|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.36 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna Medicare |
$278.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.69
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$267.75
|
| Rate for Payer: BCBS Trust/PPO |
$832.70
|
| Rate for Payer: BCN Commercial |
$832.70
|
| Rate for Payer: BCN Medicare Advantage |
$267.75
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.75
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$281.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PACE Senior Care Partners |
$254.36
|
| Rate for Payer: PACE SWMI |
$267.75
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: PHP Medicare Advantage |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Medicare |
$267.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: Railroad Medicare Medicare |
$267.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.75
|
| Rate for Payer: UHC Medicare Advantage |
$275.78
|
| Rate for Payer: VA VA |
$267.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$653.20 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: BCBS Trust/PPO |
$827.67
|
| Rate for Payer: BCN Commercial |
$827.67
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,604.41 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.94
|
| Rate for Payer: BCN Commercial |
$2,032.94
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.77 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna Medicare |
$683.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.07
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$657.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.30
|
| Rate for Payer: BCN Commercial |
$2,045.30
|
| Rate for Payer: BCN Medicare Advantage |
$657.65
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.65
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$690.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PACE Senior Care Partners |
$624.77
|
| Rate for Payer: PACE SWMI |
$657.65
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: PHP Medicare Advantage |
$657.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Medicare |
$657.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: Railroad Medicare Medicare |
$657.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.65
|
| Rate for Payer: UHC Medicare Advantage |
$677.38
|
| Rate for Payer: VA VA |
$657.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.36 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna Medicare |
$278.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.69
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$267.75
|
| Rate for Payer: BCBS Trust/PPO |
$832.70
|
| Rate for Payer: BCN Commercial |
$832.70
|
| Rate for Payer: BCN Medicare Advantage |
$267.75
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.75
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$281.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PACE Senior Care Partners |
$254.36
|
| Rate for Payer: PACE SWMI |
$267.75
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: PHP Medicare Advantage |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Medicare |
$267.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: Railroad Medicare Medicare |
$267.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.75
|
| Rate for Payer: UHC Medicare Advantage |
$275.78
|
| Rate for Payer: VA VA |
$267.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$653.20 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: BCBS Trust/PPO |
$827.67
|
| Rate for Payer: BCN Commercial |
$827.67
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,604.41 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.94
|
| Rate for Payer: BCN Commercial |
$2,032.94
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.77 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna Medicare |
$683.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.07
|
| Rate for Payer: BCBS Complete |
$1,329.91
|
| Rate for Payer: BCBS MAPPO |
$657.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,045.30
|
| Rate for Payer: BCN Commercial |
$2,045.30
|
| Rate for Payer: BCN Medicare Advantage |
$657.65
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.65
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Mclaren Medicaid |
$1,266.58
|
| Rate for Payer: Meridian Medicaid |
$1,329.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$690.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PACE Senior Care Partners |
$624.77
|
| Rate for Payer: PACE SWMI |
$657.65
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: PHP Medicare Advantage |
$657.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,266.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,288.63
|
| Rate for Payer: Priority Health Medicare |
$657.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,604.41
|
| Rate for Payer: Railroad Medicare Medicare |
$657.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,314.94
|
| Rate for Payer: UHC Core |
$2,196.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.65
|
| Rate for Payer: UHC Medicare Advantage |
$677.38
|
| Rate for Payer: VA VA |
$657.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,012.11 |
| Max. Negotiated Rate |
$3,835.38 |
| Rate for Payer: Aetna Commercial |
$3,622.30
|
| Rate for Payer: Aetna Medicare |
$1,108.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,331.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,331.73
|
| Rate for Payer: BCBS Complete |
$1,704.61
|
| Rate for Payer: BCBS MAPPO |
$1,065.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,313.34
|
| Rate for Payer: BCN Commercial |
$3,313.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,065.38
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$3,664.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,065.38
|
| Rate for Payer: Healthscope Commercial |
$3,835.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,196.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,118.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,225.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: PACE Senior Care Partners |
