|
HC ATYPICAL PNEUMO EVAL M PNEUM
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.97
|
| Rate for Payer: BCBS Complete |
$2.95
|
| Rate for Payer: BCBS MAPPO |
$3.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.09
|
| Rate for Payer: BCN Commercial |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.98
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.98
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.18
|
| Rate for Payer: Meridian Medicaid |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Senior Care Partners |
$3.78
|
| Rate for Payer: PACE SWMI |
$3.98
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$3.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: UHC Exchange |
$3.98
|
| Rate for Payer: UHC Medicaid |
$2.81
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: UHCCP Medicaid |
$2.81
|
| Rate for Payer: VA VA |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC ATYPICAL PNEUMO EVALUATION
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200241
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.15
|
| Rate for Payer: BCN Commercial |
$13.15
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.01
|
| Rate for Payer: UHC Core |
$13.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
IP
|
$216.41
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$194.77 |
| Rate for Payer: Aetna Commercial |
$183.95
|
| Rate for Payer: BCBS Trust/PPO |
$178.73
|
| Rate for Payer: BCN Commercial |
$178.73
|
| Rate for Payer: Cash Price |
$173.13
|
| Rate for Payer: Cofinity Commercial |
$186.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.13
|
| Rate for Payer: Healthscope Commercial |
$194.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.95
|
| Rate for Payer: Nomi Health Commercial |
$177.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.31
|
| Rate for Payer: PHP Commercial |
$183.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$180.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.31
|
|
|
HC AUDIOMETRY AIR AND BONE
|
Facility
|
OP
|
$216.41
|
|
|
Service Code
|
CPT 92553
|
| Hospital Charge Code |
47100010
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$194.77 |
| Rate for Payer: Aetna Commercial |
$183.95
|
| Rate for Payer: Aetna Medicare |
$56.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.63
|
| Rate for Payer: BCBS Complete |
$40.06
|
| Rate for Payer: BCBS MAPPO |
$54.10
|
| Rate for Payer: BCBS Trust/PPO |
$177.91
|
| Rate for Payer: BCN Commercial |
$177.91
|
| Rate for Payer: BCN Medicare Advantage |
$54.10
|
| Rate for Payer: Cash Price |
$173.13
|
| Rate for Payer: Cofinity Commercial |
$186.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$194.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.31
|
| Rate for Payer: Mclaren Medicaid |
$38.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.81
|
| Rate for Payer: Meridian Medicaid |
$40.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.95
|
| Rate for Payer: Nomi Health Commercial |
$177.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.31
|
| Rate for Payer: PACE Senior Care Partners |
$51.40
|
| Rate for Payer: PACE SWMI |
$54.10
|
| Rate for Payer: PHP Commercial |
$183.95
|
| Rate for Payer: PHP Medicare Advantage |
$54.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.28
|
| Rate for Payer: Priority Health Medicare |
$54.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.62
|
| Rate for Payer: Railroad Medicare Medicare |
$54.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$180.70
|
| Rate for Payer: UHC Exchange |
$54.10
|
| Rate for Payer: UHC Medicaid |
$38.15
|
| Rate for Payer: UHC Medicare Advantage |
$54.10
|
| Rate for Payer: UHCCP Medicaid |
$38.15
|
| Rate for Payer: VA VA |
$54.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.31
|
|
|
HC AUDITORY EVOKED POTENTIAL SCREENING
|
Facility
|
IP
|
$261.25
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
47100015
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$181.83 |
| Max. Negotiated Rate |
$235.12 |
| Rate for Payer: Aetna Commercial |
$222.06
|
| Rate for Payer: BCBS Trust/PPO |
$215.77
|
| Rate for Payer: BCN Commercial |
$215.77
|
| Rate for Payer: Cash Price |
$209.00
|
| Rate for Payer: Cofinity Commercial |
$224.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.00
|
| Rate for Payer: Healthscope Commercial |
$235.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.06
|
| Rate for Payer: Nomi Health Commercial |
$214.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.94
|
| Rate for Payer: PHP Commercial |
$222.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$227.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.90
|
| Rate for Payer: UHC Core |
$218.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.94
|
|
|
HC AUDITORY EVOKED POTENTIAL SCREENING
|
Facility
|
OP
|
$261.25
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
47100015
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$235.12 |
| Rate for Payer: Aetna Commercial |
$222.06
|
| Rate for Payer: Aetna Medicare |
$67.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.64
|
| Rate for Payer: BCBS Complete |
$48.36
|
| Rate for Payer: BCBS MAPPO |
$65.31
|
| Rate for Payer: BCBS Trust/PPO |
$214.77
|
