|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
OP
|
$3,966.57
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$394.27 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: Aetna Medicare |
$1,031.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,239.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,239.55
|
| Rate for Payer: BCBS Complete |
$1,586.63
|
| Rate for Payer: BCBS MAPPO |
$991.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,084.01
|
| Rate for Payer: BCCCP Commercial |
$394.27
|
| Rate for Payer: BCN Commercial |
$3,084.01
|
| Rate for Payer: BCN Medicare Advantage |
$991.64
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.64
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,041.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,140.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PACE Senior Care Partners |
$942.06
|
| Rate for Payer: PACE SWMI |
$991.64
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: PHP Medicare Advantage |
$991.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,450.92
|
| Rate for Payer: Priority Health Medicare |
$991.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,419.21
|
| Rate for Payer: Railroad Medicare Medicare |
$991.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,490.58
|
| Rate for Payer: UHC Core |
$3,312.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$991.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,021.39
|
| Rate for Payer: VA VA |
$991.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
IP
|
$3,966.57
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,419.21 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,065.37
|
| Rate for Payer: BCN Commercial |
$3,065.37
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,450.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,419.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,490.58
|
| Rate for Payer: UHC Core |
$3,312.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
IP
|
$3,036.13
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,851.74 |
| Max. Negotiated Rate |
$2,732.52 |
| Rate for Payer: Aetna Commercial |
$2,580.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,346.32
|
| Rate for Payer: BCN Commercial |
$2,346.32
|
| Rate for Payer: Cash Price |
$2,428.90
|
| Rate for Payer: Cofinity Commercial |
$2,611.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.90
|
| Rate for Payer: Healthscope Commercial |
$2,732.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,277.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.71
|
| Rate for Payer: PHP Commercial |
$2,580.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,641.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.79
|
| Rate for Payer: UHC Core |
$2,535.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,277.10
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
OP
|
$3,036.13
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$721.08 |
| Max. Negotiated Rate |
$2,732.52 |
| Rate for Payer: Aetna Commercial |
$2,580.71
|
| Rate for Payer: Aetna Medicare |
$789.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$948.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$948.79
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$759.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,360.59
|
| Rate for Payer: BCCCP Commercial |
$791.70
|
| Rate for Payer: BCN Commercial |
$2,360.59
|
| Rate for Payer: BCN Medicare Advantage |
$759.03
|
| Rate for Payer: Cash Price |
$2,428.90
|
| Rate for Payer: Cash Price |
$2,428.90
|
| Rate for Payer: Cofinity Commercial |
$2,611.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.03
|
| Rate for Payer: Healthscope Commercial |
$2,732.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,277.10
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$796.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$872.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.71
|
| Rate for Payer: PACE Senior Care Partners |
$721.08
|
| Rate for Payer: PACE SWMI |
$759.03
|
| Rate for Payer: PHP Commercial |
$2,580.71
|
| Rate for Payer: PHP Medicare Advantage |
$759.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,125.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,641.43
|
| Rate for Payer: Priority Health Medicare |
$759.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.74
|
| Rate for Payer: Railroad Medicare Medicare |
$759.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.79
|
| Rate for Payer: UHC Core |
$2,535.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.03
|
| Rate for Payer: UHC Medicare Advantage |
$781.80
|
| Rate for Payer: VA VA |
$759.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,277.10
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
OP
|
$3,667.20
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$519.00 |
| Max. Negotiated Rate |
$3,300.48 |
| Rate for Payer: Aetna Commercial |
$3,117.12
|
| Rate for Payer: Aetna Medicare |
$953.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,146.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,146.00
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$916.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,851.25
|
| Rate for Payer: BCCCP Commercial |
$519.00
|
| Rate for Payer: BCN Commercial |
$2,851.25
|
| Rate for Payer: BCN Medicare Advantage |
$916.80
|
| Rate for Payer: Cash Price |
$2,933.76
|
| Rate for Payer: Cash Price |
$2,933.76
|
| Rate for Payer: Cofinity Commercial |
$3,153.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,933.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$916.80
|
| Rate for Payer: Healthscope Commercial |
$3,300.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,750.40
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$962.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,054.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,117.12
|
| Rate for Payer: PACE Senior Care Partners |
$870.96