$1,012.11
|
| Rate for Payer: PACE SWMI |
$1,065.38
|
| Rate for Payer: PHP Commercial |
$3,622.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,065.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,707.53
|
| Rate for Payer: Priority Health Medicare |
$1,065.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,599.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,065.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,750.15
|
| Rate for Payer: UHC Core |
$3,558.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,065.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,097.34
|
| Rate for Payer: VA VA |
$1,065.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,196.15
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,599.11 |
| Max. Negotiated Rate |
$3,835.38 |
| Rate for Payer: Aetna Commercial |
$3,622.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,293.31
|
| Rate for Payer: BCN Commercial |
$3,293.31
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$3,664.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Healthscope Commercial |
$3,835.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,196.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: PHP Commercial |
$3,622.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,707.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,599.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,750.15
|
| Rate for Payer: UHC Core |
$3,558.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,196.15
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,796.29
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,535.16 |
| Max. Negotiated Rate |
$5,216.66 |
| Rate for Payer: Aetna Commercial |
$4,926.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,479.37
|
| Rate for Payer: BCN Commercial |
$4,479.37
|
| Rate for Payer: Cash Price |
$4,637.03
|
| Rate for Payer: Cofinity Commercial |
$4,984.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
| Rate for Payer: Healthscope Commercial |
$5,216.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,347.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
| Rate for Payer: PHP Commercial |
$4,926.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,042.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,535.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,100.74
|
| Rate for Payer: UHC Core |
$4,839.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,347.22
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
OP
|
$5,796.29
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,376.62 |
| Max. Negotiated Rate |
$5,216.66 |
| Rate for Payer: Aetna Commercial |
$4,926.85
|
| Rate for Payer: Aetna Medicare |
$1,507.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,811.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,811.34
|
| Rate for Payer: BCBS Complete |
$2,318.52
|
| Rate for Payer: BCBS MAPPO |
$1,449.07
|
| Rate for Payer: BCBS Trust/PPO |
$4,506.62
|
| Rate for Payer: BCN Commercial |
$4,506.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,449.07
|
| Rate for Payer: Cash Price |
$4,637.03
|
| Rate for Payer: Cofinity Commercial |
$4,984.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,449.07
|
| Rate for Payer: Healthscope Commercial |
$5,216.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,347.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,521.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,666.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,376.62
|
| Rate for Payer: PACE SWMI |
$1,449.07
|
| Rate for Payer: PHP Commercial |
$4,926.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,449.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,042.77
|
| Rate for Payer: Priority Health Medicare |
$1,449.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,535.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,449.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,100.74
|
| Rate for Payer: UHC Core |
$4,839.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,449.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,492.54
|
| Rate for Payer: VA VA |
$1,449.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,347.22
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,080.84
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,681.70 |
| Max. Negotiated Rate |
$6,372.76 |
| Rate for Payer: Aetna Commercial |
$6,018.71
|
| Rate for Payer: Aetna Medicare |
$1,841.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,212.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,212.76
|
| Rate for Payer: BCBS Complete |
$2,832.34
|
| Rate for Payer: BCBS MAPPO |
$1,770.21
|
| Rate for Payer: BCBS Trust/PPO |
$5,505.35
|
| Rate for Payer: BCN Commercial |
$5,505.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,770.21
|
| Rate for Payer: Cash Price |
$5,664.67
|
| Rate for Payer: Cofinity Commercial |
$6,089.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,770.21
|
| Rate for Payer: Healthscope Commercial |
$6,372.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,858.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,035.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
| Rate for Payer: PACE Senior Care Partners |
$1,681.70
|
| Rate for Payer: PACE SWMI |
$1,770.21
|
| Rate for Payer: PHP Commercial |
$6,018.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,770.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,160.33
|
| Rate for Payer: Priority Health Medicare |
$1,770.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,318.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,770.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,231.14
|
| Rate for Payer: UHC Core |
$5,912.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,770.21
|
| Rate for Payer: UHC Medicare Advantage |
$1,823.32
|
| Rate for Payer: VA VA |
$1,770.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.63
|
