|
HC EEG AWAKE & ASLEEP
|
Facility
|
IP
|
$2,534.65
|
|
|
Service Code
|
CPT 95819
|
| Hospital Charge Code |
74000006
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,764.12 |
| Max. Negotiated Rate |
$2,281.18 |
| Rate for Payer: Aetna Commercial |
$2,154.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.37
|
| Rate for Payer: BCN Commercial |
$2,093.37
|
| Rate for Payer: Cash Price |
$2,027.72
|
| Rate for Payer: Cofinity Commercial |
$2,179.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,027.72
|
| Rate for Payer: Healthscope Commercial |
$2,281.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,154.45
|
| Rate for Payer: Nomi Health Commercial |
$2,078.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,900.99
|
| Rate for Payer: PHP Commercial |
$2,154.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,205.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,764.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,230.49
|
| Rate for Payer: UHC Core |
$2,116.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.99
|
|
|
HC EEG AWAKE/DROWSY
|
Facility
|
IP
|
$2,123.62
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
74000005
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,478.04 |
| Max. Negotiated Rate |
$1,911.26 |
| Rate for Payer: Aetna Commercial |
$1,805.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.90
|
| Rate for Payer: BCN Commercial |
$1,753.90
|
| Rate for Payer: Cash Price |
$1,698.90
|
| Rate for Payer: Cofinity Commercial |
$1,826.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.90
|
| Rate for Payer: Healthscope Commercial |
$1,911.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,592.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,805.08
|
| Rate for Payer: Nomi Health Commercial |
$1,741.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,592.71
|
| Rate for Payer: PHP Commercial |
$1,805.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,847.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,478.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,868.79
|
| Rate for Payer: UHC Core |
$1,773.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,592.71
|
|
|
HC EEG AWAKE/DROWSY
|
Facility
|
OP
|
$2,123.62
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
74000005
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$374.39 |
| Max. Negotiated Rate |
$1,911.26 |
| Rate for Payer: Aetna Commercial |
$1,805.08
|
| Rate for Payer: Aetna Medicare |
$552.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$663.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$663.63
|
| Rate for Payer: BCBS Complete |
$393.08
|
| Rate for Payer: BCBS MAPPO |
$530.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,745.83
|
| Rate for Payer: BCN Commercial |
$1,745.83
|
| Rate for Payer: BCN Medicare Advantage |
$530.90
|
| Rate for Payer: Cash Price |
$1,698.90
|
| Rate for Payer: Cofinity Commercial |
$1,826.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,698.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.90
|
| Rate for Payer: Healthscope Commercial |
$1,911.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,592.71
|
| Rate for Payer: Mclaren Medicaid |
$374.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$557.45
|
| Rate for Payer: Meridian Medicaid |
$393.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$610.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$584.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,805.08
|
| Rate for Payer: Nomi Health Commercial |
$1,741.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,592.71
|
| Rate for Payer: PACE Senior Care Partners |
$504.36
|
| Rate for Payer: PACE SWMI |
$530.90
|
| Rate for Payer: PHP Commercial |
$1,805.08
|
| Rate for Payer: PHP Medicare Advantage |
$530.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$374.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,847.55
|
| Rate for Payer: Priority Health Medicare |
$536.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,478.04
|
| Rate for Payer: Railroad Medicare Medicare |
$530.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,868.79
|
| Rate for Payer: UHC Core |
$1,773.22
|
| Rate for Payer: UHC Exchange |
$530.90
|
| Rate for Payer: UHC Medicaid |
$374.39
|
| Rate for Payer: UHC Medicare Advantage |
$530.90
|
| Rate for Payer: UHCCP Medicaid |
$374.39
|
| Rate for Payer: VA VA |
$530.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,592.71
|
|
|
HC EEG COMA/SLEEP
|
Facility
|
OP
|
$808.43
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
74000007
