|
HC EAKIN SEAL 2"
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$11.29 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: Aetna Medicare |
$3.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.92
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$3.14
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$9.75
|
| Rate for Payer: BCN Medicare Advantage |
$3.14
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$10.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.14
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$10.28
|
| Rate for Payer: PACE Senior Care Partners |
$2.98
|
| Rate for Payer: PACE SWMI |
$3.14
|
| Rate for Payer: PHP Commercial |
$10.66
|
| Rate for Payer: PHP Medicare Advantage |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO |
$10.91
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.04
|
| Rate for Payer: UHC Core |
$10.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.14
|
| Rate for Payer: UHC Exchange |
$3.14
|
| Rate for Payer: UHC Medicare Advantage |
$3.14
|
| Rate for Payer: VA VA |
$3.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.40
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$29.68
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$24.23
|
| Rate for Payer: BCN Commercial |
$22.94
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cofinity Commercial |
$25.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.74
|
| Rate for Payer: Healthscope Commercial |
$26.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.23
|
| Rate for Payer: Nomi Health Commercial |
$24.34
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.29
|
| Rate for Payer: Priority Health HMO/PPO |
$25.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.12
|
| Rate for Payer: UHC Core |
$24.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.26
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
OP
|
$29.68
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$13.77
|
| Rate for Payer: BCBS MAPPO |
$7.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.40
|
| Rate for Payer: BCN Commercial |
$23.08
|
| Rate for Payer: BCN Medicare Advantage |
$7.42
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cofinity Commercial |
$25.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.42
|
| Rate for Payer: Healthscope Commercial |
$26.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.26
|
| Rate for Payer: Mclaren Medicaid |
$13.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.79
|
| Rate for Payer: Meridian Medicaid |
$13.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.23
|
| Rate for Payer: Nomi Health Commercial |
$24.34
|
| Rate for Payer: PACE Senior Care Partners |
$7.05
|
| Rate for Payer: PACE SWMI |
$7.42
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicare Advantage |
$7.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.29
|
| Rate for Payer: Priority Health HMO/PPO |
$25.82
|
| Rate for Payer: Priority Health Medicare |
$7.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.89
|
| Rate for Payer: Railroad Medicare Medicare |
$7.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.12
|
| Rate for Payer: UHC Core |
$24.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.42
|
| Rate for Payer: UHC Exchange |
$7.42
|
| Rate for Payer: UHC Medicare Advantage |
$7.42
|
| Rate for Payer: UHCCP Medicaid |
$13.12
|
| Rate for Payer: VA VA |
$7.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.26
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$37.02
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$33.32 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare |
$9.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.57
|
| Rate for Payer: BCBS Complete |
$11.61
|
| Rate for Payer: BCBS MAPPO |
$9.26
|
| Rate for Payer: BCBS Trust/PPO |
$30.43
|
| Rate for Payer: BCN Commercial |
$28.78
|
| Rate for Payer: BCN Medicare Advantage |
$9.26
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$31.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.26
|
| Rate for Payer: Healthscope Commercial |
$33.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.76
|
| Rate for Payer: Mclaren Medicaid |
$11.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.72
|
| Rate for Payer: Meridian Medicaid |
$11.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.47
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: PACE Senior Care Partners |
$8.79
|
| Rate for Payer: PACE SWMI |
$9.26
|
| Rate for Payer: PHP Commercial |
$31.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.06
|
| Rate for Payer: Priority Health HMO/PPO |
$32.21
|
| Rate for Payer: Priority Health Medicare |
$9.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.80
|
| Rate for Payer: Railroad Medicare Medicare |
$9.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.58
|
| Rate for Payer: UHC Core |
$30.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.26
|
| Rate for Payer: UHC Exchange |
$9.26
|
| Rate for Payer: UHC Medicare Advantage |
$9.26
|
| Rate for Payer: UHCCP Medicaid |
$11.05
|
| Rate for Payer: VA VA |
$9.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.76
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
IP
|
$37.02
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$33.32 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$30.22
|
| Rate for Payer: BCN Commercial |
$28.61
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$31.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.62
|
| Rate for Payer: Healthscope Commercial |
$33.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.47
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: PHP Commercial |
$31.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.06
