|
HC BRAZIL NUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200076
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BRAZIL NUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200076
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION MR
|
Facility
|
OP
|
$5,282.80
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
36100413
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$524.38 |
| Max. Negotiated Rate |
$4,754.52 |
| Rate for Payer: Aetna Commercial |
$4,490.38
|
| Rate for Payer: Aetna Medicare |
$1,373.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,650.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,650.88
|
| Rate for Payer: BCBS Complete |
$977.85
|
| Rate for Payer: BCBS MAPPO |
$1,320.70
|
| Rate for Payer: BCBS Trust/PPO |
$4,342.99
|
| Rate for Payer: BCCCP Commercial |
$524.38
|
| Rate for Payer: BCN Commercial |
$4,342.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,320.70
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cofinity Commercial |
$4,543.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,226.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,320.70
|
| Rate for Payer: Healthscope Commercial |
$4,754.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,962.10
|
| Rate for Payer: Mclaren Medicaid |
$931.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,386.73
|
| Rate for Payer: Meridian Medicaid |
$977.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,518.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,452.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,490.38
|
| Rate for Payer: Nomi Health Commercial |
$4,331.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,962.10
|
| Rate for Payer: PACE Senior Care Partners |
$1,254.66
|
| Rate for Payer: PACE SWMI |
$1,320.70
|
| Rate for Payer: PHP Commercial |
$4,490.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,320.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,596.04
|
| Rate for Payer: Priority Health Medicare |
$1,333.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,676.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,320.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,648.86
|
| Rate for Payer: UHC Core |
$4,411.14
|
| Rate for Payer: UHC Exchange |
$1,320.70
|
| Rate for Payer: UHC Medicaid |
$931.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,320.70
|
| Rate for Payer: UHCCP Medicaid |
$931.36
|
| Rate for Payer: VA VA |
$1,320.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,962.10
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION MR
|
Facility
|
IP
|
$5,282.80
|
|
|
Service Code
|
CPT 19086
|
| Hospital Charge Code |
36100413
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,676.83 |
| Max. Negotiated Rate |
$4,754.52 |
| Rate for Payer: Aetna Commercial |
$4,490.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,363.06
|
| Rate for Payer: BCN Commercial |
$4,363.06
|
| Rate for Payer: Cash Price |
$4,226.24
|
| Rate for Payer: Cofinity Commercial |
$4,543.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,226.24
|
| Rate for Payer: Healthscope Commercial |
$4,754.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,962.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,490.38
|
| Rate for Payer: Nomi Health Commercial |
$4,331.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,962.10
|
| Rate for Payer: PHP Commercial |
$4,490.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,596.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,676.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,648.86
|
| Rate for Payer: UHC Core |
$4,411.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,962.10
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
OP
|
$3,743.75
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.68 |
| Max. Negotiated Rate |
$3,369.38 |
| Rate for Payer: Aetna Commercial |
$3,182.19
|
| Rate for Payer: Aetna Medicare |
$973.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,169.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,169.92
|
| Rate for Payer: BCBS Complete |
$692.97
|
| Rate for Payer: BCBS MAPPO |
$935.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,077.74
|
| Rate for Payer: BCCCP Commercial |
$344.68
|
| Rate for Payer: BCN Commercial |
$3,077.74
|
| Rate for Payer: BCN Medicare Advantage |
$935.94
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cofinity Commercial |
$3,219.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,995.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$935.94
|
| Rate for Payer: Healthscope Commercial |
$3,369.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,807.81
|
| Rate for Payer: Mclaren Medicaid |
$660.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$982.73
|
| Rate for Payer: Meridian Medicaid |
$692.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,076.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,029.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,182.19
|
| Rate for Payer: Nomi Health Commercial |
$3,069.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,807.81
|
| Rate for Payer: PACE Senior Care Partners |
$889.14
|
| Rate for Payer: PACE SWMI |
$935.94
|
| Rate for Payer: PHP Commercial |
$3,182.19
|
| Rate for Payer: PHP Medicare Advantage |
$935.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$660.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,257.06
|
| Rate for Payer: Priority Health Medicare |
$945.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,605.65
|
| Rate for Payer: Railroad Medicare Medicare |