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$142.53 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$687.17
|
| Rate for Payer: Aetna Medicare |
$210.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$252.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$252.63
|
| Rate for Payer: BCBS Complete |
$149.64
|
| Rate for Payer: BCBS MAPPO |
$202.11
|
| Rate for Payer: BCBS Trust/PPO |
$664.61
|
| Rate for Payer: BCN Commercial |
$664.61
|
| Rate for Payer: BCN Medicare Advantage |
$202.11
|
| Rate for Payer: Cash Price |
$646.74
|
| Rate for Payer: Cofinity Commercial |
$695.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.11
|
| Rate for Payer: Healthscope Commercial |
$727.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.32
|
| Rate for Payer: Mclaren Medicaid |
$142.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.21
|
| Rate for Payer: Meridian Medicaid |
$149.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$222.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.17
|
| Rate for Payer: Nomi Health Commercial |
$662.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.32
|
| Rate for Payer: PACE Senior Care Partners |
$192.00
|
| Rate for Payer: PACE SWMI |
$202.11
|
| Rate for Payer: PHP Commercial |
$687.17
|
| Rate for Payer: PHP Medicare Advantage |
$202.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$703.33
|
| Rate for Payer: Priority Health Medicare |
$204.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$562.67
|
| Rate for Payer: Railroad Medicare Medicare |
$202.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.42
|
| Rate for Payer: UHC Core |
$675.04
|
| Rate for Payer: UHC Exchange |
$202.11
|
| Rate for Payer: UHC Medicaid |
$142.53
|
| Rate for Payer: UHC Medicare Advantage |
$202.11
|
| Rate for Payer: UHCCP Medicaid |
$142.53
|
| Rate for Payer: VA VA |
$202.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.32
|
|
|
HC EEG COMA/SLEEP
|
Facility
|
IP
|
$808.43
|
|
|
Service Code
|
CPT 95822
|
| Hospital Charge Code |
74000007
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$562.67 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$687.17
|
| Rate for Payer: BCBS Trust/PPO |
$667.68
|
| Rate for Payer: BCN Commercial |
$667.68
|
| Rate for Payer: Cash Price |
$646.74
|
| Rate for Payer: Cofinity Commercial |
$695.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.74
|
| Rate for Payer: Healthscope Commercial |
$727.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.17
|
| Rate for Payer: Nomi Health Commercial |
$662.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.32
|
| Rate for Payer: PHP Commercial |
$687.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$703.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$562.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.42
|
| Rate for Payer: UHC Core |
$675.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.32
|
|
|
HC EEG CONT REC W/VID EEG TECH
|
Facility
|
OP
|
$1,235.74
|
|
|
Service Code
|
CPT 95700
|
| Hospital Charge Code |
74000019
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$217.86 |
| Max. Negotiated Rate |
$1,112.17 |
| Rate for Payer: Aetna Commercial |
$1,050.38
|
| Rate for Payer: Aetna Medicare |
$321.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$386.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$386.17
|
| Rate for Payer: BCBS Complete |
$228.74
|
| Rate for Payer: BCBS MAPPO |
$308.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.90
|
| Rate for Payer: BCN Commercial |
$1,015.90
|
| Rate for Payer: BCN Medicare Advantage |
$308.94
|
| Rate for Payer: Cash Price |
$988.59
|
| Rate for Payer: Cofinity Commercial |
$1,062.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.94
|
| Rate for Payer: Healthscope Commercial |
$1,112.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.80
|
| Rate for Payer: Mclaren Medicaid |
$217.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.38
|
| Rate for Payer: Meridian Medicaid |
$228.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.38
|
| Rate for Payer: Nomi Health Commercial |
$1,013.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.80
|
| Rate for Payer: PACE Senior Care Partners |
$293.49
|
| Rate for Payer: PACE SWMI |
$308.94
|
| Rate for Payer: PHP Commercial |
$1,050.38
|
| Rate for Payer: PHP Medicare Advantage |
$308.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,075.09
|
| Rate for Payer: Priority Health Medicare |
$312.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$860.08
|
| Rate for Payer: Railroad Medicare Medicare |
$308.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.45
|
| Rate for Payer: UHC Core |
