|
HC CODFISH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200035
|
|
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 COGNITIVE EXAM
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
43400002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$70.06 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: Aetna Medicare |
$76.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.19
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$73.75
|
| Rate for Payer: BCBS Trust/PPO |
$229.36
|
| Rate for Payer: BCN Commercial |
$229.36
|
| Rate for Payer: BCN Medicare Advantage |
$73.75
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.75
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PACE Senior Care Partners |
$70.06
|
| Rate for Payer: PACE SWMI |
$73.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: PHP Medicare Advantage |
$73.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.65
|
| Rate for Payer: Priority Health Medicare |
$73.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.92
|
| Rate for Payer: Railroad Medicare Medicare |
$73.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.60
|
| Rate for Payer: UHC Core |
$246.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.75
|
| Rate for Payer: UHC Medicare Advantage |
$75.96
|
| Rate for Payer: VA VA |
$73.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC COGNITIVE EXAM
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
43400002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$179.92 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: BCBS Trust/PPO |
$227.98
|
| Rate for Payer: BCN Commercial |
$227.98
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.60
|
| Rate for Payer: UHC Core |
$246.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC COGNITIVE FUNCTION, ADDL 15 MIN
|
Facility
|
OP
|
$111.26
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
43000023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$26.42 |
| Max. Negotiated Rate |
$100.13 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$44.50
|
| Rate for Payer: BCBS MAPPO |
$27.82
|
| Rate for Payer: BCBS Trust/PPO |
$86.50
|
| Rate for Payer: BCN Commercial |
$86.50
|
| Rate for Payer: BCN Medicare Advantage |
$27.82
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cofinity Commercial |
$95.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.82
|
| Rate for Payer: Healthscope Commercial |
$100.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.57
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.82
|
| Rate for Payer: PHP Commercial |
$94.57
|
| Rate for Payer: PHP Medicare Advantage |
$27.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.80
|
| Rate for Payer: Priority Health Medicare |
$27.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.86
|
| Rate for Payer: Railroad Medicare Medicare |
$27.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.91
|
| Rate for Payer: UHC Core |
$92.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.82
|
| Rate for Payer: UHC Medicare Advantage |
$28.65
|
| Rate for Payer: VA VA |
$27.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC COGNITIVE FUNCTION, ADDL 15 MIN
|
Facility
|
IP
|
$111.26
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
43000023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$67.86 |
| Max. Negotiated Rate |
$100.13 |
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: BCBS Trust/PPO |
$85.98
|
| Rate for Payer: BCN Commercial |
$85.98
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cofinity Commercial |
$95.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.01
|
| Rate for Payer: Healthscope Commercial |
$100.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.57
|
| Rate for Payer: PHP Commercial |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.91
|
| Rate for Payer: UHC Core |
$92.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC COGNITIVE FUNCTION, INITIAL 15 MIN
|
Facility
|
OP
|
$113.49
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
43000022
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$26.95 |
| Max. Negotiated Rate |
$102.14 |
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: Aetna Medicare |
$29.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.47
|
| Rate for Payer: BCBS Complete |
$45.40
|
| Rate for Payer: BCBS MAPPO |
$28.37
|
| Rate for Payer: BCBS Trust/PPO |
$88.24
|
| Rate for Payer: BCN Commercial |
$88.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.37
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cofinity Commercial |
$97.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.37
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.47
|
| Rate for Payer: PACE Senior Care Partners |
$26.95
|
| Rate for Payer: PACE SWMI |
$28.37
|
| Rate for Payer: PHP Commercial |
$96.47
|
| Rate for Payer: PHP Medicare Advantage |
$28.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.74
|
| Rate for Payer: Priority Health Medicare |
$28.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.22
|
| Rate for Payer: Railroad Medicare Medicare |
$28.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.87
|
| Rate for Payer: UHC Core |
$94.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.37
|
| Rate for Payer: UHC Medicare Advantage |
$29.22
|
| Rate for Payer: VA VA |
$28.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.12
|
|
|
HC COGNITIVE FUNCTION, INITIAL 15 MIN
|
Facility
|
IP
|
$113.49
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
43000022
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$69.22 |
| Max. Negotiated Rate |
$102.14 |
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: BCBS Trust/PPO |
$87.71
|
| Rate for Payer: BCN Commercial |
