|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$450.54
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$274.78 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: BCBS Trust/PPO |
$348.18
|
| Rate for Payer: BCN Commercial |
$348.18
|
| 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: Healthscope Commercial |
$405.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PHP Commercial |
$382.96
|
| 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 Narrow/Tiered Network |
$274.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.48
|
| Rate for Payer: UHC Core |
$376.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$272.42
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$166.15 |
| Max. Negotiated Rate |
$245.18 |
| Rate for Payer: Aetna Commercial |
$231.56
|
| Rate for Payer: BCBS Trust/PPO |
$210.53
|
| Rate for Payer: BCN Commercial |
$210.53
|
| Rate for Payer: Cash Price |
$217.94
|
| Rate for Payer: Cofinity Commercial |
$234.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.94
|
| Rate for Payer: Healthscope Commercial |
$245.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.56
|
| Rate for Payer: PHP Commercial |
$231.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.73
|
| Rate for Payer: UHC Core |
$227.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.32
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$272.42
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$64.70 |
| Max. Negotiated Rate |
$245.18 |
| Rate for Payer: Aetna Commercial |
$231.56
|
| Rate for Payer: Aetna Medicare |
$70.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.13
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$68.10
|
| Rate for Payer: BCBS Trust/PPO |
$211.81
|
| Rate for Payer: BCN Commercial |
$211.81
|
| Rate for Payer: BCN Medicare Advantage |
$68.10
|
| Rate for Payer: Cash Price |
$217.94
|
| Rate for Payer: Cash Price |
$217.94
|
| Rate for Payer: Cofinity Commercial |
$234.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.10
|
| Rate for Payer: Healthscope Commercial |
$245.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.32
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.56
|
| Rate for Payer: PACE Senior Care Partners |
$64.70
|
| Rate for Payer: PACE SWMI |
$68.10
|
| Rate for Payer: PHP Commercial |
$231.56
|
| Rate for Payer: PHP Medicare Advantage |
$68.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.01
|
| Rate for Payer: Priority Health Medicare |
$68.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.15
|
| Rate for Payer: Railroad Medicare Medicare |
$68.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.73
|
| Rate for Payer: UHC Core |
$227.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.10
|
| Rate for Payer: UHC Medicare Advantage |
$70.15
|
| Rate for Payer: VA VA |
$68.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.32
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$514.90
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$122.29 |
| Max. Negotiated Rate |
$463.41 |
| Rate for Payer: Aetna Commercial |
$437.66
|
| Rate for Payer: Aetna Medicare |
$133.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.91
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$128.72
|
| Rate for Payer: BCBS Trust/PPO |
$400.33
|
| Rate for Payer: BCN Commercial |
$400.33
|
| Rate for Payer: BCN Medicare Advantage |
$128.72
|
| Rate for Payer: Cash Price |
$411.92
|
| Rate for Payer: Cash Price |
$411.92
|
| Rate for Payer: Cofinity Commercial |
$442.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$411.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.72
|
| Rate for Payer: Healthscope Commercial |
$463.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.18
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$437.66
|
| Rate for Payer: PACE Senior Care Partners |
$122.29
|
| Rate for Payer: PACE SWMI |
$128.72
|
| Rate for Payer: PHP Commercial |
$437.66
|
| Rate for Payer: PHP Medicare Advantage |
$128.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.96
|
| Rate for Payer: Priority Health Medicare |
$128.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.04
|
| Rate for Payer: Railroad Medicare Medicare |
$128.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.11
|
| Rate for Payer: UHC Core |
$429.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.72
|
| Rate for Payer: UHC Medicare Advantage |
$132.59
|
| Rate for Payer: VA VA |
$128.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.18
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$514.90
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$314.04 |
| Max. Negotiated Rate |
$463.41 |
| Rate for Payer: Aetna Commercial |
$437.66
|
| Rate for Payer: BCBS Trust/PPO |
$397.91
|
| Rate for Payer: BCN Commercial |
$397.91
|
| Rate for Payer: Cash Price |
$411.92
|
| Rate for Payer: Cofinity Commercial |
$442.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$411.92
|
| Rate for Payer: Healthscope Commercial |
$463.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$437.66
|
| Rate for Payer: PHP Commercial |
$437.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$314.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.11
|
| Rate for Payer: UHC Core |
$429.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.18
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$573.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$136.09 |
| Max. Negotiated Rate |
$592.28 |
| Rate for Payer: Aetna Commercial |
$487.05
|
| Rate for Payer: Aetna Medicare |
$148.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.06
|
| Rate for Payer: BCBS Complete |
$592.28
|
| Rate for Payer: BCBS MAPPO |
$143.25
|
| Rate for Payer: BCBS Trust/PPO |
$445.51
|
| Rate for Payer: BCN Commercial |
