|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.18 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: Aetna Medicare |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.19
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$142.55
|
| Rate for Payer: BCN Commercial |
$134.82
|
| Rate for Payer: BCN Medicare Advantage |
$43.35
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.35
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.52
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| Rate for Payer: PACE Senior Care Partners |
$41.18
|
| Rate for Payer: PACE SWMI |
$43.35
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: PHP Medicare Advantage |
$43.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO |
$150.86
|
| Rate for Payer: Priority Health Medicare |
$43.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| Rate for Payer: Railroad Medicare Medicare |
$43.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.35
|
| Rate for Payer: UHC Exchange |
$43.35
|
| Rate for Payer: UHC Medicare Advantage |
$43.35
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$43.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.71 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: BCBS Trust/PPO |
$141.55
|
| Rate for Payer: BCN Commercial |
$134.00
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO |
$150.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$76.83
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: BCBS Trust/PPO |
$62.72
|
| Rate for Payer: BCN Commercial |
$59.37
|
| Rate for Payer: Cash Price |
$61.46
|
| Rate for Payer: Cofinity Commercial |
$66.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.46
|
| Rate for Payer: Healthscope Commercial |
$69.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.00
|
| Rate for Payer: PHP Commercial |
$65.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.94
|
| Rate for Payer: Priority Health HMO/PPO |
$66.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.61
|
| Rate for Payer: UHC Core |
$64.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.62
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$76.83
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$69.15 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.01
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$19.21
|
| Rate for Payer: BCBS Trust/PPO |
$63.16
|
| Rate for Payer: BCN Commercial |
$59.74
|
| Rate for Payer: BCN Medicare Advantage |
$19.21
|
| Rate for Payer: Cash Price |
$61.46
|
| Rate for Payer: Cash Price |
$61.46
|
| Rate for Payer: Cofinity Commercial |
$66.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.21
|
| Rate for Payer: Healthscope Commercial |
$69.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.62
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.17
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.00
|
| Rate for Payer: PACE Senior Care Partners |
$18.25
|
| Rate for Payer: PACE SWMI |
$19.21
|
| Rate for Payer: PHP Commercial |
$65.31
|
| Rate for Payer: PHP Medicare Advantage |
$19.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.94
|
| Rate for Payer: Priority Health HMO/PPO |
$66.84
|
| Rate for Payer: Priority Health Medicare |
$19.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.48
|
| Rate for Payer: Railroad Medicare Medicare |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.61
|
| Rate for Payer: UHC Core |
$64.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.21
|
| Rate for Payer: UHC Exchange |
$19.21
|
| Rate for Payer: UHC Medicare Advantage |
$19.21
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$19.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.62
|
|
|
HC TRIVISC FOR INTRA-ARTICULAR INJ, 1 MG
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS J7329
|
| Hospital Charge Code |
63600237
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$3.56 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$3.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$3.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.00
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC TRIVISC FOR INTRA-ARTICULAR INJ, 1 MG
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS J7329
|
| Hospital Charge Code |
63600237
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC TRMT DEVICE - C
|
Facility
|
IP
|
$949.89
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
33300014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$617.43 |
| Max. Negotiated Rate |
$854.90 |
| Rate for Payer: Aetna Commercial |
$807.41
|
| Rate for Payer: BCBS Trust/PPO |
$775.40
|
| Rate for Payer: BCN Commercial |
$734.07
|
| Rate for Payer: Cash Price |
$759.91
|
| Rate for Payer: Cofinity Commercial |
$816.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.91
|
| Rate for Payer: Healthscope Commercial |
$854.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.41
|
| Rate for Payer: Nomi Health Commercial |
$778.91
|
| Rate for Payer: PHP Commercial |
$807.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$617.43
|
| Rate for Payer: Priority Health HMO/PPO |
