|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
OP
|
$43.20
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$33.59
|
| Rate for Payer: BCN Commercial |
$33.59
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.40
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PACE Senior Care Partners |
$10.26
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.58
|
| Rate for Payer: Priority Health Medicare |
$10.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.35
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Core |
$36.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
| Rate for Payer: VA VA |
$10.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.40
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$43.20
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$33.38
|
| Rate for Payer: BCN Commercial |
$33.38
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Core |
$36.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.40
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
OP
|
$942.69
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$223.89 |
| Max. Negotiated Rate |
$848.42 |
| Rate for Payer: Aetna Commercial |
$801.29
|
| Rate for Payer: Aetna Medicare |
$245.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.59
|
| Rate for Payer: BCBS Complete |
$377.08
|
| Rate for Payer: BCBS MAPPO |
$235.67
|
| Rate for Payer: BCBS Trust/PPO |
$732.94
|
| Rate for Payer: BCN Commercial |
$732.94
|
| Rate for Payer: BCN Medicare Advantage |
$235.67
|
| Rate for Payer: Cash Price |
$754.15
|
| Rate for Payer: Cofinity Commercial |
$810.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.67
|
| Rate for Payer: Healthscope Commercial |
$848.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$247.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$801.29
|
| Rate for Payer: PACE Senior Care Partners |
$223.89
|
| Rate for Payer: PACE SWMI |
$235.67
|
| Rate for Payer: PHP Commercial |
$801.29
|
| Rate for Payer: PHP Medicare Advantage |
$235.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$820.14
|
| Rate for Payer: Priority Health Medicare |
$235.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.95
|
| Rate for Payer: Railroad Medicare Medicare |
$235.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.57
|
| Rate for Payer: UHC Core |
$787.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.67
|
| Rate for Payer: UHC Medicare Advantage |
$242.74
|
| Rate for Payer: VA VA |
$235.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.02
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
IP
|
$942.69
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$574.95 |
| Max. Negotiated Rate |
$848.42 |
| Rate for Payer: Aetna Commercial |
$801.29
|
| Rate for Payer: BCBS Trust/PPO |
$728.51
|
| Rate for Payer: BCN Commercial |
$728.51
|
| Rate for Payer: Cash Price |
$754.15
|
| Rate for Payer: Cofinity Commercial |
$810.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.15
|
| Rate for Payer: Healthscope Commercial |
$848.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$801.29
|
| Rate for Payer: PHP Commercial |
$801.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$659.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$820.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$574.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.57
|
| Rate for Payer: UHC Core |
$787.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.02
|
|
|
HC MAGGOT THERAPY
|
Facility
|
IP
|
$1,071.00
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$653.20 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: BCBS Trust/PPO |
$827.67
|
| Rate for Payer: BCN Commercial |
$827.67
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC MAGGOT THERAPY
|
Facility
|
OP
|
$1,071.00
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$254.36 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna Medicare |
$278.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.69
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS MAPPO |
$267.75
|
| Rate for Payer: BCBS Trust/PPO |
$832.70
|
| Rate for Payer: BCN Commercial |
$832.70
|
| Rate for Payer: BCN Medicare Advantage |
$267.75
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.75
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$281.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PACE Senior Care Partners |
$254.36
|
| Rate for Payer: PACE SWMI |
$267.75
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: PHP Medicare Advantage |
$267.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.77
|
| Rate for Payer: Priority Health Medicare |
$267.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.20
|
| Rate for Payer: Railroad Medicare Medicare |
$267.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$942.48
|
| Rate for Payer: UHC Core |
$894.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.75
|
| Rate for Payer: UHC Medicare Advantage |
$275.78
|
| Rate for Payer: VA VA |
$267.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$5.19
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.94
