|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$409.92
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.27 |
| Max. Negotiated Rate |
$368.93 |
| Rate for Payer: Aetna Commercial |
$348.43
|
| Rate for Payer: Aetna Medicare |
$106.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.10
|
| Rate for Payer: BCBS Complete |
$75.88
|
| Rate for Payer: BCBS MAPPO |
$102.48
|
| Rate for Payer: BCBS Trust/PPO |
$337.00
|
| Rate for Payer: BCN Commercial |
$337.00
|
| Rate for Payer: BCN Medicare Advantage |
$102.48
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cofinity Commercial |
$352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.48
|
| Rate for Payer: Healthscope Commercial |
$368.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.44
|
| Rate for Payer: Mclaren Medicaid |
$72.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.60
|
| Rate for Payer: Meridian Medicaid |
$75.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.43
|
| Rate for Payer: Nomi Health Commercial |
$336.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.44
|
| Rate for Payer: PACE Senior Care Partners |
$97.36
|
| Rate for Payer: PACE SWMI |
$102.48
|
| Rate for Payer: PHP Commercial |
$348.43
|
| Rate for Payer: PHP Medicare Advantage |
$102.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$356.63
|
| Rate for Payer: Priority Health Medicare |
$103.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$285.30
|
| Rate for Payer: Railroad Medicare Medicare |
$102.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.73
|
| Rate for Payer: UHC Core |
$342.28
|
| Rate for Payer: UHC Exchange |
$102.48
|
| Rate for Payer: UHC Medicaid |
$72.27
|
| Rate for Payer: UHC Medicare Advantage |
$102.48
|
| Rate for Payer: UHCCP Medicaid |
$72.27
|
| Rate for Payer: VA VA |
$102.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.44
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,116.00
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$373.05 |
| Max. Negotiated Rate |
$1,904.40 |
| Rate for Payer: Aetna Commercial |
$1,798.60
|
| Rate for Payer: Aetna Medicare |
$550.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$661.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$661.25
|
| Rate for Payer: BCBS Complete |
$391.67
|
| Rate for Payer: BCBS MAPPO |
$529.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.56
|
| Rate for Payer: BCN Commercial |
$1,739.56
|
| Rate for Payer: BCN Medicare Advantage |
$529.00
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cofinity Commercial |
$1,819.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.00
|
| Rate for Payer: Healthscope Commercial |
$1,904.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,587.00
|
| Rate for Payer: Mclaren Medicaid |
$373.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.45
|
| Rate for Payer: Meridian Medicaid |
$391.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$608.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$581.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.60
|
| Rate for Payer: Nomi Health Commercial |
$1,735.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.00
|
| Rate for Payer: PACE Senior Care Partners |
$502.55
|
| Rate for Payer: PACE SWMI |
$529.00
|
| Rate for Payer: PHP Commercial |
$1,798.60
|
| Rate for Payer: PHP Medicare Advantage |
$529.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,840.92
|
| Rate for Payer: Priority Health Medicare |
$534.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.74
|
| Rate for Payer: Railroad Medicare Medicare |
$529.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,862.08
|
| Rate for Payer: UHC Core |
$1,766.86
|
| Rate for Payer: UHC Exchange |
$529.00
|
| Rate for Payer: UHC Medicaid |
$373.05
|
| Rate for Payer: UHC Medicare Advantage |
$529.00
|
| Rate for Payer: UHCCP Medicaid |
$373.05
|
| Rate for Payer: VA VA |
$529.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,587.00
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,116.00
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,472.74 |
| Max. Negotiated Rate |
$1,904.40 |
| Rate for Payer: Aetna Commercial |
$1,798.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.60
|
| Rate for Payer: BCN Commercial |
$1,747.60
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cofinity Commercial |
$1,819.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.80
|
| Rate for Payer: Healthscope Commercial |
$1,904.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,587.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.60
|
| Rate for Payer: Nomi Health Commercial |
$1,735.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.00
|
| Rate for Payer: PHP Commercial |
$1,798.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,840.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,862.08
|
| Rate for Payer: UHC Core |
$1,766.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,587.00
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$230.02
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.09 |
| Max. Negotiated Rate |
$207.02 |
| Rate for Payer: Aetna Commercial |
$195.52
|
| Rate for Payer: BCBS Trust/PPO |
$189.97
|
| Rate for Payer: BCN Commercial |
$189.97
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cofinity Commercial |
