|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
IP
|
$290.70
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$188.96 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: BCBS Trust/PPO |
$237.30
|
| Rate for Payer: BCN Commercial |
$224.65
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
OP
|
$290.70
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.12 |
| Max. Negotiated Rate |
$261.63 |
| Rate for Payer: Aetna Commercial |
$247.09
|
| Rate for Payer: Aetna Medicare |
$75.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.84
|
| Rate for Payer: BCBS Complete |
$22.18
|
| Rate for Payer: BCBS MAPPO |
$72.67
|
| Rate for Payer: BCBS Trust/PPO |
$238.98
|
| Rate for Payer: BCN Commercial |
$226.02
|
| Rate for Payer: BCN Medicare Advantage |
$72.67
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cash Price |
$232.56
|
| Rate for Payer: Cofinity Commercial |
$250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.67
|
| Rate for Payer: Healthscope Commercial |
$261.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.03
|
| Rate for Payer: Mclaren Medicaid |
$21.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.31
|
| Rate for Payer: Meridian Medicaid |
$22.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.09
|
| Rate for Payer: Nomi Health Commercial |
$238.37
|
| Rate for Payer: PACE Senior Care Partners |
$69.04
|
| Rate for Payer: PACE SWMI |
$72.67
|
| Rate for Payer: PHP Commercial |
$247.09
|
| Rate for Payer: PHP Medicare Advantage |
$72.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.96
|
| Rate for Payer: Priority Health HMO/PPO |
$252.91
|
| Rate for Payer: Priority Health Medicare |
$73.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.77
|
| Rate for Payer: Railroad Medicare Medicare |
$72.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.82
|
| Rate for Payer: UHC Core |
$242.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.67
|
| Rate for Payer: UHC Exchange |
$72.67
|
| Rate for Payer: UHC Medicare Advantage |
$72.67
|
| Rate for Payer: UHCCP Medicaid |
$21.12
|
| Rate for Payer: VA VA |
$72.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.03
|
|
|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
OP
|
$9,241.20
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,194.78 |
| Max. Negotiated Rate |
$8,317.08 |
| Rate for Payer: Aetna Commercial |
$7,855.02
|
| Rate for Payer: Aetna Medicare |
$2,402.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,887.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,887.88
|
| Rate for Payer: BCBS Complete |
$2,463.31
|
| Rate for Payer: BCBS MAPPO |
$2,310.30
|
| Rate for Payer: BCBS Trust/PPO |
$7,597.19
|
| Rate for Payer: BCN Commercial |
$7,185.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,310.30
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cofinity Commercial |
$7,947.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,392.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,310.30
|
| Rate for Payer: Healthscope Commercial |
$8,317.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,930.90
|
| Rate for Payer: Mclaren Medicaid |
$2,345.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,425.82
|
| Rate for Payer: Meridian Medicaid |
$2,463.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,656.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,855.02
|
| Rate for Payer: Nomi Health Commercial |
$7,577.78
|
| Rate for Payer: PACE Senior Care Partners |
$2,194.78
|
| Rate for Payer: PACE SWMI |
$2,310.30
|
| Rate for Payer: PHP Commercial |
$7,855.02
|
| Rate for Payer: PHP Medicare Advantage |
$2,310.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,345.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,006.78
|
| Rate for Payer: Priority Health HMO/PPO |
$8,039.84
|
| Rate for Payer: Priority Health Medicare |
$2,333.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,191.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,310.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,132.26
|
| Rate for Payer: UHC Core |
$7,716.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,310.30
|
| Rate for Payer: UHC Exchange |
$2,310.30
|
| Rate for Payer: UHC Medicare Advantage |
$2,310.30
|
| Rate for Payer: UHCCP Medicaid |
$2,345.85
|
| Rate for Payer: VA VA |
$2,310.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,930.90
|
|
|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
IP
|
$9,241.20
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,006.78 |
| Max. Negotiated Rate |
$8,317.08 |
| Rate for Payer: Aetna Commercial |
$7,855.02
|
| Rate for Payer: BCBS Trust/PPO |
$7,543.59
|
| Rate for Payer: BCN Commercial |
$7,141.60
|
| Rate for Payer: Cash Price |
$7,392.96
|
| Rate for Payer: Cofinity Commercial |
$7,947.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,392.96
|
| Rate for Payer: Healthscope Commercial |
$8,317.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,930.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,855.02
|
| Rate for Payer: Nomi Health Commercial |
$7,577.78
|
| Rate for Payer: PHP Commercial |
$7,855.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,006.78
|
| Rate for Payer: Priority Health HMO/PPO |
$8,039.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,191.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,132.26
|
| Rate for Payer: UHC Core |
$7,716.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,930.90
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC AMYLASE FLUID
|
Facility
|
OP
|
$61.61
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.25
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$15.40
|
| Rate for Payer: BCBS Trust/PPO |
$50.65
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$15.40
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.40
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.17
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PACE Senior Care Partners |
$14.63
|
| Rate for Payer: PACE SWMI |
$15.40
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: PHP Medicare Advantage |
$15.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: Railroad Medicare Medicare |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.40
|
| Rate for Payer: UHC Exchange |
$15.40
|
| Rate for Payer: UHC Medicare Advantage |
$15.40
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: VA VA |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC AMYLASE FLUID
|
Facility
|
IP
|
$61.61
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.05 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: BCBS Trust/PPO |
$50.29
|
| Rate for Payer: BCN Commercial |
$47.61
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
IP
|
$213.49
