiated Rate |
$1,298.48 |
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: Aetna Medicare |
$375.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$450.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$450.86
|
| Rate for Payer: BCBS Complete |
$267.05
|
| Rate for Payer: BCBS MAPPO |
$360.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.09
|
| Rate for Payer: BCN Commercial |
$1,186.09
|
| Rate for Payer: BCN Medicare Advantage |
$360.69
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.69
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.07
|
| Rate for Payer: Mclaren Medicaid |
$254.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.72
|
| Rate for Payer: Meridian Medicaid |
$267.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Nomi Health Commercial |
$1,183.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PACE Senior Care Partners |
$342.66
|
| Rate for Payer: PACE SWMI |
$360.69
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: PHP Medicare Advantage |
$360.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,255.20
|
| Rate for Payer: Priority Health Medicare |
$364.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,004.16
|
| Rate for Payer: Railroad Medicare Medicare |
$360.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,269.63
|
| Rate for Payer: UHC Core |
$1,204.70
|
| Rate for Payer: UHC Exchange |
$360.69
|
| Rate for Payer: UHC Medicaid |
$254.36
|
| Rate for Payer: UHC Medicare Advantage |
$360.69
|
| Rate for Payer: UHCCP Medicaid |
$254.36
|
| Rate for Payer: VA VA |
$360.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.07
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,004.16 |
| Max. Negotiated Rate |
$1,298.48 |
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,191.58
|
| Rate for Payer: BCN Commercial |
$1,191.58
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Nomi Health Commercial |
$1,183.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,255.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,004.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,269.63
|
| Rate for Payer: UHC Core |
$1,204.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.07
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$198.34 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna Medicare |
$292.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$351.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$351.56
|
| Rate for Payer: BCBS Complete |
$208.24
|
| Rate for Payer: BCBS MAPPO |
$281.25
|
| Rate for Payer: BCBS Trust/PPO |
$924.86
|
| Rate for Payer: BCN Commercial |
$924.86
|
| Rate for Payer: BCN Medicare Advantage |
$281.25
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.25
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: Mclaren Medicaid |
$198.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.31
|
| Rate for Payer: Meridian Medicaid |
$208.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$323.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$309.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Nomi Health Commercial |
$922.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PACE Senior Care Partners |
$267.19
|
| Rate for Payer: PACE SWMI |
$281.25
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: PHP Medicare Advantage |
$281.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$978.75
|
| Rate for Payer: Priority Health Medicare |
$284.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.00
|
| Rate for Payer: Railroad Medicare Medicare |
$281.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.00
|
| Rate for Payer: UHC Core |
$939.38
|
| Rate for Payer: UHC Exchange |
$281.25
|
| Rate for Payer: UHC Medicaid |
$198.34
|
| Rate for Payer: UHC Medicare Advantage |
$281.25
|
| Rate for Payer: UHCCP Medicaid |
$198.34
|
| Rate for Payer: VA VA |
$281.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$783.00 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: BCBS Trust/PPO |
$929.14
|
| Rate for Payer: BCN Commercial |
$929.14
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Nomi Health Commercial |
$922.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$978.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.00
|
| Rate for Payer: UHC Core |
$939.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
OP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$196.01 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: Aetna Medicare |
$289.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$347.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$347.43
|
| Rate for Payer: BCBS Complete |
$205.79
|
| Rate for Payer: BCBS MAPPO |
$277.95
|
| Rate for Payer: BCBS Trust/PPO |
$914.00
|
| Rate for Payer: BCN Commercial |
$914.00
|
| Rate for Payer: BCN Medicare Advantage |
$277.95
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.95
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$833.84
|
| Rate for Payer: Mclaren Medicaid |
$196.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$291.84
|
| Rate for Payer: Meridian Medicaid |
$205.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$319.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$305.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Nomi Health Commercial |
$911.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PACE Senior Care Partners |
$264.05
|
| Rate for Payer: PACE SWMI |
$277.95
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: PHP Medicare Advantage |
$277.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$196.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$967.26
|
| Rate for Payer: Priority Health Medicare |
$280.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$773.81
|
| Rate for Payer: Railroad Medicare Medicare |
$277.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$978.38
|
| Rate for Payer: UHC Core |
$928.34
|
| Rate for Payer: UHC Exchange |
$277.95
|
| Rate for Payer: UHC Medicaid |
$196.01
|
| Rate for Payer: UHC Medicare Advantage |
$277.95
|
| Rate for Payer: UHCCP Medicaid |
