|
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
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.21 |
| Max. Negotiated Rate |
$432.78 |
| Rate for Payer: Aetna Commercial |
$408.74
|
| Rate for Payer: Aetna Medicare |
$125.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.27
|
| Rate for Payer: BCBS Complete |
$302.95
|
| Rate for Payer: BCBS MAPPO |
$120.22
|
| Rate for Payer: BCBS Trust/PPO |
$395.32
|
| Rate for Payer: BCN Commercial |
$373.88
|
| Rate for Payer: BCN Medicare Advantage |
$120.22
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$432.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.65
|
| Rate for Payer: Mclaren Medicaid |
$288.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.23
|
| Rate for Payer: Meridian Medicaid |
$302.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: Nomi Health Commercial |
$394.31
|
| Rate for Payer: PACE Senior Care Partners |
$114.21
|
| Rate for Payer: PACE SWMI |
$120.22
|
| Rate for Payer: PHP Commercial |
$408.74
|
| Rate for Payer: PHP Medicare Advantage |
$120.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health HMO/PPO |
$418.36
|
| Rate for Payer: Priority Health Medicare |
$121.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.18
|
| Rate for Payer: Railroad Medicare Medicare |
$120.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.17
|
| Rate for Payer: UHC Core |
$401.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.22
|
| Rate for Payer: UHC Exchange |
$120.22
|
| Rate for Payer: UHC Medicare Advantage |
$120.22
|
| Rate for Payer: UHCCP Medicaid |
$288.51
|
| Rate for Payer: VA VA |
$120.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.65
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.57 |
| Max. Negotiated Rate |
$432.78 |
| Rate for Payer: Aetna Commercial |
$408.74
|
| Rate for Payer: BCBS Trust/PPO |
$392.53
|
| Rate for Payer: BCN Commercial |
$371.62
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Healthscope Commercial |
$432.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: Nomi Health Commercial |
$394.31
|
| Rate for Payer: PHP Commercial |
$408.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health HMO/PPO |
$418.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.17
|
| Rate for Payer: UHC Core |
$401.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.65
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$201.10 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: BCBS Trust/PPO |
$252.55
|
| Rate for Payer: BCN Commercial |
$239.09
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO |
$269.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.25
|
| Rate for Payer: UHC Core |
$258.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.48 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna Medicare |
$80.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.68
|
| Rate for Payer: BCBS Complete |
$123.75
|
| Rate for Payer: BCBS MAPPO |
$77.34
|
| Rate for Payer: BCBS Trust/PPO |
$254.34
|
| Rate for Payer: BCN Commercial |
$240.54
|
| Rate for Payer: BCN Medicare Advantage |
$77.34
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.34
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: Nomi Health Commercial |
$253.69
|
| Rate for Payer: PACE Senior Care Partners |
$73.48
|
| Rate for Payer: PACE SWMI |
$77.34
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: PHP Medicare Advantage |
$77.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health HMO/PPO |
$269.16
|
| Rate for Payer: Priority Health Medicare |
$78.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.28
|
| Rate for Payer: Railroad Medicare Medicare |
$77.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.25
|
| Rate for Payer: UHC Core |
$258.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.34
|
| Rate for Payer: UHC Exchange |
$77.34
|
| Rate for Payer: UHC Medicare Advantage |
$77.34
|
| Rate for Payer: VA VA |
$77.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$14.99
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$15.06
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Medicare |
$4.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.74
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$4.59
|
| Rate for Payer: BCBS Trust/PPO |
$15.09
|
| Rate for Payer: BCN Commercial |
$14.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.59
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.59
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: Nomi Health Commercial |
$15.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.36
|
| Rate for Payer: PACE SWMI |
$4.59
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: PHP Medicare Advantage |
$4.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$4.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.30
|
| Rate for Payer: Railroad Medicare Medicare |
$4.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.59
|
| Rate for Payer: UHC Exchange |
$4.59
|
| Rate for Payer: UHC Medicare Advantage |
$4.59
|
| Rate for Payer: VA VA |
$4.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| 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 |
$9.79
|
| 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: 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.43
|
| 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 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: VA VA |
$6.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| 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 TUBING 3/8
|
Facility
|
IP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$26.16 |
| Rate for Payer: Aetna Commercial |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$23.73
|
| Rate for Payer: BCN Commercial |
$22.47
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$25.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: Nomi Health Commercial |
$23.84
|
| Rate for Payer: PHP Commercial |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO |
$25.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.58
|
| Rate for Payer: UHC Core |
$24.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.80
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$26.16 |
| Rate for Payer: Aetna Commercial |
$24.71
|
| Rate for Payer: Aetna Medicare |
$7.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.08
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$7.27
|
| Rate for Payer: BCBS Trust/PPO |
$23.90
|
| Rate for Payer: BCN Commercial |
$22.60
|
| Rate for Payer: BCN Medicare Advantage |
$7.27
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$25.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.27