|
| Rate for Payer: PACE SWMI |
$916.80
|
| Rate for Payer: PHP Commercial |
$3,117.12
|
| Rate for Payer: PHP Medicare Advantage |
$916.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,567.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,190.46
|
| Rate for Payer: Priority Health Medicare |
$916.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,236.63
|
| Rate for Payer: Railroad Medicare Medicare |
$916.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,227.14
|
| Rate for Payer: UHC Core |
$3,062.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$916.80
|
| Rate for Payer: UHC Medicare Advantage |
$944.30
|
| Rate for Payer: VA VA |
$916.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,750.40
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
IP
|
$3,667.20
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,236.63 |
| Max. Negotiated Rate |
$3,300.48 |
| Rate for Payer: Aetna Commercial |
$3,117.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,834.01
|
| Rate for Payer: BCN Commercial |
$2,834.01
|
| Rate for Payer: Cash Price |
$2,933.76
|
| Rate for Payer: Cofinity Commercial |
$3,153.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,933.76
|
| Rate for Payer: Healthscope Commercial |
$3,300.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,750.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,117.12
|
| Rate for Payer: PHP Commercial |
$3,117.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,567.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,190.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,236.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,227.14
|
| Rate for Payer: UHC Core |
$3,062.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,750.40
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
IP
|
$4,045.36
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,467.27 |
| Max. Negotiated Rate |
$3,640.82 |
| Rate for Payer: Aetna Commercial |
$3,438.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,126.25
|
| Rate for Payer: BCN Commercial |
$3,126.25
|
| Rate for Payer: Cash Price |
$3,236.29
|
| Rate for Payer: Cofinity Commercial |
$3,479.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.29
|
| Rate for Payer: Healthscope Commercial |
$3,640.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,034.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,438.56
|
| Rate for Payer: PHP Commercial |
$3,438.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,831.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,519.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,467.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,559.92
|
| Rate for Payer: UHC Core |
$3,377.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,034.02
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
OP
|
$4,045.36
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.26 |
| Max. Negotiated Rate |
$3,640.82 |
| Rate for Payer: Aetna Commercial |
$3,438.56
|
| Rate for Payer: Aetna Medicare |
$1,051.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,264.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,264.18
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$1,011.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,145.27
|
| Rate for Payer: BCCCP Commercial |
$518.26
|
| Rate for Payer: BCN Commercial |
$3,145.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,011.34
|
| Rate for Payer: Cash Price |
$3,236.29
|
| Rate for Payer: Cash Price |
$3,236.29
|
| Rate for Payer: Cofinity Commercial |
$3,479.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,236.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,011.34
|
| Rate for Payer: Healthscope Commercial |
$3,640.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,034.02
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,061.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,163.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,438.56
|
| Rate for Payer: PACE Senior Care Partners |
$960.77
|
| Rate for Payer: PACE SWMI |
$1,011.34
|
| Rate for Payer: PHP Commercial |
$3,438.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,011.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,831.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,519.46
|
| Rate for Payer: Priority Health Medicare |
$1,011.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,467.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,011.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,559.92
|
| Rate for Payer: UHC Core |
$3,377.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,011.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,041.68
|
| Rate for Payer: VA VA |
$1,011.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,034.02
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
OP
|
$355.98
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$84.55 |
| Max. Negotiated Rate |
$320.38 |
| Rate for Payer: Aetna Commercial |
$302.58
|
| Rate for Payer: Aetna Medicare |
$92.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.24
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$89.00
|
| Rate for Payer: BCBS Trust/PPO |
$276.77
|
| Rate for Payer: BCN Commercial |
$276.77
|
| Rate for Payer: BCN Medicare Advantage |
$89.00
|
| Rate for Payer: Cash Price |
$284.78
|
| Rate for Payer: Cash Price |
$284.78
|
| Rate for Payer: Cofinity Commercial |
$306.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$320.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.98
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.58
|
| Rate for Payer: PACE Senior Care Partners |
$84.55
|
| Rate for Payer: PACE SWMI |
$89.00
|
| Rate for Payer: PHP Commercial |
$302.58
|
| Rate for Payer: PHP Medicare Advantage |
$89.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.70
|
| Rate for Payer: Priority Health Medicare |
$89.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.11
|
| Rate for Payer: Railroad Medicare Medicare |