$445.51
|
| Rate for Payer: BCN Medicare Advantage |
$143.25
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$492.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.25
|
| Rate for Payer: Healthscope Commercial |
$515.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.75
|
| Rate for Payer: Mclaren Medicaid |
$564.08
|
| Rate for Payer: Meridian Medicaid |
$592.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.05
|
| Rate for Payer: PACE Senior Care Partners |
$136.09
|
| Rate for Payer: PACE SWMI |
$143.25
|
| Rate for Payer: PHP Commercial |
$487.05
|
| Rate for Payer: PHP Medicare Advantage |
$143.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.51
|
| Rate for Payer: Priority Health Medicare |
$143.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.47
|
| Rate for Payer: Railroad Medicare Medicare |
$143.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.24
|
| Rate for Payer: UHC Core |
$478.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.25
|
| Rate for Payer: UHC Medicare Advantage |
$147.55
|
| Rate for Payer: VA VA |
$143.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.75
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$573.00
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$349.47 |
| Max. Negotiated Rate |
$515.70 |
| Rate for Payer: Aetna Commercial |
$487.05
|
| Rate for Payer: BCBS Trust/PPO |
$442.81
|
| Rate for Payer: BCN Commercial |
$442.81
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cofinity Commercial |
$492.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.40
|
| Rate for Payer: Healthscope Commercial |
$515.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.05
|
| Rate for Payer: PHP Commercial |
$487.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.24
|
| Rate for Payer: UHC Core |
$478.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.75
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$32.45
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$29.20 |
| Rate for Payer: Aetna Commercial |
$27.58
|
| Rate for Payer: BCBS Trust/PPO |
$25.08
|
| Rate for Payer: BCN Commercial |
$25.08
|
| Rate for Payer: Cash Price |
$25.96
|
| Rate for Payer: Cofinity Commercial |
$27.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.96
|
| Rate for Payer: Healthscope Commercial |
$29.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.58
|
| Rate for Payer: PHP Commercial |
$27.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.56
|
| Rate for Payer: UHC Core |
$27.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.34
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$32.45
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$29.20 |
| Rate for Payer: Aetna Commercial |
$27.58
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.14
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.11
|
| Rate for Payer: BCBS Trust/PPO |
$25.23
|
| Rate for Payer: BCN Commercial |
$25.23
|
| Rate for Payer: BCN Medicare Advantage |
$8.11
|
| Rate for Payer: Cash Price |
$25.96
|
| Rate for Payer: Cash Price |
$25.96
|
| Rate for Payer: Cofinity Commercial |
$27.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.11
|
| Rate for Payer: Healthscope Commercial |
$29.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.34
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.58
|
| Rate for Payer: PACE Senior Care Partners |
$7.71
|
| Rate for Payer: PACE SWMI |
$8.11
|
| Rate for Payer: PHP Commercial |
$27.58
|
| Rate for Payer: PHP Medicare Advantage |
$8.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.23
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.79
|
| Rate for Payer: Railroad Medicare Medicare |
$8.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.56
|
| Rate for Payer: UHC Core |
$27.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.11
|
| Rate for Payer: UHC Medicare Advantage |
$8.36
|
| Rate for Payer: VA VA |
$8.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.34
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
IP
|
$151.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.09 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Aetna Commercial |
$128.35
|
| Rate for Payer: BCBS Trust/PPO |
$116.69
|
| Rate for Payer: BCN Commercial |
$116.69
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$129.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.80
|
| Rate for Payer: Healthscope Commercial |
$135.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.35
|
| Rate for Payer: PHP Commercial |
$128.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Core |
$126.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.25
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
OP
|
$151.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$135.90 |
| Rate for Payer: Aetna Commercial |
$128.35
|
| Rate for Payer: Aetna Medicare |
$39.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.19
|
| Rate for Payer: BCBS Complete |
$18.26
|
| Rate for Payer: BCBS MAPPO |
$37.75
|
| Rate for Payer: BCBS Trust/PPO |
$117.40
|
| Rate for Payer: BCN Commercial |
$117.40
|
| Rate for Payer: BCN Medicare Advantage |
$37.75
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$129.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.75
|
| Rate for Payer: Healthscope Commercial |
$135.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.25
|
| Rate for Payer: Mclaren Medicaid |
$17.39
|
| Rate for Payer: Meridian Medicaid |
$18.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.35
|
| Rate for Payer: PACE Senior Care Partners |
$35.86
|
| Rate for Payer: PACE SWMI |
$37.75
|
| Rate for Payer: PHP Commercial |
$128.35
|
| Rate for Payer: PHP Medicare Advantage |
$37.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.37
|
