|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$283.43
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$197.27 |
| Max. Negotiated Rate |
$255.09 |
| Rate for Payer: Aetna Commercial |
$240.92
|
| Rate for Payer: BCBS Trust/PPO |
$234.08
|
| Rate for Payer: BCN Commercial |
$234.08
|
| Rate for Payer: Cash Price |
$226.74
|
| Rate for Payer: Cofinity Commercial |
$243.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.74
|
| Rate for Payer: Healthscope Commercial |
$255.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.92
|
| Rate for Payer: Nomi Health Commercial |
$232.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.57
|
| Rate for Payer: PHP Commercial |
$240.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.42
|
| Rate for Payer: UHC Core |
$236.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.57
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$535.70
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$372.85 |
| Max. Negotiated Rate |
$482.13 |
| Rate for Payer: Aetna Commercial |
$455.35
|
| Rate for Payer: BCBS Trust/PPO |
$442.43
|
| Rate for Payer: BCN Commercial |
$442.43
|
| Rate for Payer: Cash Price |
$428.56
|
| Rate for Payer: Cofinity Commercial |
$460.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.56
|
| Rate for Payer: Healthscope Commercial |
$482.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.35
|
| Rate for Payer: Nomi Health Commercial |
$439.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.77
|
| Rate for Payer: PHP Commercial |
$455.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$466.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.42
|
| Rate for Payer: UHC Core |
$447.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.77
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$535.70
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$94.44 |
| Max. Negotiated Rate |
$482.13 |
| Rate for Payer: Aetna Commercial |
$455.35
|
| Rate for Payer: Aetna Medicare |
$139.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.41
|
| Rate for Payer: BCBS Complete |
$99.16
|
| Rate for Payer: BCBS MAPPO |
$133.93
|
| Rate for Payer: BCBS Trust/PPO |
$440.40
|
| Rate for Payer: BCN Commercial |
$440.40
|
| Rate for Payer: BCN Medicare Advantage |
$133.93
|
| Rate for Payer: Cash Price |
$428.56
|
| Rate for Payer: Cofinity Commercial |
$460.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.93
|
| Rate for Payer: Healthscope Commercial |
$482.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.77
|
| Rate for Payer: Mclaren Medicaid |
$94.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.62
|
| Rate for Payer: Meridian Medicaid |
$99.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.35
|
| Rate for Payer: Nomi Health Commercial |
$439.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.77
|
| Rate for Payer: PACE Senior Care Partners |
$127.23
|
| Rate for Payer: PACE SWMI |
$133.93
|
| Rate for Payer: PHP Commercial |
$455.35
|
| Rate for Payer: PHP Medicare Advantage |
$133.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$466.06
|
| Rate for Payer: Priority Health Medicare |
$135.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.85
|
| Rate for Payer: Railroad Medicare Medicare |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.42
|
| Rate for Payer: UHC Core |
$447.31
|
| Rate for Payer: UHC Exchange |
$133.93
|
| Rate for Payer: UHC Medicaid |
$94.44
|
| Rate for Payer: UHC Medicare Advantage |
$133.93
|
| Rate for Payer: UHCCP Medicaid |
$94.44
|
| Rate for Payer: VA VA |
$133.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.77
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$596.15
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$105.10 |
| Max. Negotiated Rate |
$536.53 |
| Rate for Payer: Aetna Commercial |
$506.73
|
| Rate for Payer: Aetna Medicare |
$155.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.30
|
| Rate for Payer: BCBS Complete |
$110.35
|
| Rate for Payer: BCBS MAPPO |
$149.04
|
| Rate for Payer: BCBS Trust/PPO |
$490.09
|
| Rate for Payer: BCN Commercial |
$490.09
|
| Rate for Payer: BCN Medicare Advantage |
$149.04
|
| Rate for Payer: Cash Price |
$476.92
|
| Rate for Payer: Cofinity Commercial |
$512.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.04
|
| Rate for Payer: Healthscope Commercial |
$536.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.11
|
| Rate for Payer: Mclaren Medicaid |
$105.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.49
|
| Rate for Payer: Meridian Medicaid |
$110.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.73
|
| Rate for Payer: Nomi Health Commercial |
$488.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.11
|
| Rate for Payer: PACE Senior Care Partners |
$141.59
|
| Rate for Payer: PACE SWMI |
$149.04
|
| Rate for Payer: PHP Commercial |
$506.73
|
| Rate for Payer: PHP Medicare Advantage |
$149.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$518.65
|
| Rate for Payer: Priority Health Medicare |
$150.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.92
|
| Rate for Payer: Railroad Medicare Medicare |
$149.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.61
|
| Rate for Payer: UHC Core |
$497.79
|
| Rate for Payer: UHC Exchange |
$149.04
|
