|
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
|
|
|
HC ETHOSUXIMIDE/ZARONTIN LEVEL
|
Facility
|
OP
|
$58.26
|
|
|
Service Code
|
CPT 80168
|
| Hospital Charge Code |
30100029
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$14.56
|
| Rate for Payer: BCBS Trust/PPO |
$47.90
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$14.56
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.56
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PACE Senior Care Partners |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.56
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: PHP Medicare Advantage |
$14.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: Railroad Medicare Medicare |
$14.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: UHC Exchange |
$14.56
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHC Medicare Advantage |
$14.56
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$14.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC ETHOSUXIMIDE/ZARONTIN LEVEL
|
Facility
|
IP
|
$58.26
|
|
|
Service Code
|
CPT 80168
|
| Hospital Charge Code |
30100029
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC ETHYLENE GLYCOL
|
Facility
|
OP
|
$167.50
|
|
|
Service Code
|
CPT 82693
|
| Hospital Charge Code |
30100197
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.53 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Commercial |
$142.38
|
| Rate for Payer: Aetna Medicare |
$43.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.34
|
| Rate for Payer: BCBS Complete |
$31.00
|
| Rate for Payer: BCBS MAPPO |
$41.88
|
| Rate for Payer: BCBS Trust/PPO |
$137.70
|
| Rate for Payer: BCN Commercial |
$137.70
|
| Rate for Payer: BCN Medicare Advantage |
$41.88
|
| Rate for Payer: Cash Price |
$134.00
|
| Rate for Payer: Cofinity Commercial |
$144.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.88
|
| Rate for Payer: Healthscope Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.62
|
| Rate for Payer: Mclaren Medicaid |
$29.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.97
|
| Rate for Payer: Meridian Medicaid |
$31.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.38
|
| Rate for Payer: Nomi Health Commercial |
$137.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.62
|
| Rate for Payer: PACE Senior Care Partners |
$39.78
|
| Rate for Payer: PACE SWMI |
$41.88
|
| Rate for Payer: PHP Commercial |
$142.38
|
| Rate for Payer: PHP Medicare Advantage |
$41.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.72
|
| Rate for Payer: Priority Health Medicare |
$42.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.58
|
| Rate for Payer: Railroad Medicare Medicare |
$41.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.40
|
| Rate for Payer: UHC Core |
$139.86
|
| Rate for Payer: UHC Exchange |
$41.88
|
| Rate for Payer: UHC Medicaid |
$29.53
|
| Rate for Payer: UHC Medicare Advantage |
$41.88
|
| Rate for Payer: UHCCP Medicaid |
$29.53
|
| Rate for Payer: VA VA |
$41.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.62
|
|
|
HC ETHYLENE GLYCOL
|
Facility
|
IP
|
$167.50
|
|
|
Service Code
|
CPT 82693
|
| Hospital Charge Code |
30100197
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$116.58 |
| Max. Negotiated Rate |
$150.75 |
| Rate for Payer: Aetna Commercial |
$142.38
|
| Rate for Payer: BCBS Trust/PPO |
$138.34
|
| Rate for Payer: BCN Commercial |
$138.34
|
| Rate for Payer: Cash Price |
$134.00
|
| Rate for Payer: Cofinity Commercial |
$144.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.00
|
| Rate for Payer: Healthscope Commercial |
$150.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.38
|
| Rate for Payer: Nomi Health Commercial |
$137.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.62
|
| Rate for Payer: PHP Commercial |
$142.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.40
|
| Rate for Payer: UHC Core |
$139.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.62
|
|
|
HC ETHYL GLUCURONIDE SCREEN W/REFLEX, URINE
|
Facility
|
OP
|
$130.99
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100749
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.09 |
| Max. Negotiated Rate |
$117.89 |
| Rate for Payer: Aetna Commercial |
$111.34
|
| Rate for Payer: Aetna Medicare |
$34.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.93
|
| Rate for Payer: BCBS Complete |
$24.25
|
| Rate for Payer: BCBS MAPPO |
$32.75
|
| Rate for Payer: BCBS Trust/PPO |
$107.69
|
| Rate for Payer: BCN Commercial |
$107.69
|
| Rate for Payer: BCN Medicare Advantage |
$32.75
|
| Rate for Payer: Cash Price |
$104.79
|
| Rate for Payer: Cofinity Commercial |
$112.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.75
|
| Rate for Payer: Healthscope Commercial |
$117.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.24
|
| Rate for Payer: Mclaren Medicaid |
$23.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.38
|
| Rate for Payer: Meridian Medicaid |
$24.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.34
|
| Rate for Payer: Nomi Health Commercial |
$107.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.24
|
| Rate for Payer: PACE Senior Care Partners |
$31.11
|
| Rate for Payer: PACE SWMI |
$32.75
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: PHP Medicare Advantage |
$32.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.96
|
| Rate for Payer: Priority Health Medicare |
