|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$738.44 |
| Max. Negotiated Rate |
$1,089.68 |
| Rate for Payer: Aetna Commercial |
$1,029.14
|
| Rate for Payer: BCBS Trust/PPO |
$935.67
|
| Rate for Payer: BCN Commercial |
$935.67
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cofinity Commercial |
$1,041.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.60
|
| Rate for Payer: Healthscope Commercial |
$1,089.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: PHP Commercial |
$1,029.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.46
|
| Rate for Payer: UHC Core |
$1,010.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.06
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.55 |
| Max. Negotiated Rate |
$1,089.68 |
| Rate for Payer: Aetna Commercial |
$1,029.14
|
| Rate for Payer: Aetna Medicare |
$314.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.36
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$302.69
|
| Rate for Payer: BCBS Trust/PPO |
$941.36
|
| Rate for Payer: BCN Commercial |
$941.36
|
| Rate for Payer: BCN Medicare Advantage |
$302.69
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cofinity Commercial |
$1,041.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.69
|
| Rate for Payer: Healthscope Commercial |
$1,089.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.06
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$317.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: PACE Senior Care Partners |
$287.55
|
| Rate for Payer: PACE SWMI |
$302.69
|
| Rate for Payer: PHP Commercial |
$1,029.14
|
| Rate for Payer: PHP Medicare Advantage |
$302.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,053.35
|
| Rate for Payer: Priority Health Medicare |
$302.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.44
|
| Rate for Payer: Railroad Medicare Medicare |
$302.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.46
|
| Rate for Payer: UHC Core |
$1,010.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.69
|
| Rate for Payer: UHC Medicare Advantage |
$311.77
|
| Rate for Payer: VA VA |
$302.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.06
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$30.74
|
| Rate for Payer: BCN Commercial |
$30.74
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$10.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.43
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$9.94
|
| Rate for Payer: BCBS Trust/PPO |
$30.93
|
| Rate for Payer: BCN Commercial |
$30.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.94
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.94
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: PACE Senior Care Partners |
$9.45
|
| Rate for Payer: PACE SWMI |
$9.94
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: PHP Medicare Advantage |
$9.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.61
|
| Rate for Payer: Priority Health Medicare |
$9.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.26
|
| Rate for Payer: Railroad Medicare Medicare |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.94
|
| Rate for Payer: UHC Medicare Advantage |
$10.24
|
| Rate for Payer: VA VA |
$9.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.01 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna Commercial |
$69.70
|
| Rate for Payer: BCBS Trust/PPO |
$63.37
|
| Rate for Payer: BCN Commercial |
$63.37
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$70.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Healthscope Commercial |
$73.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: PHP Commercial |
$69.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.16
|
| Rate for Payer: UHC Core |
$68.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.50
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna Commercial |
$69.70
|
| Rate for Payer: Aetna Medicare |
$21.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.62
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$20.50
|
| Rate for Payer: BCBS Trust/PPO |
$63.76
|
| Rate for Payer: BCN Commercial |
$63.76
|
| Rate for Payer: BCN Medicare Advantage |
$20.50
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$70.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.50
|
| Rate for Payer: Healthscope Commercial |
$73.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.50
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: PACE Senior Care Partners |
$19.48
|
| Rate for Payer: PACE SWMI |
$20.50
|
| Rate for Payer: PHP Commercial |
$69.70
|
| Rate for Payer: PHP Medicare Advantage |
$20.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.34
|
| Rate for Payer: Priority Health Medicare |
$20.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.01
|
| Rate for Payer: Railroad Medicare Medicare |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.16
|
| Rate for Payer: UHC Core |
$68.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.50
|
| Rate for Payer: UHC Medicare Advantage |
$21.12
|
| Rate for Payer: VA VA |
$20.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.50
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna Commercial |
$75.65
|
| Rate for Payer: Aetna Medicare |
$23.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.81
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$22.25
|
| Rate for Payer: BCBS Trust/PPO |
$69.20
|
| Rate for Payer: BCN Commercial |
$69.20
|
| Rate for Payer: BCN Medicare Advantage |
$22.25
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$76.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.25
|
| Rate for Payer: Healthscope Commercial |
$80.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.75
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: PACE Senior Care Partners |
$21.14
|
| Rate for Payer: PACE SWMI |
$22.25
|
| Rate for Payer: PHP Commercial |
$75.65
|
| Rate for Payer: PHP Medicare Advantage |
$22.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.43
|
| Rate for Payer: Priority Health Medicare |
$22.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.28
|
| Rate for Payer: Railroad Medicare Medicare |
$22.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.32
|
| Rate for Payer: UHC Core |
$74.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.25
|
| Rate for Payer: UHC Medicare Advantage |
$22.92
|
| Rate for Payer: VA VA |
$22.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.75