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,080.84
|
|
|
Service Code
|
HCPCS C1886
|
| Hospital Charge Code |
27000645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,318.60 |
| Max. Negotiated Rate |
$6,372.76 |
| Rate for Payer: Aetna Commercial |
$6,018.71
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.07
|
| Rate for Payer: BCN Commercial |
$5,472.07
|
| Rate for Payer: Cash Price |
$5,664.67
|
| Rate for Payer: Cofinity Commercial |
$6,089.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
| Rate for Payer: Healthscope Commercial |
$6,372.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
| Rate for Payer: PHP Commercial |
$6,018.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,160.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,318.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,231.14
|
| Rate for Payer: UHC Core |
$5,912.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.63
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
OP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$302.81 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: Aetna Medicare |
$331.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.44
|
| Rate for Payer: BCBS Complete |
$510.00
|
| Rate for Payer: BCBS MAPPO |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$991.31
|
| Rate for Payer: BCN Commercial |
$991.31
|
| Rate for Payer: BCN Medicare Advantage |
$318.75
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
| Rate for Payer: PACE Senior Care Partners |
$302.81
|
| Rate for Payer: PACE SWMI |
$318.75
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: PHP Medicare Advantage |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.25
|
| Rate for Payer: Priority Health Medicare |
$318.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.62
|
| Rate for Payer: Railroad Medicare Medicare |
$318.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.75
|
| Rate for Payer: UHC Medicare Advantage |
$328.31
|
| Rate for Payer: VA VA |
$318.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
IP
|
$1,275.00
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$777.62 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Aetna Commercial |
$1,083.75
|
| Rate for Payer: BCBS Trust/PPO |
$985.32
|
| Rate for Payer: BCN Commercial |
$985.32
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cofinity Commercial |
$1,096.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$1,147.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
| Rate for Payer: PHP Commercial |
$1,083.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$777.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.00
|
| Rate for Payer: UHC Core |
$1,064.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$5,899.37
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,598.03 |
| Max. Negotiated Rate |
$5,309.43 |
| Rate for Payer: Aetna Commercial |
$5,014.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,559.03
|
| Rate for Payer: BCN Commercial |
$4,559.03
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cofinity Commercial |
$5,073.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
| Rate for Payer: Healthscope Commercial |
$5,309.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,424.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
| Rate for Payer: PHP Commercial |
$5,014.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,132.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,598.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,191.45
|
| Rate for Payer: UHC Core |
$4,925.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,424.53
|
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$5,899.37
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
36100055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,401.10 |
| Max. Negotiated Rate |
$5,309.43 |
| Rate for Payer: Aetna Commercial |
$5,014.46
|
| Rate for Payer: Aetna Medicare |
$1,533.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,843.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,843.55
|
| Rate for Payer: BCBS Complete |
$3,974.31
|
| Rate for Payer: BCBS MAPPO |
$1,474.84
|
| Rate for Payer: BCBS Trust/PPO |
$4,586.76
|
| Rate for Payer: BCN Commercial |
$4,586.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,474.84
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cash Price |
$4,719.50
|
| Rate for Payer: Cofinity Commercial |
$5,073.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,474.84
|
| Rate for Payer: Healthscope Commercial |
$5,309.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,424.53
|
| Rate for Payer: Mclaren Medicaid |
$3,785.06
|
| Rate for Payer: Meridian Medicaid |
$3,974.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,548.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,696.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
| Rate for Payer: PACE Senior Care Partners |
$1,401.10
|
| Rate for Payer: PACE SWMI |
$1,474.84
|
| Rate for Payer: PHP Commercial |
$5,014.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,474.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,785.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,132.45
|
| Rate for Payer: Priority Health Medicare |
$1,474.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,598.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,474.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,191.45
|
| Rate for Payer: UHC Core |
$4,925.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,474.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,519.09
|
| Rate for Payer: VA VA |
$1,474.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,424.53
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,725.45
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$7,852.90 |
| Rate for Payer: Aetna Commercial |
$7,416.63
|
| Rate for Payer: Aetna Medicare |
$2,268.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,726.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,726.70
