|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$18.67
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$37.27
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$18.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.81 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.23
|
| Rate for Payer: BCN Commercial |
$16.23
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.48
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: Aetna Medicare |
$5.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.56
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$5.25
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$16.33
|
| Rate for Payer: BCN Medicare Advantage |
$5.25
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.25
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PACE Senior Care Partners |
$4.99
|
| Rate for Payer: PACE SWMI |
$5.25
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.27
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.81
|
| Rate for Payer: Railroad Medicare Medicare |
$5.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.48
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.25
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: VA VA |
$5.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC ABBY RETRACTOR
|
Facility
|
IP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$158.54 |
| Max. Negotiated Rate |
$233.96 |
| Rate for Payer: Aetna Commercial |
$220.96
|
| Rate for Payer: BCBS Trust/PPO |
$200.89
|
| Rate for Payer: BCN Commercial |
$200.89
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$223.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Healthscope Commercial |
$233.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: PHP Commercial |
$220.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.76
|
| Rate for Payer: UHC Core |
$217.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.96
|
|
|
HC ABBY RETRACTOR
|
Facility
|
OP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$61.74 |
| Max. Negotiated Rate |
$233.96 |
| Rate for Payer: Aetna Commercial |
$220.96
|
| Rate for Payer: Aetna Medicare |
$67.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.23
|
| Rate for Payer: BCBS Complete |
$103.98
|
| Rate for Payer: BCBS MAPPO |
$64.99
|
| Rate for Payer: BCBS Trust/PPO |
$202.11
|
| Rate for Payer: BCN Commercial |
$202.11
|
| Rate for Payer: BCN Medicare Advantage |
$64.99
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$223.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.99
|
| Rate for Payer: Healthscope Commercial |
$233.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: PACE Senior Care Partners |
$61.74
|
| Rate for Payer: PACE SWMI |
$64.99
|
| Rate for Payer: PHP Commercial |
$220.96
|
| Rate for Payer: PHP Medicare Advantage |
$64.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.16
|
| Rate for Payer: Priority Health Medicare |
$64.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.54
|
| Rate for Payer: Railroad Medicare Medicare |
$64.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.76
|
| Rate for Payer: UHC Core |
$217.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.99
|
| Rate for Payer: UHC Medicare Advantage |
$66.94
|
| Rate for Payer: VA VA |
$64.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.96
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,533.94 |
| Max. Negotiated Rate |
$2,263.56 |
| Rate for Payer: Aetna Commercial |
$2,137.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.65
|
| Rate for Payer: BCN Commercial |
$1,943.65
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$2,162.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Healthscope Commercial |
$2,263.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,886.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: PHP Commercial |
$2,137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,188.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,213.26
|
| Rate for Payer: UHC Core |
$2,100.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,886.30
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$597.33 |
| Max. Negotiated Rate |
$2,263.56 |
| Rate for Payer: Aetna Commercial |
$2,137.81
|
| Rate for Payer: Aetna Medicare |
$653.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$785.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$785.96
|
| Rate for Payer: BCBS Complete |
$1,006.03
|
| Rate for Payer: BCBS MAPPO |
$628.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.47
|
| Rate for Payer: BCN Commercial |
$1,955.47
|
| Rate for Payer: BCN Medicare Advantage |
$628.77
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$2,162.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.77
|
| Rate for Payer: Healthscope Commercial |
$2,263.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,886.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$660.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$723.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: PACE Senior Care Partners |
$597.33
|
| Rate for Payer: PACE SWMI |
$628.77
|
| Rate for Payer: PHP Commercial |
$2,137.81
|
| Rate for Payer: PHP Medicare Advantage |
$628.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,188.11
|
| Rate for Payer: Priority Health Medicare |
$628.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.94
|
| Rate for Payer: Railroad Medicare Medicare |
$628.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,213.26
|
| Rate for Payer: UHC Core |
$2,100.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.77
|
| Rate for Payer: UHC Medicare Advantage |
$647.63
|
| Rate for Payer: VA VA |
$628.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,886.30
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$367.18 |
| Max. Negotiated Rate |
$1,391.42 |
| Rate for Payer: Aetna Commercial |
$1,314.12
|
| Rate for Payer: Aetna Medicare |
$401.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$483.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$483.13
|
| Rate for Payer: BCBS Complete |
$618.41
|
| Rate for Payer: BCBS MAPPO |
$386.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.03
|
| Rate for Payer: BCN Commercial |
$1,202.03
|
| Rate for Payer: BCN Medicare Advantage |
$386.50
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,329.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$386.50
|
| Rate for Payer: Healthscope Commercial |
$1,391.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$405.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$444.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: PACE Senior Care Partners |
$367.18
|
| Rate for Payer: PACE SWMI |
$386.50
|
| Rate for Payer: PHP Commercial |
$1,314.12
|
| Rate for Payer: PHP Medicare Advantage |
$386.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,345.04
|
| Rate for Payer: Priority Health Medicare |
$386.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.92
|
| Rate for Payer: Railroad Medicare Medicare |
$386.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.50
|
| Rate for Payer: UHC Core |
$1,290.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$386.50
