|
HC COMPLEX CYSTOMETROGRAM
|
Facility
|
OP
|
$397.27
|
|
|
Service Code
|
CPT 51726
|
| Hospital Charge Code |
76100190
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.35 |
| Max. Negotiated Rate |
$357.54 |
| Rate for Payer: Aetna Commercial |
$337.68
|
| Rate for Payer: Aetna Medicare |
$103.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.15
|
| Rate for Payer: BCBS Complete |
$180.91
|
| Rate for Payer: BCBS MAPPO |
$99.32
|
| Rate for Payer: BCBS Trust/PPO |
$326.60
|
| Rate for Payer: BCN Commercial |
$308.88
|
| Rate for Payer: BCN Medicare Advantage |
$99.32
|
| Rate for Payer: Cash Price |
$317.82
|
| Rate for Payer: Cash Price |
$317.82
|
| Rate for Payer: Cofinity Commercial |
$341.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.32
|
| Rate for Payer: Healthscope Commercial |
$357.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.95
|
| Rate for Payer: Mclaren Medicaid |
$172.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.28
|
| Rate for Payer: Meridian Medicaid |
$180.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.68
|
| Rate for Payer: Nomi Health Commercial |
$325.76
|
| Rate for Payer: PACE Senior Care Partners |
$94.35
|
| Rate for Payer: PACE SWMI |
$99.32
|
| Rate for Payer: PHP Commercial |
$337.68
|
| Rate for Payer: PHP Medicare Advantage |
$99.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.23
|
| Rate for Payer: Priority Health HMO/PPO |
$345.62
|
| Rate for Payer: Priority Health Medicare |
$100.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.17
|
| Rate for Payer: Railroad Medicare Medicare |
$99.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.60
|
| Rate for Payer: UHC Core |
$331.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.32
|
| Rate for Payer: UHC Exchange |
$99.32
|
| Rate for Payer: UHC Medicare Advantage |
$99.32
|
| Rate for Payer: UHCCP Medicaid |
$172.28
|
| Rate for Payer: VA VA |
$99.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.95
|
|
|
HC COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Facility
|
OP
|
$877.06
|
|
|
Service Code
|
CPT 51727
|
| Hospital Charge Code |
76100220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.30 |
| Max. Negotiated Rate |
$789.35 |
| Rate for Payer: Aetna Commercial |
$745.50
|
| Rate for Payer: Aetna Medicare |
$228.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.08
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$219.26
|
| Rate for Payer: BCBS Trust/PPO |
$721.03
|
| Rate for Payer: BCN Commercial |
$681.91
|
| Rate for Payer: BCN Medicare Advantage |
$219.26
|
| Rate for Payer: Cash Price |
$701.65
|
| Rate for Payer: Cash Price |
$701.65
|
| Rate for Payer: Cofinity Commercial |
$754.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.26
|
| Rate for Payer: Healthscope Commercial |
$789.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.80
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.23
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.50
|
| Rate for Payer: Nomi Health Commercial |
$719.19
|
| Rate for Payer: PACE Senior Care Partners |
$208.30
|
| Rate for Payer: PACE SWMI |
$219.26
|
| Rate for Payer: PHP Commercial |
$745.50
|
| Rate for Payer: PHP Medicare Advantage |
$219.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.09
|
| Rate for Payer: Priority Health HMO/PPO |
$763.04
|
| Rate for Payer: Priority Health Medicare |
$221.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.63
|
| Rate for Payer: Railroad Medicare Medicare |
$219.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.81
|
| Rate for Payer: UHC Core |
$732.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.26
|
| Rate for Payer: UHC Exchange |
$219.26
|
| Rate for Payer: UHC Medicare Advantage |
$219.26
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$219.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.80
|
|
|
HC COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE
|
Facility
|
IP
|
$877.06
|
|
|
Service Code
|
CPT 51727
|
| Hospital Charge Code |
76100220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$570.09 |
| Max. Negotiated Rate |
$789.35 |
| Rate for Payer: Aetna Commercial |
$745.50
|
| Rate for Payer: BCBS Trust/PPO |
$715.94
|
| Rate for Payer: BCN Commercial |
$677.79
|
| Rate for Payer: Cash Price |
$701.65
|
| Rate for Payer: Cofinity Commercial |
$754.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.65
|
| Rate for Payer: Healthscope Commercial |
$789.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$657.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.50
|
| Rate for Payer: Nomi Health Commercial |
$719.19
|
| Rate for Payer: PHP Commercial |
$745.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.09
|
| Rate for Payer: Priority Health HMO/PPO |
$763.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$771.81
|
| Rate for Payer: UHC Core |
$732.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$657.80
|
|
|
HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Facility
|
OP
|
$877.46
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
76100191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.40 |
| Max. Negotiated Rate |
$789.71 |
| Rate for Payer: Aetna Commercial |