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$2,181.36
|
| Rate for Payer: BCBS Trust/PPO |
$6,784.04
|
| Rate for Payer: BCN Commercial |
$6,784.04
|
| Rate for Payer: BCN Medicare Advantage |
$2,181.36
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cofinity Commercial |
$7,503.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,181.36
|
| Rate for Payer: Healthscope Commercial |
$7,852.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.09
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,290.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,508.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
| Rate for Payer: PACE Senior Care Partners |
$2,072.29
|
| Rate for Payer: PACE SWMI |
$2,181.36
|
| Rate for Payer: PHP Commercial |
$7,416.63
|
| Rate for Payer: PHP Medicare Advantage |
$2,181.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,591.14
|
| Rate for Payer: Priority Health Medicare |
$2,181.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,321.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,181.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,678.40
|
| Rate for Payer: UHC Core |
$7,285.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,181.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,246.80
|
| Rate for Payer: VA VA |
$2,181.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.09
|
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,725.45
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100122
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,321.65 |
| Max. Negotiated Rate |
$7,852.90 |
| Rate for Payer: Aetna Commercial |
$7,416.63
|
| Rate for Payer: BCBS Trust/PPO |
$6,743.03
|
| Rate for Payer: BCN Commercial |
$6,743.03
|
| Rate for Payer: Cash Price |
$6,980.36
|
| Rate for Payer: Cofinity Commercial |
$7,503.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
| Rate for Payer: Healthscope Commercial |
$7,852.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
| Rate for Payer: PHP Commercial |
$7,416.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,591.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,321.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,678.40
|
| Rate for Payer: UHC Core |
$7,285.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.09
|
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.86 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Commercial |
$22.10
|
| Rate for Payer: BCBS Trust/PPO |
$20.09
|
| Rate for Payer: BCN Commercial |
$20.09
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$22.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
| Rate for Payer: Healthscope Commercial |
$23.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
| Rate for Payer: PHP Commercial |
$22.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.88
|
| Rate for Payer: UHC Core |
$21.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.50
|
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
HCPCS A9583
|
| Hospital Charge Code |
63600007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Commercial |
$22.10
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.12
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$20.22
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$22.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.10
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.62
|
| Rate for Payer: Priority Health Medicare |
$6.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.86
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.88
|
| Rate for Payer: UHC Core |
$21.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.70
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.50
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$488.86
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$439.97 |
| Rate for Payer: Aetna Commercial |
$415.53
|
| Rate for Payer: Aetna Medicare |
$127.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.77
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$380.09
|
| Rate for Payer: BCN Commercial |
$380.09
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$420.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$439.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PACE Senior Care Partners |
$116.10
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$415.53
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
| Rate for Payer: UHC Core |
$408.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Medicare Advantage |
$125.88
|
| Rate for Payer: VA VA |
$122.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$488.86
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
76100037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$298.16 |
| Max. Negotiated Rate |
$439.97 |
| Rate for Payer: Aetna Commercial |
$415.53
|
| Rate for Payer: BCBS Trust/PPO |
$377.79
|
| Rate for Payer: BCN Commercial |
$377.79
|
| Rate for Payer: Cash Price |
$391.09
|
| Rate for Payer: Cofinity Commercial |
$420.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
| Rate for Payer: Healthscope Commercial |
$439.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
| Rate for Payer: PHP Commercial |
$415.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
| Rate for Payer: UHC Core |
$408.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$391.99
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36100002
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.07 |
| Max. Negotiated Rate |
$352.79 |
| Rate for Payer: Aetna Commercial |
$333.19
|
| Rate for Payer: BCBS Trust/PPO |
$302.93
|
| Rate for Payer: BCN Commercial |
$302.93
|
| Rate for Payer: Cash Price |
$313.59
|
| Rate for Payer: Cofinity Commercial |
$337.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.59
|
| Rate for Payer: Healthscope Commercial |
$352.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.19
|
| Rate for Payer: PHP Commercial |
$333.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.95
|
| Rate for Payer: UHC Core |
$327.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.99
|
|