$87.71
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cofinity Commercial |
$97.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.79
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.47
|
| Rate for Payer: PHP Commercial |
$96.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.87
|
| Rate for Payer: UHC Core |
$94.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.12
|
|
|
HC COLD AGGLUTININS
|
Facility
|
OP
|
$60.30
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
30200149
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$54.27 |
| Rate for Payer: Aetna Commercial |
$51.26
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.84
|
| Rate for Payer: BCBS Complete |
$6.25
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$46.88
|
| Rate for Payer: BCN Commercial |
$46.88
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$54.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.22
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Medicaid |
$6.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.26
|
| Rate for Payer: PACE Senior Care Partners |
$14.32
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$51.26
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.46
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.78
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.06
|
| Rate for Payer: UHC Core |
$50.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.53
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.22
|
|
|
HC COLD AGGLUTININS
|
Facility
|
IP
|
$60.30
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
30200149
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.78 |
| Max. Negotiated Rate |
$54.27 |
| Rate for Payer: Aetna Commercial |
$51.26
|
| Rate for Payer: BCBS Trust/PPO |
$46.60
|
| Rate for Payer: BCN Commercial |
$46.60
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.24
|
| Rate for Payer: Healthscope Commercial |
$54.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.26
|
| Rate for Payer: PHP Commercial |
$51.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.06
|
| Rate for Payer: UHC Core |
$50.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.22
|
|
|
HC COLD SNARE POLYPECTOMY
|
Facility
|
IP
|
$534.47
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$325.97 |
| Max. Negotiated Rate |
$481.02 |
| Rate for Payer: Aetna Commercial |
$454.30
|
| Rate for Payer: BCBS Trust/PPO |
$413.04
|
| Rate for Payer: BCN Commercial |
$413.04
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$459.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Healthscope Commercial |
$481.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$454.30
|
| Rate for Payer: PHP Commercial |
$454.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.33
|
| Rate for Payer: UHC Core |
$446.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.85
|
|
|
HC COLD SNARE POLYPECTOMY
|
Facility
|
OP
|
$534.47
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$481.02 |
| Rate for Payer: Aetna Commercial |
$454.30
|
| Rate for Payer: Aetna Medicare |
$138.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.02
|
| Rate for Payer: BCBS Complete |
$213.79
|
| Rate for Payer: BCBS MAPPO |
$133.62
|
| Rate for Payer: BCBS Trust/PPO |
$415.55
|
| Rate for Payer: BCN Commercial |
$415.55
|
| Rate for Payer: BCN Medicare Advantage |
$133.62
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$459.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.62
|
| Rate for Payer: Healthscope Commercial |
$481.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$140.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$454.30
|
| Rate for Payer: PACE Senior Care Partners |
$126.94
|
| Rate for Payer: PACE SWMI |
$133.62
|
| Rate for Payer: PHP Commercial |
$454.30
|
| Rate for Payer: PHP Medicare Advantage |
$133.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$464.99
|
| Rate for Payer: Priority Health Medicare |
$133.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.97
|
| Rate for Payer: Railroad Medicare Medicare |
$133.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.33
|
| Rate for Payer: UHC Core |
$446.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.62
|
| Rate for Payer: UHC Medicare Advantage |
$137.63
|
| Rate for Payer: VA VA |
$133.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.85
|
|
|
HC COLLAGEN IMPLANT
|
Facility
|
IP
|
$1,844.10
|
|
|
Service Code
|
HCPCS L8603
|
| Hospital Charge Code |
27800005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,124.72 |
| Max. Negotiated Rate |
$1,659.69 |
| Rate for Payer: Aetna Commercial |
$1,567.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,425.12
|
| Rate for Payer: BCN Commercial |
$1,425.12
|
| Rate for Payer: Cash Price |
$1,475.28
|
| Rate for Payer: Cofinity Commercial |
$1,585.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,475.28
|
| Rate for Payer: Healthscope Commercial |
$1,659.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,383.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,567.48
|
| Rate for Payer: PHP Commercial |
$1,567.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,604.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,124.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,622.81
|
| Rate for Payer: UHC Core |
$1,539.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,383.08
|
|
|
HC COLLAGEN IMPLANT
|
Facility
|
OP
|
$1,844.10
|
|
|
Service Code
|
HCPCS L8603
|
| Hospital Charge Code |
27800005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$437.97 |
| Max. Negotiated Rate |
$1,659.69 |
| Rate for Payer: Aetna Commercial |
$1,567.48
|
| Rate for Payer: Aetna Medicare |