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$54.28 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna Commercial |
$75.65
|
| Rate for Payer: BCBS Trust/PPO |
$68.78
|
| Rate for Payer: BCN Commercial |
$68.78
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$76.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Healthscope Commercial |
$80.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: PHP Commercial |
$75.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.32
|
| Rate for Payer: UHC Core |
$74.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.75
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$44.05
|
| Rate for Payer: BCN Commercial |
$44.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$14.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.81
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$14.25
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.25
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Senior Care Partners |
$13.54
|
| Rate for Payer: PACE SWMI |
$14.25
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$14.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$14.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.25
|
| Rate for Payer: UHC Medicare Advantage |
$14.68
|
| Rate for Payer: VA VA |
$14.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$504.36 |
| Max. Negotiated Rate |
$744.26 |
| Rate for Payer: Aetna Commercial |
$702.91
|
| Rate for Payer: BCBS Trust/PPO |
$639.07
|
| Rate for Payer: BCN Commercial |
$639.07
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$711.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Healthscope Commercial |
$744.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.91
|
| Rate for Payer: PHP Commercial |
$702.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$504.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.72
|
| Rate for Payer: UHC Core |
$690.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.21
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.40 |
| Max. Negotiated Rate |
$744.26 |
| Rate for Payer: Aetna Commercial |
$702.91
|
| Rate for Payer: Aetna Medicare |
$215.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.42
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$206.74
|
| Rate for Payer: BCBS Trust/PPO |
$642.95
|
| Rate for Payer: BCN Commercial |
$642.95
|
| Rate for Payer: BCN Medicare Advantage |
$206.74
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$711.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.74
|
| Rate for Payer: Healthscope Commercial |
$744.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.21
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.91
|
| Rate for Payer: PACE Senior Care Partners |
$196.40
|
| Rate for Payer: PACE SWMI |
$206.74
|
| Rate for Payer: PHP Commercial |
$702.91
|
| Rate for Payer: PHP Medicare Advantage |
$206.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$719.45
|
| Rate for Payer: Priority Health Medicare |
$206.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$504.36
|
| Rate for Payer: Railroad Medicare Medicare |
$206.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$727.72
|
| Rate for Payer: UHC Core |
$690.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.74
|
| Rate for Payer: UHC Medicare Advantage |
$212.94
|
| Rate for Payer: VA VA |
$206.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.21
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.93 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: BCBS Trust/PPO |
$292.61
|
| Rate for Payer: BCN Commercial |
$292.61
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.20
|
| Rate for Payer: UHC Core |
$316.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.93 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: Aetna Medicare |
$98.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.32
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$94.66
|
| Rate for Payer: BCBS Trust/PPO |
$294.39
|
| Rate for Payer: BCN Commercial |
$294.39
|
| Rate for Payer: BCN Medicare Advantage |
$94.66
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.66
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PACE Senior Care Partners |
$89.93
|
| Rate for Payer: PACE SWMI |
$94.66
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: PHP Medicare Advantage |
$94.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.42
|
| Rate for Payer: Priority Health Medicare |
$94.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.93
|
| Rate for Payer: Railroad Medicare Medicare |
$94.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.20
|
| Rate for Payer: UHC Core |
$316.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.50
|
| Rate for Payer: VA VA |
$94.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$728.39 |
| Max. Negotiated Rate |
$2,760.20 |
| Rate for Payer: Aetna Commercial |
$2,606.86
|
| Rate for Payer: Aetna Medicare |
$797.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$958.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$958.40
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$766.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.51
|
| Rate for Payer: BCN Commercial |
$2,384.51
|
| Rate for Payer: BCN Medicare Advantage |
$766.72
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,637.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.72
|
| Rate for Payer: Healthscope Commercial |
$2,760.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.17
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$805.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$881.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: PACE Senior Care Partners |
$728.39
|
| Rate for Payer: PACE SWMI |
$766.72
|
| Rate for Payer: PHP Commercial |
$2,606.86
|
| Rate for Payer: PHP Medicare Advantage |
$766.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,668.19
|
| Rate for Payer: Priority Health Medicare |
$766.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.50
|
| Rate for Payer: Railroad Medicare Medicare |
$766.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,698.86
|
| Rate for Payer: UHC Core |
$2,560.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.72
|
| Rate for Payer: UHC Medicare Advantage |
$789.72
|
| Rate for Payer: VA VA |
$766.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.17
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,870.50 |
| Max. Negotiated Rate |