$935.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,294.50
|
| Rate for Payer: UHC Core |
$3,126.03
|
| Rate for Payer: UHC Exchange |
$935.94
|
| Rate for Payer: UHC Medicaid |
$660.02
|
| Rate for Payer: UHC Medicare Advantage |
$935.94
|
| Rate for Payer: UHCCP Medicaid |
$660.02
|
| Rate for Payer: VA VA |
$935.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,807.81
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION STEREO
|
Facility
|
IP
|
$3,743.75
|
|
|
Service Code
|
CPT 19082
|
| Hospital Charge Code |
36100409
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,605.65 |
| Max. Negotiated Rate |
$3,369.38 |
| Rate for Payer: Aetna Commercial |
$3,182.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,091.96
|
| Rate for Payer: BCN Commercial |
$3,091.96
|
| Rate for Payer: Cash Price |
$2,995.00
|
| Rate for Payer: Cofinity Commercial |
$3,219.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,995.00
|
| Rate for Payer: Healthscope Commercial |
$3,369.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,807.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,182.19
|
| Rate for Payer: Nomi Health Commercial |
$3,069.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,807.81
|
| Rate for Payer: PHP Commercial |
$3,182.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,257.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,605.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,294.50
|
| Rate for Payer: UHC Core |
$3,126.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,807.81
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
OP
|
$4,126.82
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$338.10 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: Aetna Medicare |
$1,072.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,289.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,289.63
|
| Rate for Payer: BCBS Complete |
$763.87
|
| Rate for Payer: BCBS MAPPO |
$1,031.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,392.66
|
| Rate for Payer: BCCCP Commercial |
$338.10
|
| Rate for Payer: BCN Commercial |
$3,392.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.70
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.70
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: Mclaren Medicaid |
$727.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,083.29
|
| Rate for Payer: Meridian Medicaid |
$763.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,186.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,134.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Nomi Health Commercial |
$3,383.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PACE Senior Care Partners |
$980.12
|
| Rate for Payer: PACE SWMI |
$1,031.70
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,590.33
|
| Rate for Payer: Priority Health Medicare |
$1,042.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,872.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,031.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,631.60
|
| Rate for Payer: UHC Core |
$3,445.89
|
| Rate for Payer: UHC Exchange |
$1,031.70
|
| Rate for Payer: UHC Medicaid |
$727.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,031.70
|
| Rate for Payer: UHCCP Medicaid |
$727.56
|
| Rate for Payer: VA VA |
$1,031.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
|
HC BREAST BX W CLIP EACH ADDL LESION US
|
Facility
|
IP
|
$4,126.82
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
36100411
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,872.27 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,408.34
|
| Rate for Payer: BCN Commercial |
$3,408.34
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Nomi Health Commercial |
$3,383.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,590.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,872.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,631.60
|
| Rate for Payer: UHC Core |
$3,445.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
OP
|
$3,158.79
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$556.89 |
| Max. Negotiated Rate |
$2,842.91 |
| Rate for Payer: Aetna Commercial |
$2,684.97
|
| Rate for Payer: Aetna Medicare |
$821.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$987.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$987.12
|
| Rate for Payer: BCBS Complete |
$584.69
|
| Rate for Payer: BCBS MAPPO |
$789.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,596.84
|
| Rate for Payer: BCCCP Commercial |
$685.36
|
| Rate for Payer: BCN Commercial |
$2,596.84
|
| Rate for Payer: BCN Medicare Advantage |
$789.70
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cofinity Commercial |
$2,716.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,527.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.70
|
| Rate for Payer: Healthscope Commercial |
$2,842.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,369.09
|
| Rate for Payer: Mclaren Medicaid |
$556.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.18
|
| Rate for Payer: Meridian Medicaid |
$584.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$908.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$868.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.97
|
| Rate for Payer: Nomi Health Commercial |
$2,590.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,369.09
|
| Rate for Payer: PACE Senior Care Partners |
$750.21
|
| Rate for Payer: PACE SWMI |
$789.70
|
| Rate for Payer: PHP Commercial |
$2,684.97
|
| Rate for Payer: PHP Medicare Advantage |