$33.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.17
|
| Rate for Payer: Railroad Medicare Medicare |
$32.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.27
|
| Rate for Payer: UHC Core |
$109.38
|
| Rate for Payer: UHC Exchange |
$32.75
|
| Rate for Payer: UHC Medicaid |
$23.09
|
| Rate for Payer: UHC Medicare Advantage |
$32.75
|
| Rate for Payer: UHCCP Medicaid |
$23.09
|
| Rate for Payer: VA VA |
$32.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.24
|
|
|
HC ETHYL GLUCURONIDE SCREEN W/REFLEX, URINE
|
Facility
|
IP
|
$130.99
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100749
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.17 |
| Max. Negotiated Rate |
$117.89 |
| Rate for Payer: Aetna Commercial |
$111.34
|
| Rate for Payer: BCBS Trust/PPO |
$108.18
|
| Rate for Payer: BCN Commercial |
$108.18
|
| Rate for Payer: Cash Price |
$104.79
|
| Rate for Payer: Cofinity Commercial |
$112.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.79
|
| Rate for Payer: Healthscope Commercial |
$117.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.34
|
| Rate for Payer: Nomi Health Commercial |
$107.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.24
|
| Rate for Payer: PHP Commercial |
$111.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.27
|
| Rate for Payer: UHC Core |
$109.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.24
|
|
|
HC ETONOGESTREL IMPLANT SYSTEM
|
Facility
|
OP
|
$1,577.34
|
|
|
Service Code
|
HCPCS J7307
|
| Hospital Charge Code |
63600148
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$278.09 |
| Max. Negotiated Rate |
$1,419.61 |
| Rate for Payer: Aetna Commercial |
$1,340.74
|
| Rate for Payer: Aetna Medicare |
$410.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.92
|
| Rate for Payer: BCBS Complete |
$291.97
|
| Rate for Payer: BCBS MAPPO |
$394.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.73
|
| Rate for Payer: BCN Commercial |
$1,296.73
|
| Rate for Payer: BCN Medicare Advantage |
$394.33
|
| Rate for Payer: Cash Price |
$1,261.87
|
| Rate for Payer: Cofinity Commercial |
$1,356.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.33
|
| Rate for Payer: Healthscope Commercial |
$1,419.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,183.01
|
| Rate for Payer: Mclaren Medicaid |
$278.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.05
|
| Rate for Payer: Meridian Medicaid |
$291.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$433.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.74
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,183.01
|
| Rate for Payer: PACE Senior Care Partners |
$374.62
|
| Rate for Payer: PACE SWMI |
$394.33
|
| Rate for Payer: PHP Commercial |
$1,340.74
|
| Rate for Payer: PHP Medicare Advantage |
$394.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,372.29
|
| Rate for Payer: Priority Health Medicare |
$398.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,097.83
|
| Rate for Payer: Railroad Medicare Medicare |
$394.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,388.06
|
| Rate for Payer: UHC Core |
$1,317.08
|
| Rate for Payer: UHC Exchange |
$394.33
|
| Rate for Payer: UHC Medicaid |
$278.09
|
| Rate for Payer: UHC Medicare Advantage |
$394.33
|
| Rate for Payer: UHCCP Medicaid |
$278.09
|
| Rate for Payer: VA VA |
$394.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,183.01
|
|
|
HC ETONOGESTREL IMPLANT SYSTEM
|
Facility
|
IP
|
$1,577.34
|
|
|
Service Code
|
HCPCS J7307
|
| Hospital Charge Code |
63600148
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,097.83 |
| Max. Negotiated Rate |
$1,419.61 |
| Rate for Payer: Aetna Commercial |
$1,340.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,302.73
|
| Rate for Payer: BCN Commercial |
$1,302.73
|
| Rate for Payer: Cash Price |
$1,261.87
|
| Rate for Payer: Cofinity Commercial |
$1,356.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.87
|
| Rate for Payer: Healthscope Commercial |
$1,419.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,183.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.74
|
| Rate for Payer: Nomi Health Commercial |
$1,293.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,183.01
|
| Rate for Payer: PHP Commercial |
$1,340.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,372.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,097.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,388.06
|
| Rate for Payer: UHC Core |
$1,317.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,183.01
|
|
|
HC EUFLEXXA INJ PER DOSE
|
Facility
|
IP
|
$307.01
|
|
|
Service Code
|
HCPCS J7323
|
| Hospital Charge Code |
63600145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$213.68 |
| Max. Negotiated Rate |
$276.31 |
| Rate for Payer: Aetna Commercial |
$260.96
|
| Rate for Payer: BCBS Trust/PPO |
$253.56
|
| Rate for Payer: BCN Commercial |
$253.56
|
| Rate for Payer: Cash Price |
$245.61
|
| Rate for Payer: Cofinity Commercial |
$264.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.61
|
| Rate for Payer: Healthscope Commercial |
$276.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.96
|
| Rate for Payer: Nomi Health Commercial |
$251.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.26
|
| Rate for Payer: PHP Commercial |
$260.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.17
|
