|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,204.67
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.29 |
| Max. Negotiated Rate |
$1,084.20 |
| Rate for Payer: Aetna Commercial |
$1,023.97
|
| Rate for Payer: Aetna Medicare |
$313.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.46
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$301.17
|
| Rate for Payer: BCBS Trust/PPO |
$936.63
|
| Rate for Payer: BCN Commercial |
$936.63
|
| Rate for Payer: BCN Medicare Advantage |
$301.17
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cash Price |
$963.74
|
| Rate for Payer: Cofinity Commercial |
$1,036.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.17
|
| Rate for Payer: Healthscope Commercial |
$1,084.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.50
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,023.97
|
| Rate for Payer: PACE Senior Care Partners |
$286.11
|
| Rate for Payer: PACE SWMI |
$301.17
|
| Rate for Payer: PHP Commercial |
$1,023.97
|
| Rate for Payer: PHP Medicare Advantage |
$301.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,048.06
|
| Rate for Payer: Priority Health Medicare |
$301.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$734.73
|
| Rate for Payer: Railroad Medicare Medicare |
$301.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,060.11
|
| Rate for Payer: UHC Core |
$1,005.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.17
|
| Rate for Payer: UHC Medicare Advantage |
$310.20
|
| Rate for Payer: VA VA |
$301.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.50
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
OP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$194.29 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$950.91
|
| Rate for Payer: Aetna Medicare |
$290.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.60
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$279.68
|
| Rate for Payer: BCBS Trust/PPO |
$869.80
|
| Rate for Payer: BCN Commercial |
$869.80
|
| Rate for Payer: BCN Medicare Advantage |
$279.68
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$962.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.68
|
| Rate for Payer: Healthscope Commercial |
$1,006.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.04
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$293.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$950.91
|
| Rate for Payer: PACE Senior Care Partners |
$265.70
|
| Rate for Payer: PACE SWMI |
$279.68
|
| Rate for Payer: PHP Commercial |
$950.91
|
| Rate for Payer: PHP Medicare Advantage |
$279.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$973.29
|
| Rate for Payer: Priority Health Medicare |
$279.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$682.31
|
| Rate for Payer: Railroad Medicare Medicare |
$279.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.47
|
| Rate for Payer: UHC Core |
$934.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.68
|
| Rate for Payer: UHC Medicare Advantage |
$288.07
|
| Rate for Payer: VA VA |
$279.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.04
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
IP
|
$1,118.72
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$682.31 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$950.91
|
| Rate for Payer: BCBS Trust/PPO |
$864.55
|
| Rate for Payer: BCN Commercial |
$864.55
|
| Rate for Payer: Cash Price |
$894.98
|
| Rate for Payer: Cofinity Commercial |
$962.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.98
|
| Rate for Payer: Healthscope Commercial |
$1,006.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$950.91
|
| Rate for Payer: PHP Commercial |
$950.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$973.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$682.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.47
|
| Rate for Payer: UHC Core |
$934.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.04
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
OP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$288.13 |
| Rate for Payer: Aetna Commercial |
$272.12
|
| Rate for Payer: Aetna Medicare |
$83.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.04
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$80.04
|
| Rate for Payer: BCBS Trust/PPO |
$248.91
|
| Rate for Payer: BCN Commercial |
$248.91
|
| Rate for Payer: BCN Medicare Advantage |
$80.04
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.04
|
| Rate for Payer: Healthscope Commercial |
$288.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.10
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.12
|
| Rate for Payer: PACE Senior Care Partners |
$76.03
|
| Rate for Payer: PACE SWMI |
$80.04
|
| Rate for Payer: PHP Commercial |
$272.12
|
| Rate for Payer: PHP Medicare Advantage |
$80.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.52
|
| Rate for Payer: Priority Health Medicare |
$80.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.25
|
| Rate for Payer: Railroad Medicare Medicare |
$80.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.72
|
| Rate for Payer: UHC Core |
$267.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.04
|
| Rate for Payer: UHC Medicare Advantage |
$82.44
|
| Rate for Payer: VA VA |
$80.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.10
|
|
|
HC ARTHROCENTESIS SMALL JOINT
|
Facility
|
IP
|
$320.14
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100022
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.25 |