$745.84
|
| Rate for Payer: Aetna Medicare |
$228.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.21
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$219.36
|
| Rate for Payer: BCBS Trust/PPO |
$721.36
|
| Rate for Payer: BCN Commercial |
$682.23
|
| Rate for Payer: BCN Medicare Advantage |
$219.36
|
| Rate for Payer: Cash Price |
$701.97
|
| Rate for Payer: Cash Price |
$701.97
|
| Rate for Payer: Cofinity Commercial |
$754.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.36
|
| Rate for Payer: Healthscope Commercial |
$789.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.10
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.33
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.84
|
| Rate for Payer: Nomi Health Commercial |
$719.52
|
| Rate for Payer: PACE Senior Care Partners |
$208.40
|
| Rate for Payer: PACE SWMI |
$219.36
|
| Rate for Payer: PHP Commercial |
$745.84
|
| Rate for Payer: PHP Medicare Advantage |
$219.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.35
|
| Rate for Payer: Priority Health HMO/PPO |
$763.39
|
| Rate for Payer: Priority Health Medicare |
$221.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.90
|
| Rate for Payer: Railroad Medicare Medicare |
$219.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.16
|
| Rate for Payer: UHC Core |
$732.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.36
|
| Rate for Payer: UHC Exchange |
$219.36
|
| Rate for Payer: UHC Medicare Advantage |
$219.36
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$219.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.10
|
|
|
HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES
|
Facility
|
IP
|
$877.46
|
|
|
Service Code
|
CPT 51728
|
| Hospital Charge Code |
76100191
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$570.35 |
| Max. Negotiated Rate |
$789.71 |
| Rate for Payer: Aetna Commercial |
$745.84
|
| Rate for Payer: BCBS Trust/PPO |
$716.27
|
| Rate for Payer: BCN Commercial |
$678.10
|
| Rate for Payer: Cash Price |
$701.97
|
| Rate for Payer: Cofinity Commercial |
$754.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$701.97
|
| Rate for Payer: Healthscope Commercial |
$789.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$745.84
|
| Rate for Payer: Nomi Health Commercial |
$719.52
|
| Rate for Payer: PHP Commercial |
$745.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$570.35
|
| Rate for Payer: Priority Health HMO/PPO |
$763.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$772.16
|
| Rate for Payer: UHC Core |
$732.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.10
|
|
|
HC COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$810.90
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$527.08 |
| Max. Negotiated Rate |
$729.81 |
| Rate for Payer: Aetna Commercial |
$689.26
|
| Rate for Payer: BCBS Trust/PPO |
$661.94
|
| Rate for Payer: BCN Commercial |
$626.66
|
| Rate for Payer: Cash Price |
$648.72
|
| Rate for Payer: Cofinity Commercial |
$697.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.72
|
| Rate for Payer: Healthscope Commercial |
$729.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$608.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.26
|
| Rate for Payer: Nomi Health Commercial |
$664.94
|
| Rate for Payer: PHP Commercial |
$689.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.08
|
| Rate for Payer: Priority Health HMO/PPO |
$705.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$713.59
|
| Rate for Payer: UHC Core |
$677.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$608.18
|
|
|
HC COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$810.90
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.78 |
| Max. Negotiated Rate |
$729.81 |
| Rate for Payer: Aetna Commercial |
$689.26
|
| Rate for Payer: Aetna Medicare |
$210.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$253.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$253.41
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$202.72
|
| Rate for Payer: BCBS Trust/PPO |
$666.64
|
| Rate for Payer: BCN Commercial |
$630.47
|
| Rate for Payer: BCN Medicare Advantage |
$202.72
|
| Rate for Payer: Cash Price |
$648.72
|
| Rate for Payer: Cash Price |
$648.72
|
| Rate for Payer: Cofinity Commercial |
$697.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.72
|
| Rate for Payer: Healthscope Commercial |
$729.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$608.18
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.86
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$689.26
|
| Rate for Payer: Nomi Health Commercial |
$664.94
|
| Rate for Payer: PACE Senior Care Partners |
$192.59
|
| Rate for Payer: PACE SWMI |
$202.72
|
| Rate for Payer: PHP Commercial |
$689.26
|
| Rate for Payer: PHP Medicare Advantage |
$202.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$527.08
|
| Rate for Payer: Priority Health HMO/PPO |
$705.48
|
| Rate for Payer: Priority Health Medicare |
$204.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.30
|
| Rate for Payer: Railroad Medicare Medicare |
$202.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$713.59
|
| Rate for Payer: UHC Core |