$89.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.26
|
| Rate for Payer: UHC Core |
$297.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.00
|
| Rate for Payer: UHC Medicare Advantage |
$91.66
|
| Rate for Payer: VA VA |
$89.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.98
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
IP
|
$355.98
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$217.11 |
| Max. Negotiated Rate |
$320.38 |
| Rate for Payer: Aetna Commercial |
$302.58
|
| Rate for Payer: BCBS Trust/PPO |
$275.10
|
| Rate for Payer: BCN Commercial |
$275.10
|
| Rate for Payer: Cash Price |
$284.78
|
| Rate for Payer: Cofinity Commercial |
$306.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.78
|
| Rate for Payer: Healthscope Commercial |
$320.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.58
|
| Rate for Payer: PHP Commercial |
$302.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.26
|
| Rate for Payer: UHC Core |
$297.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.98
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
IP
|
$24.13
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$21.72 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCN Commercial |
$18.65
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.51
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.23
|
| Rate for Payer: UHC Core |
$20.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$24.13
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$5.73 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Medicare |
$6.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$18.76
|
| Rate for Payer: BCN Commercial |
$18.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.51
|
| Rate for Payer: PACE Senior Care Partners |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.99
|
| Rate for Payer: Priority Health Medicare |
$6.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.23
|
| Rate for Payer: UHC Core |
$20.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.21
|
| Rate for Payer: VA VA |
$6.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$252.97
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$227.67 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna Medicare |
$65.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.05
|
| Rate for Payer: BCBS Complete |
$101.19
|
| Rate for Payer: BCBS MAPPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$196.68
|
| Rate for Payer: BCN Commercial |
$196.68
|
| Rate for Payer: BCN Medicare Advantage |
$63.24
|
| Rate for Payer: Cash Price |
$202.38
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$227.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.02
|
| Rate for Payer: PACE Senior Care Partners |
$60.08
|
| Rate for Payer: PACE SWMI |
$63.24
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: PHP Medicare Advantage |
$63.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.08
|
| Rate for Payer: Priority Health Medicare |
$63.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.29
|
| Rate for Payer: Railroad Medicare Medicare |
$63.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.61
|
| Rate for Payer: UHC Core |
$211.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.24
|
| Rate for Payer: UHC Medicare Advantage |
$65.14
|
| Rate for Payer: VA VA |
$63.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.73
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$252.97
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$154.29 |
| Max. Negotiated Rate |
$227.67 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: BCBS Trust/PPO |
$195.50
|
| Rate for Payer: BCN Commercial |
$195.50
|
| Rate for Payer: Cash Price |
$202.38
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.38
|
| Rate for Payer: Healthscope Commercial |
$227.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$215.02
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$220.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.61
|
| Rate for Payer: UHC Core |
$211.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.73
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,042.82
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,855.82 |
| Max. Negotiated Rate |
$2,738.54 |
| Rate for Payer: Aetna Commercial |
$2,586.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,351.49
|
| Rate for Payer: BCN Commercial |
$2,351.49
|
| Rate for Payer: Cash Price |
$2,434.26
|
| Rate for Payer: Cofinity Commercial |
$2,616.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,434.26
|
| Rate for Payer: Healthscope Commercial |
$2,738.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,282.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,586.40
|
| Rate for Payer: PHP Commercial |
$2,586.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,647.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,855.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,677.68
|
| Rate for Payer: UHC Core |
$2,540.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,282.12
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,042.82
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$722.67 |
| Max. Negotiated Rate |
$2,738.54 |
| Rate for Payer: Aetna Commercial |
$2,586.40
|
| Rate for Payer: Aetna Medicare |
$791.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$950.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$950.88
|
| Rate for Payer: BCBS Complete |
$1,217.13
|
| Rate for Payer: BCBS MAPPO |
$760.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,365.79
|
| Rate for Payer: BCN Commercial |
$2,365.79
|
| Rate for Payer: BCN Medicare Advantage |
$760.70
|
| Rate for Payer: Cash Price |
$2,434.26
|
| Rate for Payer: Cofinity Commercial |
$2,616.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,434.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.70
|
| Rate for Payer: Healthscope Commercial |