$2,760.20 |
| Rate for Payer: Aetna Commercial |
$2,606.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,370.09
|
| Rate for Payer: BCN Commercial |
$2,370.09
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,637.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Healthscope Commercial |
$2,760.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: PHP Commercial |
$2,606.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,668.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,698.86
|
| Rate for Payer: UHC Core |
$2,560.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.17
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,591.70 |
| Max. Negotiated Rate |
$3,824.45 |
| Rate for Payer: Aetna Commercial |
$3,611.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,283.93
|
| Rate for Payer: BCN Commercial |
$3,283.93
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$3,654.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Healthscope Commercial |
$3,824.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,187.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: PHP Commercial |
$3,611.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,696.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,591.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,739.46
|
| Rate for Payer: UHC Core |
$3,548.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,187.04
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,009.23 |
| Max. Negotiated Rate |
$3,824.45 |
| Rate for Payer: Aetna Commercial |
$3,611.98
|
| Rate for Payer: Aetna Medicare |
$1,104.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,327.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,327.93
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,062.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,303.90
|
| Rate for Payer: BCN Commercial |
$3,303.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,062.35
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$3,654.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,062.35
|
| Rate for Payer: Healthscope Commercial |
$3,824.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,187.04
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,115.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,221.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: PACE Senior Care Partners |
$1,009.23
|
| Rate for Payer: PACE SWMI |
$1,062.35
|
| Rate for Payer: PHP Commercial |
$3,611.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,062.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,696.97
|
| Rate for Payer: Priority Health Medicare |
$1,062.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,591.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,062.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,739.46
|
| Rate for Payer: UHC Core |
$3,548.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,062.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.22
|
| Rate for Payer: VA VA |
$1,062.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,187.04
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.42 |
| Max. Negotiated Rate |
$2,244.97 |
| Rate for Payer: Aetna Commercial |
$2,120.25
|
| Rate for Payer: Aetna Medicare |
$648.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$779.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$779.50
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$623.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.40
|
| Rate for Payer: BCN Commercial |
$1,939.40
|
| Rate for Payer: BCN Medicare Advantage |
$623.60
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$2,145.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.60
|
| Rate for Payer: Healthscope Commercial |
$2,244.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.81
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$654.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$717.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: PACE Senior Care Partners |
$592.42
|
| Rate for Payer: PACE SWMI |
$623.60
|
| Rate for Payer: PHP Commercial |
$2,120.25
|
| Rate for Payer: PHP Medicare Advantage |
$623.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,170.14
|
| Rate for Payer: Priority Health Medicare |
$623.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,521.34
|
| Rate for Payer: Railroad Medicare Medicare |
$623.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,195.08
|
| Rate for Payer: UHC Core |
$2,082.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.60
|
| Rate for Payer: UHC Medicare Advantage |
$642.31
|
| Rate for Payer: VA VA |
$623.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.81
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,521.34 |
| Max. Negotiated Rate |
$2,244.97 |
| Rate for Payer: Aetna Commercial |
$2,120.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,927.68
|
| Rate for Payer: BCN Commercial |
$1,927.68
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$2,145.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Healthscope Commercial |
$2,244.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: PHP Commercial |
$2,120.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,170.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,521.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,195.08
|
| Rate for Payer: UHC Core |
$2,082.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.81
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,523.74
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,759.03 |
| Max. Negotiated Rate |
$4,071.37 |
| Rate for Payer: Aetna Commercial |
$3,845.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,495.95
|
| Rate for Payer: BCN Commercial |
$3,495.95
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cofinity Commercial |
$3,890.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,618.99
|
| Rate for Payer: Healthscope Commercial |
$4,071.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,392.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,845.18
|
| Rate for Payer: PHP Commercial |
$3,845.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,166.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,935.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,759.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,980.89
|
| Rate for Payer: UHC Core |
$3,777.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,392.80
|
|
