|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$115.86 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: BCBS Trust/PPO |
$137.48
|
| Rate for Payer: BCN Commercial |
$137.48
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 92504
|
| Hospital Charge Code |
47000003
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$29.35 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.02
|
| Rate for Payer: BCBS Complete |
$30.81
|
| Rate for Payer: BCBS MAPPO |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.85
|
| Rate for Payer: BCN Commercial |
$136.85
|
| Rate for Payer: BCN Medicare Advantage |
$41.62
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.70
|
| Rate for Payer: Meridian Medicaid |
$30.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PACE Senior Care Partners |
$39.53
|
| Rate for Payer: PACE SWMI |
$41.62
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$41.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Medicare |
$42.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: Railroad Medicare Medicare |
$41.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: UHC Exchange |
$41.62
|
| Rate for Payer: UHC Medicaid |
$29.35
|
| Rate for Payer: UHC Medicare Advantage |
$41.62
|
| Rate for Payer: UHCCP Medicaid |
$29.35
|
| Rate for Payer: VA VA |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC BIOELECT IMPEDANCE ANALYSIS (BIA) WHOLE BODY
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 0358T
|
| Hospital Charge Code |
92000032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.28
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.05
|
| Rate for Payer: BCN Commercial |
$27.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.64
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicaid |
$5.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
IP
|
$1,770.86
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,232.52 |
| Max. Negotiated Rate |
$1,593.77 |
| Rate for Payer: Aetna Commercial |
$1,505.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,462.55
|
| Rate for Payer: BCN Commercial |
$1,462.55
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cofinity Commercial |
$1,522.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.69
|
| Rate for Payer: Healthscope Commercial |
$1,593.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,328.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,505.23
|
| Rate for Payer: Nomi Health Commercial |
$1,452.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.14
|
| Rate for Payer: PHP Commercial |
$1,505.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,540.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,232.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,558.36
|
| Rate for Payer: UHC Core |
$1,478.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,328.14
|
|
|
HC BIOPSY ABDOMEN OR RETROPERITONEAL
|
Facility
|
OP
|
$1,770.86
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
36100218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.20 |
| Max. Negotiated Rate |
$1,593.77 |
| Rate for Payer: Aetna Commercial |
$1,505.23
|
| Rate for Payer: Aetna Medicare |
$460.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$553.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$553.39
|
| Rate for Payer: BCBS Complete |
$327.79
|
| Rate for Payer: BCBS MAPPO |
$442.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,455.82
|
| Rate for Payer: BCN Commercial |
$1,455.82
|
| Rate for Payer: BCN Medicare Advantage |
$442.71
|
| Rate for Payer: Cash Price |
$1,416.69
|
| Rate for Payer: Cofinity Commercial |
$1,522.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,416.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.71
|
| Rate for Payer: Healthscope Commercial |
$1,593.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,328.14
|
| Rate for Payer: Mclaren Medicaid |
$312.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$464.85
|
| Rate for Payer: Meridian Medicaid |
$327.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$509.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$486.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,505.23
|
| Rate for Payer: Nomi Health Commercial |
$1,452.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,328.14
|
| Rate for Payer: PACE Senior Care Partners |
$420.58
|
| Rate for Payer: PACE SWMI |
$442.71
|
| Rate for Payer: PHP Commercial |
$1,505.23
|
| Rate for Payer: PHP Medicare Advantage |
$442.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,540.65
|
| Rate for Payer: Priority Health Medicare |
$447.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,232.52
|
| Rate for Payer: Railroad Medicare Medicare |
$442.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,558.36
|
| Rate for Payer: UHC Core |
$1,478.67
|
| Rate for Payer: UHC Exchange |
$442.71
|
| Rate for Payer: UHC Medicaid |
$312.20
|
| Rate for Payer: UHC Medicare Advantage |
$442.71
|
| Rate for Payer: UHCCP Medicaid |
$312.20
|
| Rate for Payer: VA VA |
$442.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,328.14
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
OP
|
$8.32
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: Aetna Medicare |
$2.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.60
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: BCBS MAPPO |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$6.84
|
| Rate for Payer: BCN Commercial |
$6.84
|
| Rate for Payer: BCN Medicare Advantage |
$2.08
