|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
IP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.96
|
| Rate for Payer: BCBS Trust/PPO |
$77.24
|
| Rate for Payer: BCN Commercial |
$77.24
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$85.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: PHP Commercial |
$84.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.96
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$124.40
|
| Rate for Payer: BCN Commercial |
$124.40
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.58
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.00
|
| Rate for Payer: UHC Medicare Advantage |
$41.20
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$97.58 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$123.65
|
| Rate for Payer: BCN Commercial |
$123.65
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$24.44
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$20.51
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$24.58
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Mclaren Medicaid |
$19.53
|
| Rate for Payer: Meridian Medicaid |
$20.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.14
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,653.46
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$1,488.11 |
| Rate for Payer: Aetna Commercial |
$1,405.44
|
| Rate for Payer: Aetna Medicare |
$429.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$516.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$516.71
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$413.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,285.57
|
| Rate for Payer: BCN Commercial |
$1,285.57
|
| Rate for Payer: BCN Medicare Advantage |
$413.36
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cofinity Commercial |
$1,421.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$413.36
|
| Rate for Payer: Healthscope Commercial |
$1,488.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,240.10
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$434.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$475.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,405.44
|
| Rate for Payer: PACE Senior Care Partners |
$392.70
|
| Rate for Payer: PACE SWMI |
$413.36
|
| Rate for Payer: PHP Commercial |
$1,405.44
|
| Rate for Payer: PHP Medicare Advantage |
$413.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,438.51
|
| Rate for Payer: Priority Health Medicare |
$413.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,008.45
|
| Rate for Payer: Railroad Medicare Medicare |
$413.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,455.04
|
| Rate for Payer: UHC Core |
$1,380.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$413.36
|
| Rate for Payer: UHC Medicare Advantage |
$425.77
|
| Rate for Payer: VA VA |
$413.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,240.10
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,653.46
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,008.45 |
| Max. Negotiated Rate |
$1,488.11 |
| Rate for Payer: Aetna Commercial |
$1,405.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,277.79
|
| Rate for Payer: BCN Commercial |
$1,277.79
|
| Rate for Payer: Cash Price |
$1,322.77
|
| Rate for Payer: Cofinity Commercial |
$1,421.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.77
|
| Rate for Payer: Healthscope Commercial |
$1,488.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,240.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,405.44
|
| Rate for Payer: PHP Commercial |
$1,405.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,438.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,008.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,455.04
|
| Rate for Payer: UHC Core |
$1,380.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,240.10
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.00
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna Commercial |
$6.80
|
| Rate for Payer: BCBS Trust/PPO |
$6.18
|
| Rate for Payer: BCN Commercial |
$6.18
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$6.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$7.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.80
|
| Rate for Payer: PHP Commercial |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.04
|
| Rate for Payer: UHC Core |
$6.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.00
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.00
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna Commercial |
$6.80
|
| Rate for Payer: Aetna Medicare |
$2.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.50
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$2.00
|
| Rate for Payer: BCBS Trust/PPO |
$6.22
|
| Rate for Payer: BCN Commercial |
$6.22
|
| Rate for Payer: BCN Medicare Advantage |
$2.00
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$6.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.00
|
| Rate for Payer: Healthscope Commercial |
$7.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.80
|
| Rate for Payer: PACE Senior Care Partners |
$1.90
|
| Rate for Payer: PACE SWMI |
$2.00
|
| Rate for Payer: PHP Commercial |
$6.80
|
| Rate for Payer: PHP Medicare Advantage |
$2.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.96
|
| Rate for Payer: Priority Health Medicare |
$2.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.04
|
| Rate for Payer: UHC Core |
$6.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.00
|
| Rate for Payer: UHC Medicare Advantage |
$2.06
|
| Rate for Payer: VA VA |
$2.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.00
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,064.25
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$490.26 |
| Max. Negotiated Rate |
$1,857.82 |
| Rate for Payer: Aetna Commercial |
$1,754.61
|
| Rate for Payer: Aetna Medicare |
$536.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$645.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$645.08
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$516.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,604.95
|
| Rate for Payer: BCN Commercial |
$1,604.95
|
| Rate for Payer: BCN Medicare Advantage |
$516.06
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cofinity Commercial |
$1,775.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.06
|
| Rate for Payer: Healthscope Commercial |
$1,857.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.19
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$541.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$593.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,754.61
|
| Rate for Payer: PACE Senior Care Partners |
$490.26
|
| Rate for Payer: PACE SWMI |
$516.06
|
| Rate for Payer: PHP Commercial |
$1,754.61
|
| Rate for Payer: PHP Medicare Advantage |
$516.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,444.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,795.90
|
| Rate for Payer: Priority Health Medicare |
$516.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,258.99
|
| Rate for Payer: Railroad Medicare Medicare |
$516.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.54
|
| Rate for Payer: UHC Core |
$1,723.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.06
|
| Rate for Payer: UHC Medicare Advantage |
$531.54
|
| Rate for Payer: VA VA |
$516.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.19