$826.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.90
|
| Rate for Payer: UHC Core |
$793.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.42
|
|
|
HC TRMT DEVICE - C
|
Facility
|
OP
|
$949.89
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
33300014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$225.60 |
| Max. Negotiated Rate |
$854.90 |
| Rate for Payer: Aetna Commercial |
$807.41
|
| Rate for Payer: Aetna Medicare |
$246.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.84
|
| Rate for Payer: BCBS Complete |
$277.92
|
| Rate for Payer: BCBS MAPPO |
$237.47
|
| Rate for Payer: BCBS Trust/PPO |
$780.90
|
| Rate for Payer: BCN Commercial |
$738.54
|
| Rate for Payer: BCN Medicare Advantage |
$237.47
|
| Rate for Payer: Cash Price |
$759.91
|
| Rate for Payer: Cash Price |
$759.91
|
| Rate for Payer: Cofinity Commercial |
$816.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.47
|
| Rate for Payer: Healthscope Commercial |
$854.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.42
|
| Rate for Payer: Mclaren Medicaid |
$264.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.35
|
| Rate for Payer: Meridian Medicaid |
$277.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.41
|
| Rate for Payer: Nomi Health Commercial |
$778.91
|
| Rate for Payer: PACE Senior Care Partners |
$225.60
|
| Rate for Payer: PACE SWMI |
$237.47
|
| Rate for Payer: PHP Commercial |
$807.41
|
| Rate for Payer: PHP Medicare Advantage |
$237.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$617.43
|
| Rate for Payer: Priority Health HMO/PPO |
$826.40
|
| Rate for Payer: Priority Health Medicare |
$239.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.43
|
| Rate for Payer: Railroad Medicare Medicare |
$237.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.90
|
| Rate for Payer: UHC Core |
$793.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.47
|
| Rate for Payer: UHC Exchange |
$237.47
|
| Rate for Payer: UHC Medicare Advantage |
$237.47
|
| Rate for Payer: UHCCP Medicaid |
$264.67
|
| Rate for Payer: VA VA |
$237.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.42
|
|
|
HC TROFILE
|
Facility
|
OP
|
$2,050.20
|
|
|
Service Code
|
CPT 87999
|
| Hospital Charge Code |
30600179
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$486.92 |
| Max. Negotiated Rate |
$1,845.18 |
| Rate for Payer: Aetna Commercial |
$1,742.67
|
| Rate for Payer: Aetna Medicare |
$533.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$640.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$640.69
|
| Rate for Payer: BCBS Complete |
$820.08
|
| Rate for Payer: BCBS MAPPO |
$512.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.47
|
| Rate for Payer: BCN Commercial |
$1,594.03
|
| Rate for Payer: BCN Medicare Advantage |
$512.55
|
| Rate for Payer: Cash Price |
$1,640.16
|
| Rate for Payer: Cofinity Commercial |
$1,763.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.55
|
| Rate for Payer: Healthscope Commercial |
$1,845.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$538.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$589.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.67
|
| Rate for Payer: Nomi Health Commercial |
$1,681.16
|
| Rate for Payer: PACE Senior Care Partners |
$486.92
|
| Rate for Payer: PACE SWMI |
$512.55
|
| Rate for Payer: PHP Commercial |
$1,742.67
|
| Rate for Payer: PHP Medicare Advantage |
$512.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,783.67
|
| Rate for Payer: Priority Health Medicare |
$517.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.63
|
| Rate for Payer: Railroad Medicare Medicare |
$512.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.18
|
| Rate for Payer: UHC Core |
$1,711.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.55
|
| Rate for Payer: UHC Exchange |
$512.55
|
| Rate for Payer: UHC Medicare Advantage |
$512.55
|
| Rate for Payer: VA VA |
$512.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.65
|
|
|
HC TROFILE
|
Facility
|
IP
|
$2,050.20
|
|
|
Service Code
|
CPT 87999
|
| Hospital Charge Code |
30600179
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1,332.63 |
| Max. Negotiated Rate |
$1,845.18 |
| Rate for Payer: Aetna Commercial |
$1,742.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.58
|
| Rate for Payer: BCN Commercial |
$1,584.39
|
| Rate for Payer: Cash Price |
$1,640.16
|
| Rate for Payer: Cofinity Commercial |
$1,763.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.16
|
| Rate for Payer: Healthscope Commercial |
$1,845.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,742.67
|
| Rate for Payer: Nomi Health Commercial |
$1,681.16
|
| Rate for Payer: PHP Commercial |
$1,742.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,332.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,783.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.18
|
| Rate for Payer: UHC Core |
$1,711.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.65
|
|
|
HC TROPONIN QUANTITATIVE
|
Facility
|
IP
|
$107.51
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