| Max. Negotiated Rate |
$288.13 |
| Rate for Payer: Aetna Commercial |
$272.12
|
| Rate for Payer: BCBS Trust/PPO |
$247.40
|
| Rate for Payer: BCN Commercial |
$247.40
|
| Rate for Payer: Cash Price |
$256.11
|
| Rate for Payer: Cofinity Commercial |
$275.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.11
|
| Rate for Payer: Healthscope Commercial |
$288.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.12
|
| Rate for Payer: PHP Commercial |
$272.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$278.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.72
|
| Rate for Payer: UHC Core |
$267.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.10
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$707.02 |
| Max. Negotiated Rate |
$1,043.32 |
| Rate for Payer: Aetna Commercial |
$985.35
|
| Rate for Payer: BCBS Trust/PPO |
$895.86
|
| Rate for Payer: BCN Commercial |
$895.86
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$996.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.39
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.35
|
| Rate for Payer: PHP Commercial |
$985.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,008.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,020.13
|
| Rate for Payer: UHC Core |
$967.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.43
|
|
|
HC ARTHROCENTESIS SMALL JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,159.24
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.29 |
| Max. Negotiated Rate |
$1,043.32 |
| Rate for Payer: Aetna Commercial |
$985.35
|
| Rate for Payer: Aetna Medicare |
$301.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.26
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$289.81
|
| Rate for Payer: BCBS Trust/PPO |
$901.31
|
| Rate for Payer: BCN Commercial |
$901.31
|
| Rate for Payer: BCN Medicare Advantage |
$289.81
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cash Price |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$996.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$927.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.81
|
| Rate for Payer: Healthscope Commercial |
$1,043.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$869.43
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$304.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$985.35
|
| Rate for Payer: PACE Senior Care Partners |
$275.32
|
| Rate for Payer: PACE SWMI |
$289.81
|
| Rate for Payer: PHP Commercial |
$985.35
|
| Rate for Payer: PHP Medicare Advantage |
$289.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$811.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,008.54
|
| Rate for Payer: Priority Health Medicare |
$289.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.02
|
| Rate for Payer: Railroad Medicare Medicare |
$289.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,020.13
|
| Rate for Payer: UHC Core |
$967.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.81
|
| Rate for Payer: UHC Medicare Advantage |
$298.50
|
| Rate for Payer: VA VA |
$289.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$869.43
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
OP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.29 |
| Max. Negotiated Rate |
$886.37 |
| Rate for Payer: Aetna Commercial |
$837.13
|
| Rate for Payer: Aetna Medicare |
$256.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.77
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$246.22
|
| Rate for Payer: BCBS Trust/PPO |
$765.73
|
| Rate for Payer: BCN Commercial |
$765.73
|
| Rate for Payer: BCN Medicare Advantage |
$246.22
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.22
|
| Rate for Payer: Healthscope Commercial |
$886.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$738.64
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$258.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.13
|
| Rate for Payer: PACE Senior Care Partners |
$233.90
|
| Rate for Payer: PACE SWMI |
$246.22
|
| Rate for Payer: PHP Commercial |
$837.13
|
| Rate for Payer: PHP Medicare Advantage |
$246.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$856.83
|
| Rate for Payer: Priority Health Medicare |
$246.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$600.67
|
| Rate for Payer: Railroad Medicare Medicare |
$246.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.68
|
| Rate for Payer: UHC Core |
$822.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.22
|
| Rate for Payer: UHC Medicare Advantage |
$253.60
|
| Rate for Payer: VA VA |
$246.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$738.64
|
|
|
HC ARTHROCENTESIS SMALL JOINT W US GUIDE
|
Facility
|
IP
|
$984.86
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
36100458
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.67 |
| Max. Negotiated Rate |
$886.37 |
| Rate for Payer: Aetna Commercial |
$837.13
|
| Rate for Payer: BCBS Trust/PPO |
$761.10
|
| Rate for Payer: BCN Commercial |
$761.10
|
| Rate for Payer: Cash Price |
$787.89
|
| Rate for Payer: Cofinity Commercial |
$846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.89
|
| Rate for Payer: Healthscope Commercial |
$886.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$738.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$837.13
|
| Rate for Payer: PHP Commercial |
$837.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$689.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$856.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$600.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.68