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,064.25
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,258.99 |
| Max. Negotiated Rate |
$1,857.82 |
| Rate for Payer: Aetna Commercial |
$1,754.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,595.25
|
| Rate for Payer: BCN Commercial |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,651.40
|
| Rate for Payer: Cofinity Commercial |
$1,775.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.40
|
| Rate for Payer: Healthscope Commercial |
$1,857.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,754.61
|
| Rate for Payer: PHP Commercial |
$1,754.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,444.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,795.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,258.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.54
|
| Rate for Payer: UHC Core |
$1,723.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.19
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,547.91
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$842.63 |
| Max. Negotiated Rate |
$3,193.12 |
| Rate for Payer: Aetna Commercial |
$3,015.72
|
| Rate for Payer: Aetna Medicare |
$922.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,108.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,108.72
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$886.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,758.50
|
| Rate for Payer: BCN Commercial |
$2,758.50
|
| Rate for Payer: BCN Medicare Advantage |
$886.98
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,051.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$886.98
|
| Rate for Payer: Healthscope Commercial |
$3,193.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.93
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$931.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,020.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PACE Senior Care Partners |
$842.63
|
| Rate for Payer: PACE SWMI |
$886.98
|
| Rate for Payer: PHP Commercial |
$3,015.72
|
| Rate for Payer: PHP Medicare Advantage |
$886.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,086.68
|
| Rate for Payer: Priority Health Medicare |
$886.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,163.87
|
| Rate for Payer: Railroad Medicare Medicare |
$886.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,122.16
|
| Rate for Payer: UHC Core |
$2,962.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$886.98
|
| Rate for Payer: UHC Medicare Advantage |
$913.59
|
| Rate for Payer: VA VA |
$886.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.93
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,547.91
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,163.87 |
| Max. Negotiated Rate |
$3,193.12 |
| Rate for Payer: Aetna Commercial |
$3,015.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.82
|
| Rate for Payer: BCN Commercial |
$2,741.82
|
| Rate for Payer: Cash Price |
$2,838.33
|
| Rate for Payer: Cofinity Commercial |
$3,051.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,838.33
|
| Rate for Payer: Healthscope Commercial |
$3,193.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,660.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,015.72
|
| Rate for Payer: PHP Commercial |
$3,015.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,086.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,163.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,122.16
|
| Rate for Payer: UHC Core |
$2,962.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,660.93
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,875.63 |
| Max. Negotiated Rate |
$2,767.77 |
| Rate for Payer: Aetna Commercial |
$2,614.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,376.59
|
| Rate for Payer: BCN Commercial |
$2,376.59
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,644.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.24
|
| Rate for Payer: Healthscope Commercial |
$2,767.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,306.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: PHP Commercial |
$2,614.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,675.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,875.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,706.26
|
| Rate for Payer: UHC Core |
$2,567.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,306.48
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,075.30
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$730.38 |
| Max. Negotiated Rate |
$2,767.77 |
| Rate for Payer: Aetna Commercial |
$2,614.00
|
| Rate for Payer: Aetna Medicare |
$799.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$961.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$961.03
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$768.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.05
|
| Rate for Payer: BCN Commercial |
$2,391.05
|
| Rate for Payer: BCN Medicare Advantage |
$768.82
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cash Price |
$2,460.24
|
| Rate for Payer: Cofinity Commercial |
$2,644.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,460.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$768.82
|
| Rate for Payer: Healthscope Commercial |
$2,767.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,306.48
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$807.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$884.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,614.00
|
| Rate for Payer: PACE Senior Care Partners |
$730.38
|
| Rate for Payer: PACE SWMI |
$768.82
|
| Rate for Payer: PHP Commercial |
$2,614.00
|
| Rate for Payer: PHP Medicare Advantage |
$768.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,152.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,675.51
|
| Rate for Payer: Priority Health Medicare |
$768.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,875.63
|
| Rate for Payer: Railroad Medicare Medicare |
$768.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,706.26
|
| Rate for Payer: UHC Core |
$2,567.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$768.82
|
| Rate for Payer: UHC Medicare Advantage |
$791.89
|
| Rate for Payer: VA VA |
$768.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,306.48
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,227.72 |
| Max. Negotiated Rate |
$1,811.68 |
| Rate for Payer: Aetna Commercial |
$1,711.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,555.63
|
| Rate for Payer: BCN Commercial |
$1,555.63
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,731.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,610.38
|
| Rate for Payer: Healthscope Commercial |
$1,811.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,509.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,711.03
|
| Rate for Payer: PHP Commercial |
$1,711.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,751.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,227.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,771.42
|
| Rate for Payer: UHC Core |
$1,680.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,509.74
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,012.98
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$478.08 |
| Max. Negotiated Rate |
$1,811.68 |
| Rate for Payer: Aetna Commercial |
$1,711.03
|
| Rate for Payer: Aetna Medicare |
