|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$68.13
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: BCBS Trust/PPO |
$56.27
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$55.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.10
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.95
|
| Rate for Payer: UHC Core |
$56.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.10
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
IP
|
$34.08
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.72 |
| Max. Negotiated Rate |
$30.67 |
| Rate for Payer: Aetna Commercial |
$28.97
|
| Rate for Payer: BCBS Trust/PPO |
$28.15
|
| Rate for Payer: BCN Commercial |
$28.15
|
| Rate for Payer: Cash Price |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$29.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.26
|
| Rate for Payer: Healthscope Commercial |
$30.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.97
|
| Rate for Payer: Nomi Health Commercial |
$27.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.56
|
| Rate for Payer: PHP Commercial |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.99
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.56
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
OP
|
$34.08
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$6.01 |
| Max. Negotiated Rate |
$30.67 |
| Rate for Payer: Aetna Commercial |
$28.97
|
| Rate for Payer: Aetna Medicare |
$8.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.65
|
| Rate for Payer: BCBS Complete |
$6.31
|
| Rate for Payer: BCBS MAPPO |
$8.52
|
| Rate for Payer: BCBS Trust/PPO |
$28.02
|
| Rate for Payer: BCN Commercial |
$28.02
|
| Rate for Payer: BCN Medicare Advantage |
$8.52
|
| Rate for Payer: Cash Price |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$29.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.52
|
| Rate for Payer: Healthscope Commercial |
$30.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.56
|
| Rate for Payer: Mclaren Medicaid |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.95
|
| Rate for Payer: Meridian Medicaid |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.97
|
| Rate for Payer: Nomi Health Commercial |
$27.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.56
|
| Rate for Payer: PACE Senior Care Partners |
$8.09
|
| Rate for Payer: PACE SWMI |
$8.52
|
| Rate for Payer: PHP Commercial |
$28.97
|
| Rate for Payer: PHP Medicare Advantage |
$8.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.65
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.72
|
| Rate for Payer: Railroad Medicare Medicare |
$8.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.99
|
| Rate for Payer: UHC Core |
$28.46
|
| Rate for Payer: UHC Exchange |
$8.52
|
| Rate for Payer: UHC Medicaid |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$6.01
|
| Rate for Payer: VA VA |
$8.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.56
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.71 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$135.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.56
|
| Rate for Payer: BCBS Complete |
$96.29
|
| Rate for Payer: BCBS MAPPO |
$130.05
|
| Rate for Payer: BCBS Trust/PPO |
$427.66
|
| Rate for Payer: BCN Commercial |
$427.66
|
| Rate for Payer: BCN Medicare Advantage |
$130.05
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.05
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Mclaren Medicaid |
$91.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.55
|
| Rate for Payer: Meridian Medicaid |
$96.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.15
|
| Rate for Payer: PACE Senior Care Partners |
$123.55
|
| Rate for Payer: PACE SWMI |
$130.05
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: PHP Medicare Advantage |
$130.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.57
|
| Rate for Payer: Priority Health Medicare |
$131.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.06
|
| Rate for Payer: Railroad Medicare Medicare |
$130.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.78
|
| Rate for Payer: UHC Core |
$434.37
|
| Rate for Payer: UHC Exchange |
$130.05
|
| Rate for Payer: UHC Medicaid |
$91.71
|
| Rate for Payer: UHC Medicare Advantage |
$130.05
|
| Rate for Payer: UHCCP Medicaid |
$91.71
|
| Rate for Payer: VA VA |
$130.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.06 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: BCBS Trust/PPO |
$429.63
|
| Rate for Payer: BCN Commercial |
$429.63
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$426.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.15
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$452.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$362.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.78
|
| Rate for Payer: UHC Core |