|
| Rate for Payer: UHC Core |
$822.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$738.64
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
OP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$218.34 |
| Max. Negotiated Rate |
$827.39 |
| Rate for Payer: Aetna Commercial |
$781.42
|
| Rate for Payer: Aetna Medicare |
$239.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.29
|
| Rate for Payer: BCBS Complete |
$367.73
|
| Rate for Payer: BCBS MAPPO |
$229.83
|
| Rate for Payer: BCBS Trust/PPO |
$714.77
|
| Rate for Payer: BCN Commercial |
$714.77
|
| Rate for Payer: BCN Medicare Advantage |
$229.83
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$790.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.83
|
| Rate for Payer: Healthscope Commercial |
$827.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$241.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: PACE Senior Care Partners |
$218.34
|
| Rate for Payer: PACE SWMI |
$229.83
|
| Rate for Payer: PHP Commercial |
$781.42
|
| Rate for Payer: PHP Medicare Advantage |
$229.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.81
|
| Rate for Payer: Priority Health Medicare |
$229.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.69
|
| Rate for Payer: Railroad Medicare Medicare |
$229.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.00
|
| Rate for Payer: UHC Core |
$767.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.72
|
| Rate for Payer: VA VA |
$229.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.49
|
|
|
HC ARTHROGRAM SACROILIAC
|
Facility
|
IP
|
$919.32
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100585
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.69 |
| Max. Negotiated Rate |
$827.39 |
| Rate for Payer: Aetna Commercial |
$781.42
|
| Rate for Payer: BCBS Trust/PPO |
$710.45
|
| Rate for Payer: BCN Commercial |
$710.45
|
| Rate for Payer: Cash Price |
$735.46
|
| Rate for Payer: Cofinity Commercial |
$790.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.46
|
| Rate for Payer: Healthscope Commercial |
$827.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$781.42
|
| Rate for Payer: PHP Commercial |
$781.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$799.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$560.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.00
|
| Rate for Payer: UHC Core |
$767.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.49
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.08 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: BCBS Trust/PPO |
$809.78
|
| Rate for Payer: BCN Commercial |
$809.78
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$911.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.11
|
| Rate for Payer: UHC Core |
$874.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.86 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna Medicare |
$272.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$327.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$327.45
|
| Rate for Payer: BCBS Complete |
$419.14
|
| Rate for Payer: BCBS MAPPO |
$261.96
|
| Rate for Payer: BCBS Trust/PPO |
$814.70
|
| Rate for Payer: BCN Commercial |
$814.70
|
| Rate for Payer: BCN Medicare Advantage |
$261.96
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.96
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$275.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PACE Senior Care Partners |
$248.86
|
| Rate for Payer: PACE SWMI |
$261.96
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: PHP Medicare Advantage |
$261.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$911.63
|
| Rate for Payer: Priority Health Medicare |
$261.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.08
|
| Rate for Payer: Railroad Medicare Medicare |
$261.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.11
|
| Rate for Payer: UHC Core |
$874.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$261.96
|
| Rate for Payer: UHC Medicare Advantage |
$269.82
|
| Rate for Payer: VA VA |
$261.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,086.38 |
| Max. Negotiated Rate |
$1,603.12 |
| Rate for Payer: Aetna Commercial |
$1,514.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,376.54
|
| Rate for Payer: BCN Commercial |
$1,376.54
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,531.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Healthscope Commercial |
$1,603.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,335.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PHP Commercial |
$1,514.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,549.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.49
|
| Rate for Payer: UHC Core |
$1,487.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,335.93
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
OP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$423.04 |
| Max. Negotiated Rate |
$2,229.50 |
| Rate for Payer: Aetna Commercial |
$1,514.05
|
| Rate for Payer: Aetna Medicare |
$463.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.64
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$445.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,384.91
|
| Rate for Payer: BCN Commercial |
$1,384.91
|
| Rate for Payer: BCN Medicare Advantage |
$445.31
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,531.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.31
|
