|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,064.32 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: BCBS Trust/PPO |
$5,104.16
|
| Rate for Payer: BCN Commercial |
$4,832.16
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: Nomi Health Commercial |
$5,127.30
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health HMO/PPO |
$5,439.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,189.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,502.46
|
| Rate for Payer: UHC Core |
$5,221.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,485.04 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna Medicare |
$1,625.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,954.00
|
| Rate for Payer: BCBS Complete |
$3,781.45
|
| Rate for Payer: BCBS MAPPO |
$1,563.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,140.43
|
| Rate for Payer: BCN Commercial |
$4,861.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,563.20
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,563.20
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Mclaren Medicaid |
$3,601.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,641.36
|
| Rate for Payer: Meridian Medicaid |
$3,781.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,797.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: Nomi Health Commercial |
$5,127.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,485.04
|
| Rate for Payer: PACE SWMI |
$1,563.20
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,563.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,601.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health HMO/PPO |
$5,439.94
|
| Rate for Payer: Priority Health Medicare |
$1,578.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,189.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,563.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,502.46
|
| Rate for Payer: UHC Core |
$5,221.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,563.20
|
| Rate for Payer: UHC Exchange |
$1,563.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,563.20
|
| Rate for Payer: UHCCP Medicaid |
$3,601.14
|
| Rate for Payer: VA VA |
$1,563.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,400.81 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.04
|
| Rate for Payer: BCN Commercial |
$2,854.38
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: Nomi Health Commercial |
$3,028.71
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.32
|
| Rate for Payer: UHC Core |
$3,084.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$877.22 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna Medicare |
$960.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,154.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,154.23
|
| Rate for Payer: BCBS Complete |
$1,477.42
|
| Rate for Payer: BCBS MAPPO |
$923.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,036.47
|
| Rate for Payer: BCN Commercial |
$2,871.74
|
| Rate for Payer: BCN Medicare Advantage |
$923.39
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.39
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: Nomi Health Commercial |
$3,028.71
|
| Rate for Payer: PACE Senior Care Partners |
$877.22
|
| Rate for Payer: PACE SWMI |
$923.39
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: PHP Medicare Advantage |
$923.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.39
|
| Rate for Payer: Priority Health Medicare |
$932.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.68
|
| Rate for Payer: Railroad Medicare Medicare |
$923.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.32
|
| Rate for Payer: UHC Core |
$3,084.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.39
|
| Rate for Payer: UHC Exchange |
$923.39
|
| Rate for Payer: UHC Medicare Advantage |
$923.39
|
| Rate for Payer: VA VA |
$923.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,199.90 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: BCBS Trust/PPO |
$4,018.59
|
| Rate for Payer: BCN Commercial |
$3,804.44
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,282.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,332.18
|
| Rate for Payer: UHC Core |
$4,110.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,169.20 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: Aetna Medicare |
$1,279.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,538.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,538.42
|
| Rate for Payer: BCBS Complete |
$1,969.17
|
| Rate for Payer: BCBS MAPPO |
$1,230.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,047.14
|
| Rate for Payer: BCN Commercial |
$3,827.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,230.73
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,230.73
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,292.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,415.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: Nomi Health Commercial |
$4,036.80
|
| Rate for Payer: PACE Senior Care Partners |
$1,169.20
|
| Rate for Payer: PACE SWMI |
$1,230.73
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,230.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health HMO/PPO |
$4,282.95
|
| Rate for Payer: Priority Health Medicare |
$1,243.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,230.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,332.18
|
| Rate for Payer: UHC Core |
$4,110.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,230.73
|
| Rate for Payer: UHC Exchange |
$1,230.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,230.73
|
| Rate for Payer: VA VA |
$1,230.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$214.79 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: Aetna Medicare |
$235.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$282.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$282.62
|
| Rate for Payer: BCBS Complete |
$361.76
|
| Rate for Payer: BCBS MAPPO |
$226.10
|
| Rate for Payer: BCBS Trust/PPO |
$743.50
|
| Rate for Payer: BCN Commercial |
$703.16
|
| Rate for Payer: BCN Medicare Advantage |
$226.10
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.10
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: PACE Senior Care Partners |
$214.79
|
| Rate for Payer: PACE SWMI |
$226.10
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: PHP Medicare Advantage |
$226.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health HMO/PPO |
$786.82
|