$523.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$629.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$629.06
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$503.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,565.09
|
| Rate for Payer: BCN Commercial |
$1,565.09
|
| Rate for Payer: BCN Medicare Advantage |
$503.24
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cash Price |
$1,610.38
|
| Rate for Payer: Cofinity Commercial |
$1,731.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,610.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.24
|
| Rate for Payer: Healthscope Commercial |
$1,811.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,509.74
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$528.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$578.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,711.03
|
| Rate for Payer: PACE Senior Care Partners |
$478.08
|
| Rate for Payer: PACE SWMI |
$503.24
|
| Rate for Payer: PHP Commercial |
$1,711.03
|
| Rate for Payer: PHP Medicare Advantage |
$503.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,751.29
|
| Rate for Payer: Priority Health Medicare |
$503.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,227.72
|
| Rate for Payer: Railroad Medicare Medicare |
$503.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,771.42
|
| Rate for Payer: UHC Core |
$1,680.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.24
|
| Rate for Payer: UHC Medicare Advantage |
$518.34
|
| Rate for Payer: VA VA |
$503.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,509.74
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.46 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$172.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.19
|
| Rate for Payer: BCBS Complete |
$553.73
|
| Rate for Payer: BCBS MAPPO |
$165.75
|
| Rate for Payer: BCBS Trust/PPO |
$515.48
|
| Rate for Payer: BCN Commercial |
$515.48
|
| Rate for Payer: BCN Medicare Advantage |
$165.75
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.75
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Mclaren Medicaid |
$527.36
|
| Rate for Payer: Meridian Medicaid |
$553.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PACE Senior Care Partners |
$157.46
|
| Rate for Payer: PACE SWMI |
$165.75
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$165.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$527.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.81
|
| Rate for Payer: Priority Health Medicare |
$165.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$404.36
|
| Rate for Payer: Railroad Medicare Medicare |
$165.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.75
|
| Rate for Payer: UHC Medicare Advantage |
$170.72
|
| Rate for Payer: VA VA |
$165.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$404.36 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: BCBS Trust/PPO |
$512.37
|
| Rate for Payer: BCN Commercial |
$512.37
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$576.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$404.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.44
|
| Rate for Payer: UHC Core |
$553.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,401.18 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,042.51
|
| Rate for Payer: BCN Commercial |
$3,042.51
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,425.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,401.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,464.56
|
| Rate for Payer: UHC Core |
$3,287.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.75
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$3,937.00
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$935.04 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: Aetna Medicare |
$1,023.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,230.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,230.31
|
| Rate for Payer: BCBS Complete |
$1,050.44
|
| Rate for Payer: BCBS MAPPO |
$984.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,061.02
|
| Rate for Payer: BCN Commercial |
$3,061.02
|
| Rate for Payer: BCN Medicare Advantage |
$984.25
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.25
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.75
|
| Rate for Payer: Mclaren Medicaid |
$1,000.42
|
| Rate for Payer: Meridian Medicaid |
$1,050.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,033.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,131.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PACE Senior Care Partners |
$935.04
|
| Rate for Payer: PACE SWMI |
$984.25
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: PHP Medicare Advantage |
$984.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,425.19
|
| Rate for Payer: Priority Health Medicare |
$984.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,401.18
|
| Rate for Payer: Railroad Medicare Medicare |
$984.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,464.56
|
| Rate for Payer: UHC Core |
$3,287.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,013.78
|
| Rate for Payer: VA VA |
$984.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.75
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
OP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.97 |
| Max. Negotiated Rate |
$344.73 |
| Rate for Payer: Aetna Commercial |
$325.58
|
| Rate for Payer: Aetna Medicare |
$99.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.70
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$95.76
|
| Rate for Payer: BCBS Trust/PPO |
$297.81
|
| Rate for Payer: BCN Commercial |
$297.81
|
| Rate for Payer: BCN Medicare Advantage |
$95.76
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$329.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.76
|
| Rate for Payer: Healthscope Commercial |
$344.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.27
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: PACE Senior Care Partners |
$90.97
|
| Rate for Payer: PACE SWMI |
$95.76
|
| Rate for Payer: PHP Commercial |
$325.58
|
| Rate for Payer: PHP Medicare Advantage |
$95.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.24
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.61
|
| Rate for Payer: Railroad Medicare Medicare |
$95.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.07
|
| Rate for Payer: UHC Core |
$319.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.76
|
| Rate for Payer: UHC Medicare Advantage |
$98.63
|
| Rate for Payer: VA VA |
$95.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.27
|
|
|
HC BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$383.03
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
36100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.61 |
| Max. Negotiated Rate |
$344.73 |
| Rate for Payer: Aetna Commercial |
$325.58
|
| Rate for Payer: BCBS Trust/PPO |
$296.01
|
| Rate for Payer: BCN Commercial |
$296.01
|
| Rate for Payer: Cash Price |
$306.42
|
| Rate for Payer: Cofinity Commercial |
$329.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.42
|
| Rate for Payer: Healthscope Commercial |
$344.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.58
|
| Rate for Payer: PHP Commercial |
$325.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.07
|
| Rate for Payer: UHC Core |
$319.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.27
|
|