$789.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,748.15
|
| Rate for Payer: Priority Health Medicare |
$797.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.52
|
| Rate for Payer: Railroad Medicare Medicare |
$789.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.74
|
| Rate for Payer: UHC Core |
$2,637.59
|
| Rate for Payer: UHC Exchange |
$789.70
|
| Rate for Payer: UHC Medicaid |
$556.89
|
| Rate for Payer: UHC Medicare Advantage |
$789.70
|
| Rate for Payer: UHCCP Medicaid |
$556.89
|
| Rate for Payer: VA VA |
$789.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,369.09
|
|
|
HC BREAST BX W CLIP FIRST LESION MR
|
Facility
|
IP
|
$3,158.79
|
|
|
Service Code
|
CPT 19085
|
| Hospital Charge Code |
36100412
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,198.52 |
| Max. Negotiated Rate |
$2,842.91 |
| Rate for Payer: Aetna Commercial |
$2,684.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,608.84
|
| Rate for Payer: BCN Commercial |
$2,608.84
|
| Rate for Payer: Cash Price |
$2,527.03
|
| Rate for Payer: Cofinity Commercial |
$2,716.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,527.03
|
| Rate for Payer: Healthscope Commercial |
$2,842.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,369.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.97
|
| Rate for Payer: Nomi Health Commercial |
$2,590.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,369.09
|
| Rate for Payer: PHP Commercial |
$2,684.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,748.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.74
|
| Rate for Payer: UHC Core |
$2,637.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,369.09
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
IP
|
$3,815.35
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,655.48 |
| Max. Negotiated Rate |
$3,433.82 |
| Rate for Payer: Aetna Commercial |
$3,243.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,151.10
|
| Rate for Payer: BCN Commercial |
$3,151.10
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cofinity Commercial |
$3,281.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,052.28
|
| Rate for Payer: Healthscope Commercial |
$3,433.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,243.05
|
| Rate for Payer: Nomi Health Commercial |
$3,128.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,861.51
|
| Rate for Payer: PHP Commercial |
$3,243.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,319.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,655.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,357.51
|
| Rate for Payer: UHC Core |
$3,185.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.51
|
|
|
HC BREAST BX W CLIP FIRST LESION STEREO
|
Facility
|
OP
|
$3,815.35
|
|
|
Service Code
|
CPT 19081
|
| Hospital Charge Code |
36100408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$456.33 |
| Max. Negotiated Rate |
$3,433.82 |
| Rate for Payer: Aetna Commercial |
$3,243.05
|
| Rate for Payer: Aetna Medicare |
$991.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,192.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,192.30
|
| Rate for Payer: BCBS Complete |
$706.22
|
| Rate for Payer: BCBS MAPPO |
$953.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,136.60
|
| Rate for Payer: BCCCP Commercial |
$456.33
|
| Rate for Payer: BCN Commercial |
$3,136.60
|
| Rate for Payer: BCN Medicare Advantage |
$953.84
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cash Price |
$3,052.28
|
| Rate for Payer: Cofinity Commercial |
$3,281.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,052.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.84
|
| Rate for Payer: Healthscope Commercial |
$3,433.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,861.51
|
| Rate for Payer: Mclaren Medicaid |
$672.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.53
|
| Rate for Payer: Meridian Medicaid |
$706.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,096.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,049.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,243.05
|
| Rate for Payer: Nomi Health Commercial |
$3,128.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,861.51
|
| Rate for Payer: PACE Senior Care Partners |
$906.15
|
| Rate for Payer: PACE SWMI |
$953.84
|
| Rate for Payer: PHP Commercial |
$3,243.05
|
| Rate for Payer: PHP Medicare Advantage |
$953.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,319.35
|
| Rate for Payer: Priority Health Medicare |
$963.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,655.48
|
| Rate for Payer: Railroad Medicare Medicare |
$953.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,357.51
|
| Rate for Payer: UHC Core |
$3,185.82
|
| Rate for Payer: UHC Exchange |
$953.84
|
| Rate for Payer: UHC Medicaid |
$672.65
|
| Rate for Payer: UHC Medicare Advantage |
$953.84
|
| Rate for Payer: UHCCP Medicaid |
$672.65
|
| Rate for Payer: VA VA |
$953.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,861.51
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
IP
|
$4,208.80
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,929.32 |
| Max. Negotiated Rate |
$3,787.92 |
| Rate for Payer: Aetna Commercial |
$3,577.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,476.05
|
| Rate for Payer: BCN Commercial |
$3,476.05
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cofinity Commercial |
$3,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,367.04
|
| Rate for Payer: Healthscope Commercial |
$3,787.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,156.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,577.48
