|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$600.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$142.51 |
| Max. Negotiated Rate |
$540.04 |
| Rate for Payer: Aetna Commercial |
$510.04
|
| Rate for Payer: Aetna Medicare |
$156.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.52
|
| Rate for Payer: BCBS Complete |
$240.02
|
| Rate for Payer: BCBS MAPPO |
$150.01
|
| Rate for Payer: BCBS Trust/PPO |
$466.54
|
| Rate for Payer: BCN Commercial |
$466.54
|
| Rate for Payer: BCN Medicare Advantage |
$150.01
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cofinity Commercial |
$516.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.01
|
| Rate for Payer: Healthscope Commercial |
$540.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.04
|
| Rate for Payer: PACE Senior Care Partners |
$142.51
|
| Rate for Payer: PACE SWMI |
$150.01
|
| Rate for Payer: PHP Commercial |
$510.04
|
| Rate for Payer: PHP Medicare Advantage |
$150.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.04
|
| Rate for Payer: Priority Health Medicare |
$150.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$365.97
|
| Rate for Payer: Railroad Medicare Medicare |
$150.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.04
|
| Rate for Payer: UHC Core |
$501.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.01
|
| Rate for Payer: UHC Medicare Advantage |
$154.51
|
| Rate for Payer: VA VA |
$150.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.04
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$600.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$365.97 |
| Max. Negotiated Rate |
$540.04 |
| Rate for Payer: Aetna Commercial |
$510.04
|
| Rate for Payer: BCBS Trust/PPO |
$463.72
|
| Rate for Payer: BCN Commercial |
$463.72
|
| Rate for Payer: Cash Price |
$480.04
|
| Rate for Payer: Cofinity Commercial |
$516.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.04
|
| Rate for Payer: Healthscope Commercial |
$540.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.04
|
| Rate for Payer: PHP Commercial |
$510.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$365.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.04
|
| Rate for Payer: UHC Core |
$501.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.04
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$112.04 |
| Max. Negotiated Rate |
$165.34 |
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: BCBS Trust/PPO |
$141.97
|
| Rate for Payer: BCN Commercial |
$141.97
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$157.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Healthscope Commercial |
$165.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.66
|
| Rate for Payer: UHC Core |
$153.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$183.71
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$43.63 |
| Max. Negotiated Rate |
$165.34 |
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna Medicare |
$47.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.41
|
| Rate for Payer: BCBS Complete |
$73.48
|
| Rate for Payer: BCBS MAPPO |
$45.93
|
| Rate for Payer: BCBS Trust/PPO |
$142.83
|
| Rate for Payer: BCN Commercial |
$142.83
|
| Rate for Payer: BCN Medicare Advantage |
$45.93
|
| Rate for Payer: Cash Price |
$146.97
|
| Rate for Payer: Cofinity Commercial |
$157.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.93
|
| Rate for Payer: Healthscope Commercial |
$165.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.15
|
| Rate for Payer: PACE Senior Care Partners |
$43.63
|
| Rate for Payer: PACE SWMI |
$45.93
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: PHP Medicare Advantage |
$45.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$159.83
|
| Rate for Payer: Priority Health Medicare |
$45.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.04
|
| Rate for Payer: Railroad Medicare Medicare |
$45.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.66
|
| Rate for Payer: UHC Core |
$153.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.93
|
| Rate for Payer: UHC Medicare Advantage |
$47.31
|
| Rate for Payer: VA VA |
$45.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$526.92 |
| Rate for Payer: Aetna Commercial |
$497.65
|
| Rate for Payer: Aetna Medicare |
$152.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.96
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$146.37
|
| Rate for Payer: BCBS Trust/PPO |
$455.20
|
| Rate for Payer: BCN Commercial |
$455.20
|
| Rate for Payer: BCN Medicare Advantage |
$146.37
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.37
|
| Rate for Payer: Healthscope Commercial |
$526.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.10
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: PACE Senior Care Partners |
$139.05
|
| Rate for Payer: PACE SWMI |
$146.37
|
| Rate for Payer: PHP Commercial |
$497.65
|
| Rate for Payer: PHP Medicare Advantage |
$146.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$509.36
|
| Rate for Payer: Priority Health Medicare |
$146.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$357.08
|
| Rate for Payer: Railroad Medicare Medicare |
$146.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.21
|
| Rate for Payer: UHC Core |
$488.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$150.76
|
| Rate for Payer: VA VA |
$146.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.10
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$585.47
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$357.08 |
| Max. Negotiated Rate |
$526.92 |
| Rate for Payer: Aetna Commercial |
$497.65
|
| Rate for Payer: BCBS Trust/PPO |
$452.45
|
| Rate for Payer: BCN Commercial |
$452.45
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$503.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Healthscope Commercial |