$1,031.84
|
| Rate for Payer: UHC Exchange |
$308.94
|
| Rate for Payer: UHC Medicaid |
$217.86
|
| Rate for Payer: UHC Medicare Advantage |
$308.94
|
| Rate for Payer: UHCCP Medicaid |
$217.86
|
| Rate for Payer: VA VA |
$308.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.80
|
|
|
HC EEG CONT REC W/VID EEG TECH
|
Facility
|
IP
|
$1,235.74
|
|
|
Service Code
|
CPT 95700
|
| Hospital Charge Code |
74000019
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$860.08 |
| Max. Negotiated Rate |
$1,112.17 |
| Rate for Payer: Aetna Commercial |
$1,050.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.60
|
| Rate for Payer: BCN Commercial |
$1,020.60
|
| Rate for Payer: Cash Price |
$988.59
|
| Rate for Payer: Cofinity Commercial |
$1,062.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.59
|
| Rate for Payer: Healthscope Commercial |
$1,112.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.38
|
| Rate for Payer: Nomi Health Commercial |
$1,013.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.80
|
| Rate for Payer: PHP Commercial |
$1,050.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,075.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$860.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.45
|
| Rate for Payer: UHC Core |
$1,031.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.80
|
|
|
HC EEG ELECTROCEREBRAL SILENCE
|
Facility
|
IP
|
$911.67
|
|
|
Service Code
|
CPT 95824
|
| Hospital Charge Code |
74000008
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$634.52 |
| Max. Negotiated Rate |
$820.50 |
| Rate for Payer: Aetna Commercial |
$774.92
|
| Rate for Payer: BCBS Trust/PPO |
$752.95
|
| Rate for Payer: BCN Commercial |
$752.95
|
| Rate for Payer: Cash Price |
$729.34
|
| Rate for Payer: Cofinity Commercial |
$784.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.34
|
| Rate for Payer: Healthscope Commercial |
$820.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.92
|
| Rate for Payer: Nomi Health Commercial |
$747.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$683.75
|
| Rate for Payer: PHP Commercial |
$774.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$793.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$634.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.27
|
| Rate for Payer: UHC Core |
$761.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.75
|
|
|
HC EEG ELECTROCEREBRAL SILENCE
|
Facility
|
OP
|
$911.67
|
|
|
Service Code
|
CPT 95824
|
| Hospital Charge Code |
74000008
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$160.73 |
| Max. Negotiated Rate |
$820.50 |
| Rate for Payer: Aetna Commercial |
$774.92
|
| Rate for Payer: Aetna Medicare |
$237.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.90
|
| Rate for Payer: BCBS Complete |
$168.75
|
| Rate for Payer: BCBS MAPPO |
$227.92
|
| Rate for Payer: BCBS Trust/PPO |
$749.48
|
| Rate for Payer: BCN Commercial |
$749.48
|
| Rate for Payer: BCN Medicare Advantage |
$227.92
|
| Rate for Payer: Cash Price |
$729.34
|
| Rate for Payer: Cofinity Commercial |
$784.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.92
|
| Rate for Payer: Healthscope Commercial |
$820.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.75
|
| Rate for Payer: Mclaren Medicaid |
$160.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$239.31
|
| Rate for Payer: Meridian Medicaid |
$168.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$262.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$250.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$774.92
|
| Rate for Payer: Nomi Health Commercial |
$747.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$683.75
|
| Rate for Payer: PACE Senior Care Partners |
$216.52
|
| Rate for Payer: PACE SWMI |
$227.92
|
| Rate for Payer: PHP Commercial |
$774.92
|
| Rate for Payer: PHP Medicare Advantage |
$227.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$793.15
|
| Rate for Payer: Priority Health Medicare |
$230.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$634.52
|
| Rate for Payer: Railroad Medicare Medicare |
$227.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$802.27
|
| Rate for Payer: UHC Core |
$761.24
|
| Rate for Payer: UHC Exchange |
$227.92
|
| Rate for Payer: UHC Medicaid |
$160.73
|
| Rate for Payer: UHC Medicare Advantage |
$227.92
|
| Rate for Payer: UHCCP Medicaid |
$160.73
|
| Rate for Payer: VA VA |
$227.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.75
|
|
|
HC EEG EXTENDED 41-60 MINUTES
|
Facility
|
IP
|
$2,075.86
|
|
|
Service Code
|
CPT 95812
|
| Hospital Charge Code |
74000003
