|
HC E72 MOUSE URINE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
IP
|
$12.29
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Aetna Commercial |
$10.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.50
|
| Rate for Payer: BCN Commercial |
$9.50
|
| Rate for Payer: Cash Price |
$9.83
|
| Rate for Payer: Cofinity Commercial |
$10.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.83
|
| Rate for Payer: Healthscope Commercial |
$11.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.45
|
| Rate for Payer: PHP Commercial |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.82
|
| Rate for Payer: UHC Core |
$10.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.22
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
OP
|
$12.29
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Aetna Commercial |
$10.45
|
| Rate for Payer: Aetna Medicare |
$3.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.84
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$3.07
|
| Rate for Payer: BCBS Trust/PPO |
$9.56
|
| Rate for Payer: BCN Commercial |
$9.56
|
| Rate for Payer: BCN Medicare Advantage |
$3.07
|
| Rate for Payer: Cash Price |
$9.83
|
| Rate for Payer: Cofinity Commercial |
$10.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.07
|
| Rate for Payer: Healthscope Commercial |
$11.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.45
|
| Rate for Payer: PACE Senior Care Partners |
$2.92
|
| Rate for Payer: PACE SWMI |
$3.07
|
| Rate for Payer: PHP Commercial |
$10.45
|
| Rate for Payer: PHP Medicare Advantage |
$3.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.69
|
| Rate for Payer: Priority Health Medicare |
$3.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.50
|
| Rate for Payer: Railroad Medicare Medicare |
$3.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.82
|
| Rate for Payer: UHC Core |
$10.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.07
|
| Rate for Payer: UHC Medicare Advantage |
$3.16
|
| Rate for Payer: VA VA |
$3.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.22
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$19.32
|
| Rate for Payer: BCN Commercial |
$19.32
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.81
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$6.25
|
| Rate for Payer: BCBS Trust/PPO |
$19.44
|
| Rate for Payer: BCN Commercial |
$19.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.25
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PACE Senior Care Partners |
$5.94
|
| Rate for Payer: PACE SWMI |
$6.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$6.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.75
|
| Rate for Payer: Priority Health Medicare |
$6.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.25
|
| Rate for Payer: Railroad Medicare Medicare |
$6.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.25
|
| Rate for Payer: UHC Medicare Advantage |
$6.44
|
| Rate for Payer: VA VA |
$6.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$36.29
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.34
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$9.07
|
| Rate for Payer: BCBS Trust/PPO |
$28.22
|
| Rate for Payer: BCN Commercial |
$28.22
|
| Rate for Payer: BCN Medicare Advantage |
$9.07
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.07
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Mclaren Medicaid |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PACE Senior Care Partners |
$8.62
|
| Rate for Payer: PACE SWMI |
$9.07
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$9.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.57
|
| Rate for Payer: Priority Health Medicare |
$9.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.13
|
| Rate for Payer: Railroad Medicare Medicare |
$9.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.94
|
| Rate for Payer: UHC Core |
$30.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.07
|
| Rate for Payer: UHC Medicare Advantage |
$9.34
|
| Rate for Payer: VA VA |
$9.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$28.04
|
| Rate for Payer: BCN Commercial |
$28.04
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.94
|
| Rate for Payer: UHC Core |
$30.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.38
|
| Rate for Payer: BCN Commercial |
$28.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$361.89 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Aetna Commercial |
$1,673.65
|
| Rate for Payer: Aetna Medicare |
$511.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$615.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$615.31
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$492.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.90
|
| Rate for Payer: BCN Commercial |
$1,530.90
|
| Rate for Payer: BCN Medicare Advantage |
$492.25
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,693.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.25
|
| Rate for Payer: Healthscope Commercial |
$1,772.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.75
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$516.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$566.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,673.65
|
| Rate for Payer: PACE Senior Care Partners |
$467.64
|
