|
HC ESOPHAGOSCOPY
|
Facility
|
IP
|
$1,404.77
|
|
| Hospital Charge Code |
36000041
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$977.72 |
| Max. Negotiated Rate |
$1,264.29 |
| Rate for Payer: Aetna Commercial |
$1,194.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.20
|
| Rate for Payer: BCN Commercial |
$1,160.20
|
| Rate for Payer: Cash Price |
$1,123.82
|
| Rate for Payer: Cofinity Commercial |
$1,208.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.82
|
| Rate for Payer: Healthscope Commercial |
$1,264.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,194.05
|
| Rate for Payer: Nomi Health Commercial |
$1,151.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.58
|
| Rate for Payer: PHP Commercial |
$1,194.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,222.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$977.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.20
|
| Rate for Payer: UHC Core |
$1,172.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.58
|
|
|
HC ESOPHAGOSCOPY
|
Facility
|
OP
|
$1,404.77
|
|
| Hospital Charge Code |
36000041
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$247.66 |
| Max. Negotiated Rate |
$1,264.29 |
| Rate for Payer: Aetna Commercial |
$1,194.05
|
| Rate for Payer: Aetna Medicare |
$365.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.99
|
| Rate for Payer: BCBS Complete |
$260.02
|
| Rate for Payer: BCBS MAPPO |
$351.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,154.86
|
| Rate for Payer: BCN Commercial |
$1,154.86
|
| Rate for Payer: BCN Medicare Advantage |
$351.19
|
| Rate for Payer: Cash Price |
$1,123.82
|
| Rate for Payer: Cofinity Commercial |
$1,208.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.19
|
| Rate for Payer: Healthscope Commercial |
$1,264.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.58
|
| Rate for Payer: Mclaren Medicaid |
$247.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.75
|
| Rate for Payer: Meridian Medicaid |
$260.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$386.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,194.05
|
| Rate for Payer: Nomi Health Commercial |
$1,151.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.58
|
| Rate for Payer: PACE Senior Care Partners |
$333.63
|
| Rate for Payer: PACE SWMI |
$351.19
|
| Rate for Payer: PHP Commercial |
$1,194.05
|
| Rate for Payer: PHP Medicare Advantage |
$351.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$247.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,222.15
|
| Rate for Payer: Priority Health Medicare |
$354.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$977.72
|
| Rate for Payer: Railroad Medicare Medicare |
$351.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.20
|
| Rate for Payer: UHC Core |
$1,172.98
|
| Rate for Payer: UHC Exchange |
$351.19
|
| Rate for Payer: UHC Medicaid |
$247.66
|
| Rate for Payer: UHC Medicare Advantage |
$351.19
|
| Rate for Payer: UHCCP Medicaid |
$247.66
|
| Rate for Payer: VA VA |
$351.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.58
|
|
|
HC ESOPHGL FUNC G-ESOP RFLX IMPD ELTRD PROLNG
|
Facility
|
IP
|
$2,439.74
|
|
|
Service Code
|
CPT 91038
|
| Hospital Charge Code |
76100426
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,698.06 |
| Max. Negotiated Rate |
$2,195.77 |
| Rate for Payer: Aetna Commercial |
$2,073.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,014.98
|
| Rate for Payer: BCN Commercial |
$2,014.98
|
| Rate for Payer: Cash Price |
$1,951.79
|
| Rate for Payer: Cofinity Commercial |
$2,098.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.79
|
| Rate for Payer: Healthscope Commercial |
$2,195.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.78
|
| Rate for Payer: Nomi Health Commercial |
$2,000.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.81
|
| Rate for Payer: PHP Commercial |
$2,073.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,122.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,698.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,146.97
|
| Rate for Payer: UHC Core |
$2,037.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.81
|
|
|
HC ESOPHGL FUNC G-ESOP RFLX IMPD ELTRD PROLNG
|
Facility
|
OP
|
$2,439.74
|
|
|
Service Code
|
CPT 91038
|
| Hospital Charge Code |
76100426
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.13 |
| Max. Negotiated Rate |
$2,195.77 |
| Rate for Payer: Aetna Commercial |
$2,073.78
|
| Rate for Payer: Aetna Medicare |