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,444.80 |
| Max. Negotiated Rate |
$1,868.27 |
| Rate for Payer: Aetna Commercial |
$1,764.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.45
|
| Rate for Payer: BCN Commercial |
$1,714.45
|
| Rate for Payer: Cash Price |
$1,660.69
|
| Rate for Payer: Cofinity Commercial |
$1,785.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.69
|
| Rate for Payer: Healthscope Commercial |
$1,868.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.48
|
| Rate for Payer: Nomi Health Commercial |
$1,702.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.89
|
| Rate for Payer: PHP Commercial |
$1,764.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,806.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,826.76
|
| Rate for Payer: UHC Core |
$1,733.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.89
|
|
|
HC EEG EXTENDED 41-60 MINUTES
|
Facility
|
OP
|
$2,075.86
|
|
|
Service Code
|
CPT 95812
|
| Hospital Charge Code |
74000003
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$365.97 |
| Max. Negotiated Rate |
$1,868.27 |
| Rate for Payer: Aetna Commercial |
$1,764.48
|
| Rate for Payer: Aetna Medicare |
$539.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.71
|
| Rate for Payer: BCBS Complete |
$384.24
|
| Rate for Payer: BCBS MAPPO |
$518.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.56
|
| Rate for Payer: BCN Commercial |
$1,706.56
|
| Rate for Payer: BCN Medicare Advantage |
$518.97
|
| Rate for Payer: Cash Price |
$1,660.69
|
| Rate for Payer: Cofinity Commercial |
$1,785.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.97
|
| Rate for Payer: Healthscope Commercial |
$1,868.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.89
|
| Rate for Payer: Mclaren Medicaid |
$365.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.91
|
| Rate for Payer: Meridian Medicaid |
$384.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.48
|
| Rate for Payer: Nomi Health Commercial |
$1,702.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.89
|
| Rate for Payer: PACE Senior Care Partners |
$493.02
|
| Rate for Payer: PACE SWMI |
$518.97
|
| Rate for Payer: PHP Commercial |
$1,764.48
|
| Rate for Payer: PHP Medicare Advantage |
$518.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,806.00
|
| Rate for Payer: Priority Health Medicare |
$524.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.80
|
| Rate for Payer: Railroad Medicare Medicare |
$518.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,826.76
|
| Rate for Payer: UHC Core |
$1,733.34
|
| Rate for Payer: UHC Exchange |
$518.97
|
| Rate for Payer: UHC Medicaid |
$365.97
|
| Rate for Payer: UHC Medicare Advantage |
$518.97
|
| Rate for Payer: UHCCP Medicaid |
$365.97
|
| Rate for Payer: VA VA |
$518.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.89
|
|
|
HC EEG EXTENDED 61-119 MIN
|
Facility
|
IP
|
$2,317.01
|
|
|
Service Code
|
CPT 95813
|
| Hospital Charge Code |
74000004
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,612.64 |
| Max. Negotiated Rate |
$2,085.31 |
| Rate for Payer: Aetna Commercial |
$1,969.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,913.62
|
| Rate for Payer: BCN Commercial |
$1,913.62
|
| Rate for Payer: Cash Price |
$1,853.61
|
| Rate for Payer: Cofinity Commercial |
$1,992.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,853.61
|
| Rate for Payer: Healthscope Commercial |
$2,085.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,737.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,969.46
|
| Rate for Payer: Nomi Health Commercial |
$1,899.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,737.76
|
| Rate for Payer: PHP Commercial |
$1,969.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,015.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,612.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,038.97
|
| Rate for Payer: UHC Core |
$1,934.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,737.76
|
|
|
HC EEG EXTENDED 61-119 MIN
|
Facility
|
OP
|
$2,317.01
|
|
|
Service Code
|
CPT 95813
|
| Hospital Charge Code |
74000004
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$408.49 |
| Max. Negotiated Rate |
$2,085.31 |
| Rate for Payer: Aetna Commercial |
$1,969.46
|
| Rate for Payer: Aetna Medicare |
$602.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$724.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$724.07
|
| Rate for Payer: BCBS Complete |
$428.88
|
| Rate for Payer: BCBS MAPPO |
$579.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.81
|
| Rate for Payer: BCN Commercial |
$1,904.81
|
| Rate for Payer: BCN Medicare Advantage |