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Mclaren Medicaid |
$1.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.18
|
| Rate for Payer: Meridian Medicaid |
$1.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PACE Senior Care Partners |
$1.98
|
| Rate for Payer: PACE SWMI |
$2.08
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: PHP Medicare Advantage |
$2.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Medicare |
$2.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: UHC Exchange |
$2.08
|
| Rate for Payer: UHC Medicaid |
$1.47
|
| Rate for Payer: UHC Medicare Advantage |
$2.08
|
| Rate for Payer: UHCCP Medicaid |
$1.47
|
| Rate for Payer: VA VA |
$2.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC BIOPSY ACCESSION & GROSS
|
Facility
|
IP
|
$8.32
|
|
| Hospital Charge Code |
31000069
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$6.87
|
| Rate for Payer: BCN Commercial |
$6.87
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
OP
|
$2,147.65
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$378.63 |
| Max. Negotiated Rate |
$1,932.88 |
| Rate for Payer: Aetna Commercial |
$1,825.50
|
| Rate for Payer: Aetna Medicare |
$558.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.14
|
| Rate for Payer: BCBS Complete |
$397.53
|
| Rate for Payer: BCBS MAPPO |
$536.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,765.58
|
| Rate for Payer: BCN Commercial |
$1,765.58
|
| Rate for Payer: BCN Medicare Advantage |
$536.91
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cofinity Commercial |
$1,846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,718.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.91
|
| Rate for Payer: Healthscope Commercial |
$1,932.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,610.74
|
| Rate for Payer: Mclaren Medicaid |
$378.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$563.76
|
| Rate for Payer: Meridian Medicaid |
$397.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$590.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,825.50
|
| Rate for Payer: Nomi Health Commercial |
$1,761.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,610.74
|
| Rate for Payer: PACE Senior Care Partners |
$510.07
|
| Rate for Payer: PACE SWMI |
$536.91
|
| Rate for Payer: PHP Commercial |
$1,825.50
|
| Rate for Payer: PHP Medicare Advantage |
$536.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$378.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,868.46
|
| Rate for Payer: Priority Health Medicare |
$542.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,494.76
|
| Rate for Payer: Railroad Medicare Medicare |
$536.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.93
|
| Rate for Payer: UHC Core |
$1,793.29
|
| Rate for Payer: UHC Exchange |
$536.91
|
| Rate for Payer: UHC Medicaid |
$378.63
|
| Rate for Payer: UHC Medicare Advantage |
$536.91
|
| Rate for Payer: UHCCP Medicaid |
$378.63
|
| Rate for Payer: VA VA |
$536.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,610.74
|
|
|
HC BIOPSY BONE DEEP
|
Facility
|
IP
|
$2,147.65
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
36100019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,494.76 |
| Max. Negotiated Rate |
$1,932.88 |
| Rate for Payer: Aetna Commercial |
$1,825.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.74
|
| Rate for Payer: BCN Commercial |
$1,773.74
|
| Rate for Payer: Cash Price |
$1,718.12
|
| Rate for Payer: Cofinity Commercial |
$1,846.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,718.12
|
| Rate for Payer: Healthscope Commercial |
$1,932.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,610.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,825.50
|
| Rate for Payer: Nomi Health Commercial |
$1,761.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,610.74
|
| Rate for Payer: PHP Commercial |
$1,825.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,868.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,494.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,889.93
|
| Rate for Payer: UHC Core |
$1,793.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,610.74
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
IP
|
$3,691.25
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,569.11 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: BCBS Trust/PPO |
$3,048.60
|
| Rate for Payer: BCN Commercial |
$3,048.60
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC BIOPSY, BONE, OPEN, DEEP
|
Facility
|
OP
|
$3,691.25
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
76100271
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$650.77 |
| Max. Negotiated Rate |
$3,322.12 |
| Rate for Payer: Aetna Commercial |
$3,137.56
|
| Rate for Payer: Aetna Medicare |
$959.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,153.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,153.52
|
| Rate for Payer: BCBS Complete |
$683.25
|
| Rate for Payer: BCBS MAPPO |
$922.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,034.58
|
| Rate for Payer: BCN Commercial |
$3,034.58
|
| Rate for Payer: BCN Medicare Advantage |
$922.81
|
| Rate for Payer: Cash Price |
$2,953.00
|
| Rate for Payer: Cofinity Commercial |
$3,174.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,953.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$922.81
|
| Rate for Payer: Healthscope Commercial |
$3,322.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,768.44
|
| Rate for Payer: Mclaren Medicaid |