$634.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$762.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$762.42
|
| Rate for Payer: BCBS Complete |
$451.60
|
| Rate for Payer: BCBS MAPPO |
$609.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,005.71
|
| Rate for Payer: BCN Commercial |
$2,005.71
|
| Rate for Payer: BCN Medicare Advantage |
$609.93
|
| Rate for Payer: Cash Price |
$1,951.79
|
| Rate for Payer: Cofinity Commercial |
$2,098.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.93
|
| Rate for Payer: Healthscope Commercial |
$2,195.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.81
|
| Rate for Payer: Mclaren Medicaid |
$430.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.43
|
| Rate for Payer: Meridian Medicaid |
$451.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$701.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.78
|
| Rate for Payer: Nomi Health Commercial |
$2,000.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.81
|
| Rate for Payer: PACE Senior Care Partners |
$579.44
|
| Rate for Payer: PACE SWMI |
$609.93
|
| Rate for Payer: PHP Commercial |
$2,073.78
|
| Rate for Payer: PHP Medicare Advantage |
$609.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,122.57
|
| Rate for Payer: Priority Health Medicare |
$616.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,698.06
|
| Rate for Payer: Railroad Medicare Medicare |
$609.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,146.97
|
| Rate for Payer: UHC Core |
$2,037.18
|
| Rate for Payer: UHC Exchange |
$609.93
|
| Rate for Payer: UHC Medicaid |
$430.13
|
| Rate for Payer: UHC Medicare Advantage |
$609.93
|
| Rate for Payer: UHCCP Medicaid |
$430.13
|
| Rate for Payer: VA VA |
$609.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.81
|
|
|
HC ESOPH IMPEDENCE MONITOR/MANOMETRY
|
Facility
|
OP
|
$1,480.45
|
|
| Hospital Charge Code |
75000003
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$1,332.40 |
| Rate for Payer: Aetna Commercial |
$1,258.38
|
| Rate for Payer: Aetna Medicare |
$384.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$462.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$462.64
|
| Rate for Payer: BCBS Complete |
$274.03
|
| Rate for Payer: BCBS MAPPO |
$370.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.08
|
| Rate for Payer: BCN Commercial |
$1,217.08
|
| Rate for Payer: BCN Medicare Advantage |
$370.11
|
| Rate for Payer: Cash Price |
$1,184.36
|
| Rate for Payer: Cofinity Commercial |
$1,273.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,184.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.11
|
| Rate for Payer: Healthscope Commercial |
$1,332.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,110.34
|
| Rate for Payer: Mclaren Medicaid |
$261.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.62
|
| Rate for Payer: Meridian Medicaid |
$274.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$425.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$407.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,258.38
|
| Rate for Payer: Nomi Health Commercial |
$1,213.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.34
|
| Rate for Payer: PACE Senior Care Partners |
$351.61
|
| Rate for Payer: PACE SWMI |
$370.11
|
| Rate for Payer: PHP Commercial |
$1,258.38
|
| Rate for Payer: PHP Medicare Advantage |
$370.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,287.99
|
| Rate for Payer: Priority Health Medicare |
$373.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,030.39
|
| Rate for Payer: Railroad Medicare Medicare |
$370.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,302.80
|
| Rate for Payer: UHC Core |
$1,236.18
|
| Rate for Payer: UHC Exchange |
$370.11
|
| Rate for Payer: UHC Medicaid |
$261.00
|
| Rate for Payer: UHC Medicare Advantage |
$370.11
|
| Rate for Payer: UHCCP Medicaid |
$261.00
|
| Rate for Payer: VA VA |
$370.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,110.34
|
|
|
HC ESOPH IMPEDENCE MONITOR/MANOMETRY
|
Facility
|
IP
|
$1,480.45
|
|
| Hospital Charge Code |
75000003
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,030.39 |
| Max. Negotiated Rate |
$1,332.40 |
| Rate for Payer: Aetna Commercial |
$1,258.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,222.70
|
| Rate for Payer: BCN Commercial |
$1,222.70
|
| Rate for Payer: Cash Price |
$1,184.36
|
| Rate for Payer: Cofinity Commercial |
$1,273.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,184.36
|
| Rate for Payer: Healthscope Commercial |