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: Nomi Health Commercial |
$23.84
|
| Rate for Payer: PACE Senior Care Partners |
$6.90
|
| Rate for Payer: PACE SWMI |
$7.27
|
| Rate for Payer: PHP Commercial |
$24.71
|
| Rate for Payer: PHP Medicare Advantage |
$7.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO |
$25.29
|
| Rate for Payer: Priority Health Medicare |
$7.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.48
|
| Rate for Payer: Railroad Medicare Medicare |
$7.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.58
|
| Rate for Payer: UHC Core |
$24.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.27
|
| Rate for Payer: UHC Exchange |
$7.27
|
| Rate for Payer: UHC Medicare Advantage |
$7.27
|
| Rate for Payer: VA VA |
$7.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.80
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$189.26 |
| Rate for Payer: Aetna Commercial |
$178.75
|
| Rate for Payer: Aetna Medicare |
$54.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.72
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$52.57
|
| Rate for Payer: BCBS Trust/PPO |
$172.88
|
| Rate for Payer: BCN Commercial |
$163.50
|
| Rate for Payer: BCN Medicare Advantage |
$52.57
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$180.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.57
|
| Rate for Payer: Healthscope Commercial |
$189.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.72
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.20
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$172.44
|
| Rate for Payer: PACE Senior Care Partners |
$49.94
|
| Rate for Payer: PACE SWMI |
$52.57
|
| Rate for Payer: PHP Commercial |
$178.75
|
| Rate for Payer: PHP Medicare Advantage |
$52.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health HMO/PPO |
$182.95
|
| Rate for Payer: Priority Health Medicare |
$53.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.89
|
| Rate for Payer: Railroad Medicare Medicare |
$52.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.06
|
| Rate for Payer: UHC Core |
$175.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.57
|
| Rate for Payer: UHC Exchange |
$52.57
|
| Rate for Payer: UHC Medicare Advantage |
$52.57
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$52.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.72
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$136.69 |
| Max. Negotiated Rate |
$189.26 |
| Rate for Payer: Aetna Commercial |
$178.75
|
| Rate for Payer: BCBS Trust/PPO |
$171.66
|
| Rate for Payer: BCN Commercial |
$162.51
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$180.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Healthscope Commercial |
$189.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$172.44
|
| Rate for Payer: PHP Commercial |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health HMO/PPO |
$182.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.06
|
| Rate for Payer: UHC Core |
$175.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.72
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
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 TUNA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
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 TVT DEVICE KIT
|
Facility
|
OP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$989.95 |
| Max. Negotiated Rate |
$3,751.38 |
| Rate for Payer: Aetna Commercial |
$3,542.97
|
| Rate for Payer: Aetna Medicare |
$1,083.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,302.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,302.56
|
| Rate for Payer: BCBS Complete |
$1,667.28
|
| Rate for Payer: BCBS MAPPO |
$1,042.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,426.68
|
| Rate for Payer: BCN Commercial |
$3,240.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,042.05
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$3,584.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,042.05
|
| Rate for Payer: Healthscope Commercial |
$3,751.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,126.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,094.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,198.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: Nomi Health Commercial |
$3,417.92
|
| Rate for Payer: PACE Senior Care Partners |
$989.95
|
| Rate for Payer: PACE SWMI |
$1,042.05
|
| Rate for Payer: PHP Commercial |
$3,542.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,042.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: Priority Health HMO/PPO |
$3,626.33
|
| Rate for Payer: Priority Health Medicare |
$1,052.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,792.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1,042.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,668.02
|
| Rate for Payer: UHC Core |
$3,480.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,042.05
|
| Rate for Payer: UHC Exchange |
$1,042.05
|
| Rate for Payer: UHC Medicare Advantage |
$1,042.05
|
| Rate for Payer: VA VA |
$1,042.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,126.15
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,709.33 |
| Max. Negotiated Rate |
$3,751.38 |
| Rate for Payer: Aetna Commercial |
$3,542.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,402.50
|
| Rate for Payer: BCN Commercial |
$3,221.18
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$3,584.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Healthscope Commercial |
$3,751.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,126.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: Nomi Health Commercial |
$3,417.92
|
| Rate for Payer: PHP Commercial |
$3,542.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: Priority Health HMO/PPO |
$3,626.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,792.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,668.02
|
| Rate for Payer: UHC Core |
$3,480.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,126.15
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$872.10 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: Aetna Medicare |
$954.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.50
|
| Rate for Payer: BCBS Complete |
$1,468.80
|
| Rate for Payer: BCBS MAPPO |
$918.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,018.75
|
| Rate for Payer: BCN Commercial |
$2,854.98
|
| Rate for Payer: BCN Medicare Advantage |
$918.00
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.00