|
| Rate for Payer: Nomi Health Commercial |
$3,451.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,156.60
|
| Rate for Payer: PHP Commercial |
$3,577.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,661.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,929.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,703.74
|
| Rate for Payer: UHC Core |
$3,514.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,156.60
|
|
|
HC BREAST BX W CLIP FIRST LESION US
|
Facility
|
OP
|
$4,208.80
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
36100410
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.69 |
| Max. Negotiated Rate |
$3,787.92 |
| Rate for Payer: Aetna Commercial |
$3,577.48
|
| Rate for Payer: Aetna Medicare |
$1,094.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,315.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,315.25
|
| Rate for Payer: BCBS Complete |
$779.05
|
| Rate for Payer: BCBS MAPPO |
$1,052.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,460.05
|
| Rate for Payer: BCCCP Commercial |
$450.69
|
| Rate for Payer: BCN Commercial |
$3,460.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,052.20
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cash Price |
$3,367.04
|
| Rate for Payer: Cofinity Commercial |
$3,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,367.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,052.20
|
| Rate for Payer: Healthscope Commercial |
$3,787.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,156.60
|
| Rate for Payer: Mclaren Medicaid |
$742.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,104.81
|
| Rate for Payer: Meridian Medicaid |
$779.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,210.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,157.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,577.48
|
| Rate for Payer: Nomi Health Commercial |
$3,451.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,156.60
|
| Rate for Payer: PACE Senior Care Partners |
$999.59
|
| Rate for Payer: PACE SWMI |
$1,052.20
|
| Rate for Payer: PHP Commercial |
$3,577.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,052.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$742.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,661.66
|
| Rate for Payer: Priority Health Medicare |
$1,062.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,929.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,052.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,703.74
|
| Rate for Payer: UHC Core |
$3,514.35
|
| Rate for Payer: UHC Exchange |
$1,052.20
|
| Rate for Payer: UHC Medicaid |
$742.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,052.20
|
| Rate for Payer: UHCCP Medicaid |
$742.01
|
| Rate for Payer: VA VA |
$1,052.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,156.60
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
OP
|
$370.36
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$333.32 |
| Rate for Payer: Aetna Commercial |
$314.81
|
| Rate for Payer: Aetna Medicare |
$96.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.74
|
| Rate for Payer: BCBS Complete |
$68.55
|
| Rate for Payer: BCBS MAPPO |
$92.59
|
| Rate for Payer: BCBS Trust/PPO |
$304.47
|
| Rate for Payer: BCN Commercial |
$304.47
|
| Rate for Payer: BCN Medicare Advantage |
$92.59
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cofinity Commercial |
$318.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.59
|
| Rate for Payer: Healthscope Commercial |
$333.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.77
|
| Rate for Payer: Mclaren Medicaid |
$65.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.22
|
| Rate for Payer: Meridian Medicaid |
$68.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.81
|
| Rate for Payer: Nomi Health Commercial |
$303.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.77
|
| Rate for Payer: PACE Senior Care Partners |
$87.96
|
| Rate for Payer: PACE SWMI |
$92.59
|
| Rate for Payer: PHP Commercial |
$314.81
|
| Rate for Payer: PHP Medicare Advantage |
$92.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.21
|
| Rate for Payer: Priority Health Medicare |
$93.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.77
|
| Rate for Payer: Railroad Medicare Medicare |
$92.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.92
|
| Rate for Payer: UHC Core |
$309.25
|
| Rate for Payer: UHC Exchange |
$92.59
|
| Rate for Payer: UHC Medicaid |
$65.29
|
| Rate for Payer: UHC Medicare Advantage |
$92.59
|
| Rate for Payer: UHCCP Medicaid |
$65.29
|
| Rate for Payer: VA VA |
$92.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.77
|
|
|
HC BREATH HYDROGEN/METHANE TEST
|
Facility
|
IP
|
$370.36
|
|
|
Service Code
|
CPT 91065
|
| Hospital Charge Code |
75000012
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$257.77 |
| Max. Negotiated Rate |
$333.32 |
| Rate for Payer: Aetna Commercial |
$314.81
|
| Rate for Payer: BCBS Trust/PPO |
$305.88
|
| Rate for Payer: BCN Commercial |
$305.88
|
| Rate for Payer: Cash Price |
$296.29
|
| Rate for Payer: Cofinity Commercial |
$318.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.29
|
| Rate for Payer: Healthscope Commercial |
$333.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.81
|
| Rate for Payer: Nomi Health Commercial |
$303.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.77
|
| Rate for Payer: PHP Commercial |
$314.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.92
|
| Rate for Payer: UHC Core |