$2,738.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,282.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$798.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$874.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,586.40
|
| Rate for Payer: PACE Senior Care Partners |
$722.67
|
| Rate for Payer: PACE SWMI |
$760.70
|
| Rate for Payer: PHP Commercial |
$2,586.40
|
| Rate for Payer: PHP Medicare Advantage |
$760.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,647.25
|
| Rate for Payer: Priority Health Medicare |
$760.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,855.82
|
| Rate for Payer: Railroad Medicare Medicare |
$760.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,677.68
|
| Rate for Payer: UHC Core |
$2,540.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.70
|
| Rate for Payer: UHC Medicare Advantage |
$783.53
|
| Rate for Payer: VA VA |
$760.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,282.12
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$268.39
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$163.69 |
| Max. Negotiated Rate |
$241.55 |
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: BCBS Trust/PPO |
$207.41
|
| Rate for Payer: BCN Commercial |
$207.41
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cofinity Commercial |
$230.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.71
|
| Rate for Payer: Healthscope Commercial |
$241.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.13
|
| Rate for Payer: PHP Commercial |
$228.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.18
|
| Rate for Payer: UHC Core |
$224.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.29
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$268.39
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$63.74 |
| Max. Negotiated Rate |
$241.55 |
| Rate for Payer: Aetna Commercial |
$228.13
|
| Rate for Payer: Aetna Medicare |
$69.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.87
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$67.10
|
| Rate for Payer: BCBS Trust/PPO |
$208.67
|
| Rate for Payer: BCN Commercial |
$208.67
|
| Rate for Payer: BCN Medicare Advantage |
$67.10
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cash Price |
$214.71
|
| Rate for Payer: Cofinity Commercial |
$230.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.10
|
| Rate for Payer: Healthscope Commercial |
$241.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.29
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.13
|
| Rate for Payer: PACE Senior Care Partners |
$63.74
|
| Rate for Payer: PACE SWMI |
$67.10
|
| Rate for Payer: PHP Commercial |
$228.13
|
| Rate for Payer: PHP Medicare Advantage |
$67.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.50
|
| Rate for Payer: Priority Health Medicare |
$67.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.69
|
| Rate for Payer: Railroad Medicare Medicare |
$67.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.18
|
| Rate for Payer: UHC Core |
$224.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.10
|
| Rate for Payer: UHC Medicare Advantage |
$69.11
|
| Rate for Payer: VA VA |
$67.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.29
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
OP
|
$257.96
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$61.27 |
| Max. Negotiated Rate |
$232.16 |
| Rate for Payer: Aetna Commercial |
$219.27
|
| Rate for Payer: Aetna Medicare |
$67.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.61
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$64.49
|
| Rate for Payer: BCBS Trust/PPO |
$200.56
|
| Rate for Payer: BCN Commercial |
$200.56
|
| Rate for Payer: BCN Medicare Advantage |
$64.49
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cofinity Commercial |
$221.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.49
|
| Rate for Payer: Healthscope Commercial |
$232.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.47
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.27
|
| Rate for Payer: PACE Senior Care Partners |
$61.27
|
| Rate for Payer: PACE SWMI |
$64.49
|
| Rate for Payer: PHP Commercial |
$219.27
|
| Rate for Payer: PHP Medicare Advantage |
$64.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.43
|
| Rate for Payer: Priority Health Medicare |
$64.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.33
|
| Rate for Payer: Railroad Medicare Medicare |
$64.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.00
|
| Rate for Payer: UHC Core |
$215.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.49
|
| Rate for Payer: UHC Medicare Advantage |
$66.42
|
| Rate for Payer: VA VA |
$64.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.47
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$257.96
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$157.33 |
| Max. Negotiated Rate |
$232.16 |
| Rate for Payer: Aetna Commercial |
$219.27
|
| Rate for Payer: BCBS Trust/PPO |
$199.35
|
| Rate for Payer: BCN Commercial |
$199.35
|
| Rate for Payer: Cash Price |
$206.37
|
| Rate for Payer: Cofinity Commercial |
$221.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.37
|
| Rate for Payer: Healthscope Commercial |
$232.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.27
|
| Rate for Payer: PHP Commercial |
$219.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.00
|
| Rate for Payer: UHC Core |
$215.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.47
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,514.51
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,533.60 |
| Max. Negotiated Rate |
$2,263.06 |
| Rate for Payer: Aetna Commercial |
$2,137.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,943.21
|
| Rate for Payer: BCN Commercial |
$1,943.21
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$2,162.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Healthscope Commercial |
$2,263.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: PHP Commercial |