| Rate for Payer: Healthscope Commercial |
$1,603.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,335.93
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$512.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PACE Senior Care Partners |
$423.04
|
| Rate for Payer: PACE SWMI |
$445.31
|
| Rate for Payer: PHP Commercial |
$1,514.05
|
| Rate for Payer: PHP Medicare Advantage |
$445.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,549.68
|
| Rate for Payer: Priority Health Medicare |
$445.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.38
|
| Rate for Payer: Railroad Medicare Medicare |
$445.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,567.49
|
| Rate for Payer: UHC Core |
$1,487.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.31
|
| Rate for Payer: UHC Medicare Advantage |
$458.67
|
| Rate for Payer: VA VA |
$445.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,335.93
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$953.96 |
| Max. Negotiated Rate |
$3,614.99 |
| Rate for Payer: Aetna Commercial |
$3,414.16
|
| Rate for Payer: Aetna Medicare |
$1,044.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,255.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,255.21
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$1,004.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,122.95
|
| Rate for Payer: BCN Commercial |
$3,122.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,004.16
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$3,454.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,004.16
|
| Rate for Payer: Healthscope Commercial |
$3,614.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,012.50
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,054.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,154.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: PACE Senior Care Partners |
$953.96
|
| Rate for Payer: PACE SWMI |
$1,004.16
|
| Rate for Payer: PHP Commercial |
$3,414.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,004.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,494.49
|
| Rate for Payer: Priority Health Medicare |
$1,004.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,449.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,004.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,534.66
|
| Rate for Payer: UHC Core |
$3,353.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,004.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,034.29
|
| Rate for Payer: VA VA |
$1,004.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,012.50
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
IP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,449.76 |
| Max. Negotiated Rate |
$3,614.99 |
| Rate for Payer: Aetna Commercial |
$3,414.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,104.07
|
| Rate for Payer: BCN Commercial |
$3,104.07
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$3,454.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Healthscope Commercial |
$3,614.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: PHP Commercial |
$3,414.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,494.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,449.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,534.66
|
| Rate for Payer: UHC Core |
$3,353.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,012.50
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$551.43 |
| Max. Negotiated Rate |
$813.72 |
| Rate for Payer: Aetna Commercial |
$768.51
|
| Rate for Payer: BCBS Trust/PPO |
$698.71
|
| Rate for Payer: BCN Commercial |
$698.71
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$777.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Healthscope Commercial |
$813.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: PHP Commercial |
$768.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.63
|
| Rate for Payer: UHC Core |
$754.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.10
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$813.72 |
| Rate for Payer: Aetna Commercial |
$768.51
|
| Rate for Payer: Aetna Medicare |
$235.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$282.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$282.54
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$226.03
|
| Rate for Payer: BCBS Trust/PPO |
$702.96
|
| Rate for Payer: BCN Commercial |
$702.96
|
| Rate for Payer: BCN Medicare Advantage |
$226.03
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$777.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.03
|
| Rate for Payer: Healthscope Commercial |
$813.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.10
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$237.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: PACE Senior Care Partners |
$214.73
|
| Rate for Payer: PACE SWMI |
$226.03
|
| Rate for Payer: PHP Commercial |
$768.51
|
| Rate for Payer: PHP Medicare Advantage |
$226.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.59
|
| Rate for Payer: Priority Health Medicare |
$226.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$551.43
|
| Rate for Payer: Railroad Medicare Medicare |
$226.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$795.63
|
| Rate for Payer: UHC Core |
$754.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.03
|
| Rate for Payer: UHC Medicare Advantage |
$232.81
|
| Rate for Payer: VA VA |
$226.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.10
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$667.37 |