$197.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.02
|
| Rate for Payer: Healthscope Commercial |
$207.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.52
|
| Rate for Payer: Nomi Health Commercial |
$188.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: PHP Commercial |
$195.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.42
|
| Rate for Payer: UHC Core |
$192.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
OP
|
$230.02
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$207.02 |
| Rate for Payer: Aetna Commercial |
$195.52
|
| Rate for Payer: Aetna Medicare |
$59.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.88
|
| Rate for Payer: BCBS Complete |
$42.58
|
| Rate for Payer: BCBS MAPPO |
$57.51
|
| Rate for Payer: BCBS Trust/PPO |
$189.10
|
| Rate for Payer: BCN Commercial |
$189.10
|
| Rate for Payer: BCN Medicare Advantage |
$57.51
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cofinity Commercial |
$197.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.51
|
| Rate for Payer: Healthscope Commercial |
$207.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Mclaren Medicaid |
$40.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.38
|
| Rate for Payer: Meridian Medicaid |
$42.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.52
|
| Rate for Payer: Nomi Health Commercial |
$188.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: PACE Senior Care Partners |
$54.63
|
| Rate for Payer: PACE SWMI |
$57.51
|
| Rate for Payer: PHP Commercial |
$195.52
|
| Rate for Payer: PHP Medicare Advantage |
$57.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.12
|
| Rate for Payer: Priority Health Medicare |
$58.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.09
|
| Rate for Payer: Railroad Medicare Medicare |
$57.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.42
|
| Rate for Payer: UHC Core |
$192.07
|
| Rate for Payer: UHC Exchange |
$57.51
|
| Rate for Payer: UHC Medicaid |
$40.55
|
| Rate for Payer: UHC Medicare Advantage |
$57.51
|
| Rate for Payer: UHCCP Medicaid |
$40.55
|
| Rate for Payer: VA VA |
$57.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$490.49
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$86.47 |
| Max. Negotiated Rate |
$441.44 |
| Rate for Payer: Aetna Commercial |
$416.92
|
| Rate for Payer: Aetna Medicare |
$127.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.28
|
| Rate for Payer: BCBS Complete |
$90.79
|
| Rate for Payer: BCBS MAPPO |
$122.62
|
| Rate for Payer: BCBS Trust/PPO |
$403.23
|
| Rate for Payer: BCN Commercial |
$403.23
|
| Rate for Payer: BCN Medicare Advantage |
$122.62
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cofinity Commercial |
$421.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.62
|
| Rate for Payer: Healthscope Commercial |
$441.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.87
|
| Rate for Payer: Mclaren Medicaid |
$86.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.75
|
| Rate for Payer: Meridian Medicaid |
$90.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.92
|
| Rate for Payer: Nomi Health Commercial |
$402.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.87
|
| Rate for Payer: PACE Senior Care Partners |
$116.49
|
| Rate for Payer: PACE SWMI |
$122.62
|
| Rate for Payer: PHP Commercial |
$416.92
|
| Rate for Payer: PHP Medicare Advantage |
$122.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$426.73
|
| Rate for Payer: Priority Health Medicare |
$123.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.38
|
| Rate for Payer: Railroad Medicare Medicare |
$122.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.63
|
| Rate for Payer: UHC Core |
$409.56
|
| Rate for Payer: UHC Exchange |
$122.62
|
| Rate for Payer: UHC Medicaid |
$86.47
|
| Rate for Payer: UHC Medicare Advantage |
$122.62
|
| Rate for Payer: UHCCP Medicaid |
$86.47
|
| Rate for Payer: VA VA |
$122.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.87
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$490.49
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.38 |
| Max. Negotiated Rate |
$441.44 |
| Rate for Payer: Aetna Commercial |
$416.92
|
| Rate for Payer: BCBS Trust/PPO |
$405.10
|
| Rate for Payer: BCN Commercial |
$405.10
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cofinity Commercial |
$421.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.39
|
| Rate for Payer: Healthscope Commercial |
$441.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.92
|
| Rate for Payer: Nomi Health Commercial |
$402.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.87
|
| Rate for Payer: PHP Commercial |
$416.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$426.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.63
|
| Rate for Payer: UHC Core |
$409.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.87
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$315.57
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.64 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: BCBS Trust/PPO |
$260.63
|
| Rate for Payer: BCN Commercial |
$260.63
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.70
|
| Rate for Payer: UHC Core |
$263.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.68