$434.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$1,061.43
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$187.13 |
| Max. Negotiated Rate |
$955.29 |
| Rate for Payer: Aetna Commercial |
$902.22
|
| Rate for Payer: Aetna Medicare |
$275.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$331.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$331.70
|
| Rate for Payer: BCBS Complete |
$196.47
|
| Rate for Payer: BCBS MAPPO |
$265.36
|
| Rate for Payer: BCBS Trust/PPO |
$872.60
|
| Rate for Payer: BCN Commercial |
$872.60
|
| Rate for Payer: BCN Medicare Advantage |
$265.36
|
| Rate for Payer: Cash Price |
$849.14
|
| Rate for Payer: Cofinity Commercial |
$912.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$849.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$265.36
|
| Rate for Payer: Healthscope Commercial |
$955.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.07
|
| Rate for Payer: Mclaren Medicaid |
$187.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$278.63
|
| Rate for Payer: Meridian Medicaid |
$196.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$305.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$291.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$902.22
|
| Rate for Payer: Nomi Health Commercial |
$870.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.07
|
| Rate for Payer: PACE Senior Care Partners |
$252.09
|
| Rate for Payer: PACE SWMI |
$265.36
|
| Rate for Payer: PHP Commercial |
$902.22
|
| Rate for Payer: PHP Medicare Advantage |
$265.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$923.44
|
| Rate for Payer: Priority Health Medicare |
$268.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.76
|
| Rate for Payer: Railroad Medicare Medicare |
$265.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.06
|
| Rate for Payer: UHC Core |
$886.29
|
| Rate for Payer: UHC Exchange |
$265.36
|
| Rate for Payer: UHC Medicaid |
$187.13
|
| Rate for Payer: UHC Medicare Advantage |
$265.36
|
| Rate for Payer: UHCCP Medicaid |
$187.13
|
| Rate for Payer: VA VA |
$265.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.07
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$1,061.43
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$738.76 |
| Max. Negotiated Rate |
$955.29 |
| Rate for Payer: Aetna Commercial |
$902.22
|
| Rate for Payer: BCBS Trust/PPO |
$876.64
|
| Rate for Payer: BCN Commercial |
$876.64
|
| Rate for Payer: Cash Price |
$849.14
|
| Rate for Payer: Cofinity Commercial |
$912.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$849.14
|
| Rate for Payer: Healthscope Commercial |
$955.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$796.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$902.22
|
| Rate for Payer: Nomi Health Commercial |
$870.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$796.07
|
| Rate for Payer: PHP Commercial |
$902.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$923.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$934.06
|
| Rate for Payer: UHC Core |
$886.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$796.07
|
|
|
HC ANOSCOPY
|
Facility
|
OP
|
$166.18
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$149.56 |
| Rate for Payer: Aetna Commercial |
$141.25
|
| Rate for Payer: Aetna Medicare |
$43.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.93
|
| Rate for Payer: BCBS Complete |
$30.76
|
| Rate for Payer: BCBS MAPPO |
$41.55
|
| Rate for Payer: BCBS Trust/PPO |
$136.62
|
| Rate for Payer: BCN Commercial |
$136.62
|
| Rate for Payer: BCN Medicare Advantage |
$41.55
|
| Rate for Payer: Cash Price |
$132.94
|
| Rate for Payer: Cofinity Commercial |
$142.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.55
|
| Rate for Payer: Healthscope Commercial |
$149.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Mclaren Medicaid |
$29.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.62
|
| Rate for Payer: Meridian Medicaid |
$30.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.25
|
| Rate for Payer: Nomi Health Commercial |
$136.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.64
|
| Rate for Payer: PACE Senior Care Partners |
$39.47
|
| Rate for Payer: PACE SWMI |
$41.55
|
| Rate for Payer: PHP Commercial |
$141.25
|
| Rate for Payer: PHP Medicare Advantage |
$41.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.58
|
| Rate for Payer: Priority Health Medicare |
$41.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.66
|
| Rate for Payer: Railroad Medicare Medicare |
$41.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.24
|
| Rate for Payer: UHC Core |
$138.76
|
| Rate for Payer: UHC Exchange |
$41.55
|
| Rate for Payer: UHC Medicaid |
$29.30
|
| Rate for Payer: UHC Medicare Advantage |
$41.55
|
| Rate for Payer: UHCCP Medicaid |
$29.30
|