$1,332.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,110.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,258.38
|
| Rate for Payer: Nomi Health Commercial |
$1,213.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,110.34
|
| Rate for Payer: PHP Commercial |
$1,258.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,287.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,030.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,302.80
|
| Rate for Payer: UHC Core |
$1,236.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,110.34
|
|
|
HC ESOSURE ESOPHAGEAL DEVICE
|
Facility
|
IP
|
$1,257.53
|
|
| Hospital Charge Code |
27200326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$875.24 |
| Max. Negotiated Rate |
$1,131.78 |
| Rate for Payer: Aetna Commercial |
$1,068.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,038.59
|
| Rate for Payer: BCN Commercial |
$1,038.59
|
| Rate for Payer: Cash Price |
$1,006.02
|
| Rate for Payer: Cofinity Commercial |
$1,081.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,006.02
|
| Rate for Payer: Healthscope Commercial |
$1,131.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$943.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.90
|
| Rate for Payer: Nomi Health Commercial |
$1,031.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$943.15
|
| Rate for Payer: PHP Commercial |
$1,068.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,094.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$875.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.63
|
| Rate for Payer: UHC Core |
$1,050.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$943.15
|
|
|
HC ESOSURE ESOPHAGEAL DEVICE
|
Facility
|
OP
|
$1,257.53
|
|
| Hospital Charge Code |
27200326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$221.70 |
| Max. Negotiated Rate |
$1,131.78 |
| Rate for Payer: Aetna Commercial |
$1,068.90
|
| Rate for Payer: Aetna Medicare |
$326.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$392.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$392.98
|
| Rate for Payer: BCBS Complete |
$232.77
|
| Rate for Payer: BCBS MAPPO |
$314.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.82
|
| Rate for Payer: BCN Commercial |
$1,033.82
|
| Rate for Payer: BCN Medicare Advantage |
$314.38
|
| Rate for Payer: Cash Price |
$1,006.02
|
| Rate for Payer: Cofinity Commercial |
$1,081.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,006.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.38
|
| Rate for Payer: Healthscope Commercial |
$1,131.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$943.15
|
| Rate for Payer: Mclaren Medicaid |
$221.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.10
|
| Rate for Payer: Meridian Medicaid |
$232.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$361.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$345.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.90
|
| Rate for Payer: Nomi Health Commercial |
$1,031.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$943.15
|
| Rate for Payer: PACE Senior Care Partners |
$298.66
|
| Rate for Payer: PACE SWMI |
$314.38
|
| Rate for Payer: PHP Commercial |
$1,068.90
|
| Rate for Payer: PHP Medicare Advantage |
$314.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,094.05
|
| Rate for Payer: Priority Health Medicare |
$317.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$875.24
|
| Rate for Payer: Railroad Medicare Medicare |
$314.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.63
|
| Rate for Payer: UHC Core |
$1,050.04
|
| Rate for Payer: UHC Exchange |
$314.38
|
| Rate for Payer: UHC Medicaid |
$221.70
|
| Rate for Payer: UHC Medicare Advantage |
$314.38
|
| Rate for Payer: UHCCP Medicaid |
$221.70
|
| Rate for Payer: VA VA |
$314.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$943.15
|
|
|
HC E- STIM ATTENDED PER 15 MIN
|
Facility
|
OP
|
$108.24
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna Medicare |
$28.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.83
|
| Rate for Payer: BCBS Complete |
$20.04
|
| Rate for Payer: BCBS MAPPO |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$88.98
|
| Rate for Payer: BCN Commercial |
$88.98
|
| Rate for Payer: BCN Medicare Advantage |
$27.06
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.06
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Mclaren Medicaid |
$19.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.41
|
| Rate for Payer: Meridian Medicaid |