| Rate for Payer: BCN Commercial |
$214.77
|
| Rate for Payer: BCN Medicare Advantage |
$65.31
|
| Rate for Payer: Cash Price |
$209.00
|
| Rate for Payer: Cofinity Commercial |
$224.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.31
|
| Rate for Payer: Healthscope Commercial |
$235.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.94
|
| Rate for Payer: Mclaren Medicaid |
$46.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.58
|
| Rate for Payer: Meridian Medicaid |
$48.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.06
|
| Rate for Payer: Nomi Health Commercial |
$214.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.94
|
| Rate for Payer: PACE Senior Care Partners |
$62.05
|
| Rate for Payer: PACE SWMI |
$65.31
|
| Rate for Payer: PHP Commercial |
$222.06
|
| Rate for Payer: PHP Medicare Advantage |
$65.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$227.29
|
| Rate for Payer: Priority Health Medicare |
$65.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.83
|
| Rate for Payer: Railroad Medicare Medicare |
$65.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.90
|
| Rate for Payer: UHC Core |
$218.14
|
| Rate for Payer: UHC Exchange |
$65.31
|
| Rate for Payer: UHC Medicaid |
$46.06
|
| Rate for Payer: UHC Medicare Advantage |
$65.31
|
| Rate for Payer: UHCCP Medicaid |
$46.06
|
| Rate for Payer: VA VA |
$65.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.94
|
|
|
HC AUDITORY EVOK POT NEURODIAGNOSTIC W I&R
|
Facility
|
OP
|
$701.60
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
47000001
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$123.69 |
| Max. Negotiated Rate |
$631.44 |
| Rate for Payer: Aetna Commercial |
$596.36
|
| Rate for Payer: Aetna Medicare |
$182.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: BCBS Complete |
$129.87
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$576.79
|
| Rate for Payer: BCN Commercial |
$576.79
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$561.28
|
| Rate for Payer: Cofinity Commercial |
$603.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$631.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.20
|
| Rate for Payer: Mclaren Medicaid |
$123.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: Meridian Medicaid |
$129.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.36
|
| Rate for Payer: Nomi Health Commercial |
$575.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.20
|
| Rate for Payer: PACE Senior Care Partners |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$596.36
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.39
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.31
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.41
|
| Rate for Payer: UHC Core |
$585.84
|
| Rate for Payer: UHC Exchange |
$175.40
|
| Rate for Payer: UHC Medicaid |
$123.69
|
| Rate for Payer: UHC Medicare Advantage |
$175.40
|
| Rate for Payer: UHCCP Medicaid |
$123.69
|
| Rate for Payer: VA VA |
$175.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.20
|
|
|
HC AUDITORY EVOK POT NEURODIAGNOSTIC W I&R
|
Facility
|
IP
|
$701.60
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
47000001
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$488.31 |
| Max. Negotiated Rate |
$631.44 |
| Rate for Payer: Aetna Commercial |
$596.36
|
| Rate for Payer: BCBS Trust/PPO |
$579.45
|
| Rate for Payer: BCN Commercial |
$579.45
|
| Rate for Payer: Cash Price |
$561.28
|
| Rate for Payer: Cofinity Commercial |
$603.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.28
|
| Rate for Payer: Healthscope Commercial |
$631.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.36
|
| Rate for Payer: Nomi Health Commercial |
$575.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.20
|
| Rate for Payer: PHP Commercial |
$596.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.41
|
| Rate for Payer: UHC Core |
$585.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.20
|
|
|
HC AUDITORY EVOK POT THRESHOLD MULTI FREQ
|
Facility
|
IP
|
$701.60
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47000002
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$488.31 |
| Max. Negotiated Rate |
$631.44 |
| Rate for Payer: Aetna Commercial |
$596.36
|
| Rate for Payer: BCBS Trust/PPO |
$579.45
|
| Rate for Payer: BCN Commercial |
$579.45
|
| Rate for Payer: Cash Price |
$561.28
|
| Rate for Payer: Cofinity Commercial |
$603.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.28
|
| Rate for Payer: Healthscope Commercial |
$631.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.36
|
| Rate for Payer: Nomi Health Commercial |
$575.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.20
|
| Rate for Payer: PHP Commercial |
$596.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.41
|
| Rate for Payer: UHC Core |
$585.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.20
|
|
|
HC AUDITORY EVOK POT THRESHOLD MULTI FREQ
|
Facility
|
OP
|
$701.60
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47000002
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$123.69 |
| Max. Negotiated Rate |
$631.44 |
| Rate for Payer: Aetna Commercial |
$596.36
|
| Rate for Payer: Aetna Medicare |
$182.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: BCBS Complete |