| Rate for Payer: VA VA |
$41.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
|
HC ANOSCOPY
|
Facility
|
IP
|
$166.18
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$115.66 |
| Max. Negotiated Rate |
$149.56 |
| Rate for Payer: Aetna Commercial |
$141.25
|
| Rate for Payer: BCBS Trust/PPO |
$137.25
|
| Rate for Payer: BCN Commercial |
$137.25
|
| Rate for Payer: Cash Price |
$132.94
|
| Rate for Payer: Cofinity Commercial |
$142.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.94
|
| Rate for Payer: Healthscope Commercial |
$149.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.25
|
| Rate for Payer: Nomi Health Commercial |
$136.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.64
|
| Rate for Payer: PHP Commercial |
$141.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.24
|
| Rate for Payer: UHC Core |
$138.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$365.16
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.38 |
| Max. Negotiated Rate |
$328.64 |
| Rate for Payer: Aetna Commercial |
$310.39
|
| Rate for Payer: Aetna Medicare |
$94.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.11
|
| Rate for Payer: BCBS Complete |
$67.59
|
| Rate for Payer: BCBS MAPPO |
$91.29
|
| Rate for Payer: BCBS Trust/PPO |
$300.20
|
| Rate for Payer: BCN Commercial |
$300.20
|
| Rate for Payer: BCN Medicare Advantage |
$91.29
|
| Rate for Payer: Cash Price |
$292.13
|
| Rate for Payer: Cofinity Commercial |
$314.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.29
|
| Rate for Payer: Healthscope Commercial |
$328.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.87
|
| Rate for Payer: Mclaren Medicaid |
$64.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.85
|
| Rate for Payer: Meridian Medicaid |
$67.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.39
|
| Rate for Payer: Nomi Health Commercial |
$299.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.87
|
| Rate for Payer: PACE Senior Care Partners |
$86.73
|
| Rate for Payer: PACE SWMI |
$91.29
|
| Rate for Payer: PHP Commercial |
$310.39
|
| Rate for Payer: PHP Medicare Advantage |
$91.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.69
|
| Rate for Payer: Priority Health Medicare |
$92.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.15
|
| Rate for Payer: Railroad Medicare Medicare |
$91.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.34
|
| Rate for Payer: UHC Core |
$304.91
|
| Rate for Payer: UHC Exchange |
$91.29
|
| Rate for Payer: UHC Medicaid |
$64.38
|
| Rate for Payer: UHC Medicare Advantage |
$91.29
|
| Rate for Payer: UHCCP Medicaid |
$64.38
|
| Rate for Payer: VA VA |
$91.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.87
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$365.16
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.15 |
| Max. Negotiated Rate |
$328.64 |
| Rate for Payer: Aetna Commercial |
$310.39
|
| Rate for Payer: BCBS Trust/PPO |
$301.59
|
| Rate for Payer: BCN Commercial |
$301.59
|
| Rate for Payer: Cash Price |
$292.13
|
| Rate for Payer: Cofinity Commercial |
$314.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.13
|
| Rate for Payer: Healthscope Commercial |
$328.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.39
|
| Rate for Payer: Nomi Health Commercial |
$299.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.87
|
| Rate for Payer: PHP Commercial |
$310.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.34
|
| Rate for Payer: UHC Core |
$304.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.87
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
IP
|
$1,598.53
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,112.58 |
| Max. Negotiated Rate |
$1,438.68 |
| Rate for Payer: Aetna Commercial |
$1,358.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.23
|
| Rate for Payer: BCN Commercial |
$1,320.23
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Commercial |
$1,374.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Healthscope Commercial |
$1,438.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,198.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Nomi Health Commercial |
$1,310.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: PHP Commercial |
$1,358.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,390.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,112.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,406.71
|
| Rate for Payer: UHC Core |
$1,334.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,198.90
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
OP
|
$1,598.53
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.82 |
| Max. Negotiated Rate |
$1,438.68 |
| Rate for Payer: Aetna Commercial |
$1,358.75
|
| Rate for Payer: Aetna Medicare |
$415.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$499.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$499.54