$196.01
|
| Rate for Payer: VA VA |
$277.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$833.84
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
IP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$773.81 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: BCBS Trust/PPO |
$918.23
|
| Rate for Payer: BCN Commercial |
$918.23
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$833.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Nomi Health Commercial |
$911.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$967.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$773.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$978.38
|
| Rate for Payer: UHC Core |
$928.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$833.84
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$132.22 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: Aetna Medicare |
$195.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$234.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$234.38
|
| Rate for Payer: BCBS Complete |
$138.82
|
| Rate for Payer: BCBS MAPPO |
$187.50
|
| Rate for Payer: BCBS Trust/PPO |
$616.58
|
| Rate for Payer: BCN Commercial |
$616.58
|
| Rate for Payer: BCN Medicare Advantage |
$187.50
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.50
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.50
|
| Rate for Payer: Mclaren Medicaid |
$132.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.88
|
| Rate for Payer: Meridian Medicaid |
$138.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Nomi Health Commercial |
$615.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PACE Senior Care Partners |
$178.12
|
| Rate for Payer: PACE SWMI |
$187.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: PHP Medicare Advantage |
$187.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$652.50
|
| Rate for Payer: Priority Health Medicare |
$189.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$522.00
|
| Rate for Payer: Railroad Medicare Medicare |
$187.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.00
|
| Rate for Payer: UHC Core |
$626.25
|
| Rate for Payer: UHC Exchange |
$187.50
|
| Rate for Payer: UHC Medicaid |
$132.22
|
| Rate for Payer: UHC Medicare Advantage |
$187.50
|
| Rate for Payer: UHCCP Medicaid |
$132.22
|
| Rate for Payer: VA VA |
$187.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.50
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: BCBS Trust/PPO |
$619.42
|
| Rate for Payer: BCN Commercial |
$619.42
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Nomi Health Commercial |
$615.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$652.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$522.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$660.00
|
| Rate for Payer: UHC Core |
$626.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.50
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT INJ
|
Facility
|
IP
|
$741.19
|
|
|
Service Code
|
CPT 64466
|
| Hospital Charge Code |
37000021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$515.87 |
| Max. Negotiated Rate |
$667.07 |
| Rate for Payer: Aetna Commercial |
$630.01
|
| Rate for Payer: BCBS Trust/PPO |
$612.15
|
| Rate for Payer: BCN Commercial |
$612.15
|
| Rate for Payer: Cash Price |
$592.95
|
| Rate for Payer: Cofinity Commercial |
$637.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.95
|
| Rate for Payer: Healthscope Commercial |
$667.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$555.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.01
|
| Rate for Payer: Nomi Health Commercial |
$607.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.89
|
| Rate for Payer: PHP Commercial |
$630.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$644.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.25
|
| Rate for Payer: UHC Core |
$618.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$555.89
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT INJ
|
Facility
|
OP
|
$741.19
|
|
|
Service Code
|
CPT 64466
|
| Hospital Charge Code |
37000021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$130.67 |
| Max. Negotiated Rate |
$667.07 |
| Rate for Payer: Aetna Commercial |
$630.01
|
| Rate for Payer: Aetna Medicare |
$192.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.62
|
| Rate for Payer: BCBS Complete |
$137.19
|
| Rate for Payer: BCBS MAPPO |
$185.30
|
| Rate for Payer: BCBS Trust/PPO |
$609.33
|
| Rate for Payer: BCN Commercial |
$609.33
|
| Rate for Payer: BCN Medicare Advantage |
$185.30
|
| Rate for Payer: Cash Price |
$592.95
|
| Rate for Payer: Cofinity Commercial |
$637.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.30
|
| Rate for Payer: Healthscope Commercial |
$667.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$555.89
|
| Rate for Payer: Mclaren Medicaid |
$130.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.56
|
| Rate for Payer: Meridian Medicaid |
$137.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$630.01
|
| Rate for Payer: Nomi Health Commercial |
$607.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.89
|
| Rate for Payer: PACE Senior Care Partners |
$176.03
|
| Rate for Payer: PACE SWMI |
$185.30
|
| Rate for Payer: PHP Commercial |
$630.01
|
| Rate for Payer: PHP Medicare Advantage |
$185.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$644.84
|
| Rate for Payer: Priority Health Medicare |
$187.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.87
|
| Rate for Payer: Railroad Medicare Medicare |
$185.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.25
|
| Rate for Payer: UHC Core |
$618.89
|
| Rate for Payer: UHC Exchange |
$185.30
|
| Rate for Payer: UHC Medicaid |
$130.67
|
| Rate for Payer: UHC Medicare Advantage |
$185.30
|
| Rate for Payer: UHCCP Medicaid |
$130.67
|
| Rate for Payer: VA VA |
$185.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$555.89
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$500.42 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: BCBS Trust/PPO |
$593.82