| Rate for Payer: Priority Health Medicare |
$228.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.94
|
| Rate for Payer: Railroad Medicare Medicare |
$226.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.86
|
| Rate for Payer: UHC Core |
$755.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.10
|
| Rate for Payer: UHC Exchange |
$226.10
|
| Rate for Payer: UHC Medicare Advantage |
$226.10
|
| Rate for Payer: VA VA |
$226.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$587.85 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: BCBS Trust/PPO |
$738.25
|
| Rate for Payer: BCN Commercial |
$698.91
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: Nomi Health Commercial |
$741.60
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health HMO/PPO |
$786.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$605.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.86
|
| Rate for Payer: UHC Core |
$755.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$381.54 |
| Max. Negotiated Rate |
$1,445.85 |
| Rate for Payer: Aetna Commercial |
$1,365.52
|
| Rate for Payer: Aetna Medicare |
$417.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$502.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$502.03
|
| Rate for Payer: BCBS Complete |
$642.60
|
| Rate for Payer: BCBS MAPPO |
$401.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.70
|
| Rate for Payer: BCN Commercial |
$1,249.05
|
| Rate for Payer: BCN Medicare Advantage |
$401.62
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.62
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$421.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.52
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: PACE Senior Care Partners |
$381.54
|
| Rate for Payer: PACE SWMI |
$401.62
|
| Rate for Payer: PHP Commercial |
$1,365.52
|
| Rate for Payer: PHP Medicare Advantage |
$401.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,397.66
|
| Rate for Payer: Priority Health Medicare |
$405.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.36
|
| Rate for Payer: Railroad Medicare Medicare |
$401.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.72
|
| Rate for Payer: UHC Core |
$1,341.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.62
|
| Rate for Payer: UHC Exchange |
$401.62
|
| Rate for Payer: UHC Medicare Advantage |
$401.62
|
| Rate for Payer: VA VA |
$401.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,044.22 |
| Max. Negotiated Rate |
$1,445.85 |
| Rate for Payer: Aetna Commercial |
$1,365.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,311.39
|
| Rate for Payer: BCN Commercial |
$1,241.50
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.52
|
| Rate for Payer: Nomi Health Commercial |
$1,317.33
|
| Rate for Payer: PHP Commercial |
$1,365.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health HMO/PPO |
$1,397.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,076.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.72
|
| Rate for Payer: UHC Core |
$1,341.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$776.35 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: BCBS Trust/PPO |
$974.97
|
| Rate for Payer: BCN Commercial |
$923.02
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.05
|
| Rate for Payer: UHC Core |
$997.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.67 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: Aetna Medicare |
$310.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$373.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$373.24
|
| Rate for Payer: BCBS Complete |
$477.75
|
| Rate for Payer: BCBS MAPPO |
$298.60
|
| Rate for Payer: BCBS Trust/PPO |
$981.90
|
| Rate for Payer: BCN Commercial |
$928.63
|
| Rate for Payer: BCN Medicare Advantage |
$298.60
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.60
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: Nomi Health Commercial |
$979.39
|
| Rate for Payer: PACE Senior Care Partners |
$283.67
|
| Rate for Payer: PACE SWMI |
$298.60
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: PHP Medicare Advantage |
$298.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,039.11
|
| Rate for Payer: Priority Health Medicare |
$301.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$800.23
|
| Rate for Payer: Railroad Medicare Medicare |
$298.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,051.05
|
| Rate for Payer: UHC Core |
$997.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.60
|
| Rate for Payer: UHC Exchange |
$298.60
|
| Rate for Payer: UHC Medicare Advantage |
$298.60
|
| Rate for Payer: VA VA |
$298.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,187.04 |
| Max. Negotiated Rate |
$4,412.83 |
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: BCBS Trust/PPO |
$4,002.43
|
| Rate for Payer: BCN Commercial |
$3,789.15
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO |
$4,265.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,314.76
|
| Rate for Payer: UHC Core |
$4,094.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,164.50 |
| Max. Negotiated Rate |
$4,412.83 |
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: Aetna Medicare |
$1,274.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,532.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,532.23
|
| Rate for Payer: BCBS Complete |
$2,565.51
|
| Rate for Payer: BCBS MAPPO |
$1,225.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,030.87
|
| Rate for Payer: BCN Commercial |
$3,812.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,225.78
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,225.78
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Mclaren Medicaid |
$2,443.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,287.07
|
| Rate for Payer: Meridian Medicaid |
$2,565.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,409.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$4,020.57
|
| Rate for Payer: PACE Senior Care Partners |
$1,164.50
|
| Rate for Payer: PACE SWMI |
$1,225.78
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,225.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,443.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO |
$4,265.73
|
| Rate for Payer: Priority Health Medicare |
$1,238.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,285.10
|
| Rate for Payer: Railroad Medicare Medicare |
$1,225.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,314.76
|
| Rate for Payer: UHC Core |