$526.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$497.65
|
| Rate for Payer: PHP Commercial |
$497.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$509.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$357.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.21
|
| Rate for Payer: UHC Core |
$488.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.10
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$621.70 |
| Rate for Payer: Aetna Commercial |
$587.16
|
| Rate for Payer: BCBS Trust/PPO |
$533.83
|
| Rate for Payer: BCN Commercial |
$533.83
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$594.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Healthscope Commercial |
$621.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: PHP Commercial |
$587.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.89
|
| Rate for Payer: UHC Core |
$576.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.08
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$690.78
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$621.70 |
| Rate for Payer: Aetna Commercial |
$587.16
|
| Rate for Payer: Aetna Medicare |
$179.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.87
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$172.70
|
| Rate for Payer: BCBS Trust/PPO |
$537.08
|
| Rate for Payer: BCN Commercial |
$537.08
|
| Rate for Payer: BCN Medicare Advantage |
$172.70
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cash Price |
$552.62
|
| Rate for Payer: Cofinity Commercial |
$594.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.70
|
| Rate for Payer: Healthscope Commercial |
$621.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.08
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$181.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.16
|
| Rate for Payer: PACE Senior Care Partners |
$164.06
|
| Rate for Payer: PACE SWMI |
$172.70
|
| Rate for Payer: PHP Commercial |
$587.16
|
| Rate for Payer: PHP Medicare Advantage |
$172.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.98
|
| Rate for Payer: Priority Health Medicare |
$172.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.31
|
| Rate for Payer: Railroad Medicare Medicare |
$172.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.89
|
| Rate for Payer: UHC Core |
$576.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.70
|
| Rate for Payer: UHC Medicare Advantage |
$177.88
|
| Rate for Payer: VA VA |
$172.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.08
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$574.52 |
| Rate for Payer: Aetna Commercial |
$542.61
|
| Rate for Payer: Aetna Medicare |
$165.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$199.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$199.49
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$159.59
|
| Rate for Payer: BCBS Trust/PPO |
$496.32
|
| Rate for Payer: BCN Commercial |
$496.32
|
| Rate for Payer: BCN Medicare Advantage |
$159.59
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$548.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.59
|
| Rate for Payer: Healthscope Commercial |
$574.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.77
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$183.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$542.61
|
| Rate for Payer: PACE Senior Care Partners |
$151.61
|
| Rate for Payer: PACE SWMI |
$159.59
|
| Rate for Payer: PHP Commercial |
$542.61
|
| Rate for Payer: PHP Medicare Advantage |
$159.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.37
|
| Rate for Payer: Priority Health Medicare |
$159.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.34
|
| Rate for Payer: Railroad Medicare Medicare |
$159.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.76
|
| Rate for Payer: UHC Core |
$533.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.59
|
| Rate for Payer: UHC Medicare Advantage |
$164.38
|
| Rate for Payer: VA VA |
$159.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.77
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$638.36
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$389.34 |
| Max. Negotiated Rate |
$574.52 |
| Rate for Payer: Aetna Commercial |
$542.61
|
| Rate for Payer: BCBS Trust/PPO |
$493.32
|
| Rate for Payer: BCN Commercial |
$493.32
|
| Rate for Payer: Cash Price |
$510.69
|
| Rate for Payer: Cofinity Commercial |
$548.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.69
|
| Rate for Payer: Healthscope Commercial |
$574.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$542.61
|
| Rate for Payer: PHP Commercial |
$542.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$555.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$561.76
|
| Rate for Payer: UHC Core |
$533.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.77
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$190.13 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$720.52
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$439.45 |
| Max. Negotiated Rate |
$648.47 |
| Rate for Payer: Aetna Commercial |
$612.44
|
| Rate for Payer: BCBS Trust/PPO |
$556.82
|
| Rate for Payer: BCN Commercial |
$556.82
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cofinity Commercial |
$619.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
| Rate for Payer: Healthscope Commercial |
$648.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.44
|
| Rate for Payer: PHP Commercial |
$612.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.06
|
| Rate for Payer: UHC Core |
$601.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.39
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$720.52
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$171.12 |
| Max. Negotiated Rate |
$648.47 |
| Rate for Payer: Aetna Commercial |