$650.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$968.95
|
| Rate for Payer: Meridian Medicaid |
$683.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,015.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,137.56
|
| Rate for Payer: Nomi Health Commercial |
$3,026.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,768.44
|
| Rate for Payer: PACE Senior Care Partners |
$876.67
|
| Rate for Payer: PACE SWMI |
$922.81
|
| Rate for Payer: PHP Commercial |
$3,137.56
|
| Rate for Payer: PHP Medicare Advantage |
$922.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,211.39
|
| Rate for Payer: Priority Health Medicare |
$932.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.11
|
| Rate for Payer: Railroad Medicare Medicare |
$922.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,248.30
|
| Rate for Payer: UHC Core |
$3,082.19
|
| Rate for Payer: UHC Exchange |
$922.81
|
| Rate for Payer: UHC Medicaid |
$650.77
|
| Rate for Payer: UHC Medicare Advantage |
$922.81
|
| Rate for Payer: UHCCP Medicaid |
$650.77
|
| Rate for Payer: VA VA |
$922.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,768.44
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
IP
|
$3,199.55
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,226.89 |
| Max. Negotiated Rate |
$2,879.59 |
| Rate for Payer: Aetna Commercial |
$2,719.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,642.51
|
| Rate for Payer: BCN Commercial |
$2,642.51
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cofinity Commercial |
$2,751.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.64
|
| Rate for Payer: Healthscope Commercial |
$2,879.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.62
|
| Rate for Payer: Nomi Health Commercial |
$2,623.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.66
|
| Rate for Payer: PHP Commercial |
$2,719.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,783.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,226.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,815.60
|
| Rate for Payer: UHC Core |
$2,671.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.66
|
|
|
HC BIOPSY BONE OPEN; SUPERFICIAL
|
Facility
|
OP
|
$3,199.55
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
76100290
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$564.08 |
| Max. Negotiated Rate |
$2,879.59 |
| Rate for Payer: Aetna Commercial |
$2,719.62
|
| Rate for Payer: Aetna Medicare |
$831.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$999.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$999.86
|
| Rate for Payer: BCBS Complete |
$592.24
|
| Rate for Payer: BCBS MAPPO |
$799.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,630.35
|
| Rate for Payer: BCN Commercial |
$2,630.35
|
| Rate for Payer: BCN Medicare Advantage |
$799.89
|
| Rate for Payer: Cash Price |
$2,559.64
|
| Rate for Payer: Cofinity Commercial |
$2,751.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,559.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$799.89
|
| Rate for Payer: Healthscope Commercial |
$2,879.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,399.66
|
| Rate for Payer: Mclaren Medicaid |
$564.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$839.88
|
| Rate for Payer: Meridian Medicaid |
$592.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$919.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$879.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,719.62
|
| Rate for Payer: Nomi Health Commercial |
$2,623.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,399.66
|
| Rate for Payer: PACE Senior Care Partners |
$759.89
|
| Rate for Payer: PACE SWMI |
$799.89
|
| Rate for Payer: PHP Commercial |
$2,719.62
|
| Rate for Payer: PHP Medicare Advantage |
$799.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,783.61
|
| Rate for Payer: Priority Health Medicare |
$807.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,226.89
|
| Rate for Payer: Railroad Medicare Medicare |
$799.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,815.60
|
| Rate for Payer: UHC Core |
$2,671.62
|
| Rate for Payer: UHC Exchange |
$799.89
|
| Rate for Payer: UHC Medicaid |
$564.08
|
| Rate for Payer: UHC Medicare Advantage |
$799.89
|
| Rate for Payer: UHCCP Medicaid |
$564.08
|
| Rate for Payer: VA VA |
$799.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,399.66
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
IP
|
$2,223.02
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,547.22 |
| Max. Negotiated Rate |
$2,000.72 |
| Rate for Payer: Aetna Commercial |
$1,889.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,835.99
|
| Rate for Payer: BCN Commercial |
$1,835.99
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cofinity Commercial |
$1,911.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,778.42
|
| Rate for Payer: Healthscope Commercial |
$2,000.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,667.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,889.57
|
| Rate for Payer: Nomi Health Commercial |
$1,822.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,667.27
|
| Rate for Payer: PHP Commercial |
$1,889.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,934.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,547.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,956.26
|
| Rate for Payer: UHC Core |
$1,856.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,667.27
|
|
|
HC BIOPSY BONE SUPERFICIAL
|
Facility
|
OP
|
$2,223.02