$579.25
|
| Rate for Payer: Cash Price |
$1,853.61
|
| Rate for Payer: Cofinity Commercial |
$1,992.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,853.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.25
|
| Rate for Payer: Healthscope Commercial |
$2,085.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,737.76
|
| Rate for Payer: Mclaren Medicaid |
$408.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$608.22
|
| Rate for Payer: Meridian Medicaid |
$428.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$666.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$637.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,969.46
|
| Rate for Payer: Nomi Health Commercial |
$1,899.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,737.76
|
| Rate for Payer: PACE Senior Care Partners |
$550.29
|
| Rate for Payer: PACE SWMI |
$579.25
|
| Rate for Payer: PHP Commercial |
$1,969.46
|
| Rate for Payer: PHP Medicare Advantage |
$579.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,015.80
|
| Rate for Payer: Priority Health Medicare |
$585.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,612.64
|
| Rate for Payer: Railroad Medicare Medicare |
$579.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,038.97
|
| Rate for Payer: UHC Core |
$1,934.70
|
| Rate for Payer: UHC Exchange |
$579.25
|
| Rate for Payer: UHC Medicaid |
$408.49
|
| Rate for Payer: UHC Medicare Advantage |
$579.25
|
| Rate for Payer: UHCCP Medicaid |
$408.49
|
| Rate for Payer: VA VA |
$579.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,737.76
|
|
|
HC EEG W/O VID 12-26 HRS CONT MNTR
|
Facility
|
IP
|
$2,865.96
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
74000031
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,994.71 |
| Max. Negotiated Rate |
$2,579.36 |
| Rate for Payer: Aetna Commercial |
$2,436.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,367.00
|
| Rate for Payer: BCN Commercial |
$2,367.00
|
| Rate for Payer: Cash Price |
$2,292.77
|
| Rate for Payer: Cofinity Commercial |
$2,464.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,292.77
|
| Rate for Payer: Healthscope Commercial |
$2,579.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,149.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,436.07
|
| Rate for Payer: Nomi Health Commercial |
$2,350.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,149.47
|
| Rate for Payer: PHP Commercial |
$2,436.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,493.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,994.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,522.04
|
| Rate for Payer: UHC Core |
$2,393.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,149.47
|
|
|
HC EEG W/O VID 12-26 HRS CONT MNTR
|
Facility
|
OP
|
$2,865.96
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
74000031
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$505.27 |
| Max. Negotiated Rate |
$2,579.36 |
| Rate for Payer: Aetna Commercial |
$2,436.07
|
| Rate for Payer: Aetna Medicare |
$745.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$895.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$895.61
|
| Rate for Payer: BCBS Complete |
$530.49
|
| Rate for Payer: BCBS MAPPO |
$716.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,356.11
|
| Rate for Payer: BCN Commercial |
$2,356.11
|
| Rate for Payer: BCN Medicare Advantage |
$716.49
|
| Rate for Payer: Cash Price |
$2,292.77
|
| Rate for Payer: Cofinity Commercial |
$2,464.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,292.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.49
|
| Rate for Payer: Healthscope Commercial |
$2,579.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,149.47
|
| Rate for Payer: Mclaren Medicaid |
$505.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.31
|
| Rate for Payer: Meridian Medicaid |
$530.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$823.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$788.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,436.07
|
| Rate for Payer: Nomi Health Commercial |
$2,350.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,149.47
|
| Rate for Payer: PACE Senior Care Partners |
$680.67
|
| Rate for Payer: PACE SWMI |
$716.49
|
| Rate for Payer: PHP Commercial |
$2,436.07
|
| Rate for Payer: PHP Medicare Advantage |
$716.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,493.39
|
| Rate for Payer: Priority Health Medicare |
$723.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,994.71
|
| Rate for Payer: Railroad Medicare Medicare |
$716.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,522.04