| Rate for Payer: UHC Core |
$256.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.26
|
|
|
HC EUFLEXXA INJ PER DOSE
|
Facility
|
OP
|
$307.01
|
|
|
Service Code
|
HCPCS J7323
|
| Hospital Charge Code |
63600145
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.13 |
| Max. Negotiated Rate |
$276.31 |
| Rate for Payer: Aetna Commercial |
$260.96
|
| Rate for Payer: Aetna Medicare |
$79.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.94
|
| Rate for Payer: BCBS Complete |
$56.83
|
| Rate for Payer: BCBS MAPPO |
$76.75
|
| Rate for Payer: BCBS Trust/PPO |
$252.39
|
| Rate for Payer: BCN Commercial |
$252.39
|
| Rate for Payer: BCN Medicare Advantage |
$76.75
|
| Rate for Payer: Cash Price |
$245.61
|
| Rate for Payer: Cofinity Commercial |
$264.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.75
|
| Rate for Payer: Healthscope Commercial |
$276.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.26
|
| Rate for Payer: Mclaren Medicaid |
$54.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.59
|
| Rate for Payer: Meridian Medicaid |
$56.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.96
|
| Rate for Payer: Nomi Health Commercial |
$251.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.26
|
| Rate for Payer: PACE Senior Care Partners |
$72.91
|
| Rate for Payer: PACE SWMI |
$76.75
|
| Rate for Payer: PHP Commercial |
$260.96
|
| Rate for Payer: PHP Medicare Advantage |
$76.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.10
|
| Rate for Payer: Priority Health Medicare |
$77.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.68
|
| Rate for Payer: Railroad Medicare Medicare |
$76.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.17
|
| Rate for Payer: UHC Core |
$256.35
|
| Rate for Payer: UHC Exchange |
$76.75
|
| Rate for Payer: UHC Medicaid |
$54.13
|
| Rate for Payer: UHC Medicare Advantage |
$76.75
|
| Rate for Payer: UHCCP Medicaid |
$54.13
|
| Rate for Payer: VA VA |
$76.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.26
|
|
|
HC EVACUATION SUBUNGUAL HEMATOMA
|
Facility
|
IP
|
$94.03
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
76100113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.44 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Aetna Commercial |
$79.93
|
| Rate for Payer: BCBS Trust/PPO |
$77.66
|
| Rate for Payer: BCN Commercial |
$77.66
|
| Rate for Payer: Cash Price |
$75.22
|
| Rate for Payer: Cofinity Commercial |
$80.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.22
|
| Rate for Payer: Healthscope Commercial |
$84.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.93
|
| Rate for Payer: Nomi Health Commercial |
$77.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.52
|
| Rate for Payer: PHP Commercial |
$79.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.75
|
| Rate for Payer: UHC Core |
$78.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.52
|
|
|
HC EVACUATION SUBUNGUAL HEMATOMA
|
Facility
|
OP
|
$94.03
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
76100113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Aetna Commercial |
$79.93
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.38
|
| Rate for Payer: BCBS Complete |
$17.40
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$77.30
|
| Rate for Payer: BCN Commercial |
$77.30
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$75.22
|
| Rate for Payer: Cofinity Commercial |
$80.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$84.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.52
|
| Rate for Payer: Mclaren Medicaid |
$16.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.68
|
| Rate for Payer: Meridian Medicaid |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.93
|
| Rate for Payer: Nomi Health Commercial |
$77.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.52
|
| Rate for Payer: PACE Senior Care Partners |
$22.33
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$79.93
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.81
|
| Rate for Payer: Priority Health Medicare |
$23.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.44
|
| Rate for Payer: Railroad Medicare Medicare |
$23.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.75
|
| Rate for Payer: UHC Core |
$78.52
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicaid |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$16.58
|
| Rate for Payer: VA VA |
$23.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.52
|
|
|
HC EVAL APHASIA PER HR
|
Facility
|
IP
|
$266.96
|
|
|
Service Code
|
CPT 96105
|
| Hospital Charge Code |
44400013
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$185.80 |
| Max. Negotiated Rate |
$240.26 |
| Rate for Payer: Aetna Commercial |
$226.92
|
| Rate for Payer: BCBS Trust/PPO |
$220.48
|
| Rate for Payer: BCN Commercial |
$220.48
|
| Rate for Payer: Cash Price |
$213.57
|
| Rate for Payer: Cofinity Commercial |
$229.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.57
|
| Rate for Payer: Healthscope Commercial |
$240.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.92
|
| Rate for Payer: Nomi Health Commercial |
$218.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.22
|
| Rate for Payer: PHP Commercial |
$226.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.92
|
| Rate for Payer: UHC Core |
$222.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.22
|