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
36100018
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.92 |
| Max. Negotiated Rate |
$2,000.72 |
| Rate for Payer: Aetna Commercial |
$1,889.57
|
| Rate for Payer: Aetna Medicare |
$577.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$694.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$694.69
|
| Rate for Payer: BCBS Complete |
$411.48
|
| Rate for Payer: BCBS MAPPO |
$555.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.54
|
| Rate for Payer: BCN Commercial |
$1,827.54
|
| Rate for Payer: BCN Medicare Advantage |
$555.75
|
| Rate for Payer: Cash Price |
$1,778.42
|
| Rate for Payer: Cofinity Commercial |
$1,911.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,778.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.75
|
| Rate for Payer: Healthscope Commercial |
$2,000.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,667.27
|
| Rate for Payer: Mclaren Medicaid |
$391.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$583.54
|
| Rate for Payer: Meridian Medicaid |
$411.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$639.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$611.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,889.57
|
| Rate for Payer: Nomi Health Commercial |
$1,822.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,667.27
|
| Rate for Payer: PACE Senior Care Partners |
$527.97
|
| Rate for Payer: PACE SWMI |
$555.75
|
| Rate for Payer: PHP Commercial |
$1,889.57
|
| Rate for Payer: PHP Medicare Advantage |
$555.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,934.03
|
| Rate for Payer: Priority Health Medicare |
$561.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,547.22
|
| Rate for Payer: Railroad Medicare Medicare |
$555.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,956.26
|
| Rate for Payer: UHC Core |
$1,856.22
|
| Rate for Payer: UHC Exchange |
$555.75
|
| Rate for Payer: UHC Medicaid |
$391.92
|
| Rate for Payer: UHC Medicare Advantage |
$555.75
|
| Rate for Payer: UHCCP Medicaid |
$391.92
|
| Rate for Payer: VA VA |
$555.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,667.27
|
|
|
HC BIOPSY BREAST OPEN INCISIONAL
|
Facility
|
IP
|
$4,660.75
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
76100558
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,243.88 |
| Max. Negotiated Rate |
$4,194.68 |
| Rate for Payer: Aetna Commercial |
$3,961.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,849.31
|
| Rate for Payer: BCN Commercial |
$3,849.31
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cofinity Commercial |
$4,008.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,728.60
|
| Rate for Payer: Healthscope Commercial |
$4,194.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,495.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,961.64
|
| Rate for Payer: Nomi Health Commercial |
$3,821.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,495.56
|
| Rate for Payer: PHP Commercial |
$3,961.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,054.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,243.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,101.46
|
| Rate for Payer: UHC Core |
$3,891.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,495.56
|
|
|
HC BIOPSY BREAST OPEN INCISIONAL
|
Facility
|
OP
|
$4,660.75
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
76100558
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$311.32 |
| Max. Negotiated Rate |
$4,194.68 |
| Rate for Payer: Aetna Commercial |
$3,961.64
|
| Rate for Payer: Aetna Medicare |
$1,211.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,456.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,456.48
|
| Rate for Payer: BCBS Complete |
$862.70
|
| Rate for Payer: BCBS MAPPO |
$1,165.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,831.60
|
| Rate for Payer: BCCCP Commercial |
$311.32
|
| Rate for Payer: BCN Commercial |
$3,831.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,165.19
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cash Price |
$3,728.60
|
| Rate for Payer: Cofinity Commercial |
$4,008.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,728.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,165.19
|
| Rate for Payer: Healthscope Commercial |
$4,194.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,495.56
|
| Rate for Payer: Mclaren Medicaid |
$821.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,223.45
|
| Rate for Payer: Meridian Medicaid |
$862.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,339.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,281.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,961.64
|
| Rate for Payer: Nomi Health Commercial |
$3,821.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,495.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,106.93
|
| Rate for Payer: PACE SWMI |
$1,165.19
|
| Rate for Payer: PHP Commercial |
$3,961.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,165.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,054.85
|
| Rate for Payer: Priority Health Medicare |
$1,176.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,243.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,165.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,101.46
|
| Rate for Payer: UHC Core |
$3,891.73
|
| Rate for Payer: UHC Exchange |
$1,165.19
|
| Rate for Payer: UHC Medicaid |
$821.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,165.19
|