$129.87
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$576.79
|
| Rate for Payer: BCN Commercial |
$576.79
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$561.28
|
| Rate for Payer: Cofinity Commercial |
$603.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$631.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.20
|
| Rate for Payer: Mclaren Medicaid |
$123.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: Meridian Medicaid |
$129.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.36
|
| Rate for Payer: Nomi Health Commercial |
$575.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.20
|
| Rate for Payer: PACE Senior Care Partners |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$596.36
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.39
|
| Rate for Payer: Priority Health Medicare |
$177.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.31
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.41
|
| Rate for Payer: UHC Core |
$585.84
|
| Rate for Payer: UHC Exchange |
$175.40
|
| Rate for Payer: UHC Medicaid |
$123.69
|
| Rate for Payer: UHC Medicare Advantage |
$175.40
|
| Rate for Payer: UHCCP Medicaid |
$123.69
|
| Rate for Payer: VA VA |
$175.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.20
|
|
|
HC AUDITORY FUNCTION 60 MIN
|
Facility
|
IP
|
$171.67
|
|
|
Service Code
|
CPT 92620
|
| Hospital Charge Code |
76100495
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$119.48 |
| Max. Negotiated Rate |
$154.50 |
| Rate for Payer: Aetna Commercial |
$145.92
|
| Rate for Payer: BCBS Trust/PPO |
$141.78
|
| Rate for Payer: BCN Commercial |
$141.78
|
| Rate for Payer: Cash Price |
$137.34
|
| Rate for Payer: Cofinity Commercial |
$147.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.34
|
| Rate for Payer: Healthscope Commercial |
$154.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.92
|
| Rate for Payer: Nomi Health Commercial |
$140.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.75
|
| Rate for Payer: PHP Commercial |
$145.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$149.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.07
|
| Rate for Payer: UHC Core |
$143.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.75
|
|
|
HC AUDITORY FUNCTION 60 MIN
|
Facility
|
OP
|
$171.67
|
|
|
Service Code
|
CPT 92620
|
| Hospital Charge Code |
76100495
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$30.27 |
| Max. Negotiated Rate |
$154.50 |
| Rate for Payer: Aetna Commercial |
$145.92
|
| Rate for Payer: Aetna Medicare |
$44.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.65
|
| Rate for Payer: BCBS Complete |
$31.78
|
| Rate for Payer: BCBS MAPPO |
$42.92
|
| Rate for Payer: BCBS Trust/PPO |
$141.13
|
| Rate for Payer: BCN Commercial |
$141.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.92
|
| Rate for Payer: Cash Price |
$137.34
|
| Rate for Payer: Cofinity Commercial |
$147.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.92
|
| Rate for Payer: Healthscope Commercial |
$154.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.75
|
| Rate for Payer: Mclaren Medicaid |
$30.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.06
|
| Rate for Payer: Meridian Medicaid |
$31.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.92
|
| Rate for Payer: Nomi Health Commercial |
$140.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.75
|
| Rate for Payer: PACE Senior Care Partners |
$40.77
|
| Rate for Payer: PACE SWMI |
$42.92
|
| Rate for Payer: PHP Commercial |
$145.92
|
| Rate for Payer: PHP Medicare Advantage |
$42.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$149.35
|
| Rate for Payer: Priority Health Medicare |
$43.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.48
|
| Rate for Payer: Railroad Medicare Medicare |
$42.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.07
|
| Rate for Payer: UHC Core |
$143.34
|
| Rate for Payer: UHC Exchange |
$42.92
|
| Rate for Payer: UHC Medicaid |
$30.27
|
| Rate for Payer: UHC Medicare Advantage |
$42.92
|
| Rate for Payer: UHCCP Medicaid |
$30.27
|
| Rate for Payer: VA VA |
$42.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.75
|
|
|
HC AUD SCREEN PURE TONE AIR ONLY
|
Facility
|
IP
|
$61.17
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
47100003
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$42.57 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Aetna Commercial |
$51.99
|
| Rate for Payer: BCBS Trust/PPO |
$50.52
|
| Rate for Payer: BCN Commercial |
$50.52
|
| Rate for Payer: Cash Price |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$52.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.94
|
| Rate for Payer: Healthscope Commercial |
$55.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.99
|
| Rate for Payer: Nomi Health Commercial |
$50.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.88
|
| Rate for Payer: PHP Commercial |
$51.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.83
|
| Rate for Payer: UHC Core |
$51.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.88
|
|
|
HC AUD SCREEN PURE TONE AIR ONLY
|
Facility
|
OP
|
$61.17
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
47100003