|
| Rate for Payer: Priority Health HMO/PPO |
$32.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.58
|
| Rate for Payer: UHC Core |
$30.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.76
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.70
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$30.79
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: BCN Medicare Advantage |
$9.36
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.83
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Senior Care Partners |
$8.89
|
| Rate for Payer: PACE SWMI |
$9.36
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: Railroad Medicare Medicare |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.36
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$9.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.57
|
| Rate for Payer: BCN Commercial |
$28.94
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
OP
|
$2,008.38
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$388.40 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna Medicare |
$522.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$627.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$627.62
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$502.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.09
|
| Rate for Payer: BCN Commercial |
$1,561.52
|
| Rate for Payer: BCN Medicare Advantage |
$502.10
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.10
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.28
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.20
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$577.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: Nomi Health Commercial |
$1,646.87
|
| Rate for Payer: PACE Senior Care Partners |
$476.99
|
| Rate for Payer: PACE SWMI |
$502.10
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: PHP Medicare Advantage |
$502.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,747.29
|
| Rate for Payer: Priority Health Medicare |
$507.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,345.61
|
| Rate for Payer: Railroad Medicare Medicare |
$502.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,767.37
|
| Rate for Payer: UHC Core |
$1,677.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.10
|
| Rate for Payer: UHC Exchange |
$502.10
|
| Rate for Payer: UHC Medicare Advantage |
$502.10
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$502.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.28
|
|
|
HC ECHO, 2D, DOPPLER, COLOR FLOW
|
Facility
|
IP
|
$2,008.38
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
48300001
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,305.45 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.44
|
| Rate for Payer: BCN Commercial |
$1,552.08
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: Nomi Health Commercial |
$1,646.87
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,747.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,345.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,767.37
|
| Rate for Payer: UHC Core |
$1,677.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.28
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
OP
|
$2,008.38
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$476.99 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: Aetna Medicare |
$522.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$627.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$627.62
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$502.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.09
|
| Rate for Payer: BCN Commercial |
$1,561.52
|
| Rate for Payer: BCN Medicare Advantage |
$502.10
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.10
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.28
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.20
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$577.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: Nomi Health Commercial |
$1,646.87
|
| Rate for Payer: PACE Senior Care Partners |
$476.99
|
| Rate for Payer: PACE SWMI |
$502.10
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: PHP Medicare Advantage |
$502.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,747.29
|
| Rate for Payer: Priority Health Medicare |
$507.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,345.61
|
| Rate for Payer: Railroad Medicare Medicare |
$502.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,767.37
|
| Rate for Payer: UHC Core |
$1,677.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.10
|
| Rate for Payer: UHC Exchange |
$502.10
|
| Rate for Payer: UHC Medicare Advantage |
$502.10
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$502.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.28
|
|
|
HC ECHO COMPLETE W/DEFINITY
|
Facility
|
IP
|
$2,008.38
|
|
|
Service Code
|
HCPCS C8929
|
| Hospital Charge Code |
48300003
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$1,305.45 |
| Max. Negotiated Rate |
$1,807.54 |
| Rate for Payer: Aetna Commercial |
$1,707.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,639.44
|
| Rate for Payer: BCN Commercial |
$1,552.08
|
| Rate for Payer: Cash Price |
$1,606.70
|
| Rate for Payer: Cofinity Commercial |
$1,727.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,606.70
|
| Rate for Payer: Healthscope Commercial |
$1,807.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,506.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,707.12
|
| Rate for Payer: Nomi Health Commercial |
$1,646.87
|
| Rate for Payer: PHP Commercial |