| Rate for Payer: PACE SWMI |
$492.25
|
| Rate for Payer: PHP Commercial |
$1,673.65
|
| Rate for Payer: PHP Medicare Advantage |
$492.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,713.03
|
| Rate for Payer: Priority Health Medicare |
$492.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.89
|
| Rate for Payer: Railroad Medicare Medicare |
$492.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.72
|
| Rate for Payer: UHC Core |
$1,644.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.25
|
| Rate for Payer: UHC Medicare Advantage |
$507.02
|
| Rate for Payer: VA VA |
$492.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.75
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,200.89 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Aetna Commercial |
$1,673.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,521.64
|
| Rate for Payer: BCN Commercial |
$1,521.64
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,693.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,575.20
|
| Rate for Payer: Healthscope Commercial |
$1,772.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,673.65
|
| Rate for Payer: PHP Commercial |
$1,673.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,713.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.72
|
| Rate for Payer: UHC Core |
$1,644.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.75
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,200.89 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Aetna Commercial |
$1,673.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,521.64
|
| Rate for Payer: BCN Commercial |
$1,521.64
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,693.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,575.20
|
| Rate for Payer: Healthscope Commercial |
$1,772.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,673.65
|
| Rate for Payer: PHP Commercial |
$1,673.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,713.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.72
|
| Rate for Payer: UHC Core |
$1,644.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.75
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$467.64 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Aetna Commercial |
$1,673.65
|
| Rate for Payer: Aetna Medicare |
$511.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$615.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$615.31
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$492.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.90
|
| Rate for Payer: BCN Commercial |
$1,530.90
|
| Rate for Payer: BCN Medicare Advantage |
$492.25
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,693.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,575.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$492.25
|
| Rate for Payer: Healthscope Commercial |
$1,772.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.75
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$516.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$566.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,673.65
|
| Rate for Payer: PACE Senior Care Partners |
$467.64
|
| Rate for Payer: PACE SWMI |
$492.25
|
| Rate for Payer: PHP Commercial |
$1,673.65
|
| Rate for Payer: PHP Medicare Advantage |
$492.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,378.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,713.03
|
| Rate for Payer: Priority Health Medicare |
$492.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,200.89
|
| Rate for Payer: Railroad Medicare Medicare |
$492.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,732.72
|
| Rate for Payer: UHC Core |
$1,644.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$492.25
|
| Rate for Payer: UHC Medicare Advantage |
$507.02
|
| Rate for Payer: VA VA |
$492.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.75
|
|
|
HC ECHO CONGENITAL
|
Facility
|
IP
|
$1,606.80
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$979.99 |
| Max. Negotiated Rate |
$1,446.12 |
| Rate for Payer: Aetna Commercial |
$1,365.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,241.74
|
| Rate for Payer: BCN Commercial |
$1,241.74
|
| Rate for Payer: Cash Price |
$1,285.44
|
| Rate for Payer: Cofinity Commercial |
$1,381.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.44
|
| Rate for Payer: Healthscope Commercial |
$1,446.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,365.78
|
| Rate for Payer: PHP Commercial |
$1,365.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,124.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,397.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.98
|
| Rate for Payer: UHC Core |
$1,341.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.10
|
|
|
HC ECHO CONGENITAL
|
Facility
|
OP
|
$1,606.80
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$361.89 |
| Max. Negotiated Rate |
$1,446.12 |
| Rate for Payer: Aetna Commercial |
$1,365.78
|
| Rate for Payer: Aetna Medicare |
$417.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$502.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$502.12
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$401.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.29
|
| Rate for Payer: BCN Commercial |
$1,249.29
|
| Rate for Payer: BCN Medicare Advantage |