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: Nomi Health Commercial |
$3,011.04
|
| Rate for Payer: PACE Senior Care Partners |
$872.10
|
| Rate for Payer: PACE SWMI |
$918.00
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: PHP Medicare Advantage |
$918.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: Priority Health HMO/PPO |
$3,194.64
|
| Rate for Payer: Priority Health Medicare |
$927.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,460.24
|
| Rate for Payer: Railroad Medicare Medicare |
$918.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,231.36
|
| Rate for Payer: UHC Core |
$3,066.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.00
|
| Rate for Payer: UHC Exchange |
$918.00
|
| Rate for Payer: UHC Medicare Advantage |
$918.00
|
| Rate for Payer: VA VA |
$918.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,386.80 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,997.45
|
| Rate for Payer: BCN Commercial |
$2,837.72
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: Nomi Health Commercial |
$3,011.04
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: Priority Health HMO/PPO |
$3,194.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,460.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,231.36
|
| Rate for Payer: UHC Core |
$3,066.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,485.94
|
| Rate for Payer: BCN Commercial |
$6,140.31
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,887.06 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$2,065.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,482.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,482.98
|
| Rate for Payer: BCBS Complete |
$2,413.90
|
| Rate for Payer: BCBS MAPPO |
$1,986.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,532.02
|
| Rate for Payer: BCN Commercial |
$6,177.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.38
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.38
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$2,298.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.70
|
| Rate for Payer: Meridian Medicaid |
$2,413.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,887.06
|
| Rate for Payer: PACE SWMI |
$1,986.38
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Medicare |
$2,006.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,986.38
|
| Rate for Payer: UHC Exchange |
$1,986.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,986.38
|
| Rate for Payer: UHCCP Medicaid |
$2,298.80
|
| Rate for Payer: VA VA |
$1,986.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,485.94
|
| Rate for Payer: BCN Commercial |
$6,140.31
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,887.06 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$2,065.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,482.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,482.98
|
| Rate for Payer: BCBS Complete |
$2,413.90
|
| Rate for Payer: BCBS MAPPO |
$1,986.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,532.02
|
| Rate for Payer: BCN Commercial |
$6,177.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.38
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.38
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$2,298.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.70
|
| Rate for Payer: Meridian Medicaid |
$2,413.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,887.06
|
| Rate for Payer: PACE SWMI |
$1,986.38
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Medicare |
$2,006.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,986.38
|
| Rate for Payer: UHC Exchange |
$1,986.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,986.38
|
| Rate for Payer: UHCCP Medicaid |
$2,298.80
|
| Rate for Payer: VA VA |
$1,986.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$775.65
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.22 |
| Max. Negotiated Rate |
$698.09 |
| Rate for Payer: Aetna Commercial |
$659.30
|
| Rate for Payer: Aetna Medicare |
$201.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.39
|
| Rate for Payer: BCBS Complete |
$464.73
|
| Rate for Payer: BCBS MAPPO |
$193.91
|
| Rate for Payer: BCBS Trust/PPO |
$637.66
|
| Rate for Payer: BCN Commercial |
$603.07
|
| Rate for Payer: BCN Medicare Advantage |
$193.91
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cofinity Commercial |
$667.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.91
|
| Rate for Payer: Healthscope Commercial |
$698.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.74
|
| Rate for Payer: Mclaren Medicaid |
$442.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.61
|
| Rate for Payer: Meridian Medicaid |
$464.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.30
|
| Rate for Payer: Nomi Health Commercial |
$636.03
|
| Rate for Payer: PACE Senior Care Partners |
$184.22
|
| Rate for Payer: PACE SWMI |
$193.91
|
| Rate for Payer: PHP Commercial |
$659.30
|
| Rate for Payer: PHP Medicare Advantage |
$193.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$442.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.17
|
| Rate for Payer: Priority Health HMO/PPO |
$674.82
|
| Rate for Payer: Priority Health Medicare |
$195.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.69
|
| Rate for Payer: Railroad Medicare Medicare |
$193.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.57
|
| Rate for Payer: UHC Core |
$647.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.91
|
| Rate for Payer: UHC Exchange |
$193.91
|
| Rate for Payer: UHC Medicare Advantage |
$193.91
|
| Rate for Payer: UHCCP Medicaid |
$442.57
|
| Rate for Payer: VA VA |
$193.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.74
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$775.65
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$504.17 |
| Max. Negotiated Rate |
$698.09 |
| Rate for Payer: Aetna Commercial |
$659.30
|
| Rate for Payer: BCBS Trust/PPO |
$633.16
|
| Rate for Payer: BCN Commercial |
$599.42
|
| Rate for Payer: Cash Price |
$620.52
|
| Rate for Payer: Cofinity Commercial |
$667.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.52
|
| Rate for Payer: Healthscope Commercial |
$698.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.30
|
| Rate for Payer: Nomi Health Commercial |
$636.03
|
| Rate for Payer: PHP Commercial |
$659.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.17
|
| Rate for Payer: Priority Health HMO/PPO |
$674.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.57
|
| Rate for Payer: UHC Core |
$647.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.74
|
|