| Rate for Payer: Priority Health Medicare |
$37.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.09
|
| Rate for Payer: Railroad Medicare Medicare |
$37.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Core |
$126.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.75
|
| Rate for Payer: UHC Medicare Advantage |
$38.88
|
| Rate for Payer: VA VA |
$37.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.25
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
IP
|
$65.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.08 |
| Max. Negotiated Rate |
$59.14 |
| Rate for Payer: Aetna Commercial |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$50.78
|
| Rate for Payer: BCN Commercial |
$50.78
|
| Rate for Payer: Cash Price |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.57
|
| Rate for Payer: Healthscope Commercial |
$59.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.85
|
| Rate for Payer: PHP Commercial |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.82
|
| Rate for Payer: UHC Core |
$54.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.28
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
OP
|
$65.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$59.14 |
| Rate for Payer: Aetna Commercial |
$55.85
|
| Rate for Payer: Aetna Medicare |
$17.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.53
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$16.43
|
| Rate for Payer: BCBS Trust/PPO |
$51.09
|
| Rate for Payer: BCN Commercial |
$51.09
|
| Rate for Payer: BCN Medicare Advantage |
$16.43
|
| Rate for Payer: Cash Price |
$52.57
|
| Rate for Payer: Cash Price |
$52.57
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.43
|
| Rate for Payer: Healthscope Commercial |
$59.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.28
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.85
|
| Rate for Payer: PACE Senior Care Partners |
$15.61
|
| Rate for Payer: PACE SWMI |
$16.43
|
| Rate for Payer: PHP Commercial |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$16.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.17
|
| Rate for Payer: Priority Health Medicare |
$16.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.08
|
| Rate for Payer: Railroad Medicare Medicare |
$16.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.82
|
| Rate for Payer: UHC Core |
$54.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.43
|
| Rate for Payer: UHC Medicare Advantage |
$16.92
|
| Rate for Payer: VA VA |
$16.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.28
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
IP
|
$151.46
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.38 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: BCBS Trust/PPO |
$117.05
|
| Rate for Payer: BCN Commercial |
$117.05
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.74
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.28
|
| Rate for Payer: UHC Core |
$126.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.60
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
OP
|
$151.46
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: Aetna Medicare |
$39.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.33
|
| Rate for Payer: BCBS Complete |
$14.26
|
| Rate for Payer: BCBS MAPPO |
$37.86
|
| Rate for Payer: BCBS Trust/PPO |
$117.76
|
| Rate for Payer: BCN Commercial |
$117.76
|
| Rate for Payer: BCN Medicare Advantage |
$37.86
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.86
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.60
|
| Rate for Payer: Mclaren Medicaid |
$13.58
|
| Rate for Payer: Meridian Medicaid |
$14.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.74
|
| Rate for Payer: PACE Senior Care Partners |
$35.97
|
| Rate for Payer: PACE SWMI |
$37.86
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: PHP Medicare Advantage |
$37.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.77
|
| Rate for Payer: Priority Health Medicare |
$37.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.38
|
| Rate for Payer: Railroad Medicare Medicare |
$37.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.28
|
| Rate for Payer: UHC Core |
$126.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.86
|
| Rate for Payer: UHC Medicare Advantage |
$39.00
|
| Rate for Payer: VA VA |
$37.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.60
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Aetna Commercial |
$79.05
|
| Rate for Payer: Aetna Medicare |
$24.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.06
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$23.25
|
| Rate for Payer: BCBS Trust/PPO |
$72.31
|
| Rate for Payer: BCN Commercial |
$72.31
|
| Rate for Payer: BCN Medicare Advantage |
$23.25
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$79.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.25
|
| Rate for Payer: Healthscope Commercial |
$83.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.75
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.05
|
| Rate for Payer: PACE Senior Care Partners |
$22.09
|
| Rate for Payer: PACE SWMI |
$23.25
|
| Rate for Payer: PHP Commercial |
$79.05
|
| Rate for Payer: PHP Medicare Advantage |
$23.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.91
|
| Rate for Payer: Priority Health Medicare |
$23.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: Railroad Medicare Medicare |
$23.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.84
|
| Rate for Payer: UHC Core |
$77.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.25
|
| Rate for Payer: UHC Medicare Advantage |
$23.95
|
| Rate for Payer: VA VA |
$23.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.75
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.72 |
| Max. Negotiated Rate |