|
| Rate for Payer: BCBS Complete |
$295.89
|
| Rate for Payer: BCBS MAPPO |
$399.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.15
|
| Rate for Payer: BCN Commercial |
$1,314.15
|
| Rate for Payer: BCN Medicare Advantage |
$399.63
|
| Rate for Payer: Cash Price |
$1,278.82
|
| Rate for Payer: Cofinity Commercial |
$1,374.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,278.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.63
|
| Rate for Payer: Healthscope Commercial |
$1,438.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,198.90
|
| Rate for Payer: Mclaren Medicaid |
$281.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.61
|
| Rate for Payer: Meridian Medicaid |
$295.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$459.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,358.75
|
| Rate for Payer: Nomi Health Commercial |
$1,310.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,198.90
|
| Rate for Payer: PACE Senior Care Partners |
$379.65
|
| Rate for Payer: PACE SWMI |
$399.63
|
| Rate for Payer: PHP Commercial |
$1,358.75
|
| Rate for Payer: PHP Medicare Advantage |
$399.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,390.72
|
| Rate for Payer: Priority Health Medicare |
$403.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,112.58
|
| Rate for Payer: Railroad Medicare Medicare |
$399.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,406.71
|
| Rate for Payer: UHC Core |
$1,334.77
|
| Rate for Payer: UHC Exchange |
$399.63
|
| Rate for Payer: UHC Medicaid |
$281.82
|
| Rate for Payer: UHC Medicare Advantage |
$399.63
|
| Rate for Payer: UHCCP Medicaid |
$281.82
|
| Rate for Payer: VA VA |
$399.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,198.90
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
IP
|
$2,115.84
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,472.62 |
| Max. Negotiated Rate |
$1,904.26 |
| Rate for Payer: Aetna Commercial |
$1,798.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,747.47
|
| Rate for Payer: BCN Commercial |
$1,747.47
|
| Rate for Payer: Cash Price |
$1,692.67
|
| Rate for Payer: Cofinity Commercial |
$1,819.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.67
|
| Rate for Payer: Healthscope Commercial |
$1,904.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,586.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.46
|
| Rate for Payer: Nomi Health Commercial |
$1,734.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,586.88
|
| Rate for Payer: PHP Commercial |
$1,798.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,840.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,861.94
|
| Rate for Payer: UHC Core |
$1,766.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,586.88
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
OP
|
$2,115.84
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$373.02 |
| Max. Negotiated Rate |
$1,904.26 |
| Rate for Payer: Aetna Commercial |
$1,798.46
|
| Rate for Payer: Aetna Medicare |
$550.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$661.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$661.20
|
| Rate for Payer: BCBS Complete |
$391.64
|
| Rate for Payer: BCBS MAPPO |
$528.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.43
|
| Rate for Payer: BCN Commercial |
$1,739.43
|
| Rate for Payer: BCN Medicare Advantage |
$528.96
|
| Rate for Payer: Cash Price |
$1,692.67
|
| Rate for Payer: Cofinity Commercial |
$1,819.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$528.96
|
| Rate for Payer: Healthscope Commercial |
$1,904.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,586.88
|
| Rate for Payer: Mclaren Medicaid |
$373.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.41
|
| Rate for Payer: Meridian Medicaid |
$391.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$608.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$581.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.46
|
| Rate for Payer: Nomi Health Commercial |
$1,734.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,586.88
|
| Rate for Payer: PACE Senior Care Partners |
$502.51
|
| Rate for Payer: PACE SWMI |
$528.96
|
| Rate for Payer: PHP Commercial |
$1,798.46
|
| Rate for Payer: PHP Medicare Advantage |
$528.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$373.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,840.78
|
| Rate for Payer: Priority Health Medicare |
$534.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,472.62
|
| Rate for Payer: Railroad Medicare Medicare |
$528.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,861.94
|
| Rate for Payer: UHC Core |
$1,766.73
|
| Rate for Payer: UHC Exchange |
$528.96
|
| Rate for Payer: UHC Medicaid |
$373.02
|
| Rate for Payer: UHC Medicare Advantage |