| Rate for Payer: Aetna Commercial |
$630.29
|
| Rate for Payer: Aetna Medicare |
$192.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.72
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$185.38
|
| Rate for Payer: BCBS Trust/PPO |
$576.53
|
| Rate for Payer: BCN Commercial |
$576.53
|
| Rate for Payer: BCN Medicare Advantage |
$185.38
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.38
|
| Rate for Payer: Healthscope Commercial |
$667.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$556.14
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: PACE Senior Care Partners |
$176.11
|
| Rate for Payer: PACE SWMI |
$185.38
|
| Rate for Payer: PHP Commercial |
$630.29
|
| Rate for Payer: PHP Medicare Advantage |
$185.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.12
|
| Rate for Payer: Priority Health Medicare |
$185.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$452.25
|
| Rate for Payer: Railroad Medicare Medicare |
$185.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.54
|
| Rate for Payer: UHC Core |
$619.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.38
|
| Rate for Payer: UHC Medicare Advantage |
$190.94
|
| Rate for Payer: VA VA |
$185.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$556.14
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$452.25 |
| Max. Negotiated Rate |
$667.37 |
| Rate for Payer: Aetna Commercial |
$630.29
|
| Rate for Payer: BCBS Trust/PPO |
$573.05
|
| Rate for Payer: BCN Commercial |
$573.05
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Healthscope Commercial |
$667.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$556.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: PHP Commercial |
$630.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$645.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$452.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.54
|
| Rate for Payer: UHC Core |
$619.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$556.14
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,081.45 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna Medicare |
$1,183.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,422.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,422.96
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,138.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,540.32
|
| Rate for Payer: BCN Commercial |
$3,540.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.36
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.36
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,195.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,309.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,081.45
|
| Rate for Payer: PACE SWMI |
$1,138.36
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,961.51
|
| Rate for Payer: Priority Health Medicare |
$1,138.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,777.16
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,007.04
|
| Rate for Payer: UHC Core |
$3,802.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.52
|
| Rate for Payer: VA VA |
$1,138.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,777.16 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,518.91
|
| Rate for Payer: BCN Commercial |
$3,518.91
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,961.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,777.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,007.04
|
| Rate for Payer: UHC Core |
$3,802.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.56 |
| Max. Negotiated Rate |
$172.64 |
| Rate for Payer: Aetna Commercial |
$163.05
|
| Rate for Payer: Aetna Medicare |
$49.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.94
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$47.96
|
| Rate for Payer: BCBS Trust/PPO |
$149.14
|
| Rate for Payer: BCN Commercial |
$149.14
|
| Rate for Payer: BCN Medicare Advantage |
$47.96
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$164.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.96
|
| Rate for Payer: Healthscope Commercial |
$172.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.86
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: PACE Senior Care Partners |
$45.56
|
| Rate for Payer: PACE SWMI |
$47.96
|
| Rate for Payer: PHP Commercial |
$163.05
|
| Rate for Payer: PHP Medicare Advantage |
$47.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.88
|
| Rate for Payer: Priority Health Medicare |
$47.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.99
|
| Rate for Payer: Railroad Medicare Medicare |
$47.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.80
|
| Rate for Payer: UHC Core |
$160.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.96
|
| Rate for Payer: UHC Medicare Advantage |
$49.39
|
| Rate for Payer: VA VA |
$47.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.86
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.99 |
| Max. Negotiated Rate |
$172.64 |
| Rate for Payer: Aetna Commercial |
$163.05
|
| Rate for Payer: BCBS Trust/PPO |
$148.24
|
| Rate for Payer: BCN Commercial |
$148.24
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$164.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Healthscope Commercial |
$172.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: PHP Commercial |
$163.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.80
|
| Rate for Payer: UHC Core |
$160.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.86
|
|