$612.44
|
| Rate for Payer: Aetna Medicare |
$187.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.16
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$180.13
|
| Rate for Payer: BCBS Trust/PPO |
$560.20
|
| Rate for Payer: BCN Commercial |
$560.20
|
| Rate for Payer: BCN Medicare Advantage |
$180.13
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cash Price |
$576.42
|
| Rate for Payer: Cofinity Commercial |
$619.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.13
|
| Rate for Payer: Healthscope Commercial |
$648.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.39
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.44
|
| Rate for Payer: PACE Senior Care Partners |
$171.12
|
| Rate for Payer: PACE SWMI |
$180.13
|
| Rate for Payer: PHP Commercial |
$612.44
|
| Rate for Payer: PHP Medicare Advantage |
$180.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.85
|
| Rate for Payer: Priority Health Medicare |
$180.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.45
|
| Rate for Payer: Railroad Medicare Medicare |
$180.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.06
|
| Rate for Payer: UHC Core |
$601.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.13
|
| Rate for Payer: UHC Medicare Advantage |
$185.53
|
| Rate for Payer: VA VA |
$180.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.39
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$367.63
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$224.22 |
| Max. Negotiated Rate |
$330.87 |
| Rate for Payer: Aetna Commercial |
$312.49
|
| Rate for Payer: BCBS Trust/PPO |
$284.10
|
| Rate for Payer: BCN Commercial |
$284.10
|
| Rate for Payer: Cash Price |
$294.10
|
| Rate for Payer: Cofinity Commercial |
$316.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
| Rate for Payer: Healthscope Commercial |
$330.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
| Rate for Payer: PHP Commercial |
$312.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.51
|
| Rate for Payer: UHC Core |
$306.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.72
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
OP
|
$367.63
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$87.31 |
| Max. Negotiated Rate |
$330.87 |
| Rate for Payer: Aetna Commercial |
$312.49
|
| Rate for Payer: Aetna Medicare |
$95.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.88
|
| Rate for Payer: BCBS Complete |
$147.05
|
| Rate for Payer: BCBS MAPPO |
$91.91
|
| Rate for Payer: BCBS Trust/PPO |
$285.83
|
| Rate for Payer: BCN Commercial |
$285.83
|
| Rate for Payer: BCN Medicare Advantage |
$91.91
|
| Rate for Payer: Cash Price |
$294.10
|
| Rate for Payer: Cofinity Commercial |
$316.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.91
|
| Rate for Payer: Healthscope Commercial |
$330.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.49
|
| Rate for Payer: PACE Senior Care Partners |
$87.31
|
| Rate for Payer: PACE SWMI |
$91.91
|
| Rate for Payer: PHP Commercial |
$312.49
|
| Rate for Payer: PHP Medicare Advantage |
$91.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.84
|
| Rate for Payer: Priority Health Medicare |
$91.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.22
|
| Rate for Payer: Railroad Medicare Medicare |
$91.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.51
|
| Rate for Payer: UHC Core |
$306.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.91
|
| Rate for Payer: UHC Medicare Advantage |
$94.66
|
| Rate for Payer: VA VA |
$91.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.72
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$445.19
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$105.73 |
| Max. Negotiated Rate |
$400.67 |
| Rate for Payer: Aetna Commercial |
$378.41
|
| Rate for Payer: Aetna Medicare |
$115.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.12
|
| Rate for Payer: BCBS Complete |
$178.08
|
| Rate for Payer: BCBS MAPPO |
$111.30
|
| Rate for Payer: BCBS Trust/PPO |
$346.14
|
| Rate for Payer: BCN Commercial |
$346.14
|
| Rate for Payer: BCN Medicare Advantage |
$111.30
|
| Rate for Payer: Cash Price |
$356.15
|
| Rate for Payer: Cofinity Commercial |
$382.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.30
|
| Rate for Payer: Healthscope Commercial |
$400.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$127.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
| Rate for Payer: PACE Senior Care Partners |
$105.73
|
| Rate for Payer: PACE SWMI |
$111.30
|
| Rate for Payer: PHP Commercial |
$378.41
|
| Rate for Payer: PHP Medicare Advantage |
$111.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.32
|
| Rate for Payer: Priority Health Medicare |
$111.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.52
|
| Rate for Payer: Railroad Medicare Medicare |
$111.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.77
|
| Rate for Payer: UHC Core |
$371.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$111.30
|
| Rate for Payer: UHC Medicare Advantage |
$114.64
|
| Rate for Payer: VA VA |
$111.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.89
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$445.19
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$271.52 |
| Max. Negotiated Rate |
$400.67 |
| Rate for Payer: Aetna Commercial |
$378.41
|
| Rate for Payer: BCBS Trust/PPO |
$344.04
|
| Rate for Payer: BCN Commercial |
$344.04
|
| Rate for Payer: Cash Price |
$356.15
|
| Rate for Payer: Cofinity Commercial |
$382.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.15
|
| Rate for Payer: Healthscope Commercial |
$400.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$378.41
|
| Rate for Payer: PHP Commercial |
$378.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.77
|
| Rate for Payer: UHC Core |