$20.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PACE Senior Care Partners |
$25.71
|
| Rate for Payer: PACE SWMI |
$27.06
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: PHP Medicare Advantage |
$27.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Medicare |
$27.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: Railroad Medicare Medicare |
$27.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: UHC Exchange |
$27.06
|
| Rate for Payer: UHC Medicaid |
$19.08
|
| Rate for Payer: UHC Medicare Advantage |
$27.06
|
| Rate for Payer: UHCCP Medicaid |
$19.08
|
| Rate for Payer: VA VA |
$27.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC E- STIM ATTENDED PER 15 MIN
|
Facility
|
IP
|
$108.24
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$75.34 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: BCBS Trust/PPO |
$89.40
|
| Rate for Payer: BCN Commercial |
$89.40
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$88.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$94.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.25
|
| Rate for Payer: UHC Core |
$90.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC ESTRADIAL, MASS SPEC, S
|
Facility
|
OP
|
$56.18
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100737
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.90 |
| Max. Negotiated Rate |
$50.56 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$14.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.56
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$14.04
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$46.19
|
| Rate for Payer: BCN Medicare Advantage |
$14.04
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$50.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.13
|
| Rate for Payer: Mclaren Medicaid |
$9.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.75
|
| Rate for Payer: Meridian Medicaid |
$10.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.13
|
| Rate for Payer: PACE Senior Care Partners |
$13.34
|
| Rate for Payer: PACE SWMI |
$14.04
|
| Rate for Payer: PHP Commercial |
$47.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.88
|
| Rate for Payer: Priority Health Medicare |
$14.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.10
|
| Rate for Payer: Railroad Medicare Medicare |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.44
|
| Rate for Payer: UHC Core |
$46.91
|
| Rate for Payer: UHC Exchange |
$14.04
|
| Rate for Payer: UHC Medicaid |
$9.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.04
|
| Rate for Payer: UHCCP Medicaid |
$9.90
|
| Rate for Payer: VA VA |
$14.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.13
|
|
|
HC ESTRADIAL, MASS SPEC, S
|
Facility
|
IP
|
$56.18
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100737
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.10 |
| Max. Negotiated Rate |
$50.56 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: BCBS Trust/PPO |
$46.40
|
| Rate for Payer: BCN Commercial |
$46.40
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Healthscope Commercial |
$50.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.13
|
| Rate for Payer: PHP Commercial |
$47.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.44
|
| Rate for Payer: UHC Core |
$46.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.13
|
|
|
HC ESTRADIOL LEVEL
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100192
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC ESTRADIOL LEVEL
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100192
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC ESTRIOL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82677
|
| Hospital Charge Code |
30100195
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC ESTRIOL
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 82677
|
| Hospital Charge Code |
30100195
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.19 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$42.95
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC ESTROGEN FRACTIONATED E1 & E2
|
Facility
|
IP
|
$51.85
|
|
|
Service Code
|
CPT 82671
|
| Hospital Charge Code |
30100527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.09 |
| Max. Negotiated Rate |
$46.66 |
| Rate for Payer: Aetna Commercial |
$44.07
|
| Rate for Payer: BCBS Trust/PPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: Cash Price |
$41.48
|
| Rate for Payer: Cofinity Commercial |
$44.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.48
|