$401.70
|
| Rate for Payer: Cash Price |
$1,285.44
|
| Rate for Payer: Cash Price |
$1,285.44
|
| Rate for Payer: Cofinity Commercial |
$1,381.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.70
|
| Rate for Payer: Healthscope Commercial |
$1,446.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,205.10
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$461.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,365.78
|
| Rate for Payer: PACE Senior Care Partners |
$381.62
|
| Rate for Payer: PACE SWMI |
$401.70
|
| Rate for Payer: PHP Commercial |
$1,365.78
|
| Rate for Payer: PHP Medicare Advantage |
$401.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,124.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,397.92
|
| Rate for Payer: Priority Health Medicare |
$401.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$979.99
|
| Rate for Payer: Railroad Medicare Medicare |
$401.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,413.98
|
| Rate for Payer: UHC Core |
$1,341.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.70
|
| Rate for Payer: UHC Medicare Advantage |
$413.75
|
| Rate for Payer: VA VA |
$401.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,205.10
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
IP
|
$1,122.22
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$684.44 |
| Max. Negotiated Rate |
$1,010.00 |
| Rate for Payer: Aetna Commercial |
$953.89
|
| Rate for Payer: BCBS Trust/PPO |
$867.25
|
| Rate for Payer: BCN Commercial |
$867.25
|
| Rate for Payer: Cash Price |
$897.78
|
| Rate for Payer: Cofinity Commercial |
$965.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.78
|
| Rate for Payer: Healthscope Commercial |
$1,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.89
|
| Rate for Payer: PHP Commercial |
$953.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Core |
$937.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.66
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
OP
|
$1,122.22
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$266.53 |
| Max. Negotiated Rate |
$1,010.00 |
| Rate for Payer: Aetna Commercial |
$953.89
|
| Rate for Payer: Aetna Medicare |
$291.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.69
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$280.56
|
| Rate for Payer: BCBS Trust/PPO |
$872.53
|
| Rate for Payer: BCN Commercial |
$872.53
|
| Rate for Payer: BCN Medicare Advantage |
$280.56
|
| Rate for Payer: Cash Price |
$897.78
|
| Rate for Payer: Cash Price |
$897.78
|
| Rate for Payer: Cofinity Commercial |
$965.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.56
|
| Rate for Payer: Healthscope Commercial |
$1,010.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.66
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$294.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$953.89
|
| Rate for Payer: PACE Senior Care Partners |
$266.53
|
| Rate for Payer: PACE SWMI |
$280.56
|
| Rate for Payer: PHP Commercial |
$953.89
|
| Rate for Payer: PHP Medicare Advantage |
$280.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.33
|
| Rate for Payer: Priority Health Medicare |
$280.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.44
|
| Rate for Payer: Railroad Medicare Medicare |
$280.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Core |
$937.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.56
|
| Rate for Payer: UHC Medicare Advantage |
$288.97
|
| Rate for Payer: VA VA |
$280.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.66
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
IP
|
$947.89
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$578.12 |
| Max. Negotiated Rate |
$853.10 |
| Rate for Payer: Aetna Commercial |
$805.71
|
| Rate for Payer: BCBS Trust/PPO |
$732.53
|
| Rate for Payer: BCN Commercial |
$732.53
|
| Rate for Payer: Cash Price |
$758.31
|
| Rate for Payer: Cofinity Commercial |
$815.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$758.31
|
| Rate for Payer: Healthscope Commercial |
$853.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$805.71
|
| Rate for Payer: PHP Commercial |
$805.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.14
|
| Rate for Payer: UHC Core |
$791.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.92
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
OP
|
$947.89
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$225.12 |
| Max. Negotiated Rate |
$853.10 |
| Rate for Payer: Aetna Commercial |
$805.71
|
| Rate for Payer: Aetna Medicare |
$246.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.22
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$236.97
|
| Rate for Payer: BCBS Trust/PPO |
$736.98
|
| Rate for Payer: BCN Commercial |
$736.98
|
| Rate for Payer: BCN Medicare Advantage |
$236.97
|
| Rate for Payer: Cash Price |
$758.31
|
| Rate for Payer: Cash Price |
$758.31
|
| Rate for Payer: Cofinity Commercial |
$815.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$758.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.97
|
| Rate for Payer: Healthscope Commercial |
$853.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$710.92
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$248.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$805.71
|