30100449
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.88 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$91.38
|
| Rate for Payer: BCBS Trust/PPO |
$87.76
|
| Rate for Payer: BCN Commercial |
$83.08
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cofinity Commercial |
$92.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.01
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.38
|
| Rate for Payer: Nomi Health Commercial |
$88.16
|
| Rate for Payer: PHP Commercial |
$91.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.88
|
| Rate for Payer: Priority Health HMO/PPO |
$93.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.61
|
| Rate for Payer: UHC Core |
$89.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.63
|
|
|
HC TROPONIN QUANTITATIVE
|
Facility
|
OP
|
$107.51
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
30100449
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$96.76 |
| Rate for Payer: Aetna Commercial |
$91.38
|
| Rate for Payer: Aetna Medicare |
$27.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.60
|
| Rate for Payer: BCBS Complete |
$9.47
|
| Rate for Payer: BCBS MAPPO |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$88.38
|
| Rate for Payer: BCN Commercial |
$83.59
|
| Rate for Payer: BCN Medicare Advantage |
$26.88
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cash Price |
$86.01
|
| Rate for Payer: Cofinity Commercial |
$92.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.88
|
| Rate for Payer: Healthscope Commercial |
$96.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.63
|
| Rate for Payer: Mclaren Medicaid |
$9.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.22
|
| Rate for Payer: Meridian Medicaid |
$9.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.38
|
| Rate for Payer: Nomi Health Commercial |
$88.16
|
| Rate for Payer: PACE Senior Care Partners |
$25.53
|
| Rate for Payer: PACE SWMI |
$26.88
|
| Rate for Payer: PHP Commercial |
$91.38
|
| Rate for Payer: PHP Medicare Advantage |
$26.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.88
|
| Rate for Payer: Priority Health HMO/PPO |
$93.53
|
| Rate for Payer: Priority Health Medicare |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.03
|
| Rate for Payer: Railroad Medicare Medicare |
$26.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.61
|
| Rate for Payer: UHC Core |
$89.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.88
|
| Rate for Payer: UHC Exchange |
$26.88
|
| Rate for Payer: UHC Medicare Advantage |
$26.88
|
| Rate for Payer: UHCCP Medicaid |
$9.02
|
| Rate for Payer: VA VA |
$26.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.63
|
|
|
HC TROUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200064
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TROUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200064
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TRYPTASE, S
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.28 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: BCBS Trust/PPO |
$54.36
|
| Rate for Payer: BCN Commercial |
$51.46
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC TRYPTASE, S
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.81
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$51.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.65
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.48
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PACE Senior Care Partners |
$15.82
|
| Rate for Payer: PACE SWMI |
$16.65
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Medicare |
$16.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: Railroad Medicare Medicare |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.65
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$16.65
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| 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: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| 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
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$12.75
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$12.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$12.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.71
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$12.15
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.45 |
| Max. Negotiated Rate |
$361.69 |
| Rate for Payer: Aetna Commercial |
$341.60
|
| Rate for Payer: Aetna Medicare |
$104.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.59
|
| Rate for Payer: BCBS Complete |
$184.65
|
| Rate for Payer: BCBS MAPPO |
$100.47
|
| Rate for Payer: BCBS Trust/PPO |
$330.39
|
| Rate for Payer: BCN Commercial |
$312.46
|
| Rate for Payer: BCN Medicare Advantage |
$100.47
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$345.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.47
|
| Rate for Payer: Healthscope Commercial |
$361.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.41
|
| Rate for Payer: Mclaren Medicaid |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.49