|
| Rate for Payer: UHC Core |
$2,393.08
|
| Rate for Payer: UHC Exchange |
$716.49
|
| Rate for Payer: UHC Medicaid |
$505.27
|
| Rate for Payer: UHC Medicare Advantage |
$716.49
|
| Rate for Payer: UHCCP Medicaid |
$505.27
|
| Rate for Payer: VA VA |
$716.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,149.47
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
IP
|
$2,865.96
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,994.71 |
| Max. Negotiated Rate |
$2,579.36 |
| Rate for Payer: Aetna Commercial |
$2,436.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,367.00
|
| Rate for Payer: BCN Commercial |
$2,367.00
|
| Rate for Payer: Cash Price |
$2,292.77
|
| Rate for Payer: Cofinity Commercial |
$2,464.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,292.77
|
| Rate for Payer: Healthscope Commercial |
$2,579.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,149.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,436.07
|
| Rate for Payer: Nomi Health Commercial |
$2,350.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,149.47
|
| Rate for Payer: PHP Commercial |
$2,436.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,493.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,994.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,522.04
|
| Rate for Payer: UHC Core |
$2,393.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,149.47
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
OP
|
$2,865.96
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$505.27 |
| Max. Negotiated Rate |
$2,579.36 |
| Rate for Payer: Aetna Commercial |
$2,436.07
|
| Rate for Payer: Aetna Medicare |
$745.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$895.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$895.61
|
| Rate for Payer: BCBS Complete |
$530.49
|
| Rate for Payer: BCBS MAPPO |
$716.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,356.11
|
| Rate for Payer: BCN Commercial |
$2,356.11
|
| Rate for Payer: BCN Medicare Advantage |
$716.49
|
| Rate for Payer: Cash Price |
$2,292.77
|
| Rate for Payer: Cofinity Commercial |
$2,464.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,292.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$716.49
|
| Rate for Payer: Healthscope Commercial |
$2,579.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,149.47
|
| Rate for Payer: Mclaren Medicaid |
$505.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$752.31
|
| Rate for Payer: Meridian Medicaid |
$530.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$823.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$788.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,436.07
|
| Rate for Payer: Nomi Health Commercial |
$2,350.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,149.47
|
| Rate for Payer: PACE Senior Care Partners |
$680.67
|
| Rate for Payer: PACE SWMI |
$716.49
|
| Rate for Payer: PHP Commercial |
$2,436.07
|
| Rate for Payer: PHP Medicare Advantage |
$716.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,493.39
|
| Rate for Payer: Priority Health Medicare |
$723.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,994.71
|
| Rate for Payer: Railroad Medicare Medicare |
$716.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,522.04
|
| Rate for Payer: UHC Core |
$2,393.08
|
| Rate for Payer: UHC Exchange |
$716.49
|
| Rate for Payer: UHC Medicaid |
$505.27
|
| Rate for Payer: UHC Medicare Advantage |
$716.49
|
| Rate for Payer: UHCCP Medicaid |
$505.27
|
| Rate for Payer: VA VA |
$716.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,149.47
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
OP
|
$1,679.41
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$296.08 |
| Max. Negotiated Rate |
$1,511.47 |
| Rate for Payer: Aetna Commercial |
$1,427.50
|
| Rate for Payer: Aetna Medicare |
$436.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$524.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$524.82
|
| Rate for Payer: BCBS Complete |
$310.86
|
| Rate for Payer: BCBS MAPPO |
$419.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.64
|
| Rate for Payer: BCN Commercial |
$1,380.64
|
| Rate for Payer: BCN Medicare Advantage |
$419.85
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cofinity Commercial |
$1,444.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.85
|
| Rate for Payer: Healthscope Commercial |
$1,511.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.56
|
| Rate for Payer: Mclaren Medicaid |
$296.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.85
|
| Rate for Payer: Meridian Medicaid |