$2,137.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,187.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,212.77
|
| Rate for Payer: UHC Core |
$2,099.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,514.51
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$597.20 |
| Max. Negotiated Rate |
$2,263.06 |
| Rate for Payer: Aetna Commercial |
$2,137.33
|
| Rate for Payer: Aetna Medicare |
$653.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$785.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$785.78
|
| Rate for Payer: BCBS Complete |
$1,005.80
|
| Rate for Payer: BCBS MAPPO |
$628.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.03
|
| Rate for Payer: BCN Commercial |
$1,955.03
|
| Rate for Payer: BCN Medicare Advantage |
$628.63
|
| Rate for Payer: Cash Price |
$2,011.61
|
| Rate for Payer: Cofinity Commercial |
$2,162.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.63
|
| Rate for Payer: Healthscope Commercial |
$2,263.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$660.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$722.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
| Rate for Payer: PACE Senior Care Partners |
$597.20
|
| Rate for Payer: PACE SWMI |
$628.63
|
| Rate for Payer: PHP Commercial |
$2,137.33
|
| Rate for Payer: PHP Medicare Advantage |
$628.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,187.62
|
| Rate for Payer: Priority Health Medicare |
$628.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.60
|
| Rate for Payer: Railroad Medicare Medicare |
$628.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,212.77
|
| Rate for Payer: UHC Core |
$2,099.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$628.63
|
| Rate for Payer: UHC Medicare Advantage |
$647.49
|
| Rate for Payer: VA VA |
$628.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,115.71
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$739.98 |
| Max. Negotiated Rate |
$2,804.14 |
| Rate for Payer: Aetna Commercial |
$2,648.35
|
| Rate for Payer: Aetna Medicare |
$810.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$973.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$973.66
|
| Rate for Payer: BCBS Complete |
$1,246.28
|
| Rate for Payer: BCBS MAPPO |
$778.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,422.46
|
| Rate for Payer: BCN Commercial |
$2,422.46
|
| Rate for Payer: BCN Medicare Advantage |
$778.93
|
| Rate for Payer: Cash Price |
$2,492.57
|
| Rate for Payer: Cofinity Commercial |
$2,679.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,492.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.93
|
| Rate for Payer: Healthscope Commercial |
$2,804.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,336.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$817.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$895.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,648.35
|
| Rate for Payer: PACE Senior Care Partners |
$739.98
|
| Rate for Payer: PACE SWMI |
$778.93
|
| Rate for Payer: PHP Commercial |
$2,648.35
|
| Rate for Payer: PHP Medicare Advantage |
$778.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,710.67
|
| Rate for Payer: Priority Health Medicare |
$778.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.27
|
| Rate for Payer: Railroad Medicare Medicare |
$778.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,741.82
|
| Rate for Payer: UHC Core |
$2,601.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$778.93
|
| Rate for Payer: UHC Medicare Advantage |
$802.30
|
| Rate for Payer: VA VA |
$778.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,336.78
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,115.71
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,900.27 |
| Max. Negotiated Rate |
$2,804.14 |
| Rate for Payer: Aetna Commercial |
$2,648.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,407.82
|
| Rate for Payer: BCN Commercial |
$2,407.82
|
| Rate for Payer: Cash Price |
$2,492.57
|
| Rate for Payer: Cofinity Commercial |
$2,679.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,492.57
|
| Rate for Payer: Healthscope Commercial |
$2,804.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,336.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,648.35
|
| Rate for Payer: PHP Commercial |
$2,648.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,710.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,741.82
|
| Rate for Payer: UHC Core |
$2,601.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,336.78
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$694.78
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$625.30 |
| Rate for Payer: Aetna Commercial |
$590.56
|
| Rate for Payer: Aetna Medicare |
$180.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.12
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$173.70
|
| Rate for Payer: BCBS Trust/PPO |
$540.19
|
| Rate for Payer: BCN Commercial |
$540.19
|
| Rate for Payer: BCN Medicare Advantage |
$173.70
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cofinity Commercial |
$597.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$625.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$521.08
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$590.56
|
| Rate for Payer: PACE Senior Care Partners |
$165.01
|
| Rate for Payer: PACE SWMI |
$173.70
|
| Rate for Payer: PHP Commercial |
$590.56
|
| Rate for Payer: PHP Medicare Advantage |
$173.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$604.46
|
| Rate for Payer: Priority Health Medicare |
$173.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.75
|
| Rate for Payer: Railroad Medicare Medicare |
$173.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.41
|
| Rate for Payer: UHC Core |
$580.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.70
|
| Rate for Payer: UHC Medicare Advantage |
$178.91
|
| Rate for Payer: VA VA |
$173.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$521.08
|
|