$1,707.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,305.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,747.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,345.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,767.37
|
| Rate for Payer: UHC Core |
$1,677.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,506.28
|
|
|
HC ECHO CONGENITAL
|
Facility
|
IP
|
$1,638.94
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,065.31 |
| Max. Negotiated Rate |
$1,475.05 |
| Rate for Payer: Aetna Commercial |
$1,393.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.87
|
| Rate for Payer: BCN Commercial |
$1,266.57
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cofinity Commercial |
$1,409.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.15
|
| Rate for Payer: Healthscope Commercial |
$1,475.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.10
|
| Rate for Payer: Nomi Health Commercial |
$1,343.93
|
| Rate for Payer: PHP Commercial |
$1,393.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.31
|
| Rate for Payer: Priority Health HMO/PPO |
$1,425.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,098.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,442.27
|
| Rate for Payer: UHC Core |
$1,368.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.20
|
|
|
HC ECHO CONGENITAL
|
Facility
|
OP
|
$1,638.94
|
|
|
Service Code
|
CPT 93303
|
| Hospital Charge Code |
48000004
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$388.40 |
| Max. Negotiated Rate |
$1,475.05 |
| Rate for Payer: Aetna Commercial |
$1,393.10
|
| Rate for Payer: Aetna Medicare |
$426.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$512.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$512.17
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$409.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.37
|
| Rate for Payer: BCN Commercial |
$1,274.28
|
| Rate for Payer: BCN Medicare Advantage |
$409.74
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cash Price |
$1,311.15
|
| Rate for Payer: Cofinity Commercial |
$1,409.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.74
|
| Rate for Payer: Healthscope Commercial |
$1,475.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.20
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.22
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$471.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.10
|
| Rate for Payer: Nomi Health Commercial |
$1,343.93
|
| Rate for Payer: PACE Senior Care Partners |
$389.25
|
| Rate for Payer: PACE SWMI |
$409.74
|
| Rate for Payer: PHP Commercial |
$1,393.10
|
| Rate for Payer: PHP Medicare Advantage |
$409.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.31
|
| Rate for Payer: Priority Health HMO/PPO |
$1,425.88
|
| Rate for Payer: Priority Health Medicare |
$413.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,098.09
|
| Rate for Payer: Railroad Medicare Medicare |
$409.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,442.27
|
| Rate for Payer: UHC Core |
$1,368.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$409.74
|
| Rate for Payer: UHC Exchange |
$409.74
|
| Rate for Payer: UHC Medicare Advantage |
$409.74
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$409.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.20
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
OP
|
$1,144.66
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$271.86 |
| Max. Negotiated Rate |
$1,030.19 |
| Rate for Payer: Aetna Commercial |
$972.96
|
| Rate for Payer: Aetna Medicare |
$297.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.71
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$286.16
|
| Rate for Payer: BCBS Trust/PPO |
$941.02
|
| Rate for Payer: BCN Commercial |
$889.97
|
| Rate for Payer: BCN Medicare Advantage |
$286.16
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cofinity Commercial |
$984.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.16
|
| Rate for Payer: Healthscope Commercial |
$1,030.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.50
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.47
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.96
|
| Rate for Payer: Nomi Health Commercial |
$938.62
|
| Rate for Payer: PACE Senior Care Partners |
$271.86
|
| Rate for Payer: PACE SWMI |
$286.16
|
| Rate for Payer: PHP Commercial |
$972.96
|
| Rate for Payer: PHP Medicare Advantage |
$286.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.03
|
| Rate for Payer: Priority Health HMO/PPO |
$995.85
|
| Rate for Payer: Priority Health Medicare |
$289.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.92
|
| Rate for Payer: Railroad Medicare Medicare |
$286.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.30
|
| Rate for Payer: UHC Core |
$955.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$286.16
|
| Rate for Payer: UHC Exchange |
$286.16
|
| Rate for Payer: UHC Medicare Advantage |
$286.16
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$286.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.50
|
|
|
HC ECHO CONGENITAL LMTD
|
Facility
|
IP
|
$1,144.66
|
|
|
Service Code
|
CPT 93304
|
| Hospital Charge Code |
48000005
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$744.03 |
| Max. Negotiated Rate |
$1,030.19 |
| Rate for Payer: Aetna Commercial |
$972.96
|
| Rate for Payer: BCBS Trust/PPO |
$934.39
|
| Rate for Payer: BCN Commercial |
$884.59
|
| Rate for Payer: Cash Price |
$915.73
|
| Rate for Payer: Cofinity Commercial |
$984.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.73
|
| Rate for Payer: Healthscope Commercial |
$1,030.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.96
|
| Rate for Payer: Nomi Health Commercial |
$938.62
|
| Rate for Payer: PHP Commercial |
