|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$66.94 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.81
|
| Rate for Payer: BCN Commercial |
$84.81
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.29
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna Medicare |
$28.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.30
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$27.44
|
| Rate for Payer: BCBS Trust/PPO |
$85.33
|
| Rate for Payer: BCN Commercial |
$85.33
|
| Rate for Payer: BCN Medicare Advantage |
$27.44
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.44
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.29
|
| Rate for Payer: PACE Senior Care Partners |
$26.07
|
| Rate for Payer: PACE SWMI |
$27.44
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: PHP Medicare Advantage |
$27.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.48
|
| Rate for Payer: Priority Health Medicare |
$27.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: Railroad Medicare Medicare |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.44
|
| Rate for Payer: UHC Medicare Advantage |
$28.26
|
| Rate for Payer: VA VA |
$27.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
IP
|
$109.75
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$66.94 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: BCBS Trust/PPO |
$84.81
|
| Rate for Payer: BCN Commercial |
$84.81
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.29
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
OP
|
$109.75
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$98.78 |
| Rate for Payer: Aetna Commercial |
$93.29
|
| Rate for Payer: Aetna Medicare |
$28.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.30
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$27.44
|
| Rate for Payer: BCBS Trust/PPO |
$85.33
|
| Rate for Payer: BCN Commercial |
$85.33
|
| Rate for Payer: BCN Medicare Advantage |
$27.44
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cash Price |
$87.80
|
| Rate for Payer: Cofinity Commercial |
$94.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.44
|
| Rate for Payer: Healthscope Commercial |
$98.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.31
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.29
|
| Rate for Payer: PACE Senior Care Partners |
$26.07
|
| Rate for Payer: PACE SWMI |
$27.44
|
| Rate for Payer: PHP Commercial |
$93.29
|
| Rate for Payer: PHP Medicare Advantage |
$27.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.48
|
| Rate for Payer: Priority Health Medicare |
$27.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.94
|
| Rate for Payer: Railroad Medicare Medicare |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.58
|
| Rate for Payer: UHC Core |
$91.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.44
|
| Rate for Payer: UHC Medicare Advantage |
$28.26
|
| Rate for Payer: VA VA |
$27.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.31
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
IP
|
$116.36
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.97 |
| Max. Negotiated Rate |
$104.72 |
| Rate for Payer: Aetna Commercial |
$98.91
|
| Rate for Payer: BCBS Trust/PPO |
$89.92
|
| Rate for Payer: BCN Commercial |
$89.92
|
| Rate for Payer: Cash Price |
$93.09
|
| Rate for Payer: Cofinity Commercial |
$100.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.09
|
| Rate for Payer: Healthscope Commercial |
$104.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.91
|
| Rate for Payer: PHP Commercial |
$98.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.40
|
| Rate for Payer: UHC Core |
$97.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.27
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
OP
|
$116.36
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$104.72 |
| Rate for Payer: Aetna Commercial |
$98.91
|
| Rate for Payer: Aetna Medicare |
$30.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.36
|
| Rate for Payer: BCBS Complete |
$46.54
|
| Rate for Payer: BCBS MAPPO |
$29.09
|
| Rate for Payer: BCBS Trust/PPO |
$90.47
|
| Rate for Payer: BCN Commercial |
$90.47
|
| Rate for Payer: BCN Medicare Advantage |
$29.09
|
| Rate for Payer: Cash Price |
$93.09
|
| Rate for Payer: Cofinity Commercial |
$100.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.09
|
| Rate for Payer: Healthscope Commercial |
$104.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.91
|
| Rate for Payer: PACE Senior Care Partners |
$27.64
|
| Rate for Payer: PACE SWMI |
$29.09
|
| Rate for Payer: PHP Commercial |
$98.91
|
| Rate for Payer: PHP Medicare Advantage |
$29.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.23
|
| Rate for Payer: Priority Health Medicare |
$29.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.97
|
| Rate for Payer: Railroad Medicare Medicare |
$29.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.40
|
| Rate for Payer: UHC Core |
$97.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.09
|
| Rate for Payer: UHC Medicare Advantage |
$29.96
|
| Rate for Payer: VA VA |
$29.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.27
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$231.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.27
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$692.33
|
| Rate for Payer: BCCCP Commercial |
$445.03
|