$677.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.72
|
| Rate for Payer: UHC Exchange |
$202.72
|
| Rate for Payer: UHC Medicare Advantage |
$202.72
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$202.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$608.18
|
|
|
HC COMPLEX UROFLOWMETRY
|
Facility
|
OP
|
$233.39
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
76100192
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.43 |
| Max. Negotiated Rate |
$231.63 |
| Rate for Payer: Aetna Commercial |
$198.38
|
| Rate for Payer: Aetna Medicare |
$60.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.93
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$58.35
|
| Rate for Payer: BCBS Trust/PPO |
$191.87
|
| Rate for Payer: BCN Commercial |
$181.46
|
| Rate for Payer: BCN Medicare Advantage |
$58.35
|
| Rate for Payer: Cash Price |
$186.71
|
| Rate for Payer: Cash Price |
$186.71
|
| Rate for Payer: Cofinity Commercial |
$200.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.35
|
| Rate for Payer: Healthscope Commercial |
$210.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.04
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.26
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.38
|
| Rate for Payer: Nomi Health Commercial |
$191.38
|
| Rate for Payer: PACE Senior Care Partners |
$55.43
|
| Rate for Payer: PACE SWMI |
$58.35
|
| Rate for Payer: PHP Commercial |
$198.38
|
| Rate for Payer: PHP Medicare Advantage |
$58.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.70
|
| Rate for Payer: Priority Health HMO/PPO |
$203.05
|
| Rate for Payer: Priority Health Medicare |
$58.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.37
|
| Rate for Payer: Railroad Medicare Medicare |
$58.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.38
|
| Rate for Payer: UHC Core |
$194.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.35
|
| Rate for Payer: UHC Exchange |
$58.35
|
| Rate for Payer: UHC Medicare Advantage |
$58.35
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$58.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.04
|
|
|
HC COMPLEX UROFLOWMETRY
|
Facility
|
IP
|
$233.39
|
|
|
Service Code
|
CPT 51741
|
| Hospital Charge Code |
76100192
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.70 |
| Max. Negotiated Rate |
$210.05 |
| Rate for Payer: Aetna Commercial |
$198.38
|
| Rate for Payer: BCBS Trust/PPO |
$190.52
|
| Rate for Payer: BCN Commercial |
$180.36
|
| Rate for Payer: Cash Price |
$186.71
|
| Rate for Payer: Cofinity Commercial |
$200.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.71
|
| Rate for Payer: Healthscope Commercial |
$210.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.38
|
| Rate for Payer: Nomi Health Commercial |
$191.38
|
| Rate for Payer: PHP Commercial |
$198.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.70
|
| Rate for Payer: Priority Health HMO/PPO |
$203.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.38
|
| Rate for Payer: UHC Core |
$194.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.04
|
|
|
HC COMP METABOLIC PANEL
|
Facility
|
OP
|
$39.17
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
30100013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.63 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.24
|
| Rate for Payer: BCBS Complete |
$8.02
|
| Rate for Payer: BCBS MAPPO |
$9.79
|
| Rate for Payer: BCBS Trust/PPO |
$32.20
|
| Rate for Payer: BCN Commercial |
$30.45
|
| Rate for Payer: BCN Medicare Advantage |
$9.79
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Mclaren Medicaid |
$7.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.28
|
| Rate for Payer: Meridian Medicaid |
$8.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: PACE Senior Care Partners |
$9.30
|
| Rate for Payer: PACE SWMI |
$9.79
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: PHP Medicare Advantage |
$9.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health HMO/PPO |
$34.08
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: Railroad Medicare Medicare |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.47
|
| Rate for Payer: UHC Core |
$32.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.79
|
| Rate for Payer: UHC Exchange |
$9.79
|
| Rate for Payer: UHC Medicare Advantage |
$9.79
|
| Rate for Payer: UHCCP Medicaid |
$7.63
|
| Rate for Payer: VA VA |
$9.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
HC COMP METABOLIC PANEL
|
Facility
|
IP
|
$39.17
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
30100013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Aetna Commercial |
$33.29
|
| Rate for Payer: BCBS Trust/PPO |
$31.97
|
| Rate for Payer: BCN Commercial |
$30.27
|
| Rate for Payer: Cash Price |
$31.34
|
| Rate for Payer: Cofinity Commercial |
$33.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$35.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.29
|
| Rate for Payer: Nomi Health Commercial |
$32.12
|
| Rate for Payer: PHP Commercial |
$33.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.46
|
| Rate for Payer: Priority Health HMO/PPO |
$34.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.47
|