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: Nomi Health Commercial |
$329.54
|
| Rate for Payer: PACE Senior Care Partners |
$95.45
|
| Rate for Payer: PACE SWMI |
$100.47
|
| Rate for Payer: PHP Commercial |
$341.60
|
| Rate for Payer: PHP Medicare Advantage |
$100.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health HMO/PPO |
$349.64
|
| Rate for Payer: Priority Health Medicare |
$101.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.26
|
| Rate for Payer: Railroad Medicare Medicare |
$100.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.65
|
| Rate for Payer: UHC Core |
$335.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.47
|
| Rate for Payer: UHC Exchange |
$100.47
|
| Rate for Payer: UHC Medicare Advantage |
$100.47
|
| Rate for Payer: UHCCP Medicaid |
$175.84
|
| Rate for Payer: VA VA |
$100.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.41
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$261.22 |
| Max. Negotiated Rate |
$361.69 |
| Rate for Payer: Aetna Commercial |
$341.60
|
| Rate for Payer: BCBS Trust/PPO |
$328.05
|
| Rate for Payer: BCN Commercial |
$310.57
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$345.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Healthscope Commercial |
$361.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: Nomi Health Commercial |
$329.54
|
| Rate for Payer: PHP Commercial |
$341.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health HMO/PPO |
$349.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.65
|
| Rate for Payer: UHC Core |
$335.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.41
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,348.43 |
| Max. Negotiated Rate |
$1,867.06 |
| Rate for Payer: Aetna Commercial |
$1,763.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.42
|
| Rate for Payer: BCN Commercial |
$1,603.18
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,784.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Healthscope Commercial |
$1,867.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: Nomi Health Commercial |
$1,701.10
|
| Rate for Payer: PHP Commercial |
$1,763.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,804.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,389.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.57
|
| Rate for Payer: UHC Core |
$1,732.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.88
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$492.70 |
| Max. Negotiated Rate |
$1,867.06 |
| Rate for Payer: Aetna Commercial |
$1,763.33
|
| Rate for Payer: Aetna Medicare |
$539.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.28
|
| Rate for Payer: BCBS Complete |
$1,555.23
|
| Rate for Payer: BCBS MAPPO |
$518.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.45
|
| Rate for Payer: BCN Commercial |
$1,612.93
|
| Rate for Payer: BCN Medicare Advantage |
$518.63
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,784.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.63
|
| Rate for Payer: Healthscope Commercial |
$1,867.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.88
|
| Rate for Payer: Mclaren Medicaid |
$1,481.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.56
|
| Rate for Payer: Meridian Medicaid |
$1,555.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: Nomi Health Commercial |
$1,701.10
|
| Rate for Payer: PACE Senior Care Partners |
$492.70
|
| Rate for Payer: PACE SWMI |
$518.63
|
| Rate for Payer: PHP Commercial |
$1,763.33
|
| Rate for Payer: PHP Medicare Advantage |
$518.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,481.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,804.82
|
| Rate for Payer: Priority Health Medicare |
$523.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,389.92
|
| Rate for Payer: Railroad Medicare Medicare |
$518.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.57
|
| Rate for Payer: UHC Core |
$1,732.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.63
|
| Rate for Payer: UHC Exchange |
$518.63
|
| Rate for Payer: UHC Medicare Advantage |
$518.63
|
| Rate for Payer: UHCCP Medicaid |
$1,481.07
|
| Rate for Payer: VA VA |
$518.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.88
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$219.07
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.40 |
| Max. Negotiated Rate |
$197.16 |
| Rate for Payer: Aetna Commercial |
$186.21
|
| Rate for Payer: BCBS Trust/PPO |
$178.83
|
| Rate for Payer: BCN Commercial |
$169.30
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cofinity Commercial |
$188.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.26
|
| Rate for Payer: Healthscope Commercial |
$197.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: Nomi Health Commercial |
$179.64
|
| Rate for Payer: PHP Commercial |
$186.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: Priority Health HMO/PPO |
$190.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.78
|
| Rate for Payer: UHC Core |
$182.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.30
|
|