$310.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$482.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$461.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.50
|
| Rate for Payer: Nomi Health Commercial |
$1,377.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.56
|
| Rate for Payer: PACE Senior Care Partners |
$398.86
|
| Rate for Payer: PACE SWMI |
$419.85
|
| Rate for Payer: PHP Commercial |
$1,427.50
|
| Rate for Payer: PHP Medicare Advantage |
$419.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,461.09
|
| Rate for Payer: Priority Health Medicare |
$424.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,168.87
|
| Rate for Payer: Railroad Medicare Medicare |
$419.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.88
|
| Rate for Payer: UHC Core |
$1,402.31
|
| Rate for Payer: UHC Exchange |
$419.85
|
| Rate for Payer: UHC Medicaid |
$296.08
|
| Rate for Payer: UHC Medicare Advantage |
$419.85
|
| Rate for Payer: UHCCP Medicaid |
$296.08
|
| Rate for Payer: VA VA |
$419.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.56
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
IP
|
$1,679.41
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,168.87 |
| Max. Negotiated Rate |
$1,511.47 |
| Rate for Payer: Aetna Commercial |
$1,427.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.02
|
| Rate for Payer: BCN Commercial |
$1,387.02
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cofinity Commercial |
$1,444.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.53
|
| Rate for Payer: Healthscope Commercial |
$1,511.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.50
|
| Rate for Payer: Nomi Health Commercial |
$1,377.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.56
|
| Rate for Payer: PHP Commercial |
$1,427.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,461.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,168.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.88
|
| Rate for Payer: UHC Core |
$1,402.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.56
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
OP
|
$1,679.22
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$296.05 |
| Max. Negotiated Rate |
$1,511.30 |
| Rate for Payer: Aetna Commercial |
$1,427.34
|
| Rate for Payer: Aetna Medicare |
$436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$524.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$524.76
|
| Rate for Payer: BCBS Complete |
$310.82
|
| Rate for Payer: BCBS MAPPO |
$419.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,380.49
|
| Rate for Payer: BCN Commercial |
$1,380.49
|
| Rate for Payer: BCN Medicare Advantage |
$419.81
|
| Rate for Payer: Cash Price |
$1,343.38
|
| Rate for Payer: Cofinity Commercial |
$1,444.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.81
|
| Rate for Payer: Healthscope Commercial |
$1,511.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.41
|
| Rate for Payer: Mclaren Medicaid |
$296.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.80
|
| Rate for Payer: Meridian Medicaid |
$310.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$482.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$461.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.34
|
| Rate for Payer: Nomi Health Commercial |
$1,376.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.41
|
| Rate for Payer: PACE Senior Care Partners |
$398.81
|
| Rate for Payer: PACE SWMI |
$419.81
|
| Rate for Payer: PHP Commercial |
$1,427.34
|
| Rate for Payer: PHP Medicare Advantage |
$419.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,460.92
|
| Rate for Payer: Priority Health Medicare |
$424.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,168.74
|
| Rate for Payer: Railroad Medicare Medicare |
$419.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.71
|
| Rate for Payer: UHC Core |
$1,402.15
|
| Rate for Payer: UHC Exchange |
$419.81
|
| Rate for Payer: UHC Medicaid |
$296.05
|
| Rate for Payer: UHC Medicare Advantage |
$419.81
|
| Rate for Payer: UHCCP Medicaid |
$296.05
|
| Rate for Payer: VA VA |
$419.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.41
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
IP
|
$1,679.22
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,168.74 |
| Max. Negotiated Rate |
$1,511.30 |
| Rate for Payer: Aetna Commercial |
$1,427.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,386.87
|
| Rate for Payer: BCN Commercial |
$1,386.87
|
| Rate for Payer: Cash Price |
$1,343.38
|
| Rate for Payer: Cofinity Commercial |
$1,444.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.38
|