| Rate for Payer: UHC Medicaid |
$105.10
|
| Rate for Payer: UHC Medicare Advantage |
$149.04
|
| Rate for Payer: UHCCP Medicaid |
$105.10
|
| Rate for Payer: VA VA |
$149.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.11
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$596.15
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$414.92 |
| Max. Negotiated Rate |
$536.53 |
| Rate for Payer: Aetna Commercial |
$506.73
|
| Rate for Payer: BCBS Trust/PPO |
$492.36
|
| Rate for Payer: BCN Commercial |
$492.36
|
| Rate for Payer: Cash Price |
$476.92
|
| Rate for Payer: Cofinity Commercial |
$512.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.92
|
| Rate for Payer: Healthscope Commercial |
$536.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.73
|
| Rate for Payer: Nomi Health Commercial |
$488.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.11
|
| Rate for Payer: PHP Commercial |
$506.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$518.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.61
|
| Rate for Payer: UHC Core |
$497.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.11
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$33.76
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$30.38 |
| Rate for Payer: Aetna Commercial |
$28.70
|
| Rate for Payer: BCBS Trust/PPO |
$27.88
|
| Rate for Payer: BCN Commercial |
$27.88
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.01
|
| Rate for Payer: Healthscope Commercial |
$30.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.70
|
| Rate for Payer: Nomi Health Commercial |
$27.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.32
|
| Rate for Payer: PHP Commercial |
$28.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.71
|
| Rate for Payer: UHC Core |
$28.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.32
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$33.76
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$30.38 |
| Rate for Payer: Aetna Commercial |
$28.70
|
| Rate for Payer: Aetna Medicare |
$8.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.55
|
| Rate for Payer: BCBS Complete |
$6.25
|
| Rate for Payer: BCBS MAPPO |
$8.44
|
| Rate for Payer: BCBS Trust/PPO |
$27.75
|
| Rate for Payer: BCN Commercial |
$27.75
|
| Rate for Payer: BCN Medicare Advantage |
$8.44
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.44
|
| Rate for Payer: Healthscope Commercial |
$30.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.32
|
| Rate for Payer: Mclaren Medicaid |
$5.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$6.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.70
|
| Rate for Payer: Nomi Health Commercial |
$27.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.32
|
| Rate for Payer: PACE Senior Care Partners |
$8.02
|
| Rate for Payer: PACE SWMI |
$8.44
|
| Rate for Payer: PHP Commercial |
$28.70
|
| Rate for Payer: PHP Medicare Advantage |
$8.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.37
|
| Rate for Payer: Priority Health Medicare |
$8.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.71
|
| Rate for Payer: UHC Core |
$28.19
|
| Rate for Payer: UHC Exchange |
$8.44
|
| Rate for Payer: UHC Medicaid |
$5.95
|
| Rate for Payer: UHC Medicare Advantage |
$8.44
|
| Rate for Payer: UHCCP Medicaid |
$5.95
|
| Rate for Payer: VA VA |
$8.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.32
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$9.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.21
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.97
|
| Rate for Payer: BCBS Trust/PPO |
$29.49
|
| Rate for Payer: BCN Commercial |
$29.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.97
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.97
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.52
|
| Rate for Payer: PACE SWMI |
$8.97
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$9.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.97
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$8.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
OP
|
$157.10
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.70 |
| Max. Negotiated Rate |
$141.39 |
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: Aetna Medicare |
$40.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.09
|
| Rate for Payer: BCBS Complete |
$29.08
|
| Rate for Payer: BCBS MAPPO |
$39.27
|
| Rate for Payer: BCBS Trust/PPO |
$129.15
|
| Rate for Payer: BCN Commercial |
$129.15
|
| Rate for Payer: BCN Medicare Advantage |
$39.27
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.27
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Mclaren Medicaid |
$27.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.24
|
| Rate for Payer: Meridian Medicaid |
$29.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$128.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.83
|
| Rate for Payer: PACE Senior Care Partners |
$37.31
|
| Rate for Payer: PACE SWMI |
$39.27
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: PHP Medicare Advantage |
$39.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.68
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.34
|
| Rate for Payer: Railroad Medicare Medicare |
$39.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.25