$371.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.89
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$390.33
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$238.06 |
| Max. Negotiated Rate |
$351.30 |
| Rate for Payer: Aetna Commercial |
$331.78
|
| Rate for Payer: BCBS Trust/PPO |
$301.65
|
| Rate for Payer: BCN Commercial |
$301.65
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cofinity Commercial |
$335.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
| Rate for Payer: Healthscope Commercial |
$351.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.78
|
| Rate for Payer: PHP Commercial |
$331.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.49
|
| Rate for Payer: UHC Core |
$325.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.75
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$390.33
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$351.30 |
| Rate for Payer: Aetna Commercial |
$331.78
|
| Rate for Payer: Aetna Medicare |
$101.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.98
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$97.58
|
| Rate for Payer: BCBS Trust/PPO |
$303.48
|
| Rate for Payer: BCN Commercial |
$303.48
|
| Rate for Payer: BCN Medicare Advantage |
$97.58
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cash Price |
$312.26
|
| Rate for Payer: Cofinity Commercial |
$335.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.58
|
| Rate for Payer: Healthscope Commercial |
$351.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.75
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.78
|
| Rate for Payer: PACE Senior Care Partners |
$92.70
|
| Rate for Payer: PACE SWMI |
$97.58
|
| Rate for Payer: PHP Commercial |
$331.78
|
| Rate for Payer: PHP Medicare Advantage |
$97.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.59
|
| Rate for Payer: Priority Health Medicare |
$97.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.06
|
| Rate for Payer: Railroad Medicare Medicare |
$97.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.49
|
| Rate for Payer: UHC Core |
$325.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.58
|
| Rate for Payer: UHC Medicare Advantage |
$100.51
|
| Rate for Payer: VA VA |
$97.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.75
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$430.40
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$102.22 |
| Max. Negotiated Rate |
$387.36 |
| Rate for Payer: Aetna Commercial |
$365.84
|
| Rate for Payer: Aetna Medicare |
$111.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.50
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$107.60
|
| Rate for Payer: BCBS Trust/PPO |
$334.64
|
| Rate for Payer: BCN Commercial |
$334.64
|
| Rate for Payer: BCN Medicare Advantage |
$107.60
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cofinity Commercial |
$370.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.60
|
| Rate for Payer: Healthscope Commercial |
$387.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.80
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.84
|
| Rate for Payer: PACE Senior Care Partners |
$102.22
|
| Rate for Payer: PACE SWMI |
$107.60
|
| Rate for Payer: PHP Commercial |
$365.84
|
| Rate for Payer: PHP Medicare Advantage |
$107.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.45
|
| Rate for Payer: Priority Health Medicare |
$107.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.50
|
| Rate for Payer: Railroad Medicare Medicare |
$107.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.75
|
| Rate for Payer: UHC Core |
$359.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.60
|
| Rate for Payer: UHC Medicare Advantage |
$110.83
|
| Rate for Payer: VA VA |
$107.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.80
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$430.40
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$262.50 |
| Max. Negotiated Rate |
$387.36 |
| Rate for Payer: Aetna Commercial |
$365.84
|
| Rate for Payer: BCBS Trust/PPO |
$332.61
|
| Rate for Payer: BCN Commercial |
$332.61
|
| Rate for Payer: Cash Price |
$344.32
|
| Rate for Payer: Cofinity Commercial |
$370.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.32
|
| Rate for Payer: Healthscope Commercial |
$387.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.84
|
| Rate for Payer: PHP Commercial |
$365.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.75
|
| Rate for Payer: UHC Core |
$359.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.80
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$450.54
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: Aetna Medicare |
$117.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.79
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$112.64
|
| Rate for Payer: BCBS Trust/PPO |
$350.29
|
| Rate for Payer: BCN Commercial |
$350.29
|
| Rate for Payer: BCN Medicare Advantage |
$112.64
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$387.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.64
|
| Rate for Payer: Healthscope Commercial |
$405.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PACE Senior Care Partners |
$107.00
|
| Rate for Payer: PACE SWMI |
$112.64
|
| Rate for Payer: PHP Commercial |
$382.96
|
| Rate for Payer: PHP Medicare Advantage |
$112.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.97
|
| Rate for Payer: Priority Health Medicare |
$112.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.78
|
| Rate for Payer: Railroad Medicare Medicare |
$112.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.48
|
| Rate for Payer: UHC Core |
$376.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.64
|
| Rate for Payer: UHC Medicare Advantage |
$116.01
|
| Rate for Payer: VA VA |
$112.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