|
| Rate for Payer: UHC Medicare Advantage |
$398.10
|
| Rate for Payer: VA VA |
$386.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.52
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$942.92 |
| Max. Negotiated Rate |
$1,391.42 |
| Rate for Payer: Aetna Commercial |
$1,314.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.76
|
| Rate for Payer: BCN Commercial |
$1,194.76
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,329.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Healthscope Commercial |
$1,391.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: PHP Commercial |
$1,314.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,345.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$942.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,360.50
|
| Rate for Payer: UHC Core |
$1,290.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.52
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,406.28 |
| Max. Negotiated Rate |
$3,550.82 |
| Rate for Payer: Aetna Commercial |
$3,353.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,048.97
|
| Rate for Payer: BCN Commercial |
$3,048.97
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$3,393.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Healthscope Commercial |
$3,550.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,959.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: PHP Commercial |
$3,353.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,432.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,406.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,471.92
|
| Rate for Payer: UHC Core |
$3,294.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,959.02
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$937.02 |
| Max. Negotiated Rate |
$3,550.82 |
| Rate for Payer: Aetna Commercial |
$3,353.56
|
| Rate for Payer: Aetna Medicare |
$1,025.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,232.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,232.92
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$986.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,067.52
|
| Rate for Payer: BCN Commercial |
$3,067.52
|
| Rate for Payer: BCN Medicare Advantage |
$986.34
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$3,393.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$986.34
|
| Rate for Payer: Healthscope Commercial |
$3,550.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,959.02
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,035.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,134.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: PACE Senior Care Partners |
$937.02
|
| Rate for Payer: PACE SWMI |
$986.34
|
| Rate for Payer: PHP Commercial |
$3,353.56
|
| Rate for Payer: PHP Medicare Advantage |
$986.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,432.46
|
| Rate for Payer: Priority Health Medicare |
$986.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,406.28
|
| Rate for Payer: Railroad Medicare Medicare |
$986.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,471.92
|
| Rate for Payer: UHC Core |
$3,294.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$986.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.93
|
| Rate for Payer: VA VA |
$986.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,959.02
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,604.39 |
| Max. Negotiated Rate |
$2,367.52 |
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.91
|
| Rate for Payer: BCN Commercial |
$2,032.91
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.91
|
| Rate for Payer: UHC Core |
$2,196.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.76 |
| Max. Negotiated Rate |
$2,367.52 |
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: Aetna Medicare |
$683.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.06
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$657.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.28
|
| Rate for Payer: BCN Commercial |
$2,045.28
|
| Rate for Payer: BCN Medicare Advantage |
$657.64
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.64
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$690.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PACE Senior Care Partners |
$624.76
|
| Rate for Payer: PACE SWMI |
$657.64
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: PHP Medicare Advantage |
$657.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.60
|
| Rate for Payer: Priority Health Medicare |
$657.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.39
|
| Rate for Payer: Railroad Medicare Medicare |
$657.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.91
|
| Rate for Payer: UHC Core |
$2,196.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.64
|
| Rate for Payer: UHC Medicare Advantage |
$677.37
|
| Rate for Payer: VA VA |
$657.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$323.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.26
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.61
|
| Rate for Payer: BCBS Trust/PPO |
$966.00
|
| Rate for Payer: BCN Commercial |
$966.00
|
| Rate for Payer: BCN Medicare Advantage |
$310.61
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.61
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Senior Care Partners |
$295.08
|
| Rate for Payer: PACE SWMI |
$310.61
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$310.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Medicare |
$310.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: Railroad Medicare Medicare |
$310.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.93
|
| Rate for Payer: VA VA |
$310.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.76 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: BCBS Trust/PPO |
$960.16
|
| Rate for Payer: BCN Commercial |
$960.16
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$323.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.26
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.61
|
| Rate for Payer: BCBS Trust/PPO |
$966.00
|
| Rate for Payer: BCN Commercial |
$966.00
|
| Rate for Payer: BCN Medicare Advantage |
$310.61
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.61
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Senior Care Partners |
$295.08
|
| Rate for Payer: PACE SWMI |
$310.61
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$310.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Medicare |
$310.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: Railroad Medicare Medicare |
$310.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.93
|
| Rate for Payer: VA VA |
$310.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.76 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: BCBS Trust/PPO |
$960.16
|
| Rate for Payer: BCN Commercial |
$960.16
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$323.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.26
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.61
|
| Rate for Payer: BCBS Trust/PPO |
$966.00
|
| Rate for Payer: BCN Commercial |
$966.00
|
| Rate for Payer: BCN Medicare Advantage |