|
| Rate for Payer: UHC Core |
$131.18
|
| Rate for Payer: UHC Exchange |
$39.27
|
| Rate for Payer: UHC Medicaid |
$27.70
|
| Rate for Payer: UHC Medicare Advantage |
$39.27
|
| Rate for Payer: UHCCP Medicaid |
$27.70
|
| Rate for Payer: VA VA |
$39.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
IP
|
$157.10
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.34 |
| Max. Negotiated Rate |
$141.39 |
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: BCBS Trust/PPO |
$129.75
|
| Rate for Payer: BCN Commercial |
$129.75
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$128.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.83
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.25
|
| Rate for Payer: UHC Core |
$131.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
IP
|
$68.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.58 |
| Max. Negotiated Rate |
$61.52 |
| Rate for Payer: Aetna Commercial |
$58.11
|
| Rate for Payer: BCBS Trust/PPO |
$56.46
|
| Rate for Payer: BCN Commercial |
$56.46
|
| Rate for Payer: Cash Price |
$54.69
|
| Rate for Payer: Cofinity Commercial |
$58.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.69
|
| Rate for Payer: Healthscope Commercial |
$61.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.11
|
| Rate for Payer: Nomi Health Commercial |
$56.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.27
|
| Rate for Payer: PHP Commercial |
$58.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.16
|
| Rate for Payer: UHC Core |
$57.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.27
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
OP
|
$68.36
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$61.52 |
| Rate for Payer: Aetna Commercial |
$58.11
|
| Rate for Payer: Aetna Medicare |
$17.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.36
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: BCBS MAPPO |
$17.09
|
| Rate for Payer: BCBS Trust/PPO |
$56.20
|
| Rate for Payer: BCN Commercial |
$56.20
|
| Rate for Payer: BCN Medicare Advantage |
$17.09
|
| Rate for Payer: Cash Price |
$54.69
|
| Rate for Payer: Cofinity Commercial |
$58.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.09
|
| Rate for Payer: Healthscope Commercial |
$61.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.27
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.94
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.11
|
| Rate for Payer: Nomi Health Commercial |
$56.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.27
|
| Rate for Payer: PACE Senior Care Partners |
$16.24
|
| Rate for Payer: PACE SWMI |
$17.09
|
| Rate for Payer: PHP Commercial |
$58.11
|
| Rate for Payer: PHP Medicare Advantage |
$17.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.47
|
| Rate for Payer: Priority Health Medicare |
$17.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.58
|
| Rate for Payer: Railroad Medicare Medicare |
$17.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.16
|
| Rate for Payer: UHC Core |
$57.08
|
| Rate for Payer: UHC Exchange |
$17.09
|
| Rate for Payer: UHC Medicaid |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$17.09
|
| Rate for Payer: UHCCP Medicaid |
$12.05
|
| Rate for Payer: VA VA |
$17.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.27
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
OP
|
$157.58
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$141.82 |
| Rate for Payer: Aetna Commercial |
$133.94
|
| Rate for Payer: Aetna Medicare |
$40.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.24
|
| Rate for Payer: BCBS Complete |
$29.17
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCBS Trust/PPO |
$129.55
|
| Rate for Payer: BCN Commercial |
$129.55
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: Cash Price |
$126.06
|
| Rate for Payer: Cofinity Commercial |
$135.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Healthscope Commercial |
$141.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.19
|
| Rate for Payer: Mclaren Medicaid |
$27.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.36
|
| Rate for Payer: Meridian Medicaid |
$29.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.94
|
| Rate for Payer: Nomi Health Commercial |
$129.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.19
|
| Rate for Payer: PACE Senior Care Partners |
$37.43
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PHP Commercial |
$133.94
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.09
|
| Rate for Payer: Priority Health Medicare |
$39.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.68
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.67
|
| Rate for Payer: UHC Core |
$131.58
|
| Rate for Payer: UHC Exchange |
$39.40
|
| Rate for Payer: UHC Medicaid |
$27.78
|
| Rate for Payer: UHC Medicare Advantage |
$39.40
|
| Rate for Payer: UHCCP Medicaid |
$27.78
|
| Rate for Payer: VA VA |
$39.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.19
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
IP
|
$157.58
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.68 |
| Max. Negotiated Rate |
$141.82 |
| Rate for Payer: Aetna Commercial |
$133.94
|
| Rate for Payer: BCBS Trust/PPO |
$130.15
|
| Rate for Payer: BCN Commercial |