$309.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.77
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
IP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$18.08 |
| Max. Negotiated Rate |
$23.37 |
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: BCBS Trust/PPO |
$21.45
|
| Rate for Payer: BCN Commercial |
$21.45
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.85
|
| Rate for Payer: UHC Core |
$21.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.48
|
|
|
HC BRIEF EMOTIONAL/BEHAVIORAL ASSESSMENT
|
Facility
|
OP
|
$25.97
|
|
|
Service Code
|
CPT 96127
|
| Hospital Charge Code |
91800002
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$23.37 |
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: Aetna Medicare |
$6.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.12
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$6.49
|
| Rate for Payer: BCBS Trust/PPO |
$21.35
|
| Rate for Payer: BCN Commercial |
$21.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.49
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Commercial |
$22.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.49
|
| Rate for Payer: Healthscope Commercial |
$23.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.48
|
| Rate for Payer: Mclaren Medicaid |
$4.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.82
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: PACE Senior Care Partners |
$6.17
|
| Rate for Payer: PACE SWMI |
$6.49
|
| Rate for Payer: PHP Commercial |
$22.07
|
| Rate for Payer: PHP Medicare Advantage |
$6.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.59
|
| Rate for Payer: Priority Health Medicare |
$6.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.85
|
| Rate for Payer: UHC Core |
$21.68
|
| Rate for Payer: UHC Exchange |
$6.49
|
| Rate for Payer: UHC Medicaid |
$4.58
|
| Rate for Payer: UHC Medicare Advantage |
$6.49
|
| Rate for Payer: UHCCP Medicaid |
$4.58
|
| Rate for Payer: VA VA |
$6.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.48
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
IP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$183.18 |
| Max. Negotiated Rate |
$236.87 |
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: BCBS Trust/PPO |
$217.37
|
| Rate for Payer: BCN Commercial |
$217.37
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Healthscope Commercial |
$236.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Nomi Health Commercial |
$215.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: PHP Commercial |
$223.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.61
|
| Rate for Payer: UHC Core |
$219.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.39
|
|
|
HC BRONCH CMPTR ASST IMAGE ADD ON
|
Facility
|
OP
|
$263.19
|
|
| Hospital Charge Code |
75000007
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$46.40 |
| Max. Negotiated Rate |
$236.87 |
| Rate for Payer: Aetna Commercial |
$223.71
|
| Rate for Payer: Aetna Medicare |
$68.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.25
|
| Rate for Payer: BCBS Complete |
$48.72
|
| Rate for Payer: BCBS MAPPO |
$65.80
|
| Rate for Payer: BCBS Trust/PPO |
$216.37
|
| Rate for Payer: BCN Commercial |
$216.37
|
| Rate for Payer: BCN Medicare Advantage |
$65.80
|
| Rate for Payer: Cash Price |
$210.55
|
| Rate for Payer: Cofinity Commercial |
$226.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.80
|
| Rate for Payer: Healthscope Commercial |
$236.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.39
|
| Rate for Payer: Mclaren Medicaid |
$46.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.09
|
| Rate for Payer: Meridian Medicaid |
$48.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.71
|
| Rate for Payer: Nomi Health Commercial |
$215.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.39
|
| Rate for Payer: PACE Senior Care Partners |
$62.51
|
| Rate for Payer: PACE SWMI |
$65.80
|
| Rate for Payer: PHP Commercial |
$223.71
|
| Rate for Payer: PHP Medicare Advantage |
$65.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.98
|
| Rate for Payer: Priority Health Medicare |
$66.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.18
|
| Rate for Payer: Railroad Medicare Medicare |
$65.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.61
|
| Rate for Payer: UHC Core |
$219.76
|
| Rate for Payer: UHC Exchange |
$65.80
|
| Rate for Payer: UHC Medicaid |
$46.40
|
| Rate for Payer: UHC Medicare Advantage |
$65.80
|
| Rate for Payer: UHCCP Medicaid |
$46.40
|
| Rate for Payer: VA VA |
$65.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.39
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
IP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,203.36 |
| Max. Negotiated Rate |
$2,849.18 |
| Rate for Payer: Aetna Commercial |
$2,690.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,614.59
|
| Rate for Payer: BCN Commercial |
$2,614.59
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Commercial |
$2,722.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Healthscope Commercial |
$2,849.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,374.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Nomi Health Commercial |
$2,595.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: PHP Commercial |
$2,690.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,754.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,203.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,785.86
|
| Rate for Payer: UHC Core |
$2,643.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,374.31
|
|
|
HC BRONCHIAL NAVIGATION
|
Facility