$83.70 |
| Rate for Payer: Aetna Commercial |
$79.05
|
| Rate for Payer: BCBS Trust/PPO |
$71.87
|
| Rate for Payer: BCN Commercial |
$71.87
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$79.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.40
|
| Rate for Payer: Healthscope Commercial |
$83.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$79.05
|
| Rate for Payer: PHP Commercial |
$79.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.84
|
| Rate for Payer: UHC Core |
$77.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.75
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
OP
|
$205.21
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$184.69 |
| Rate for Payer: Aetna Commercial |
$174.43
|
| Rate for Payer: Aetna Medicare |
$53.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.13
|
| Rate for Payer: BCBS Complete |
$18.26
|
| Rate for Payer: BCBS MAPPO |
$51.30
|
| Rate for Payer: BCBS Trust/PPO |
$159.55
|
| Rate for Payer: BCN Commercial |
$159.55
|
| Rate for Payer: BCN Medicare Advantage |
$51.30
|
| Rate for Payer: Cash Price |
$164.17
|
| Rate for Payer: Cash Price |
$164.17
|
| Rate for Payer: Cofinity Commercial |
$176.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.30
|
| Rate for Payer: Healthscope Commercial |
$184.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.91
|
| Rate for Payer: Mclaren Medicaid |
$17.39
|
| Rate for Payer: Meridian Medicaid |
$18.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.43
|
| Rate for Payer: PACE Senior Care Partners |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.30
|
| Rate for Payer: PHP Commercial |
$174.43
|
| Rate for Payer: PHP Medicare Advantage |
$51.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.53
|
| Rate for Payer: Priority Health Medicare |
$51.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.16
|
| Rate for Payer: Railroad Medicare Medicare |
$51.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.58
|
| Rate for Payer: UHC Core |
$171.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.30
|
| Rate for Payer: UHC Medicare Advantage |
$52.84
|
| Rate for Payer: VA VA |
$51.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.91
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$205.21
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$125.16 |
| Max. Negotiated Rate |
$184.69 |
| Rate for Payer: Aetna Commercial |
$174.43
|
| Rate for Payer: BCBS Trust/PPO |
$158.59
|
| Rate for Payer: BCN Commercial |
$158.59
|
| Rate for Payer: Cash Price |
$164.17
|
| Rate for Payer: Cofinity Commercial |
$176.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.17
|
| Rate for Payer: Healthscope Commercial |
$184.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$174.43
|
| Rate for Payer: PHP Commercial |
$174.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.58
|
| Rate for Payer: UHC Core |
$171.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.91
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: Aetna Medicare |
$39.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.50
|
| Rate for Payer: BCBS Complete |
$18.26
|
| Rate for Payer: BCBS MAPPO |
$38.00
|
| Rate for Payer: BCBS Trust/PPO |
$118.18
|
| Rate for Payer: BCN Commercial |
$118.18
|
| Rate for Payer: BCN Medicare Advantage |
$38.00
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cofinity Commercial |
$130.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.00
|
| Rate for Payer: Healthscope Commercial |
$136.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.00
|
| Rate for Payer: Mclaren Medicaid |
$17.39
|
| Rate for Payer: Meridian Medicaid |
$18.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$129.20
|
| Rate for Payer: PACE Senior Care Partners |
$36.10
|
| Rate for Payer: PACE SWMI |
$38.00
|
| Rate for Payer: PHP Commercial |
$129.20
|
| Rate for Payer: PHP Medicare Advantage |
$38.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.24
|
| Rate for Payer: Priority Health Medicare |
$38.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.70
|
| Rate for Payer: Railroad Medicare Medicare |
$38.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.76
|
| Rate for Payer: UHC Core |
$126.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.00
|
| Rate for Payer: UHC Medicare Advantage |
$39.14
|
| Rate for Payer: VA VA |
$38.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.00
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$92.70 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna Commercial |
$129.20
|
| Rate for Payer: BCBS Trust/PPO |
$117.47
|
| Rate for Payer: BCN Commercial |
$117.47
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cofinity Commercial |
$130.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.60
|
| Rate for Payer: Healthscope Commercial |
$136.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$129.20
|
| Rate for Payer: PHP Commercial |
$129.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.76
|
| Rate for Payer: UHC Core |
$126.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.00
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.95
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$57.10
|
| Rate for Payer: BCN Commercial |
$57.10
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.42
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.89
|
| Rate for Payer: Priority Health Medicare |
$18.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.79
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$18.91
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.79 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$56.75
|
| Rate for Payer: BCN Commercial |
$56.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.42
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