$528.96
|
| Rate for Payer: UHCCP Medicaid |
$373.02
|
| Rate for Payer: VA VA |
$528.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,586.88
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$120.17
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$83.64 |
| Max. Negotiated Rate |
$108.15 |
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: BCBS Trust/PPO |
$99.25
|
| Rate for Payer: BCN Commercial |
$99.25
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cofinity Commercial |
$103.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Healthscope Commercial |
$108.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Nomi Health Commercial |
$98.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.13
|
| Rate for Payer: PHP Commercial |
$102.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.75
|
| Rate for Payer: UHC Core |
$100.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.13
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$120.17
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$21.19 |
| Max. Negotiated Rate |
$108.15 |
| Rate for Payer: Aetna Commercial |
$102.14
|
| Rate for Payer: Aetna Medicare |
$31.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.55
|
| Rate for Payer: BCBS Complete |
$22.24
|
| Rate for Payer: BCBS MAPPO |
$30.04
|
| Rate for Payer: BCBS Trust/PPO |
$98.79
|
| Rate for Payer: BCN Commercial |
$98.79
|
| Rate for Payer: BCN Medicare Advantage |
$30.04
|
| Rate for Payer: Cash Price |
$96.14
|
| Rate for Payer: Cofinity Commercial |
$103.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.04
|
| Rate for Payer: Healthscope Commercial |
$108.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.13
|
| Rate for Payer: Mclaren Medicaid |
$21.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.54
|
| Rate for Payer: Meridian Medicaid |
$22.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.14
|
| Rate for Payer: Nomi Health Commercial |
$98.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.13
|
| Rate for Payer: PACE Senior Care Partners |
$28.54
|
| Rate for Payer: PACE SWMI |
$30.04
|
| Rate for Payer: PHP Commercial |
$102.14
|
| Rate for Payer: PHP Medicare Advantage |
$30.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.55
|
| Rate for Payer: Priority Health Medicare |
$30.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.64
|
| Rate for Payer: Railroad Medicare Medicare |
$30.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.75
|
| Rate for Payer: UHC Core |
$100.34
|
| Rate for Payer: UHC Exchange |
$30.04
|
| Rate for Payer: UHC Medicaid |
$21.19
|
| Rate for Payer: UHC Medicare Advantage |
$30.04
|
| Rate for Payer: UHCCP Medicaid |
$21.19
|
| Rate for Payer: VA VA |
$30.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.13
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: Aetna Medicare |
$6.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.30
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$5.84
|
| Rate for Payer: BCBS Trust/PPO |
$19.20
|
| Rate for Payer: BCN Commercial |
$19.20
|
| Rate for Payer: BCN Medicare Advantage |
$5.84
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.84
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Mclaren Medicaid |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.13
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Senior Care Partners |
$5.55
|
| Rate for Payer: PACE SWMI |
$5.84
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Medicare |
$5.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UHC Medicaid |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$5.84
|
| Rate for Payer: UHCCP Medicaid |
$4.12
|
| Rate for Payer: VA VA |
$5.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.28
|
| Rate for Payer: BCN Commercial |
$19.28
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: Aetna Medicare |
$6.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.30
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$5.84
|
| Rate for Payer: BCBS Trust/PPO |
$19.20
|
| Rate for Payer: BCN Commercial |
$19.20
|
| Rate for Payer: BCN Medicare Advantage |
$5.84
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.84
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Mclaren Medicaid |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.13
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Senior Care Partners |
$5.55
|
| Rate for Payer: PACE SWMI |
$5.84
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Medicare |
$5.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UHC Medicaid |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$5.84
|
| Rate for Payer: UHCCP Medicaid |
$4.12
|
| Rate for Payer: VA VA |
$5.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.28
|
| Rate for Payer: BCN Commercial |
$19.28
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