$479.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$576.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$576.28
|
| Rate for Payer: BCBS Complete |
$737.64
|
| Rate for Payer: BCBS MAPPO |
$461.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.79
|
| Rate for Payer: BCN Commercial |
$1,433.79
|
| Rate for Payer: BCN Medicare Advantage |
$461.02
|
| Rate for Payer: Cash Price |
$1,475.28
|
| Rate for Payer: Cofinity Commercial |
$1,585.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,475.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$461.02
|
| Rate for Payer: Healthscope Commercial |
$1,659.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,383.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$484.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,567.48
|
| Rate for Payer: PACE Senior Care Partners |
$437.97
|
| Rate for Payer: PACE SWMI |
$461.02
|
| Rate for Payer: PHP Commercial |
$1,567.48
|
| Rate for Payer: PHP Medicare Advantage |
$461.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,604.37
|
| Rate for Payer: Priority Health Medicare |
$461.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,124.72
|
| Rate for Payer: Railroad Medicare Medicare |
$461.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,622.81
|
| Rate for Payer: UHC Core |
$1,539.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$461.02
|
| Rate for Payer: UHC Medicare Advantage |
$474.86
|
| Rate for Payer: VA VA |
$461.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,383.08
|
|
|
HC COLL CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$8.57
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.23 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$7.28
|
| Rate for Payer: BCBS Trust/PPO |
$6.62
|
| Rate for Payer: BCN Commercial |
$6.62
|
| Rate for Payer: Cash Price |
$6.86
|
| Rate for Payer: Cofinity Commercial |
$7.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.86
|
| Rate for Payer: Healthscope Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.28
|
| Rate for Payer: PHP Commercial |
$7.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.54
|
| Rate for Payer: UHC Core |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.43
|
|
|
HC COLL CAPILLARY BLOOD SPECIMEN
|
Facility
|
OP
|
$8.57
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
30000077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$7.28
|
| Rate for Payer: Aetna Medicare |
$2.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.68
|
| Rate for Payer: BCBS Complete |
$3.43
|
| Rate for Payer: BCBS MAPPO |
$2.14
|
| Rate for Payer: BCBS Trust/PPO |
$6.66
|
| Rate for Payer: BCN Commercial |
$6.66
|
| Rate for Payer: BCN Medicare Advantage |
$2.14
|
| Rate for Payer: Cash Price |
$6.86
|
| Rate for Payer: Cofinity Commercial |
$7.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.14
|
| Rate for Payer: Healthscope Commercial |
$7.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.28
|
| Rate for Payer: PACE Senior Care Partners |
$2.04
|
| Rate for Payer: PACE SWMI |
$2.14
|
| Rate for Payer: PHP Commercial |
$7.28
|
| Rate for Payer: PHP Medicare Advantage |
$2.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.46
|
| Rate for Payer: Priority Health Medicare |
$2.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.23
|
| Rate for Payer: Railroad Medicare Medicare |
$2.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.54
|
| Rate for Payer: UHC Core |
$7.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.14
|
| Rate for Payer: UHC Medicare Advantage |
$2.21
|
| Rate for Payer: VA VA |
$2.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.43
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
OP
|
$2,355.43
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$559.41 |
| Max. Negotiated Rate |
$2,119.89 |
| Rate for Payer: Aetna Commercial |
$2,002.12
|
| Rate for Payer: Aetna Medicare |
$612.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$736.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$736.07
|
| Rate for Payer: BCBS Complete |
$942.17
|
| Rate for Payer: BCBS MAPPO |
$588.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.35
|
| Rate for Payer: BCN Commercial |
$1,831.35
|
| Rate for Payer: BCN Medicare Advantage |
$588.86
|
| Rate for Payer: Cash Price |
$1,884.34
|
| Rate for Payer: Cofinity Commercial |
$2,025.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,884.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.86
|
| Rate for Payer: Healthscope Commercial |
$2,119.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,766.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$618.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$677.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,002.12
|
| Rate for Payer: PACE Senior Care Partners |
$559.41
|
| Rate for Payer: PACE SWMI |
$588.86
|
| Rate for Payer: PHP Commercial |
$2,002.12
|
| Rate for Payer: PHP Medicare Advantage |
$588.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,648.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,049.22
|
| Rate for Payer: Priority Health Medicare |
$588.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.58
|
| Rate for Payer: Railroad Medicare Medicare |
$588.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,072.78
|
| Rate for Payer: UHC Core |
$1,966.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.86
|
| Rate for Payer: UHC Medicare Advantage |
$606.52
|
| Rate for Payer: VA VA |
$588.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,766.57
|
|
|
HC COLON DECOMPRESSION
|
Facility
|
IP
|
$2,355.43
|
|
| Hospital Charge Code |
36000019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,436.58 |
| Max. Negotiated Rate |
$2,119.89 |
| Rate for Payer: Aetna Commercial |