|
OP
|
$3,165.75
|
|
| Hospital Charge Code |
36000102
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$558.12 |
| Max. Negotiated Rate |
$2,849.18 |
| Rate for Payer: Aetna Commercial |
$2,690.89
|
| Rate for Payer: Aetna Medicare |
$823.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$989.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$989.30
|
| Rate for Payer: BCBS Complete |
$585.98
|
| Rate for Payer: BCBS MAPPO |
$791.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,602.56
|
| Rate for Payer: BCN Commercial |
$2,602.56
|
| Rate for Payer: BCN Medicare Advantage |
$791.44
|
| Rate for Payer: Cash Price |
$2,532.60
|
| Rate for Payer: Cofinity Commercial |
$2,722.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,532.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.44
|
| Rate for Payer: Healthscope Commercial |
$2,849.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,374.31
|
| Rate for Payer: Mclaren Medicaid |
$558.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.01
|
| Rate for Payer: Meridian Medicaid |
$585.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$910.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$870.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,690.89
|
| Rate for Payer: Nomi Health Commercial |
$2,595.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,374.31
|
| Rate for Payer: PACE Senior Care Partners |
$751.87
|
| Rate for Payer: PACE SWMI |
$791.44
|
| Rate for Payer: PHP Commercial |
$2,690.89
|
| Rate for Payer: PHP Medicare Advantage |
$791.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,754.20
|
| Rate for Payer: Priority Health Medicare |
$799.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,203.36
|
| Rate for Payer: Railroad Medicare Medicare |
$791.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,785.86
|
| Rate for Payer: UHC Core |
$2,643.40
|
| Rate for Payer: UHC Exchange |
$791.44
|
| Rate for Payer: UHC Medicaid |
$558.12
|
| Rate for Payer: UHC Medicare Advantage |
$791.44
|
| Rate for Payer: UHCCP Medicaid |
$558.12
|
| Rate for Payer: VA VA |
$791.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,374.31
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
OP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$251.32 |
| Rate for Payer: Aetna Commercial |
$237.35
|
| Rate for Payer: Aetna Medicare |
$72.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.26
|
| Rate for Payer: BCBS Complete |
$51.69
|
| Rate for Payer: BCBS MAPPO |
$69.81
|
| Rate for Payer: BCBS Trust/PPO |
$229.56
|
| Rate for Payer: BCN Commercial |
$229.56
|
| Rate for Payer: BCN Medicare Advantage |
$69.81
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Commercial |
$240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.81
|
| Rate for Payer: Healthscope Commercial |
$251.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.43
|
| Rate for Payer: Mclaren Medicaid |
$49.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.30
|
| Rate for Payer: Meridian Medicaid |
$51.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Nomi Health Commercial |
$228.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: PACE Senior Care Partners |
$66.32
|
| Rate for Payer: PACE SWMI |
$69.81
|
| Rate for Payer: PHP Commercial |
$237.35
|
| Rate for Payer: PHP Medicare Advantage |
$69.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$242.94
|
| Rate for Payer: Priority Health Medicare |
$70.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.35
|
| Rate for Payer: Railroad Medicare Medicare |
$69.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.73
|
| Rate for Payer: UHC Core |
$233.17
|
| Rate for Payer: UHC Exchange |
$69.81
|
| Rate for Payer: UHC Medicaid |
$49.23
|
| Rate for Payer: UHC Medicare Advantage |
$69.81
|
| Rate for Payer: UHCCP Medicaid |
$49.23
|
| Rate for Payer: VA VA |
$69.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.43
|
|
|
HC BRONCHO HYGIENE INITIAL
|
Facility
|
IP
|
$279.24
|
|
|
Service Code
|
CPT 94667
|
| Hospital Charge Code |
41000010
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$194.35 |
| Max. Negotiated Rate |
$251.32 |
| Rate for Payer: Aetna Commercial |
$237.35
|
| Rate for Payer: BCBS Trust/PPO |
$230.62
|
| Rate for Payer: BCN Commercial |
$230.62
|
| Rate for Payer: Cash Price |
$223.39
|
| Rate for Payer: Cofinity Commercial |
$240.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.39
|
| Rate for Payer: Healthscope Commercial |
$251.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.35
|
| Rate for Payer: Nomi Health Commercial |
$228.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.43
|
| Rate for Payer: PHP Commercial |
$237.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$242.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.73
|
| Rate for Payer: UHC Core |
$233.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.43
|
|
|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$186.79 |
| Max. Negotiated Rate |
$241.54 |
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: BCBS Trust/PPO |
$221.66
|
| Rate for Payer: BCN Commercial |
$221.66
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Commercial |
$230.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Healthscope Commercial |
$241.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Nomi Health Commercial |
$220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: PHP Commercial |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.17
|
| Rate for Payer: UHC Core |
$224.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.28
|
|