| Rate for Payer: UHCCP Medicaid |
$821.69
|
| Rate for Payer: VA VA |
$1,165.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,495.56
|
|
|
HC BIOPSY CERVIX
|
Facility
|
IP
|
$689.79
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.09 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: BCBS Trust/PPO |
$569.70
|
| Rate for Payer: BCN Commercial |
$569.70
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$565.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$600.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.02
|
| Rate for Payer: UHC Core |
$575.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC BIOPSY CERVIX
|
Facility
|
OP
|
$689.79
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
76100070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.61 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna Medicare |
$179.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.56
|
| Rate for Payer: BCBS Complete |
$127.68
|
| Rate for Payer: BCBS MAPPO |
$172.45
|
| Rate for Payer: BCBS Trust/PPO |
$567.08
|
| Rate for Payer: BCN Commercial |
$567.08
|
| Rate for Payer: BCN Medicare Advantage |
$172.45
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.45
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Mclaren Medicaid |
$121.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.07
|
| Rate for Payer: Meridian Medicaid |
$127.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$565.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PACE Senior Care Partners |
$163.83
|
| Rate for Payer: PACE SWMI |
$172.45
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: PHP Medicare Advantage |
$172.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$600.12
|
| Rate for Payer: Priority Health Medicare |
$174.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.09
|
| Rate for Payer: Railroad Medicare Medicare |
$172.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.02
|
| Rate for Payer: UHC Core |
$575.97
|
| Rate for Payer: UHC Exchange |
$172.45
|
| Rate for Payer: UHC Medicaid |
$121.61
|
| Rate for Payer: UHC Medicare Advantage |
$172.45
|
| Rate for Payer: UHCCP Medicaid |
$121.61
|
| Rate for Payer: VA VA |
$172.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC BIOPSY/EXCISION LYMPH NODE, OPEN SUPERFICIAL
|
Facility
|
OP
|
$7,660.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
76100535
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,350.46 |
| Max. Negotiated Rate |
$6,894.00 |
| Rate for Payer: Aetna Commercial |
$6,511.00
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS Complete |
$1,417.87
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,297.29
|
| Rate for Payer: BCN Commercial |
$6,297.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cofinity Commercial |
$6,587.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$6,894.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,745.00
|
| Rate for Payer: Mclaren Medicaid |
$1,350.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: Meridian Medicaid |
$1,417.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,511.00
|
| Rate for Payer: Nomi Health Commercial |
$6,281.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,745.00
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$6,511.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,350.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,664.20
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,331.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,740.80
|
| Rate for Payer: UHC Core |
$6,396.10
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicaid |
$1,350.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: UHCCP Medicaid |
$1,350.46
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,745.00
|
|
|
HC BIOPSY/EXCISION LYMPH NODE, OPEN SUPERFICIAL
|
Facility
|
IP
|
$7,660.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
76100535
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,331.36 |
| Max. Negotiated Rate |
$6,894.00 |
| Rate for Payer: Aetna Commercial |
$6,511.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,326.39
|
| Rate for Payer: BCN Commercial |
$6,326.39
|
| Rate for Payer: Cash Price |
$6,128.00
|
| Rate for Payer: Cofinity Commercial |
$6,587.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,128.00
|
| Rate for Payer: Healthscope Commercial |
$6,894.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,745.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,511.00
|
| Rate for Payer: Nomi Health Commercial |
$6,281.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,745.00
|
| Rate for Payer: PHP Commercial |
$6,511.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,664.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,331.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,740.80
|
| Rate for Payer: UHC Core |
$6,396.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,745.00
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$4,096.05
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$722.13 |
| Max. Negotiated Rate |
$3,686.45 |
| Rate for Payer: Aetna Commercial |
$3,481.64
|
| Rate for Payer: Aetna Commercial |
$5,222.47
|
| Rate for Payer: Aetna Medicare |
$1,597.46
|
| Rate for Payer: Aetna Medicare |
$1,064.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,920.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,280.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,280.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,920.03
|