$972.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.03
|
| Rate for Payer: Priority Health HMO/PPO |
$995.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$766.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.30
|
| Rate for Payer: UHC Core |
$955.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.50
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
OP
|
$966.85
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$229.63 |
| Max. Negotiated Rate |
$870.16 |
| Rate for Payer: Aetna Commercial |
$821.82
|
| Rate for Payer: Aetna Medicare |
$251.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.14
|
| Rate for Payer: BCBS Complete |
$407.85
|
| Rate for Payer: BCBS MAPPO |
$241.71
|
| Rate for Payer: BCBS Trust/PPO |
$794.85
|
| Rate for Payer: BCN Commercial |
$751.73
|
| Rate for Payer: BCN Medicare Advantage |
$241.71
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cofinity Commercial |
$831.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.71
|
| Rate for Payer: Healthscope Commercial |
$870.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.14
|
| Rate for Payer: Mclaren Medicaid |
$388.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.80
|
| Rate for Payer: Meridian Medicaid |
$407.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.82
|
| Rate for Payer: Nomi Health Commercial |
$792.82
|
| Rate for Payer: PACE Senior Care Partners |
$229.63
|
| Rate for Payer: PACE SWMI |
$241.71
|
| Rate for Payer: PHP Commercial |
$821.82
|
| Rate for Payer: PHP Medicare Advantage |
$241.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$388.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.45
|
| Rate for Payer: Priority Health HMO/PPO |
$841.16
|
| Rate for Payer: Priority Health Medicare |
$244.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$647.79
|
| Rate for Payer: Railroad Medicare Medicare |
$241.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.83
|
| Rate for Payer: UHC Core |
$807.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.71
|
| Rate for Payer: UHC Exchange |
$241.71
|
| Rate for Payer: UHC Medicare Advantage |
$241.71
|
| Rate for Payer: UHCCP Medicaid |
$388.40
|
| Rate for Payer: VA VA |
$241.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.14
|
|
|
HC ECHO FETAL COMPLETE
|
Facility
|
IP
|
$966.85
|
|
|
Service Code
|
CPT 76825
|
| Hospital Charge Code |
40200030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$628.45 |
| Max. Negotiated Rate |
$870.16 |
| Rate for Payer: Aetna Commercial |
$821.82
|
| Rate for Payer: BCBS Trust/PPO |
$789.24
|
| Rate for Payer: BCN Commercial |
$747.18
|
| Rate for Payer: Cash Price |
$773.48
|
| Rate for Payer: Cofinity Commercial |
$831.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.48
|
| Rate for Payer: Healthscope Commercial |
$870.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.82
|
| Rate for Payer: Nomi Health Commercial |
$792.82
|
| Rate for Payer: PHP Commercial |
$821.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.45
|
| Rate for Payer: Priority Health HMO/PPO |
$841.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$647.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.83
|
| Rate for Payer: UHC Core |
$807.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.14
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
IP
|
$736.60
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$478.79 |
| Max. Negotiated Rate |
$662.94 |
| Rate for Payer: Aetna Commercial |
$626.11
|
| Rate for Payer: BCBS Trust/PPO |
$601.29
|
| Rate for Payer: BCN Commercial |
$569.24
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cofinity Commercial |
$633.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.28
|
| Rate for Payer: Healthscope Commercial |
$662.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.11
|
| Rate for Payer: Nomi Health Commercial |
$604.01
|
| Rate for Payer: PHP Commercial |
$626.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.79
|
| Rate for Payer: Priority Health HMO/PPO |
$640.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.21
|
| Rate for Payer: UHC Core |
$615.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.45
|
|
|
HC ECHO FETAL FOLLOWUP/REPEAT
|
Facility
|
OP
|
$736.60
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200077
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$662.94 |
| Rate for Payer: Aetna Commercial |
$626.11
|
| Rate for Payer: Aetna Medicare |
$191.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.19
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$184.15
|
| Rate for Payer: BCBS Trust/PPO |
$605.56
|
| Rate for Payer: BCN Commercial |
$572.71
|
| Rate for Payer: BCN Medicare Advantage |
$184.15
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cash Price |
$589.28
|
| Rate for Payer: Cofinity Commercial |
$633.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.15
|
| Rate for Payer: Healthscope Commercial |
$662.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$552.45
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.36
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.11
|
| Rate for Payer: Nomi Health Commercial |
$604.01
|
| Rate for Payer: PACE Senior Care Partners |
$174.94
|
| Rate for Payer: PACE SWMI |
$184.15
|
| Rate for Payer: PHP Commercial |
$626.11
|
| Rate for Payer: PHP Medicare Advantage |
$184.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.79
|
| Rate for Payer: Priority Health HMO/PPO |
$640.84
|
| Rate for Payer: Priority Health Medicare |
$185.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.52
|
| Rate for Payer: Railroad Medicare Medicare |
$184.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$648.21
|