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$10.78 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Aetna Commercial |
$51.99
|
| Rate for Payer: Aetna Medicare |
$15.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$11.32
|
| Rate for Payer: BCBS MAPPO |
$15.29
|
| Rate for Payer: BCBS Trust/PPO |
$50.29
|
| Rate for Payer: BCN Commercial |
$50.29
|
| Rate for Payer: BCN Medicare Advantage |
$15.29
|
| Rate for Payer: Cash Price |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$52.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.29
|
| Rate for Payer: Healthscope Commercial |
$55.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.88
|
| Rate for Payer: Mclaren Medicaid |
$10.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$11.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.99
|
| Rate for Payer: Nomi Health Commercial |
$50.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.88
|
| Rate for Payer: PACE Senior Care Partners |
$14.53
|
| Rate for Payer: PACE SWMI |
$15.29
|
| Rate for Payer: PHP Commercial |
$51.99
|
| Rate for Payer: PHP Medicare Advantage |
$15.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.22
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.57
|
| Rate for Payer: Railroad Medicare Medicare |
$15.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.83
|
| Rate for Payer: UHC Core |
$51.08
|
| Rate for Payer: UHC Exchange |
$15.29
|
| Rate for Payer: UHC Medicaid |
$10.78
|
| Rate for Payer: UHC Medicare Advantage |
$15.29
|
| Rate for Payer: UHCCP Medicaid |
$10.78
|
| Rate for Payer: VA VA |
$15.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.88
|
|
|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
IP
|
$56.21
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$39.12 |
| Max. Negotiated Rate |
$50.59 |
| Rate for Payer: Aetna Commercial |
$47.78
|
| Rate for Payer: BCBS Trust/PPO |
$46.42
|
| Rate for Payer: BCN Commercial |
$46.42
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Nomi Health Commercial |
$46.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.16
|
| Rate for Payer: PHP Commercial |
$47.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.46
|
| Rate for Payer: UHC Core |
$46.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.16
|
|
|
HC AUD VERTICAL ELECTRODE USE
|
Facility
|
OP
|
$56.21
|
|
|
Service Code
|
CPT 92547
|
| Hospital Charge Code |
47100004
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$50.59 |
| Rate for Payer: Aetna Commercial |
$47.78
|
| Rate for Payer: Aetna Medicare |
$14.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.57
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$14.05
|
| Rate for Payer: BCBS Trust/PPO |
$46.21
|
| Rate for Payer: BCN Commercial |
$46.21
|
| Rate for Payer: BCN Medicare Advantage |
$14.05
|
| Rate for Payer: Cash Price |
$44.97
|
| Rate for Payer: Cofinity Commercial |
$48.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.05
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.16
|
| Rate for Payer: Mclaren Medicaid |
$9.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.76
|
| Rate for Payer: Meridian Medicaid |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.78
|
| Rate for Payer: Nomi Health Commercial |
$46.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.16
|
| Rate for Payer: PACE Senior Care Partners |
$13.35
|
| Rate for Payer: PACE SWMI |
$14.05
|
| Rate for Payer: PHP Commercial |
$47.78
|
| Rate for Payer: PHP Medicare Advantage |
$14.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.90
|
| Rate for Payer: Priority Health Medicare |
$14.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.12
|
| Rate for Payer: Railroad Medicare Medicare |
$14.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.46
|
| Rate for Payer: UHC Core |
$46.94
|
| Rate for Payer: UHC Exchange |
$14.05
|
| Rate for Payer: UHC Medicaid |
$9.91
|
| Rate for Payer: UHC Medicare Advantage |
$14.05
|
| Rate for Payer: UHCCP Medicaid |
$9.91
|
| Rate for Payer: VA VA |
$14.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.16
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$329.01 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: BCBS Trust/PPO |
$390.42
|
| Rate for Payer: BCN Commercial |
$390.42
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$122.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.72
|
| Rate for Payer: BCBS Complete |
$87.50
|
| Rate for Payer: BCBS MAPPO |
$118.18
|
| Rate for Payer: BCBS Trust/PPO |
$388.62
|
| Rate for Payer: BCN Commercial |
$388.62
|
| Rate for Payer: BCN Medicare Advantage |
$118.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$83.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.09
|
| Rate for Payer: Meridian Medicaid |
$87.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Senior Care Partners |
$112.27
|
| Rate for Payer: PACE SWMI |
$118.18
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$118.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: Railroad Medicare Medicare |
$118.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: UHC Exchange |
$118.18
|
| Rate for Payer: UHC Medicaid |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$118.18
|
| Rate for Payer: UHCCP Medicaid |
$83.34
|
| Rate for Payer: VA VA |