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$315.57
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$55.63 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna Medicare |
$82.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.62
|
| Rate for Payer: BCBS Complete |
$58.41
|
| Rate for Payer: BCBS MAPPO |
$78.89
|
| Rate for Payer: BCBS Trust/PPO |
$259.43
|
| Rate for Payer: BCN Commercial |
$259.43
|
| Rate for Payer: BCN Medicare Advantage |
$78.89
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.89
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.68
|
| Rate for Payer: Mclaren Medicaid |
$55.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.84
|
| Rate for Payer: Meridian Medicaid |
$58.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Nomi Health Commercial |
$258.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PACE Senior Care Partners |
$74.95
|
| Rate for Payer: PACE SWMI |
$78.89
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: PHP Medicare Advantage |
$78.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.55
|
| Rate for Payer: Priority Health Medicare |
$79.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.64
|
| Rate for Payer: Railroad Medicare Medicare |
$78.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.70
|
| Rate for Payer: UHC Core |
$263.50
|
| Rate for Payer: UHC Exchange |
$78.89
|
| Rate for Payer: UHC Medicaid |
$55.63
|
| Rate for Payer: UHC Medicare Advantage |
$78.89
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$78.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.68
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.73
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna Medicare |
$4.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.85
|
| Rate for Payer: BCBS Complete |
$3.47
|
| Rate for Payer: BCBS MAPPO |
$4.68
|
| Rate for Payer: BCBS Trust/PPO |
$15.40
|
| Rate for Payer: BCN Commercial |
$15.40
|
| Rate for Payer: BCN Medicare Advantage |
$4.68
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.68
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$3.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$3.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.05
|
| Rate for Payer: PACE Senior Care Partners |
$4.45
|
| Rate for Payer: PACE SWMI |
$4.68
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: PHP Medicare Advantage |
$4.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.30
|
| Rate for Payer: Priority Health Medicare |
$4.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: Railroad Medicare Medicare |
$4.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$15.64
|
| Rate for Payer: UHC Exchange |
$4.68
|
| Rate for Payer: UHC Medicaid |
$3.30
|
| Rate for Payer: UHC Medicare Advantage |
$4.68
|
| Rate for Payer: UHCCP Medicaid |
$3.30
|
| Rate for Payer: VA VA |
$4.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.73
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.04 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$15.47
|
| Rate for Payer: BCN Commercial |
$15.47
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.05
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$15.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.97
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.62
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$20.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.97
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$6.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.80
|
| Rate for Payer: BCBS Complete |
$4.62
|
| Rate for Payer: BCBS MAPPO |
$6.24
|
| Rate for Payer: BCBS Trust/PPO |
$20.53
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: BCN Medicare Advantage |
$6.24
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$4.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.55
|
| Rate for Payer: Meridian Medicaid |
$4.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PACE Senior Care Partners |
$5.93
|
| Rate for Payer: PACE SWMI |
$6.24
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: PHP Medicare Advantage |
$6.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.72
|
| Rate for Payer: Priority Health Medicare |
$6.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: Railroad Medicare Medicare |
$6.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$20.85
|
| Rate for Payer: UHC Exchange |
$6.24
|
| Rate for Payer: UHC Medicaid |
$4.40
|
| Rate for Payer: UHC Medicare Advantage |
$6.24
|
| Rate for Payer: UHCCP Medicaid |
$4.40
|
| Rate for Payer: VA VA |
$6.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$29.65
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$26.68 |
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Aetna Medicare |
$7.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.27
|
| Rate for Payer: BCBS Complete |
$5.49
|
| Rate for Payer: BCBS MAPPO |
$7.41
|
| Rate for Payer: BCBS Trust/PPO |
$24.38
|
| Rate for Payer: BCN Commercial |
$24.38
|
| Rate for Payer: BCN Medicare Advantage |
$7.41
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Cofinity Commercial |
$25.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.41
|
| Rate for Payer: Healthscope Commercial |
$26.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.24
|
| Rate for Payer: Mclaren Medicaid |