| Rate for Payer: UHC Core |
$615.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.15
|
| Rate for Payer: UHC Exchange |
$184.15
|
| Rate for Payer: UHC Medicare Advantage |
$184.15
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$184.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$552.45
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
IP
|
$425.52
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$276.59 |
| Max. Negotiated Rate |
$382.97 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: BCBS Trust/PPO |
$347.35
|
| Rate for Payer: BCN Commercial |
$328.84
|
| Rate for Payer: Cash Price |
$340.42
|
| Rate for Payer: Cofinity Commercial |
$365.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.42
|
| Rate for Payer: Healthscope Commercial |
$382.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.69
|
| Rate for Payer: Nomi Health Commercial |
$348.93
|
| Rate for Payer: PHP Commercial |
$361.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.59
|
| Rate for Payer: Priority Health HMO/PPO |
$370.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$285.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.46
|
| Rate for Payer: UHC Core |
$355.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.14
|
|
|
HC ECHO FETAL FOLLOW UP SPECTRAL
|
Facility
|
OP
|
$425.52
|
|
|
Service Code
|
CPT 76828
|
| Hospital Charge Code |
40200079
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$382.97 |
| Rate for Payer: Aetna Commercial |
$361.69
|
| Rate for Payer: Aetna Medicare |
$110.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.98
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$106.38
|
| Rate for Payer: BCBS Trust/PPO |
$349.82
|
| Rate for Payer: BCN Commercial |
$330.84
|
| Rate for Payer: BCN Medicare Advantage |
$106.38
|
| Rate for Payer: Cash Price |
$340.42
|
| Rate for Payer: Cash Price |
$340.42
|
| Rate for Payer: Cofinity Commercial |
$365.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.38
|
| Rate for Payer: Healthscope Commercial |
$382.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.14
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.70
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.69
|
| Rate for Payer: Nomi Health Commercial |
$348.93
|
| Rate for Payer: PACE Senior Care Partners |
$101.06
|
| Rate for Payer: PACE SWMI |
$106.38
|
| Rate for Payer: PHP Commercial |
$361.69
|
| Rate for Payer: PHP Medicare Advantage |
$106.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.59
|
| Rate for Payer: Priority Health HMO/PPO |
$370.20
|
| Rate for Payer: Priority Health Medicare |
$107.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$285.10
|
| Rate for Payer: Railroad Medicare Medicare |
$106.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.46
|
| Rate for Payer: UHC Core |
$355.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.38
|
| Rate for Payer: UHC Exchange |
$106.38
|
| Rate for Payer: UHC Medicare Advantage |
$106.38
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$106.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.14
|
|
|
HC ECHO FETAL SPECTRAL
|
Facility
|
OP
|
$701.23
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
40200078
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$631.11 |
| Rate for Payer: Aetna Commercial |
$596.05
|
| Rate for Payer: Aetna Medicare |
$182.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.13
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$175.31
|
| Rate for Payer: BCBS Trust/PPO |
$576.48
|
| Rate for Payer: BCN Commercial |
$545.21
|
| Rate for Payer: BCN Medicare Advantage |
$175.31
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cofinity Commercial |
$603.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.31
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.92
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.07
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.05
|
| Rate for Payer: Nomi Health Commercial |
$575.01
|
| Rate for Payer: PACE Senior Care Partners |
$166.54
|
| Rate for Payer: PACE SWMI |
$175.31
|
| Rate for Payer: PHP Commercial |
$596.05
|
| Rate for Payer: PHP Medicare Advantage |
$175.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.80
|
| Rate for Payer: Priority Health HMO/PPO |
$610.07
|
| Rate for Payer: Priority Health Medicare |
$177.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.82
|
| Rate for Payer: Railroad Medicare Medicare |
$175.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.08
|
| Rate for Payer: UHC Core |
$585.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.31
|
| Rate for Payer: UHC Exchange |
$175.31
|
| Rate for Payer: UHC Medicare Advantage |
$175.31
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$175.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.92
|
|
|
HC ECHO FETAL SPECTRAL
|
Facility
|
IP
|
$701.23
|
|
|
Service Code
|
CPT 76827
|
| Hospital Charge Code |
40200078
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$455.80 |
| Max. Negotiated Rate |
$631.11 |
| Rate for Payer: Aetna Commercial |
$596.05
|
| Rate for Payer: BCBS Trust/PPO |
$572.41
|
| Rate for Payer: BCN Commercial |
$541.91
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cofinity Commercial |
$603.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.98
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.05
|
| Rate for Payer: Nomi Health Commercial |
$575.01
|
| Rate for Payer: PHP Commercial |
$596.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.80
|
| Rate for Payer: Priority Health HMO/PPO |
$610.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.08
|
| Rate for Payer: UHC Core |
$585.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.92
|
|