$2,002.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,820.28
|
| Rate for Payer: BCN Commercial |
$1,820.28
|
| Rate for Payer: Cash Price |
$1,884.34
|
| Rate for Payer: Cofinity Commercial |
$2,025.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,884.34
|
| Rate for Payer: Healthscope Commercial |
$2,119.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,766.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,002.12
|
| Rate for Payer: PHP Commercial |
$2,002.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,648.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,049.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,436.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,072.78
|
| Rate for Payer: UHC Core |
$1,966.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,766.57
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
IP
|
$359.40
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$219.20 |
| Max. Negotiated Rate |
$323.46 |
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: BCBS Trust/PPO |
$277.74
|
| Rate for Payer: BCN Commercial |
$277.74
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.52
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.27
|
| Rate for Payer: UHC Core |
$300.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.55
|
|
|
HC COLON MOTILITY STUDY 6 HRS CONT RECORDING
|
Facility
|
OP
|
$359.40
|
|
|
Service Code
|
CPT 91117
|
| Hospital Charge Code |
75000011
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$85.36 |
| Max. Negotiated Rate |
$323.46 |
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: Aetna Medicare |
$93.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.31
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$89.85
|
| Rate for Payer: BCBS Trust/PPO |
$279.43
|
| Rate for Payer: BCN Commercial |
$279.43
|
| Rate for Payer: BCN Medicare Advantage |
$89.85
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.85
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.55
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PACE Senior Care Partners |
$85.36
|
| Rate for Payer: PACE SWMI |
$89.85
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: PHP Medicare Advantage |
$89.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.68
|
| Rate for Payer: Priority Health Medicare |
$89.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.20
|
| Rate for Payer: Railroad Medicare Medicare |
$89.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.27
|
| Rate for Payer: UHC Core |
$300.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.85
|
| Rate for Payer: UHC Medicare Advantage |
$92.55
|
| Rate for Payer: VA VA |
$89.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.55
|
|
|
HC COLONOSCOPY
|
Facility
|
IP
|
$2,560.49
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,561.64 |
| Max. Negotiated Rate |
$2,304.44 |
| Rate for Payer: Aetna Commercial |
$2,176.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,978.75
|
| Rate for Payer: BCN Commercial |
$1,978.75
|
| Rate for Payer: Cash Price |
$2,048.39
|
| Rate for Payer: Cofinity Commercial |
$2,202.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.39
|
| Rate for Payer: Healthscope Commercial |
$2,304.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,920.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,176.42
|
| Rate for Payer: PHP Commercial |
$2,176.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,227.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,561.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,253.23
|
| Rate for Payer: UHC Core |
$2,138.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,920.37
|
|
|
HC COLONOSCOPY
|
Facility
|
OP
|
$2,560.49
|
|
| Hospital Charge Code |
36000020
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$608.12 |
| Max. Negotiated Rate |
$2,304.44 |
| Rate for Payer: Aetna Commercial |
$2,176.42
|
| Rate for Payer: Aetna Medicare |
$665.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$800.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$800.15
|
| Rate for Payer: BCBS Complete |
$1,024.20
|
| Rate for Payer: BCBS MAPPO |
$640.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.78
|
| Rate for Payer: BCN Commercial |
$1,990.78
|
| Rate for Payer: BCN Medicare Advantage |
$640.12
|
| Rate for Payer: Cash Price |
$2,048.39
|
| Rate for Payer: Cofinity Commercial |
$2,202.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,048.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.12
|
| Rate for Payer: Healthscope Commercial |
$2,304.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,920.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$672.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$736.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,176.42
|
| Rate for Payer: PACE Senior Care Partners |
$608.12
|
| Rate for Payer: PACE SWMI |
$640.12
|
| Rate for Payer: PHP Commercial |
$2,176.42
|
| Rate for Payer: PHP Medicare Advantage |
$640.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,792.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,227.63
|
| Rate for Payer: Priority Health Medicare |
$640.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,561.64
|
| Rate for Payer: Railroad Medicare Medicare |
$640.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,253.23
|
| Rate for Payer: UHC Core |
$2,138.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$640.12
|
| Rate for Payer: UHC Medicare Advantage |
$659.33
|
| Rate for Payer: VA VA |
$640.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,920.37
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,745.16
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,674.27 |
| Max. Negotiated Rate |