$130.15
|
| Rate for Payer: Cash Price |
$126.06
|
| Rate for Payer: Cofinity Commercial |
$135.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.06
|
| Rate for Payer: Healthscope Commercial |
$141.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.94
|
| Rate for Payer: Nomi Health Commercial |
$129.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.19
|
| Rate for Payer: PHP Commercial |
$133.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.67
|
| Rate for Payer: UHC Core |
$131.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.19
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
OP
|
$96.76
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.06 |
| Max. Negotiated Rate |
$87.08 |
| Rate for Payer: Aetna Commercial |
$82.25
|
| Rate for Payer: Aetna Medicare |
$25.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.24
|
| Rate for Payer: BCBS Complete |
$17.91
|
| Rate for Payer: BCBS MAPPO |
$24.19
|
| Rate for Payer: BCBS Trust/PPO |
$79.55
|
| Rate for Payer: BCN Commercial |
$79.55
|
| Rate for Payer: BCN Medicare Advantage |
$24.19
|
| Rate for Payer: Cash Price |
$77.41
|
| Rate for Payer: Cofinity Commercial |
$83.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.19
|
| Rate for Payer: Healthscope Commercial |
$87.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.57
|
| Rate for Payer: Mclaren Medicaid |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.40
|
| Rate for Payer: Meridian Medicaid |
$17.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.25
|
| Rate for Payer: Nomi Health Commercial |
$79.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.57
|
| Rate for Payer: PACE Senior Care Partners |
$22.98
|
| Rate for Payer: PACE SWMI |
$24.19
|
| Rate for Payer: PHP Commercial |
$82.25
|
| Rate for Payer: PHP Medicare Advantage |
$24.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.18
|
| Rate for Payer: Priority Health Medicare |
$24.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.34
|
| Rate for Payer: Railroad Medicare Medicare |
$24.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.15
|
| Rate for Payer: UHC Core |
$80.79
|
| Rate for Payer: UHC Exchange |
$24.19
|
| Rate for Payer: UHC Medicaid |
$17.06
|
| Rate for Payer: UHC Medicare Advantage |
$24.19
|
| Rate for Payer: UHCCP Medicaid |
$17.06
|
| Rate for Payer: VA VA |
$24.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.57
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
IP
|
$96.76
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.34 |
| Max. Negotiated Rate |
$87.08 |
| Rate for Payer: Aetna Commercial |
$82.25
|
| Rate for Payer: BCBS Trust/PPO |
$79.91
|
| Rate for Payer: BCN Commercial |
$79.91
|
| Rate for Payer: Cash Price |
$77.41
|
| Rate for Payer: Cofinity Commercial |
$83.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.41
|
| Rate for Payer: Healthscope Commercial |
$87.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.25
|
| Rate for Payer: Nomi Health Commercial |
$79.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.57
|
| Rate for Payer: PHP Commercial |
$82.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.15
|
| Rate for Payer: UHC Core |
$80.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.57
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$213.50
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.60 |
| Max. Negotiated Rate |
$192.15 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: BCBS Trust/PPO |
$176.33
|
| Rate for Payer: BCN Commercial |
$176.33
|
| Rate for Payer: Cash Price |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$183.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.80
|
| Rate for Payer: Healthscope Commercial |
$192.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Nomi Health Commercial |
$175.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.12
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$185.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.88
|
| Rate for Payer: UHC Core |
$178.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.12
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
OP
|
$213.50
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.64 |
| Max. Negotiated Rate |
$192.15 |
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: Aetna Medicare |
$55.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.72
|
| Rate for Payer: BCBS Complete |
$39.52
|
| Rate for Payer: BCBS MAPPO |
$53.38
|
| Rate for Payer: BCBS Trust/PPO |
$175.52
|
| Rate for Payer: BCN Commercial |
$175.52
|
| Rate for Payer: BCN Medicare Advantage |
$53.38
|
| Rate for Payer: Cash Price |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$183.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.38
|
| Rate for Payer: Healthscope Commercial |
$192.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.12
|
| Rate for Payer: Mclaren Medicaid |
$37.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.04
|
| Rate for Payer: Meridian Medicaid |
$39.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Nomi Health Commercial |
$175.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.12
|
| Rate for Payer: PACE Senior Care Partners |
$50.71
|
| Rate for Payer: PACE SWMI |
$53.38
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: PHP Medicare Advantage |