|
| Rate for Payer: BCN Commercial |
$593.82
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$126.76 |
| Max. Negotiated Rate |
$647.10 |
| Rate for Payer: Aetna Commercial |
$611.15
|
| Rate for Payer: Aetna Medicare |
$186.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.69
|
| Rate for Payer: BCBS Complete |
$133.09
|
| Rate for Payer: BCBS MAPPO |
$179.75
|
| Rate for Payer: BCBS Trust/PPO |
$591.09
|
| Rate for Payer: BCN Commercial |
$591.09
|
| Rate for Payer: BCN Medicare Advantage |
$179.75
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$618.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.75
|
| Rate for Payer: Healthscope Commercial |
$647.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.25
|
| Rate for Payer: Mclaren Medicaid |
$126.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.74
|
| Rate for Payer: Meridian Medicaid |
$133.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.15
|
| Rate for Payer: Nomi Health Commercial |
$589.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.25
|
| Rate for Payer: PACE Senior Care Partners |
$170.76
|
| Rate for Payer: PACE SWMI |
$179.75
|
| Rate for Payer: PHP Commercial |
$611.15
|
| Rate for Payer: PHP Medicare Advantage |
$179.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.53
|
| Rate for Payer: Priority Health Medicare |
$181.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.42
|
| Rate for Payer: Railroad Medicare Medicare |
$179.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.72
|
| Rate for Payer: UHC Core |
$600.37
|
| Rate for Payer: UHC Exchange |
$179.75
|
| Rate for Payer: UHC Medicaid |
$126.76
|
| Rate for Payer: UHC Medicare Advantage |
$179.75
|
| Rate for Payer: UHCCP Medicaid |
$126.76
|
| Rate for Payer: VA VA |
$179.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.25
|
|
|
HC THORACOTOMY
|
Facility
|
IP
|
$2,133.72
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,485.07 |
| Max. Negotiated Rate |
$1,920.35 |
| Rate for Payer: Aetna Commercial |
$1,813.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,762.24
|
| Rate for Payer: BCN Commercial |
$1,762.24
|
| Rate for Payer: Cash Price |
$1,706.98
|
| Rate for Payer: Cofinity Commercial |
$1,835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.98
|
| Rate for Payer: Healthscope Commercial |
$1,920.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,600.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,813.66
|
| Rate for Payer: Nomi Health Commercial |
$1,749.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,600.29
|
| Rate for Payer: PHP Commercial |
$1,813.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,856.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,485.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,877.67
|
| Rate for Payer: UHC Core |
$1,781.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,600.29
|
|
|
HC THORACOTOMY
|
Facility
|
OP
|
$2,133.72
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$376.17 |
| Max. Negotiated Rate |
$1,920.35 |
| Rate for Payer: Aetna Commercial |
$1,813.66
|
| Rate for Payer: Aetna Medicare |
$554.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$666.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$666.79
|
| Rate for Payer: BCBS Complete |
$394.95
|
| Rate for Payer: BCBS MAPPO |
$533.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,754.13
|
| Rate for Payer: BCN Commercial |
$1,754.13
|
| Rate for Payer: BCN Medicare Advantage |
$533.43
|
| Rate for Payer: Cash Price |
$1,706.98
|
| Rate for Payer: Cofinity Commercial |
$1,835.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.43
|
| Rate for Payer: Healthscope Commercial |
$1,920.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,600.29
|
| Rate for Payer: Mclaren Medicaid |
$376.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$560.10
|
| Rate for Payer: Meridian Medicaid |
$394.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$613.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$586.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,813.66
|
| Rate for Payer: Nomi Health Commercial |
$1,749.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,600.29
|
| Rate for Payer: PACE Senior Care Partners |
$506.76
|
| Rate for Payer: PACE SWMI |
$533.43
|
| Rate for Payer: PHP Commercial |
$1,813.66
|
| Rate for Payer: PHP Medicare Advantage |
$533.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,856.34
|
| Rate for Payer: Priority Health Medicare |
$538.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,485.07
|
| Rate for Payer: Railroad Medicare Medicare |
$533.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,877.67
|
| Rate for Payer: UHC Core |
$1,781.66
|
| Rate for Payer: UHC Exchange |
$533.43
|
| Rate for Payer: UHC Medicaid |
$376.17
|
| Rate for Payer: UHC Medicare Advantage |
$533.43
|
| Rate for Payer: UHCCP Medicaid |
$376.17
|
| Rate for Payer: VA VA |
$533.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,600.29
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
IP
|
$5,067.48
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,526.97 |
| Max. Negotiated Rate |
$4,560.73 |
| Rate for Payer: Aetna Commercial |
$4,307.36
|
| Rate for Payer: BCBS Trust/PPO |
$4,185.23
|
| Rate for Payer: BCN Commercial |
$4,185.23
|
| Rate for Payer: Cash Price |
$4,053.98
|
| Rate for Payer: Cofinity Commercial |
$4,358.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,053.98
|
| Rate for Payer: Healthscope Commercial |
$4,560.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,800.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,307.36
|
| Rate for Payer: Nomi Health Commercial |
$4,155.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,800.61
|
| Rate for Payer: PHP Commercial |
$4,307.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,408.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,526.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,459.38
|
| Rate for Payer: UHC Core |
$4,231.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,800.61
|
|