$310.61
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.61
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Senior Care Partners |
$295.08
|
| Rate for Payer: PACE SWMI |
$310.61
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$310.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Medicare |
$310.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: Railroad Medicare Medicare |
$310.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.93
|
| Rate for Payer: VA VA |
$310.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.76 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: BCBS Trust/PPO |
$960.16
|
| Rate for Payer: BCN Commercial |
$960.16
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.76 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: BCBS Trust/PPO |
$960.16
|
| Rate for Payer: BCN Commercial |
$960.16
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.08 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$323.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.26
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$310.61
|
| Rate for Payer: BCBS Trust/PPO |
$966.00
|
| Rate for Payer: BCN Commercial |
$966.00
|
| Rate for Payer: BCN Medicare Advantage |
$310.61
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.61
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$326.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Senior Care Partners |
$295.08
|
| Rate for Payer: PACE SWMI |
$310.61
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$310.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,080.92
|
| Rate for Payer: Priority Health Medicare |
$310.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$757.76
|
| Rate for Payer: Railroad Medicare Medicare |
$310.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,093.35
|
| Rate for Payer: UHC Core |
$1,037.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.61
|
| Rate for Payer: UHC Medicare Advantage |
$319.93
|
| Rate for Payer: VA VA |
$310.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,992.84 |
| Max. Negotiated Rate |
$7,551.80 |
| Rate for Payer: Aetna Commercial |
$7,132.26
|
| Rate for Payer: Aetna Medicare |
$2,181.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,622.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,622.15
|
| Rate for Payer: BCBS Complete |
$5,144.02
|
| Rate for Payer: BCBS MAPPO |
$2,097.72
|
| Rate for Payer: BCBS Trust/PPO |
$6,523.92
|
| Rate for Payer: BCN Commercial |
$6,523.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,097.72
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$7,216.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,097.72
|
| Rate for Payer: Healthscope Commercial |
$7,551.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,293.17
|
| Rate for Payer: Mclaren Medicaid |
$4,899.07
|
| Rate for Payer: Meridian Medicaid |
$5,144.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,202.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,412.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: PACE Senior Care Partners |
$1,992.84
|
| Rate for Payer: PACE SWMI |
$2,097.72
|
| Rate for Payer: PHP Commercial |
$7,132.26
|
| Rate for Payer: PHP Medicare Advantage |
$2,097.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,300.07
|
| Rate for Payer: Priority Health Medicare |
$2,097.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,117.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,097.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,383.98
|
| Rate for Payer: UHC Core |
$7,006.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,097.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,160.65
|
| Rate for Payer: VA VA |
$2,097.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,293.17
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,117.60 |
| Max. Negotiated Rate |
$7,551.80 |
| Rate for Payer: Aetna Commercial |
$7,132.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,484.48
|
| Rate for Payer: BCN Commercial |
$6,484.48
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$7,216.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Healthscope Commercial |
$7,551.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: PHP Commercial |
$7,132.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,300.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,117.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,383.98
|
| Rate for Payer: UHC Core |
$7,006.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,293.17
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,051.61 |
| Max. Negotiated Rate |
$5,978.76 |
| Rate for Payer: Aetna Commercial |
$5,646.61
|
| Rate for Payer: BCBS Trust/PPO |
$5,133.76
|
| Rate for Payer: BCN Commercial |
$5,133.76
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$5,713.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Healthscope Commercial |
$5,978.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,982.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: PHP Commercial |
$5,646.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,779.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,051.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,845.90
|
| Rate for Payer: UHC Core |
$5,546.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,982.30
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,577.73 |
| Max. Negotiated Rate |
$9,065.28 |
| Rate for Payer: Aetna Commercial |
$5,646.61
|
| Rate for Payer: Aetna Medicare |
$1,727.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,075.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,075.96
|
| Rate for Payer: BCBS Complete |
$9,065.28
|
| Rate for Payer: BCBS MAPPO |
$1,660.77
|
| Rate for Payer: BCBS Trust/PPO |
$5,164.99
|
| Rate for Payer: BCN Commercial |
$5,164.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,660.77
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$5,713.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,660.77
|
| Rate for Payer: Healthscope Commercial |
$5,978.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,982.30
|
| Rate for Payer: Mclaren Medicaid |
$8,633.60
|
| Rate for Payer: Meridian Medicaid |
$9,065.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,743.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,909.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.73
|
| Rate for Payer: PACE SWMI |
$1,660.77
|
| Rate for Payer: PHP Commercial |
$5,646.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,660.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,633.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,779.47
|
| Rate for Payer: Priority Health Medicare |
$1,660.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,051.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,660.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,845.90
|
| Rate for Payer: UHC Core |
$5,546.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,660.77
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.59
|
| Rate for Payer: VA VA |
$1,660.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,982.30
|
|