$5.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.78
|
| Rate for Payer: Meridian Medicaid |
$5.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.20
|
| Rate for Payer: Nomi Health Commercial |
$24.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.04
|
| Rate for Payer: PACE SWMI |
$7.41
|
| Rate for Payer: PHP Commercial |
$25.20
|
| Rate for Payer: PHP Medicare Advantage |
$7.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.80
|
| Rate for Payer: Priority Health Medicare |
$7.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.64
|
| Rate for Payer: Railroad Medicare Medicare |
$7.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.09
|
| Rate for Payer: UHC Core |
$24.76
|
| Rate for Payer: UHC Exchange |
$7.41
|
| Rate for Payer: UHC Medicaid |
$5.23
|
| Rate for Payer: UHC Medicare Advantage |
$7.41
|
| Rate for Payer: UHCCP Medicaid |
$5.23
|
| Rate for Payer: VA VA |
$7.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.24
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$29.65
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$26.68 |
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$24.49
|
| Rate for Payer: BCN Commercial |
$24.49
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Cofinity Commercial |
$25.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.72
|
| Rate for Payer: Healthscope Commercial |
$26.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.20
|
| Rate for Payer: Nomi Health Commercial |
$24.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.24
|
| Rate for Payer: PHP Commercial |
$25.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.09
|
| Rate for Payer: UHC Core |
$24.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.24
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$157.27 |
| Max. Negotiated Rate |
$203.36 |
| Rate for Payer: Aetna Commercial |
$192.07
|
| Rate for Payer: BCBS Trust/PPO |
$186.62
|
| Rate for Payer: BCN Commercial |
$186.62
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Commercial |
$194.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Healthscope Commercial |
$203.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Nomi Health Commercial |
$185.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: PHP Commercial |
$192.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.84
|
| Rate for Payer: UHC Core |
$188.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.47
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$39.84 |
| Max. Negotiated Rate |
$203.36 |
| Rate for Payer: Aetna Commercial |
$192.07
|
| Rate for Payer: Aetna Medicare |
$58.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.61
|
| Rate for Payer: BCBS Complete |
$41.83
|
| Rate for Payer: BCBS MAPPO |
$56.49
|
| Rate for Payer: BCBS Trust/PPO |
$185.76
|
| Rate for Payer: BCCCP Commercial |
$110.97
|
| Rate for Payer: BCN Commercial |
$185.76
|
| Rate for Payer: BCN Medicare Advantage |
$56.49
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Commercial |
$194.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.49
|
| Rate for Payer: Healthscope Commercial |
$203.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.47
|
| Rate for Payer: Mclaren Medicaid |
$39.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.31
|
| Rate for Payer: Meridian Medicaid |
$41.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Nomi Health Commercial |
$185.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: PACE Senior Care Partners |
$53.67
|
| Rate for Payer: PACE SWMI |
$56.49
|
| Rate for Payer: PHP Commercial |
$192.07
|
| Rate for Payer: PHP Medicare Advantage |
$56.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.59
|
| Rate for Payer: Priority Health Medicare |
$57.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.27
|
| Rate for Payer: Railroad Medicare Medicare |
$56.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.84
|
| Rate for Payer: UHC Core |
$188.68
|
| Rate for Payer: UHC Exchange |
$56.49
|
| Rate for Payer: UHC Medicaid |
$39.84
|
| Rate for Payer: UHC Medicare Advantage |
$56.49
|
| Rate for Payer: UHCCP Medicaid |
$39.84
|
| Rate for Payer: VA VA |
$56.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.47
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,251.56
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$749.55 |
| Max. Negotiated Rate |
$3,826.40 |
| Rate for Payer: Aetna Commercial |
$3,613.83
|
| Rate for Payer: Aetna Medicare |
$1,105.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,328.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,328.61
|
| Rate for Payer: BCBS Complete |
$786.96
|
| Rate for Payer: BCBS MAPPO |
$1,062.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,495.21
|
| Rate for Payer: BCN Commercial |
$3,495.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,062.89
|
| Rate for Payer: Cash Price |
$3,401.25
|
| Rate for Payer: Cofinity Commercial |
$3,656.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,062.89
|
| Rate for Payer: Healthscope Commercial |
$3,826.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,188.67
|
| Rate for Payer: Mclaren Medicaid |
$749.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,116.03
|
| Rate for Payer: Meridian Medicaid |