| Rate for Payer: BCN Commercial |
$692.33
|
| Rate for Payer: BCN Medicare Advantage |
$222.62
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.62
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Senior Care Partners |
$211.48
|
| Rate for Payer: PACE SWMI |
$222.62
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$222.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Medicare |
$222.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: Railroad Medicare Medicare |
$222.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.62
|
| Rate for Payer: UHC Medicare Advantage |
$229.29
|
| Rate for Payer: VA VA |
$222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.09 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: BCBS Trust/PPO |
$688.15
|
| Rate for Payer: BCN Commercial |
$688.15
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.09 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: BCBS Trust/PPO |
$688.15
|
| Rate for Payer: BCN Commercial |
$688.15
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$231.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.27
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$692.33
|
| Rate for Payer: BCCCP Commercial |
$304.04
|
| Rate for Payer: BCN Commercial |
$692.33
|
| Rate for Payer: BCN Medicare Advantage |
$222.62
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.62
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Senior Care Partners |
$211.48
|
| Rate for Payer: PACE SWMI |
$222.62
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$222.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Medicare |
$222.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: Railroad Medicare Medicare |
$222.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.62
|
| Rate for Payer: UHC Medicare Advantage |
$229.29
|
| Rate for Payer: VA VA |
$222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.09 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: BCBS Trust/PPO |
$688.15
|
| Rate for Payer: BCN Commercial |
$688.15
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.48 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$231.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.27
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$692.33
|
| Rate for Payer: BCCCP Commercial |
$445.03
|
| Rate for Payer: BCN Commercial |
$692.33
|
| Rate for Payer: BCN Medicare Advantage |
$222.62
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.62
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Senior Care Partners |
$211.48
|
| Rate for Payer: PACE SWMI |
$222.62
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$222.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Medicare |
$222.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: Railroad Medicare Medicare |
$222.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.62
|
| Rate for Payer: UHC Medicare Advantage |
$229.29
|
| Rate for Payer: VA VA |
$222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.12 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$231.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.27
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$222.62
|
| Rate for Payer: BCBS Trust/PPO |
$692.33
|
| Rate for Payer: BCCCP Commercial |
$141.12
|
| Rate for Payer: BCN Commercial |
$692.33
|
| Rate for Payer: BCN Medicare Advantage |
$222.62
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.62
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Senior Care Partners |
$211.48
|
| Rate for Payer: PACE SWMI |
$222.62
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$222.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Medicare |
$222.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: Railroad Medicare Medicare |
$222.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.62
|
| Rate for Payer: UHC Medicare Advantage |
$229.29
|
| Rate for Payer: VA VA |
$222.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$543.09 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: BCBS Trust/PPO |
$688.15
|
| Rate for Payer: BCN Commercial |
$688.15
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.60
|
| Rate for Payer: UHC Core |
$743.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$147.90
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.20 |
| Max. Negotiated Rate |
$133.11 |
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: BCBS Trust/PPO |
$114.30
|
| Rate for Payer: BCN Commercial |
$114.30
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.15
|
| Rate for Payer: UHC Core |
$123.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$147.90
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$35.13 |
| Max. Negotiated Rate |
$245.50 |
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: Aetna Medicare |
$38.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.22
|
| Rate for Payer: BCBS Complete |
$59.16
|
| Rate for Payer: BCBS MAPPO |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$114.99
|
| Rate for Payer: BCCCP Commercial |
$245.50
|
| Rate for Payer: BCN Commercial |
$114.99
|
| Rate for Payer: BCN Medicare Advantage |
$36.98
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.98
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PACE Senior Care Partners |
$35.13
|
| Rate for Payer: PACE SWMI |
$36.98