|
|
HC EVAL APHASIA PER HR
|
Facility
|
OP
|
$266.96
|
|
|
Service Code
|
CPT 96105
|
| Hospital Charge Code |
44400013
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$240.26 |
| Rate for Payer: Aetna Commercial |
$226.92
|
| Rate for Payer: Aetna Medicare |
$69.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.42
|
| Rate for Payer: BCBS Complete |
$49.41
|
| Rate for Payer: BCBS MAPPO |
$66.74
|
| Rate for Payer: BCBS Trust/PPO |
$219.47
|
| Rate for Payer: BCN Commercial |
$219.47
|
| Rate for Payer: BCN Medicare Advantage |
$66.74
|
| Rate for Payer: Cash Price |
$213.57
|
| Rate for Payer: Cofinity Commercial |
$229.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.74
|
| Rate for Payer: Healthscope Commercial |
$240.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.22
|
| Rate for Payer: Mclaren Medicaid |
$47.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.08
|
| Rate for Payer: Meridian Medicaid |
$49.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.92
|
| Rate for Payer: Nomi Health Commercial |
$218.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.22
|
| Rate for Payer: PACE Senior Care Partners |
$63.40
|
| Rate for Payer: PACE SWMI |
$66.74
|
| Rate for Payer: PHP Commercial |
$226.92
|
| Rate for Payer: PHP Medicare Advantage |
$66.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.26
|
| Rate for Payer: Priority Health Medicare |
$67.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.80
|
| Rate for Payer: Railroad Medicare Medicare |
$66.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.92
|
| Rate for Payer: UHC Core |
$222.91
|
| Rate for Payer: UHC Exchange |
$66.74
|
| Rate for Payer: UHC Medicaid |
$47.07
|
| Rate for Payer: UHC Medicare Advantage |
$66.74
|
| Rate for Payer: UHCCP Medicaid |
$47.07
|
| Rate for Payer: VA VA |
$66.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.22
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92626
|
| Hospital Charge Code |
47100017
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$78.76 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna Medicare |
$116.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.61
|
| Rate for Payer: BCBS Complete |
$82.70
|
| Rate for Payer: BCBS MAPPO |
$111.69
|
| Rate for Payer: BCBS Trust/PPO |
$367.28
|
| Rate for Payer: BCN Commercial |
$367.28
|
| Rate for Payer: BCN Medicare Advantage |
$111.69
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.69
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Mclaren Medicaid |
$78.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.27
|
| Rate for Payer: Meridian Medicaid |
$82.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$366.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Senior Care Partners |
$106.11
|
| Rate for Payer: PACE SWMI |
$111.69
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: PHP Medicare Advantage |
$111.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.68
|
| Rate for Payer: Priority Health Medicare |
$112.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.94
|
| Rate for Payer: Railroad Medicare Medicare |
$111.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.15
|
| Rate for Payer: UHC Core |
$373.04
|
| Rate for Payer: UHC Exchange |
$111.69
|
| Rate for Payer: UHC Medicaid |
$78.76
|
| Rate for Payer: UHC Medicare Advantage |
$111.69
|
| Rate for Payer: UHCCP Medicaid |
$78.76
|
| Rate for Payer: VA VA |
$111.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92626
|
| Hospital Charge Code |
47100017
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$310.94 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: BCBS Trust/PPO |
$368.98
|
| Rate for Payer: BCN Commercial |
$368.98
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$366.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.15
|
| Rate for Payer: UHC Core |
$373.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 92627
|
| Hospital Charge Code |
47100018
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$14.16
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$62.89
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$13.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$14.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.24
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicaid |
$13.49
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$13.49
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 92627
|
| Hospital Charge Code |
47100018
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$53.24 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$63.18
|
| Rate for Payer: BCN Commercial |
$63.18
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$28.24 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: BCBS Trust/PPO |
$33.52
|
| Rate for Payer: BCN Commercial |
$33.52
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare |
$10.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.68
|
| Rate for Payer: BCBS Complete |
$7.51
|
| Rate for Payer: BCBS MAPPO |
$10.14
|
| Rate for Payer: BCBS Trust/PPO |
$33.36
|
| Rate for Payer: BCN Commercial |
$33.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.14
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.14
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: Mclaren Medicaid |
$7.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.65
|