$786.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,222.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,169.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,613.83
|
| Rate for Payer: Nomi Health Commercial |
$3,486.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,188.67
|
| Rate for Payer: PACE Senior Care Partners |
$1,009.75
|
| Rate for Payer: PACE SWMI |
$1,062.89
|
| Rate for Payer: PHP Commercial |
$3,613.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,062.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$749.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,698.86
|
| Rate for Payer: Priority Health Medicare |
$1,073.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,959.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,062.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,741.37
|
| Rate for Payer: UHC Core |
$3,550.05
|
| Rate for Payer: UHC Exchange |
$1,062.89
|
| Rate for Payer: UHC Medicaid |
$749.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,062.89
|
| Rate for Payer: UHCCP Medicaid |
$749.55
|
| Rate for Payer: VA VA |
$1,062.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,188.67
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,251.56
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,959.09 |
| Max. Negotiated Rate |
$3,826.40 |
| Rate for Payer: Aetna Commercial |
$3,613.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,511.36
|
| Rate for Payer: BCN Commercial |
$3,511.36
|
| Rate for Payer: Cash Price |
$3,401.25
|
| Rate for Payer: Cofinity Commercial |
$3,656.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.25
|
| Rate for Payer: Healthscope Commercial |
$3,826.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,188.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,613.83
|
| Rate for Payer: Nomi Health Commercial |
$3,486.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,188.67
|
| Rate for Payer: PHP Commercial |
$3,613.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,698.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,959.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,741.37
|
| Rate for Payer: UHC Core |
$3,550.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,188.67
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,745.44
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,606.83 |
| Max. Negotiated Rate |
$3,370.90 |
| Rate for Payer: Aetna Commercial |
$3,183.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,093.36
|
| Rate for Payer: BCN Commercial |
$3,093.36
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Healthscope Commercial |
$3,370.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,809.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,809.08
|
| Rate for Payer: PHP Commercial |
$3,183.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,258.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,606.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,295.99
|
| Rate for Payer: UHC Core |
$3,127.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,809.08
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,745.44
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$660.32 |
| Max. Negotiated Rate |
$3,370.90 |
| Rate for Payer: Aetna Commercial |
$3,183.62
|
| Rate for Payer: Aetna Medicare |
$973.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,170.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,170.45
|
| Rate for Payer: BCBS Complete |
$693.28
|
| Rate for Payer: BCBS MAPPO |
$936.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,079.13
|
| Rate for Payer: BCN Commercial |
$3,079.13
|
| Rate for Payer: BCN Medicare Advantage |
$936.36
|
| Rate for Payer: Cash Price |
$2,996.35
|
| Rate for Payer: Cofinity Commercial |
$3,221.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,996.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$936.36
|
| Rate for Payer: Healthscope Commercial |
$3,370.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,809.08
|
| Rate for Payer: Mclaren Medicaid |
$660.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$983.18
|
| Rate for Payer: Meridian Medicaid |
$693.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,076.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,030.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,183.62
|
| Rate for Payer: Nomi Health Commercial |
$3,071.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,809.08
|
| Rate for Payer: PACE Senior Care Partners |
$889.54
|
| Rate for Payer: PACE SWMI |
$936.36
|
| Rate for Payer: PHP Commercial |
$3,183.62
|
| Rate for Payer: PHP Medicare Advantage |
$936.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,258.53
|
| Rate for Payer: Priority Health Medicare |
$945.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,606.83
|
| Rate for Payer: Railroad Medicare Medicare |
$936.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,295.99
|
| Rate for Payer: UHC Core |
$3,127.44
|
| Rate for Payer: UHC Exchange |
$936.36
|
| Rate for Payer: UHC Medicaid |
$660.32
|
| Rate for Payer: UHC Medicare Advantage |
$936.36
|
| Rate for Payer: UHCCP Medicaid |
$660.32
|
| Rate for Payer: VA VA |
$936.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,809.08
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