| Rate for Payer: Healthscope Commercial |
$46.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$42.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.89
|
| Rate for Payer: PHP Commercial |
$44.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.63
|
| Rate for Payer: UHC Core |
$43.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.89
|
|
|
HC ESTROGEN FRACTIONATED E1 & E2
|
Facility
|
OP
|
$51.85
|
|
|
Service Code
|
CPT 82671
|
| Hospital Charge Code |
30100527
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$46.66 |
| Rate for Payer: Aetna Commercial |
$44.07
|
| Rate for Payer: Aetna Medicare |
$13.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.20
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$12.96
|
| Rate for Payer: BCBS Trust/PPO |
$42.63
|
| Rate for Payer: BCN Commercial |
$42.63
|
| Rate for Payer: BCN Medicare Advantage |
$12.96
|
| Rate for Payer: Cash Price |
$41.48
|
| Rate for Payer: Cofinity Commercial |
$44.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.96
|
| Rate for Payer: Healthscope Commercial |
$46.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.89
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.61
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.07
|
| Rate for Payer: Nomi Health Commercial |
$42.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.89
|
| Rate for Payer: PACE Senior Care Partners |
$12.31
|
| Rate for Payer: PACE SWMI |
$12.96
|
| Rate for Payer: PHP Commercial |
$44.07
|
| Rate for Payer: PHP Medicare Advantage |
$12.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.11
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: Railroad Medicare Medicare |
$12.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.63
|
| Rate for Payer: UHC Core |
$43.29
|
| Rate for Payer: UHC Exchange |
$12.96
|
| Rate for Payer: UHC Medicaid |
$9.14
|
| Rate for Payer: UHC Medicare Advantage |
$12.96
|
| Rate for Payer: UHCCP Medicaid |
$9.14
|
| Rate for Payer: VA VA |
$12.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.89
|
|
|
HC ESTROGEN RECEPTOR
|
Facility
|
IP
|
$120.55
|
|
|
Service Code
|
CPT 84233
|
| Hospital Charge Code |
30100416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.90 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna Commercial |
$102.47
|
| Rate for Payer: BCBS Trust/PPO |
$99.56
|
| Rate for Payer: BCN Commercial |
$99.56
|
| Rate for Payer: Cash Price |
$96.44
|
| Rate for Payer: Cofinity Commercial |
$103.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.44
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.47
|
| Rate for Payer: Nomi Health Commercial |
$98.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.41
|
| Rate for Payer: PHP Commercial |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.08
|
| Rate for Payer: UHC Core |
$100.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.41
|
|
|
HC ESTROGEN RECEPTOR
|
Facility
|
OP
|
$120.55
|
|
|
Service Code
|
CPT 84233
|
| Hospital Charge Code |
30100416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$108.50 |
| Rate for Payer: Aetna Commercial |
$102.47
|
| Rate for Payer: Aetna Medicare |
$31.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.67
|
| Rate for Payer: BCBS Complete |
$22.31
|
| Rate for Payer: BCBS MAPPO |
$30.14
|
| Rate for Payer: BCBS Trust/PPO |
$99.10
|
| Rate for Payer: BCN Commercial |
$99.10
|
| Rate for Payer: BCN Medicare Advantage |
$30.14
|
| Rate for Payer: Cash Price |
$96.44
|
| Rate for Payer: Cofinity Commercial |
$103.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.14
|
| Rate for Payer: Healthscope Commercial |
$108.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.41
|
| Rate for Payer: Mclaren Medicaid |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.64
|
| Rate for Payer: Meridian Medicaid |
$22.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.47
|
| Rate for Payer: Nomi Health Commercial |
$98.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.41
|
| Rate for Payer: PACE Senior Care Partners |
$28.63
|
| Rate for Payer: PACE SWMI |
$30.14
|
| Rate for Payer: PHP Commercial |
$102.47
|
| Rate for Payer: PHP Medicare Advantage |
$30.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.88
|
| Rate for Payer: Priority Health Medicare |
$30.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.90
|
| Rate for Payer: Railroad Medicare Medicare |
$30.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.08
|
| Rate for Payer: UHC Core |
$100.66
|
| Rate for Payer: UHC Exchange |