| Rate for Payer: PACE Senior Care Partners |
$225.12
|
| Rate for Payer: PACE SWMI |
$236.97
|
| Rate for Payer: PHP Commercial |
$805.71
|
| Rate for Payer: PHP Medicare Advantage |
$236.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$824.66
|
| Rate for Payer: Priority Health Medicare |
$236.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$578.12
|
| Rate for Payer: Railroad Medicare Medicare |
$236.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$834.14
|
| Rate for Payer: UHC Core |
$791.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.97
|
| Rate for Payer: UHC Medicare Advantage |
$244.08
|
| Rate for Payer: VA VA |
$236.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$710.92
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
OP
|
$722.16
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$649.94 |
| Rate for Payer: Aetna Commercial |
$613.84
|
| Rate for Payer: Aetna Medicare |
$187.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.68
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$180.54
|
| Rate for Payer: BCBS Trust/PPO |
$561.48
|
| Rate for Payer: BCN Commercial |
$561.48
|
| Rate for Payer: BCN Medicare Advantage |
$180.54
|
| Rate for Payer: Cash Price |
$577.73
|
| Rate for Payer: Cash Price |
$577.73
|
| Rate for Payer: Cofinity Commercial |
$621.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.54
|
| Rate for Payer: Healthscope Commercial |
$649.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.62
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.84
|
| Rate for Payer: PACE Senior Care Partners |
$171.51
|
| Rate for Payer: PACE SWMI |
$180.54
|
| Rate for Payer: PHP Commercial |
$613.84
|
| Rate for Payer: PHP Medicare Advantage |
$180.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.28
|
| Rate for Payer: Priority Health Medicare |
$180.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.45
|
| Rate for Payer: Railroad Medicare Medicare |
$180.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.50
|
| Rate for Payer: UHC Core |
$603.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.54
|
| Rate for Payer: UHC Medicare Advantage |
$185.96
|
| Rate for Payer: VA VA |
$180.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.62
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
IP
|
$722.16
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$440.45 |
| Max. Negotiated Rate |
$649.94 |
| Rate for Payer: Aetna Commercial |
$613.84
|
| Rate for Payer: BCBS Trust/PPO |
$558.09
|
| Rate for Payer: BCN Commercial |
$558.09
|
| Rate for Payer: Cash Price |
$577.73
|
| Rate for Payer: Cofinity Commercial |
$621.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.73
|
| Rate for Payer: Healthscope Commercial |
$649.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.84
|
| Rate for Payer: PHP Commercial |
$613.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$440.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$635.50
|
| Rate for Payer: UHC Core |
$603.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.62
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
IP
|
$417.18
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$254.44 |
| Max. Negotiated Rate |
$375.46 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: BCBS Trust/PPO |
$322.40
|
| Rate for Payer: BCN Commercial |
$322.40
|
| Rate for Payer: Cash Price |
$333.74
|
| Rate for Payer: Cofinity Commercial |
$358.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.74
|
| Rate for Payer: Healthscope Commercial |
$375.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$354.60
|
| Rate for Payer: PHP Commercial |
$354.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.12
|
| Rate for Payer: UHC Core |
$348.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.88
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
OP
|
$417.18
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$375.46 |
| Rate for Payer: Aetna Commercial |
$354.60
|
| Rate for Payer: Aetna Medicare |
$108.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.37
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$104.30
|
| Rate for Payer: BCBS Trust/PPO |
$324.36
|
| Rate for Payer: BCN Commercial |
$324.36
|
| Rate for Payer: BCN Medicare Advantage |
$104.30
|
| Rate for Payer: Cash Price |
$333.74
|
| Rate for Payer: Cash Price |
$333.74
|
| Rate for Payer: Cofinity Commercial |
$358.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.30
|
| Rate for Payer: Healthscope Commercial |
$375.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.88
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$354.60
|
| Rate for Payer: PACE Senior Care Partners |
$99.08
|
| Rate for Payer: PACE SWMI |
$104.30
|
| Rate for Payer: PHP Commercial |
$354.60
|
| Rate for Payer: PHP Medicare Advantage |
$104.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.95
|
| Rate for Payer: Priority Health Medicare |
$104.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.44
|
| Rate for Payer: Railroad Medicare Medicare |
$104.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.12
|
| Rate for Payer: UHC Core |
$348.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.30
|
| Rate for Payer: UHC Medicare Advantage |
$107.42
|
| Rate for Payer: VA VA |
$104.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.88
|
|