| Rate for Payer: BCBS Complete |
$758.18
|
| Rate for Payer: BCBS Complete |
$1,137.27
|
| Rate for Payer: BCBS MAPPO |
$1,024.01
|
| Rate for Payer: BCBS MAPPO |
$1,536.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,367.36
|
| Rate for Payer: BCBS Trust/PPO |
$5,051.05
|
| Rate for Payer: BCN Commercial |
$5,051.05
|
| Rate for Payer: BCN Commercial |
$3,367.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,536.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.01
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cofinity Commercial |
$3,522.60
|
| Rate for Payer: Cofinity Commercial |
$5,283.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,915.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,536.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.01
|
| Rate for Payer: Healthscope Commercial |
$3,686.45
|
| Rate for Payer: Healthscope Commercial |
$5,529.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,072.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,608.06
|
| Rate for Payer: Mclaren Medicaid |
$1,083.20
|
| Rate for Payer: Mclaren Medicaid |
$722.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,612.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.21
|
| Rate for Payer: Meridian Medicaid |
$758.18
|
| Rate for Payer: Meridian Medicaid |
$1,137.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,766.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,177.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,689.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,126.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,222.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Nomi Health Commercial |
$5,038.15
|
| Rate for Payer: Nomi Health Commercial |
$3,358.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,608.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,459.22
|
| Rate for Payer: PACE Senior Care Partners |
$972.81
|
| Rate for Payer: PACE SWMI |
$1,536.02
|
| Rate for Payer: PACE SWMI |
$1,024.01
|
| Rate for Payer: PHP Commercial |
$3,481.64
|
| Rate for Payer: PHP Commercial |
$5,222.47
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,536.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,083.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$722.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,345.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,563.56
|
| Rate for Payer: Priority Health Medicare |
$1,551.38
|
| Rate for Payer: Priority Health Medicare |
$1,034.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,850.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,276.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,536.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,604.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,406.79
|
| Rate for Payer: UHC Core |
$5,130.31
|
| Rate for Payer: UHC Core |
$3,420.20
|
| Rate for Payer: UHC Exchange |
$1,536.02
|
| Rate for Payer: UHC Exchange |
$1,024.01
|
| Rate for Payer: UHC Medicaid |
$1,083.20
|
| Rate for Payer: UHC Medicaid |
$722.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,024.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,536.02
|
| Rate for Payer: UHCCP Medicaid |
$722.13
|
| Rate for Payer: UHCCP Medicaid |
$1,083.20
|
| Rate for Payer: VA VA |
$1,024.01
|
| Rate for Payer: VA VA |
$1,536.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,608.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,072.04
|
|
|
HC BIOPSY EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$4,096.05
|
|
|
Service Code
|
CPT 69105
|
| Hospital Charge Code |
76100480
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,850.85 |
| Max. Negotiated Rate |
$3,686.45 |
| Rate for Payer: Aetna Commercial |
$3,481.64
|
| Rate for Payer: Aetna Commercial |
$5,222.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,382.93
|
| Rate for Payer: BCBS Trust/PPO |
$5,074.40
|
| Rate for Payer: BCN Commercial |
$3,382.93
|
| Rate for Payer: BCN Commercial |
$5,074.40
|
| Rate for Payer: Cash Price |
$3,276.84
|
| Rate for Payer: Cash Price |
$4,915.26
|
| Rate for Payer: Cofinity Commercial |
$5,283.91
|
| Rate for Payer: Cofinity Commercial |
$3,522.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,915.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.84
|
| Rate for Payer: Healthscope Commercial |
$3,686.45
|
| Rate for Payer: Healthscope Commercial |
$5,529.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,072.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,608.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,481.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,222.47
|
| Rate for Payer: Nomi Health Commercial |
$3,358.76
|
| Rate for Payer: Nomi Health Commercial |
$5,038.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,072.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,608.06
|
| Rate for Payer: PHP Commercial |
$5,222.47
|
| Rate for Payer: PHP Commercial |
$3,481.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,345.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,563.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,850.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,276.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,604.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,406.79
|
| Rate for Payer: UHC Core |
$3,420.20
|
| Rate for Payer: UHC Core |
$5,130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,072.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,608.06
|
|