$4,094.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,225.78
|
| Rate for Payer: UHC Exchange |
$1,225.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,225.78
|
| Rate for Payer: UHCCP Medicaid |
$2,443.18
|
| Rate for Payer: VA VA |
$1,225.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,007.79 |
| Max. Negotiated Rate |
$3,818.98 |
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: Aetna Medicare |
$1,103.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,326.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,326.03
|
| Rate for Payer: BCBS Complete |
$1,190.46
|
| Rate for Payer: BCBS MAPPO |
$1,060.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,488.43
|
| Rate for Payer: BCN Commercial |
$3,299.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,060.83
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,060.83
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Mclaren Medicaid |
$1,133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,113.87
|
| Rate for Payer: Meridian Medicaid |
$1,190.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,219.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,007.79
|
| Rate for Payer: PACE SWMI |
$1,060.83
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,060.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,133.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO |
$3,691.68
|
| Rate for Payer: Priority Health Medicare |
$1,071.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,843.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1,060.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,734.11
|
| Rate for Payer: UHC Core |
$3,543.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,060.83
|
| Rate for Payer: UHC Exchange |
$1,060.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,060.83
|
| Rate for Payer: UHCCP Medicaid |
$1,133.70
|
| Rate for Payer: VA VA |
$1,060.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,758.15 |
| Max. Negotiated Rate |
$3,818.98 |
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,463.81
|
| Rate for Payer: BCN Commercial |
$3,279.23
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,479.51
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO |
$3,691.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,843.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,734.11
|
| Rate for Payer: UHC Core |
$3,543.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.82
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$23.79 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$23.79
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$20.96
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$22.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$23.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Exchange |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$22.65
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$19.98
|
| Rate for Payer: BCN Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO |
$21.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$6.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.65
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$20.13
|
| Rate for Payer: BCN Commercial |
$19.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.12
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.43
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$20.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.81
|
| Rate for Payer: PACE SWMI |
$6.12
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO |
$21.30
|
| Rate for Payer: Priority Health Medicare |
$6.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.54
|
| Rate for Payer: UHC Core |
$20.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.12
|
| Rate for Payer: UHC Exchange |
$6.12
|
| Rate for Payer: UHC Medicare Advantage |
$6.12
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$6.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.57 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$18.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.99
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$17.60
|
| Rate for Payer: BCBS Trust/PPO |
$57.86
|
| Rate for Payer: BCN Commercial |
$54.72
|
| Rate for Payer: BCN Medicare Advantage |
$17.60
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.60
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Senior Care Partners |
$16.72
|
| Rate for Payer: PACE SWMI |
$17.60
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$17.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: Railroad Medicare Medicare |
$17.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.60
|
| Rate for Payer: UHC Exchange |
$17.60
|
| Rate for Payer: UHC Medicare Advantage |
$17.60
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$17.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.45
|
| Rate for Payer: BCN Commercial |
$54.39
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Medicare |
$7.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.66
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: BCBS MAPPO |
$6.92
|
| Rate for Payer: BCBS Trust/PPO |
$22.77
|
| Rate for Payer: BCN Commercial |
$21.54
|
| Rate for Payer: BCN Medicare Advantage |
$6.92
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.92
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.54
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: PACE Senior Care Partners |
$6.58
|
| Rate for Payer: PACE SWMI |
$6.92
|
| Rate for Payer: PHP Commercial |
$23.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health HMO/PPO |
$24.10
|
| Rate for Payer: Priority Health Medicare |
$6.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Core |
$23.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.92
|
| Rate for Payer: UHC Exchange |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$6.92
|
| Rate for Payer: VA VA |
$6.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.78
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: BCBS Trust/PPO |
$22.61
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.54
|
| Rate for Payer: Nomi Health Commercial |
$22.71
|
| Rate for Payer: PHP Commercial |
$23.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health HMO/PPO |
$24.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.38
|
| Rate for Payer: UHC Core |
$23.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.78
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