$53.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$185.75
|
| Rate for Payer: Priority Health Medicare |
$53.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.60
|
| Rate for Payer: Railroad Medicare Medicare |
$53.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.88
|
| Rate for Payer: UHC Core |
$178.27
|
| Rate for Payer: UHC Exchange |
$53.38
|
| Rate for Payer: UHC Medicaid |
$37.64
|
| Rate for Payer: UHC Medicare Advantage |
$53.38
|
| Rate for Payer: UHCCP Medicaid |
$37.64
|
| Rate for Payer: VA VA |
$53.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.12
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$158.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$110.07 |
| Max. Negotiated Rate |
$142.33 |
| Rate for Payer: Aetna Commercial |
$134.42
|
| Rate for Payer: BCBS Trust/PPO |
$130.61
|
| Rate for Payer: BCN Commercial |
$130.61
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Commercial |
$136.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Healthscope Commercial |
$142.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$129.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.61
|
| Rate for Payer: PHP Commercial |
$134.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.16
|
| Rate for Payer: UHC Core |
$132.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.61
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$158.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.88 |
| Max. Negotiated Rate |
$142.33 |
| Rate for Payer: Aetna Commercial |
$134.42
|
| Rate for Payer: Aetna Medicare |
$41.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.42
|
| Rate for Payer: BCBS Complete |
$29.27
|
| Rate for Payer: BCBS MAPPO |
$39.53
|
| Rate for Payer: BCBS Trust/PPO |
$130.01
|
| Rate for Payer: BCN Commercial |
$130.01
|
| Rate for Payer: BCN Medicare Advantage |
$39.53
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Commercial |
$136.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.53
|
| Rate for Payer: Healthscope Commercial |
$142.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.61
|
| Rate for Payer: Mclaren Medicaid |
$27.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.51
|
| Rate for Payer: Meridian Medicaid |
$29.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$129.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.61
|
| Rate for Payer: PACE Senior Care Partners |
$37.56
|
| Rate for Payer: PACE SWMI |
$39.53
|
| Rate for Payer: PHP Commercial |
$134.42
|
| Rate for Payer: PHP Medicare Advantage |
$39.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.58
|
| Rate for Payer: Priority Health Medicare |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.07
|
| Rate for Payer: Railroad Medicare Medicare |
$39.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.16
|
| Rate for Payer: UHC Core |
$132.05
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHC Medicaid |
$27.88
|
| Rate for Payer: UHC Medicare Advantage |
$39.53
|
| Rate for Payer: UHCCP Medicaid |
$27.88
|
| Rate for Payer: VA VA |
$39.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.61
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$76.41
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$19.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.88
|
| Rate for Payer: BCBS Complete |
$14.14
|
| Rate for Payer: BCBS MAPPO |
$19.10
|
| Rate for Payer: BCBS Trust/PPO |
$62.82
|
| Rate for Payer: BCN Commercial |
$62.82
|
| Rate for Payer: BCN Medicare Advantage |
$19.10
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.10
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Mclaren Medicaid |
$13.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.06
|
| Rate for Payer: Meridian Medicaid |
$14.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PACE Senior Care Partners |
$18.15
|
| Rate for Payer: PACE SWMI |
$19.10
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: PHP Medicare Advantage |
$19.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.48
|
| Rate for Payer: Priority Health Medicare |
$19.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.24
|
| Rate for Payer: UHC Core |
$63.80
|
| Rate for Payer: UHC Exchange |
$19.10
|
| Rate for Payer: UHC Medicaid |
$13.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.10
|
| Rate for Payer: UHCCP Medicaid |
$13.47
|
| Rate for Payer: VA VA |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$76.41
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.18 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: BCBS Trust/PPO |
$63.11
|
| Rate for Payer: BCN Commercial |
$63.11
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$62.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.24
|
| Rate for Payer: UHC Core |
$63.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$90.22
|
| Rate for Payer: BCN Commercial |
$90.22
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$20.22
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$89.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$19.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$20.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicaid |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$19.26
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