| Rate for Payer: Healthscope Commercial |
$1,511.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.34
|
| Rate for Payer: Nomi Health Commercial |
$1,376.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.41
|
| Rate for Payer: PHP Commercial |
$1,427.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,460.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,168.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.71
|
| Rate for Payer: UHC Core |
$1,402.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.41
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
IP
|
$1,041.69
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$725.02 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: BCBS Trust/PPO |
$860.33
|
| Rate for Payer: BCN Commercial |
$860.33
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Nomi Health Commercial |
$854.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$725.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.69
|
| Rate for Payer: UHC Core |
$869.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
OP
|
$1,041.69
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$183.65 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: Aetna Medicare |
$270.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.53
|
| Rate for Payer: BCBS Complete |
$192.82
|
| Rate for Payer: BCBS MAPPO |
$260.42
|
| Rate for Payer: BCBS Trust/PPO |
$856.37
|
| Rate for Payer: BCN Commercial |
$856.37
|
| Rate for Payer: BCN Medicare Advantage |
$260.42
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.42
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Mclaren Medicaid |
$183.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.44
|
| Rate for Payer: Meridian Medicaid |
$192.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Nomi Health Commercial |
$854.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PACE Senior Care Partners |
$247.40
|
| Rate for Payer: PACE SWMI |
$260.42
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: PHP Medicare Advantage |
$260.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.27
|
| Rate for Payer: Priority Health Medicare |
$263.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$725.02
|
| Rate for Payer: Railroad Medicare Medicare |
$260.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.69
|
| Rate for Payer: UHC Core |
$869.81
|
| Rate for Payer: UHC Exchange |
$260.42
|
| Rate for Payer: UHC Medicaid |
$183.65
|
| Rate for Payer: UHC Medicare Advantage |
$260.42
|
| Rate for Payer: UHCCP Medicaid |
$183.65
|
| Rate for Payer: VA VA |
$260.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
OP
|
$1,998.65
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$352.36 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: Aetna Medicare |
$519.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$624.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$624.58
|
| Rate for Payer: BCBS Complete |
$369.95
|
| Rate for Payer: BCBS MAPPO |
$499.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.09
|
| Rate for Payer: BCN Commercial |
$1,643.09
|
| Rate for Payer: BCN Medicare Advantage |
$499.66
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.66
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Mclaren Medicaid |
$352.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.65
|
| Rate for Payer: Meridian Medicaid |
$369.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$574.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PACE Senior Care Partners |
$474.68
|
| Rate for Payer: PACE SWMI |
$499.66
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: PHP Medicare Advantage |
$499.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,738.83
|
| Rate for Payer: Priority Health Medicare |
$504.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.06
|
| Rate for Payer: Railroad Medicare Medicare |
$499.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.81
|
| Rate for Payer: UHC Core |
$1,668.87
|
| Rate for Payer: UHC Exchange |
$499.66
|
| Rate for Payer: UHC Medicaid |
$352.36
|
| Rate for Payer: UHC Medicare Advantage |
$499.66
|
| Rate for Payer: UHCCP Medicaid |
$352.36
|
| Rate for Payer: VA VA |
$499.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
IP
|
$1,998.65
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,391.06 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.69
|
| Rate for Payer: BCN Commercial |
$1,650.69
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,738.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.81
|
| Rate for Payer: UHC Core |
$1,668.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