$30.14
|
| Rate for Payer: UHC Medicaid |
$21.25
|
| Rate for Payer: UHC Medicare Advantage |
$30.14
|
| Rate for Payer: UHCCP Medicaid |
$21.25
|
| Rate for Payer: VA VA |
$30.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.41
|
|
|
HC ESTROGEN RECEPTOR-PROGESTERONE
|
Facility
|
IP
|
$121.40
|
|
|
Service Code
|
CPT 84234
|
| Hospital Charge Code |
30100417
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.49 |
| Max. Negotiated Rate |
$109.26 |
| Rate for Payer: Aetna Commercial |
$103.19
|
| Rate for Payer: BCBS Trust/PPO |
$100.26
|
| Rate for Payer: BCN Commercial |
$100.26
|
| Rate for Payer: Cash Price |
$97.12
|
| Rate for Payer: Cofinity Commercial |
$104.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.12
|
| Rate for Payer: Healthscope Commercial |
$109.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.19
|
| Rate for Payer: Nomi Health Commercial |
$99.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.05
|
| Rate for Payer: PHP Commercial |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.83
|
| Rate for Payer: UHC Core |
$101.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.05
|
|
|
HC ESTROGEN RECEPTOR-PROGESTERONE
|
Facility
|
OP
|
$121.40
|
|
|
Service Code
|
CPT 84234
|
| Hospital Charge Code |
30100417
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$109.26 |
| Rate for Payer: Aetna Commercial |
$103.19
|
| Rate for Payer: Aetna Medicare |
$31.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.94
|
| Rate for Payer: BCBS Complete |
$22.47
|
| Rate for Payer: BCBS MAPPO |
$30.35
|
| Rate for Payer: BCBS Trust/PPO |
$99.80
|
| Rate for Payer: BCN Commercial |
$99.80
|
| Rate for Payer: BCN Medicare Advantage |
$30.35
|
| Rate for Payer: Cash Price |
$97.12
|
| Rate for Payer: Cofinity Commercial |
$104.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.35
|
| Rate for Payer: Healthscope Commercial |
$109.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.05
|
| Rate for Payer: Mclaren Medicaid |
$21.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.87
|
| Rate for Payer: Meridian Medicaid |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.19
|
| Rate for Payer: Nomi Health Commercial |
$99.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.05
|
| Rate for Payer: PACE Senior Care Partners |
$28.83
|
| Rate for Payer: PACE SWMI |
$30.35
|
| Rate for Payer: PHP Commercial |
$103.19
|
| Rate for Payer: PHP Medicare Advantage |
$30.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.62
|
| Rate for Payer: Priority Health Medicare |
$30.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.49
|
| Rate for Payer: Railroad Medicare Medicare |
$30.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.83
|
| Rate for Payer: UHC Core |
$101.37
|
| Rate for Payer: UHC Exchange |
$30.35
|
| Rate for Payer: UHC Medicaid |
$21.40
|
| Rate for Payer: UHC Medicare Advantage |
$30.35
|
| Rate for Payer: UHCCP Medicaid |
$21.40
|
| Rate for Payer: VA VA |
$30.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.05
|
|
|
HC ESTRONE
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 82679
|
| Hospital Charge Code |
30100196
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.27 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: BCBS Trust/PPO |
$56.10
|
| Rate for Payer: BCN Commercial |
$56.10
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ESTRONE
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 82679
|
| Hospital Charge Code |
30100196
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$17.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.23
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$16.98
|
| Rate for Payer: BCBS Trust/PPO |
$55.84
|
| Rate for Payer: BCN Commercial |
$55.84
|
| Rate for Payer: BCN Medicare Advantage |
$16.98
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.83
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Senior Care Partners |
$16.13
|
| Rate for Payer: PACE SWMI |
$16.98
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$16.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Medicare |
$17.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: UHC Exchange |
$16.98
|
| Rate for Payer: UHC Medicaid |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$16.98
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: VA VA |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ETHANOL CONFIRM URINE
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100614
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