$2,470.64 |
| Rate for Payer: Aetna Commercial |
$2,333.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.46
|
| Rate for Payer: BCN Commercial |
$2,121.46
|
| Rate for Payer: Cash Price |
$2,196.13
|
| Rate for Payer: Cofinity Commercial |
$2,360.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,196.13
|
| Rate for Payer: Healthscope Commercial |
$2,470.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,058.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,333.39
|
| Rate for Payer: PHP Commercial |
$2,333.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,388.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,674.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,415.74
|
| Rate for Payer: UHC Core |
$2,292.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,058.87
|
|
|
HC COLONOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,745.16
|
|
| Hospital Charge Code |
36000022
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$651.98 |
| Max. Negotiated Rate |
$2,470.64 |
| Rate for Payer: Aetna Commercial |
$2,333.39
|
| Rate for Payer: Aetna Medicare |
$713.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.86
|
| Rate for Payer: BCBS Complete |
$1,098.06
|
| Rate for Payer: BCBS MAPPO |
$686.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,134.36
|
| Rate for Payer: BCN Commercial |
$2,134.36
|
| Rate for Payer: BCN Medicare Advantage |
$686.29
|
| Rate for Payer: Cash Price |
$2,196.13
|
| Rate for Payer: Cofinity Commercial |
$2,360.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,196.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.29
|
| Rate for Payer: Healthscope Commercial |
$2,470.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,058.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$720.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,333.39
|
| Rate for Payer: PACE Senior Care Partners |
$651.98
|
| Rate for Payer: PACE SWMI |
$686.29
|
| Rate for Payer: PHP Commercial |
$2,333.39
|
| Rate for Payer: PHP Medicare Advantage |
$686.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,921.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,388.29
|
| Rate for Payer: Priority Health Medicare |
$686.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,674.27
|
| Rate for Payer: Railroad Medicare Medicare |
$686.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,415.74
|
| Rate for Payer: UHC Core |
$2,292.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.29
|
| Rate for Payer: UHC Medicare Advantage |
$706.88
|
| Rate for Payer: VA VA |
$686.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,058.87
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
IP
|
$6,832.88
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,167.37 |
| Max. Negotiated Rate |
$6,149.59 |
| Rate for Payer: Aetna Commercial |
$5,807.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,280.45
|
| Rate for Payer: BCN Commercial |
$5,280.45
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cofinity Commercial |
$5,876.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,466.30
|
| Rate for Payer: Healthscope Commercial |
$6,149.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,124.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,807.95
|
| Rate for Payer: PHP Commercial |
$5,807.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,783.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,944.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,167.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,012.93
|
| Rate for Payer: UHC Core |
$5,705.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,124.66
|
|
|
HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX
|
Facility
|
OP
|
$6,832.88
|
|
|
Service Code
|
CPT 57461
|
| Hospital Charge Code |
76100328
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$370.46 |
| Max. Negotiated Rate |
$6,149.59 |
| Rate for Payer: Aetna Commercial |
$5,807.95
|
| Rate for Payer: Aetna Medicare |
$1,776.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,135.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,135.28
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,708.22
|
| Rate for Payer: BCBS Trust/PPO |
$5,312.56
|
| Rate for Payer: BCCCP Commercial |
$370.46
|
| Rate for Payer: BCN Commercial |
$5,312.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,708.22
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cash Price |
$5,466.30
|
| Rate for Payer: Cofinity Commercial |
$5,876.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,466.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,708.22
|
| Rate for Payer: Healthscope Commercial |
$6,149.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,124.66
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,793.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,964.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,807.95
|
| Rate for Payer: PACE Senior Care Partners |
$1,622.81
|
| Rate for Payer: PACE SWMI |
$1,708.22
|
| Rate for Payer: PHP Commercial |
$5,807.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,708.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,783.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,944.61
|
| Rate for Payer: Priority Health Medicare |
$1,708.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,167.37
|
| Rate for Payer: Railroad Medicare Medicare |
$1,708.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,012.93
|
| Rate for Payer: UHC Core |
$5,705.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,708.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,759.47
|
| Rate for Payer: VA VA |
$1,708.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,124.66
|
|