| Rate for Payer: UHC Core |
$32.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.38
|
|
|
HC COMPONENT POOLING
|
Facility
|
IP
|
$124.13
|
|
|
Service Code
|
CPT 86965
|
| Hospital Charge Code |
39000027
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$80.68 |
| Max. Negotiated Rate |
$111.72 |
| Rate for Payer: Aetna Commercial |
$105.51
|
| Rate for Payer: BCBS Trust/PPO |
$101.33
|
| Rate for Payer: BCN Commercial |
$95.93
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cofinity Commercial |
$106.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.30
|
| Rate for Payer: Healthscope Commercial |
$111.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.51
|
| Rate for Payer: Nomi Health Commercial |
$101.79
|
| Rate for Payer: PHP Commercial |
$105.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: Priority Health HMO/PPO |
$107.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.23
|
| Rate for Payer: UHC Core |
$103.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.10
|
|
|
HC COMPONENT POOLING
|
Facility
|
OP
|
$124.13
|
|
|
Service Code
|
CPT 86965
|
| Hospital Charge Code |
39000027
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$29.48 |
| Max. Negotiated Rate |
$127.47 |
| Rate for Payer: Aetna Commercial |
$105.51
|
| Rate for Payer: Aetna Medicare |
$32.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.79
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$31.03
|
| Rate for Payer: BCBS Trust/PPO |
$102.05
|
| Rate for Payer: BCN Commercial |
$96.51
|
| Rate for Payer: BCN Medicare Advantage |
$31.03
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cash Price |
$99.30
|
| Rate for Payer: Cofinity Commercial |
$106.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.03
|
| Rate for Payer: Healthscope Commercial |
$111.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.10
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.58
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.51
|
| Rate for Payer: Nomi Health Commercial |
$101.79
|
| Rate for Payer: PACE Senior Care Partners |
$29.48
|
| Rate for Payer: PACE SWMI |
$31.03
|
| Rate for Payer: PHP Commercial |
$105.51
|
| Rate for Payer: PHP Medicare Advantage |
$31.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: Priority Health HMO/PPO |
$107.99
|
| Rate for Payer: Priority Health Medicare |
$31.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.17
|
| Rate for Payer: Railroad Medicare Medicare |
$31.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.23
|
| Rate for Payer: UHC Core |
$103.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.03
|
| Rate for Payer: UHC Exchange |
$31.03
|
| Rate for Payer: UHC Medicare Advantage |
$31.03
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$31.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.10
|
|
|
HC COMPONENT THAWING
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
39000025
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$127.47 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$28.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.79
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$27.03
|
| Rate for Payer: BCBS Trust/PPO |
$88.89
|
| Rate for Payer: BCN Commercial |
$84.06
|
| Rate for Payer: BCN Medicare Advantage |
$27.03
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.03
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.38
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PACE Senior Care Partners |
$25.68
|
| Rate for Payer: PACE SWMI |
$27.03
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$27.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Medicare |
$27.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: Railroad Medicare Medicare |
$27.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.03
|
| Rate for Payer: UHC Exchange |
$27.03
|
| Rate for Payer: UHC Medicare Advantage |
$27.03
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$27.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC COMPONENT THAWING
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 86927
|
| Hospital Charge Code |
39000025
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$70.28 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: BCBS Trust/PPO |
$88.26
|
| Rate for Payer: BCN Commercial |
$83.56
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC COMPREHENSIVE HEARING TEST
|
Facility
|
OP
|
$212.17
|
|
|
Service Code
|
CPT 92557
|
| Hospital Charge Code |
47100012
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$50.39 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$55.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.30
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$53.04
|
| Rate for Payer: BCBS Trust/PPO |
$174.42
|
| Rate for Payer: BCN Commercial |
$164.96
|
| Rate for Payer: BCN Medicare Advantage |
$53.04
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.69
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$173.98
|
| Rate for Payer: PACE Senior Care Partners |
$50.39
|
| Rate for Payer: PACE SWMI |
$53.04
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: PHP Medicare Advantage |
$53.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO |
$184.59
|
| Rate for Payer: Priority Health Medicare |
$53.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.15
|
| Rate for Payer: Railroad Medicare Medicare |
$53.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.71
|
| Rate for Payer: UHC Core |
$177.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.04
|
| Rate for Payer: UHC Exchange |
$53.04
|
| Rate for Payer: UHC Medicare Advantage |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$53.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC COMPREHENSIVE HEARING TEST
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
CPT 92557
|
| Hospital Charge Code |
47100012
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$137.91 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: BCBS Trust/PPO |
$173.19
|
| Rate for Payer: BCN Commercial |
$163.96
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$173.98
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO |
$184.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.71
|
| Rate for Payer: UHC Core |
$177.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC COMPRESS BURN GARM GAUNTLET-EL
|
Facility
|
OP
|
$87.72
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300069
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.41
|
| Rate for Payer: BCBS Complete |
$35.09
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$72.11
|
| Rate for Payer: BCN Commercial |
$68.20
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.56
|
| Rate for Payer: Nomi Health Commercial |
$71.93
|
| Rate for Payer: PACE Senior Care Partners |
$20.83
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: Priority Health HMO/PPO |
$76.32
|
| Rate for Payer: Priority Health Medicare |
$22.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.77
|
| Rate for Payer: Railroad Medicare Medicare |
$21.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.93
|
| Rate for Payer: UHC Exchange |
$21.93
|
| Rate for Payer: UHC Medicare Advantage |
$21.93
|
| Rate for Payer: VA VA |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC COMPRESS BURN GARM GAUNTLET-EL
|
Facility
|
IP
|
$87.72
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300069
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.02 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: BCBS Trust/PPO |
$71.61
|
| Rate for Payer: BCN Commercial |
$67.79
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.56
|
| Rate for Payer: Nomi Health Commercial |
$71.93
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.02
|
| Rate for Payer: Priority Health HMO/PPO |
$76.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: BCBS Trust/PPO |
$121.56
|
| Rate for Payer: BCN Commercial |
$115.09
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC CONDITIONING PLAY AUDIOMETRY
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 92582
|
| Hospital Charge Code |
76100512
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$38.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.54
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$37.23
|
| Rate for Payer: BCBS Trust/PPO |
$122.43
|
| Rate for Payer: BCN Commercial |
$115.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.23
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.23
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.09
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Senior Care Partners |
$35.37
|
| Rate for Payer: PACE SWMI |
$37.23
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$37.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Medicare |
$37.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: Railroad Medicare Medicare |
$37.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.23
|
| Rate for Payer: UHC Exchange |
$37.23
|
| Rate for Payer: UHC Medicare Advantage |
$37.23
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$37.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CONFIRMED DRUG ABUSE PANEL 9 U
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100643
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$293.81 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$2,065.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,482.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,482.98
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$1,986.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,532.02
|
| Rate for Payer: BCCCP Commercial |
$293.81
|
| Rate for Payer: BCN Commercial |
$6,177.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.38
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.38
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.70
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,887.06
|
| Rate for Payer: PACE SWMI |
$1,986.38
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Medicare |
$2,006.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,986.38
|
| Rate for Payer: UHC Exchange |
$1,986.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,986.38
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$1,986.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,485.94
|
| Rate for Payer: BCN Commercial |
$6,140.31
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