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$138.77 |
| Max. Negotiated Rate |
$192.14 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: BCBS Trust/PPO |
$174.27
|
| Rate for Payer: BCN Commercial |
$164.99
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cofinity Commercial |
$183.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.79
|
| Rate for Payer: Healthscope Commercial |
$192.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Nomi Health Commercial |
$175.06
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.77
|
| Rate for Payer: Priority Health HMO/PPO |
$185.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.87
|
| Rate for Payer: UHC Core |
$178.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.12
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
OP
|
$213.49
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$192.14 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: Aetna Medicare |
$55.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.72
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$53.37
|
| Rate for Payer: BCBS Trust/PPO |
$175.51
|
| Rate for Payer: BCN Commercial |
$165.99
|
| Rate for Payer: BCN Medicare Advantage |
$53.37
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cash Price |
$170.79
|
| Rate for Payer: Cofinity Commercial |
$183.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.37
|
| Rate for Payer: Healthscope Commercial |
$192.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.12
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.04
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Nomi Health Commercial |
$175.06
|
| Rate for Payer: PACE Senior Care Partners |
$50.70
|
| Rate for Payer: PACE SWMI |
$53.37
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: PHP Medicare Advantage |
$53.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.77
|
| Rate for Payer: Priority Health HMO/PPO |
$185.74
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.04
|
| Rate for Payer: Railroad Medicare Medicare |
$53.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.87
|
| Rate for Payer: UHC Core |
$178.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.37
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UHC Medicare Advantage |
$53.37
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: VA VA |
$53.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.12
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.92
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$31.14
|
| Rate for Payer: BCBS Trust/PPO |
$102.38
|
| Rate for Payer: BCN Commercial |
$96.83
|
| Rate for Payer: BCN Medicare Advantage |
$31.14
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.41
|
| Rate for Payer: Mclaren Medicaid |
$6.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.69
|
| Rate for Payer: Meridian Medicaid |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.86
|
| Rate for Payer: Nomi Health Commercial |
$102.12
|
| Rate for Payer: PACE Senior Care Partners |
$29.58
|
| Rate for Payer: PACE SWMI |
$31.14
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: PHP Medicare Advantage |
$31.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.95
|
| Rate for Payer: Priority Health HMO/PPO |
$108.35
|
| Rate for Payer: Priority Health Medicare |
$31.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.44
|
| Rate for Payer: Railroad Medicare Medicare |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$103.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.14
|
| Rate for Payer: UHC Exchange |
$31.14
|
| Rate for Payer: UHC Medicare Advantage |
$31.14
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: VA VA |
$31.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.41
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.95 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: BCBS Trust/PPO |
$101.66
|
| Rate for Payer: BCN Commercial |
$96.24
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.86
|
| Rate for Payer: Nomi Health Commercial |
$102.12
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.95
|
| Rate for Payer: Priority Health HMO/PPO |
$108.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$103.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.41
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$6.13
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$40.69
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Mclaren Medicaid |
$5.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$6.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: PACE Senior Care Partners |
$12.43
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: Priority Health HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Medicare |
$13.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.09
|
| Rate for Payer: UHC Exchange |
$13.09
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$5.84
|
| Rate for Payer: VA VA |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.02 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$42.73
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.02
|
| Rate for Payer: Priority Health HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.36 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.62
|
| Rate for Payer: BCBS Complete |
$69.69
|
| Rate for Payer: BCBS MAPPO |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$251.56
|
| Rate for Payer: BCN Commercial |
$237.91
|
| Rate for Payer: BCN Medicare Advantage |
$76.50
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.50
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$66.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.33
|
| Rate for Payer: Meridian Medicaid |
$69.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$250.92
|
| Rate for Payer: PACE Senior Care Partners |
$72.67
|
| Rate for Payer: PACE SWMI |
$76.50
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$76.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO |
$266.22
|
| Rate for Payer: Priority Health Medicare |
$77.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.02
|
| Rate for Payer: Railroad Medicare Medicare |
$76.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.50
|
| Rate for Payer: UHC Exchange |
$76.50
|
| Rate for Payer: UHC Medicare Advantage |
$76.50
|
| Rate for Payer: UHCCP Medicaid |
$66.36
|
| Rate for Payer: VA VA |
$76.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.90 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: BCBS Trust/PPO |
$249.79
|
| Rate for Payer: BCN Commercial |
$236.48
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.10
|
| Rate for Payer: Nomi Health Commercial |
$250.92
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO |
$266.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.28
|
| Rate for Payer: UHC Core |
$255.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$104.03 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna Medicare |
$113.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.88
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$109.50
|
| Rate for Payer: BCBS Trust/PPO |
$360.08
|
| Rate for Payer: BCN Commercial |
$340.55
|
| Rate for Payer: BCN Medicare Advantage |
$109.50
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.50
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.50
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.97
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: Nomi Health Commercial |
$359.16
|
| Rate for Payer: PACE Senior Care Partners |
$104.03
|
| Rate for Payer: PACE SWMI |
$109.50
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: PHP Medicare Advantage |
$109.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO |
$381.06
|
| Rate for Payer: Priority Health Medicare |
$110.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.46
|
| Rate for Payer: Railroad Medicare Medicare |
$109.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.44
|
| Rate for Payer: UHC Core |
$365.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.50
|
| Rate for Payer: UHC Exchange |
$109.50
|
| Rate for Payer: UHC Medicare Advantage |
$109.50
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$109.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.50
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$284.70 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: BCBS Trust/PPO |
$357.54
|
| Rate for Payer: BCN Commercial |
$338.49
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: Nomi Health Commercial |
$359.16
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO |
$381.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.44
|
| Rate for Payer: UHC Core |
$365.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.50
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
IP
|
$438.00
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.70 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: BCBS Trust/PPO |
$357.54
|
| Rate for Payer: BCN Commercial |
$338.49
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: Nomi Health Commercial |
$359.16
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO |
$381.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.44
|
| Rate for Payer: UHC Core |
$365.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.50
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
OP
|
$438.00
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.03 |
| Max. Negotiated Rate |
$394.20 |
| Rate for Payer: Aetna Commercial |
$372.30
|
| Rate for Payer: Aetna Medicare |
$113.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.88
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$109.50
|
| Rate for Payer: BCBS Trust/PPO |
$360.08
|
| Rate for Payer: BCN Commercial |
$340.55
|
| Rate for Payer: BCN Medicare Advantage |
$109.50
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$376.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.50
|
| Rate for Payer: Healthscope Commercial |
$394.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.50
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.97
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.30
|
| Rate for Payer: Nomi Health Commercial |
$359.16
|
| Rate for Payer: PACE Senior Care Partners |
$104.03
|
| Rate for Payer: PACE SWMI |
$109.50
|
| Rate for Payer: PHP Commercial |
$372.30
|
| Rate for Payer: PHP Medicare Advantage |
$109.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.70
|
| Rate for Payer: Priority Health HMO/PPO |
$381.06
|
| Rate for Payer: Priority Health Medicare |
$110.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.46
|
| Rate for Payer: Railroad Medicare Medicare |
$109.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.44
|
| Rate for Payer: UHC Core |
$365.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.50
|
| Rate for Payer: UHC Exchange |
$109.50
|
| Rate for Payer: UHC Medicare Advantage |
$109.50
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$109.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.50
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.06
|
| Rate for Payer: BCBS Complete |
$28.31
|
| Rate for Payer: BCBS MAPPO |
$28.05
|
| Rate for Payer: BCBS Trust/PPO |
$92.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.05
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Mclaren Medicaid |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.45
|
| Rate for Payer: Meridian Medicaid |
$28.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Senior Care Partners |
$26.65
|
| Rate for Payer: PACE SWMI |
$28.05
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: Railroad Medicare Medicare |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Medicare Advantage |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$26.96
|
| Rate for Payer: VA VA |
$28.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: BCBS Trust/PPO |
$91.59
|
| Rate for Payer: BCN Commercial |
$86.71
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$16.89
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Aetna Commercial |
$14.36
|
| Rate for Payer: Aetna Medicare |
$4.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.28
|
| Rate for Payer: BCBS Complete |
$6.76
|
| Rate for Payer: BCBS MAPPO |
$4.22
|
| Rate for Payer: BCBS Trust/PPO |
$13.89
|
| Rate for Payer: BCN Commercial |
$13.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.22
|
| Rate for Payer: Cash Price |
$13.51
|
| Rate for Payer: Cofinity Commercial |
$14.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.22
|
| Rate for Payer: Healthscope Commercial |
$15.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.36
|
| Rate for Payer: Nomi Health Commercial |
$13.85
|
| Rate for Payer: PACE Senior Care Partners |
$4.01
|
| Rate for Payer: PACE SWMI |
$4.22
|
| Rate for Payer: PHP Commercial |
$14.36
|
| Rate for Payer: PHP Medicare Advantage |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.98
|
| Rate for Payer: Priority Health HMO/PPO |
$14.69
|
| Rate for Payer: Priority Health Medicare |
$4.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.32
|
| Rate for Payer: Railroad Medicare Medicare |
$4.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.86
|
| Rate for Payer: UHC Core |
$14.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.22
|
| Rate for Payer: UHC Exchange |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$4.22
|
| Rate for Payer: VA VA |
$4.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.67
|
|