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: PHP Medicare Advantage |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.67
|
| Rate for Payer: Priority Health Medicare |
$36.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.15
|
| Rate for Payer: UHC Core |
$123.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.98
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: VA VA |
$36.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$162.69
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.22 |
| Max. Negotiated Rate |
$146.42 |
| Rate for Payer: Aetna Commercial |
$138.29
|
| Rate for Payer: BCBS Trust/PPO |
$125.73
|
| Rate for Payer: BCN Commercial |
$125.73
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cofinity Commercial |
$139.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.15
|
| Rate for Payer: Healthscope Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.29
|
| Rate for Payer: PHP Commercial |
$138.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.17
|
| Rate for Payer: UHC Core |
$135.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.02
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
OP
|
$162.69
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.64 |
| Max. Negotiated Rate |
$149.11 |
| Rate for Payer: Aetna Commercial |
$138.29
|
| Rate for Payer: Aetna Medicare |
$42.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.84
|
| Rate for Payer: BCBS Complete |
$65.08
|
| Rate for Payer: BCBS MAPPO |
$40.67
|
| Rate for Payer: BCBS Trust/PPO |
$126.49
|
| Rate for Payer: BCCCP Commercial |
$149.11
|
| Rate for Payer: BCN Commercial |
$126.49
|
| Rate for Payer: BCN Medicare Advantage |
$40.67
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cofinity Commercial |
$139.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.67
|
| Rate for Payer: Healthscope Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.29
|
| Rate for Payer: PACE Senior Care Partners |
$38.64
|
| Rate for Payer: PACE SWMI |
$40.67
|
| Rate for Payer: PHP Commercial |
$138.29
|
| Rate for Payer: PHP Medicare Advantage |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.54
|
| Rate for Payer: Priority Health Medicare |
$40.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.22
|
| Rate for Payer: Railroad Medicare Medicare |
$40.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.17
|
| Rate for Payer: UHC Core |
$135.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.67
|
| Rate for Payer: UHC Medicare Advantage |
$41.89
|
| Rate for Payer: VA VA |
$40.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.02
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
IP
|
$195.23
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.07 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: BCBS Trust/PPO |
$150.87
|
| Rate for Payer: BCN Commercial |
$150.87
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.95
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.80
|
| Rate for Payer: UHC Core |
$163.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
OP
|
$195.23
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.37 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: Aetna Medicare |
$50.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.01
|
| Rate for Payer: BCBS Complete |
$78.09
|
| Rate for Payer: BCBS MAPPO |
$48.81
|
| Rate for Payer: BCBS Trust/PPO |
$151.79
|
| Rate for Payer: BCCCP Commercial |
$62.74
|
| Rate for Payer: BCN Commercial |
$151.79
|
| Rate for Payer: BCN Medicare Advantage |
$48.81
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.81
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.95
|
| Rate for Payer: PACE Senior Care Partners |
$46.37
|
| Rate for Payer: PACE SWMI |
$48.81
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: PHP Medicare Advantage |
$48.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.85
|
| Rate for Payer: Priority Health Medicare |
$48.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.07
|
| Rate for Payer: Railroad Medicare Medicare |
$48.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.80
|
| Rate for Payer: UHC Core |
$163.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.81
|
| Rate for Payer: UHC Medicare Advantage |
$50.27
|
| Rate for Payer: VA VA |
$48.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
HC FNA IMED EVAL
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.89
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$56.94
|
| Rate for Payer: BCCCP Commercial |
$56.11
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$18.31
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PACE Senior Care Partners |
$17.39
|
| Rate for Payer: PACE SWMI |
$18.31
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.72
|
| Rate for Payer: Priority Health Medicare |
$18.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.67
|
| Rate for Payer: Railroad Medicare Medicare |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.31
|
| Rate for Payer: UHC Medicare Advantage |
$18.86
|
| Rate for Payer: VA VA |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC FNA IMED EVAL
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$44.67 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.60
|
| Rate for Payer: BCN Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$8.98
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCCCP Commercial |
$29.59
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