| Rate for Payer: Meridian Medicaid |
$7.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PACE Senior Care Partners |
$9.64
|
| Rate for Payer: PACE SWMI |
$10.14
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: PHP Medicare Advantage |
$10.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: Railroad Medicare Medicare |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: UHC Exchange |
$10.14
|
| Rate for Payer: UHC Medicaid |
$7.15
|
| Rate for Payer: UHC Medicare Advantage |
$10.14
|
| Rate for Payer: UHCCP Medicaid |
$7.15
|
| Rate for Payer: VA VA |
$10.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
OP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$20.98 |
| Max. Negotiated Rate |
$107.12 |
| Rate for Payer: Aetna Commercial |
$101.17
|
| Rate for Payer: Aetna Medicare |
$30.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.19
|
| Rate for Payer: BCBS Complete |
$22.03
|
| Rate for Payer: BCBS MAPPO |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$97.85
|
| Rate for Payer: BCN Commercial |
$97.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.75
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Commercial |
$102.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.75
|
| Rate for Payer: Healthscope Commercial |
$107.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.27
|
| Rate for Payer: Mclaren Medicaid |
$20.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.24
|
| Rate for Payer: Meridian Medicaid |
$22.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: PACE Senior Care Partners |
$28.27
|
| Rate for Payer: PACE SWMI |
$29.75
|
| Rate for Payer: PHP Commercial |
$101.17
|
| Rate for Payer: PHP Medicare Advantage |
$29.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.55
|
| Rate for Payer: Priority Health Medicare |
$30.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.84
|
| Rate for Payer: Railroad Medicare Medicare |
$29.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.74
|
| Rate for Payer: UHC Core |
$99.38
|
| Rate for Payer: UHC Exchange |
$29.75
|
| Rate for Payer: UHC Medicaid |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$29.75
|
| Rate for Payer: UHCCP Medicaid |
$20.98
|
| Rate for Payer: VA VA |
$29.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.27
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
IP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$107.12 |
| Rate for Payer: Aetna Commercial |
$101.17
|
| Rate for Payer: BCBS Trust/PPO |
$98.30
|
| Rate for Payer: BCN Commercial |
$98.30
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Commercial |
$102.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$107.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: PHP Commercial |
$101.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.74
|
| Rate for Payer: UHC Core |
$99.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.27
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
OP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$278.12 |
| Rate for Payer: Aetna Commercial |
$262.67
|
| Rate for Payer: Aetna Medicare |
$80.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.57
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS MAPPO |
$77.25
|
| Rate for Payer: BCBS Trust/PPO |
$254.05
|
| Rate for Payer: BCN Commercial |
$254.05
|
| Rate for Payer: BCN Medicare Advantage |
$77.25
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Commercial |
$265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.25
|
| Rate for Payer: Healthscope Commercial |
$278.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.76
|
| Rate for Payer: Mclaren Medicaid |
$54.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.12
|
| Rate for Payer: Meridian Medicaid |
$57.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$253.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: PACE Senior Care Partners |
$73.39
|
| Rate for Payer: PACE SWMI |
$77.25
|
| Rate for Payer: PHP Commercial |
$262.67
|
| Rate for Payer: PHP Medicare Advantage |
$77.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$268.85
|
| Rate for Payer: Priority Health Medicare |
$78.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.08
|
| Rate for Payer: Railroad Medicare Medicare |
$77.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.94
|
| Rate for Payer: UHC Core |
$258.03
|
| Rate for Payer: UHC Exchange |
$77.25
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHC Medicare Advantage |
$77.25
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: VA VA |
$77.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.76
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
IP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$215.08 |
| Max. Negotiated Rate |
$278.12 |
| Rate for Payer: Aetna Commercial |
$262.67
|
| Rate for Payer: BCBS Trust/PPO |
$255.22
|
| Rate for Payer: BCN Commercial |
$255.22
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Commercial |
$265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Healthscope Commercial |
$278.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$253.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: PHP Commercial |
$262.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$268.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.94
|
| Rate for Payer: UHC Core |
$258.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.76
|
|