$118.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.75
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$36.17
|
| Rate for Payer: BCN Commercial |
$36.17
|
| Rate for Payer: BCN Medicare Advantage |
$11.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Mclaren Medicaid |
$7.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.55
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE Senior Care Partners |
$10.45
|
| Rate for Payer: PACE SWMI |
$11.00
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: PHP Medicare Advantage |
$11.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.28
|
| Rate for Payer: Priority Health Medicare |
$11.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Exchange |
$11.00
|
| Rate for Payer: UHC Medicaid |
$7.76
|
| Rate for Payer: UHC Medicare Advantage |
$11.00
|
| Rate for Payer: UHCCP Medicaid |
$7.76
|
| Rate for Payer: VA VA |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.62 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: BCBS Trust/PPO |
$36.34
|
| Rate for Payer: BCN Commercial |
$36.34
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
IP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$585.89 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: BCBS Trust/PPO |
$695.23
|
| Rate for Payer: BCN Commercial |
$695.23
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$732.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.78
|
| Rate for Payer: UHC Core |
$702.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
OP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.41 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: Aetna Medicare |
$218.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.06
|
| Rate for Payer: BCBS Complete |
$155.82
|
| Rate for Payer: BCBS MAPPO |
$210.45
|
| Rate for Payer: BCBS Trust/PPO |
$692.04
|
| Rate for Payer: BCN Commercial |
$692.04
|
| Rate for Payer: BCN Medicare Advantage |
$210.45
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.45
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Mclaren Medicaid |
$148.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.97
|
| Rate for Payer: Meridian Medicaid |
$155.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PACE Senior Care Partners |
$199.93
|
| Rate for Payer: PACE SWMI |
$210.45
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: PHP Medicare Advantage |
$210.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$732.36
|
| Rate for Payer: Priority Health Medicare |
$212.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.89
|
| Rate for Payer: Railroad Medicare Medicare |
$210.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.78
|
| Rate for Payer: UHC Core |
$702.89
|
| Rate for Payer: UHC Exchange |
$210.45
|
| Rate for Payer: UHC Medicaid |
$148.41
|
| Rate for Payer: UHC Medicare Advantage |
$210.45
|
| Rate for Payer: UHCCP Medicaid |
$148.41
|
| Rate for Payer: VA VA |
$210.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$128.87 |
| Max. Negotiated Rate |
$166.64 |
| Rate for Payer: Aetna Commercial |
$157.39
|
| Rate for Payer: BCBS Trust/PPO |
$152.92
|
| Rate for Payer: BCN Commercial |
$152.92
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Commercial |
$159.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Nomi Health Commercial |
$151.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: PHP Commercial |
$157.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.94
|
| Rate for Payer: UHC Core |
$154.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.87
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$32.64 |
| Max. Negotiated Rate |
$166.64 |
| Rate for Payer: Aetna Commercial |
$157.39
|
| Rate for Payer: Aetna Medicare |
$48.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.86
|
| Rate for Payer: BCBS Complete |
$34.27
|
| Rate for Payer: BCBS MAPPO |
$46.29
|
| Rate for Payer: BCBS Trust/PPO |
$152.22
|
| Rate for Payer: BCN Commercial |
$152.22
|
| Rate for Payer: BCN Medicare Advantage |
$46.29
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Commercial |
$159.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.29
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.87
|
| Rate for Payer: Mclaren Medicaid |
$32.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.60
|
| Rate for Payer: Meridian Medicaid |
$34.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Nomi Health Commercial |
$151.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: PACE Senior Care Partners |
$43.98
|
| Rate for Payer: PACE SWMI |
$46.29
|
| Rate for Payer: PHP Commercial |
$157.39
|
| Rate for Payer: PHP Medicare Advantage |
$46.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.09
|
| Rate for Payer: Priority Health Medicare |
$46.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.87
|
| Rate for Payer: Railroad Medicare Medicare |
$46.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.94
|
| Rate for Payer: UHC Core |
$154.61
|
| Rate for Payer: UHC Exchange |
$46.29
|
| Rate for Payer: UHC Medicaid |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$46.29
|
| Rate for Payer: UHCCP Medicaid |
$32.64
|
| Rate for Payer: VA VA |
$46.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.87
|
|