|
| Rate for Payer: Meridian Medicaid |
$5.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC MAKENA 10 MG
|
Facility
|
OP
|
$2.55
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna Commercial |
$2.17
|
| Rate for Payer: Aetna Medicare |
$0.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.80
|
| Rate for Payer: BCBS Complete |
$9.36
|
| Rate for Payer: BCBS MAPPO |
$0.64
|
| Rate for Payer: BCBS Trust/PPO |
$1.98
|
| Rate for Payer: BCN Commercial |
$1.98
|
| Rate for Payer: BCN Medicare Advantage |
$0.64
|
| Rate for Payer: Cash Price |
$2.04
|
| Rate for Payer: Cash Price |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.64
|
| Rate for Payer: Healthscope Commercial |
$2.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.91
|
| Rate for Payer: Mclaren Medicaid |
$8.92
|
| Rate for Payer: Meridian Medicaid |
$9.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.17
|
| Rate for Payer: PACE Senior Care Partners |
$0.61
|
| Rate for Payer: PACE SWMI |
$0.64
|
| Rate for Payer: PHP Commercial |
$2.17
|
| Rate for Payer: PHP Medicare Advantage |
$0.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.22
|
| Rate for Payer: Priority Health Medicare |
$0.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.56
|
| Rate for Payer: Railroad Medicare Medicare |
$0.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.24
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.64
|
| Rate for Payer: UHC Medicare Advantage |
$0.66
|
| Rate for Payer: VA VA |
$0.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.91
|
|
|
HC MAKENA 10 MG
|
Facility
|
IP
|
$2.55
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.30 |
| Rate for Payer: Aetna Commercial |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$1.97
|
| Rate for Payer: BCN Commercial |
$1.97
|
| Rate for Payer: Cash Price |
$2.04
|
| Rate for Payer: Cofinity Commercial |
$2.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.04
|
| Rate for Payer: Healthscope Commercial |
$2.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.24
|
| Rate for Payer: UHC Core |
$2.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.91
|
|
|
HC MALARIA SMEAR
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC MALARIA SMEAR
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
IP
|
$1,304.30
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$795.49 |
| Max. Negotiated Rate |
$1,173.87 |
| Rate for Payer: Aetna Commercial |
$1,108.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.96
|
| Rate for Payer: BCN Commercial |
$1,007.96
|
| Rate for Payer: Cash Price |
$1,043.44
|
| Rate for Payer: Cofinity Commercial |
$1,121.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,043.44
|
| Rate for Payer: Healthscope Commercial |
$1,173.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$978.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,108.66
|
| Rate for Payer: PHP Commercial |
$1,108.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$795.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,147.78
|
| Rate for Payer: UHC Core |
$1,089.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$978.22
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
OP
|
$1,304.30
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.77 |
| Max. Negotiated Rate |
$1,173.87 |
| Rate for Payer: Aetna Commercial |
$1,108.66
|
| Rate for Payer: Aetna Medicare |
$339.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$407.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$407.59
|
| Rate for Payer: BCBS Complete |
$521.72
|
| Rate for Payer: BCBS MAPPO |
$326.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.09
|
| Rate for Payer: BCN Commercial |
$1,014.09
|
| Rate for Payer: BCN Medicare Advantage |
$326.08
|
| Rate for Payer: Cash Price |
$1,043.44
|
| Rate for Payer: Cofinity Commercial |
$1,121.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,043.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.08
|
| Rate for Payer: Healthscope Commercial |
$1,173.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$978.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$342.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,108.66
|
| Rate for Payer: PACE Senior Care Partners |
$309.77
|
| Rate for Payer: PACE SWMI |
$326.08
|
| Rate for Payer: PHP Commercial |
$1,108.66
|
| Rate for Payer: PHP Medicare Advantage |
$326.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$913.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,134.74
|
| Rate for Payer: Priority Health Medicare |
$326.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$795.49
|
| Rate for Payer: Railroad Medicare Medicare |
$326.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,147.78
|
| Rate for Payer: UHC Core |
$1,089.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.08
|
| Rate for Payer: UHC Medicare Advantage |
$335.86
|
| Rate for Payer: VA VA |
$326.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$978.22
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
IP
|
$421.71
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$257.20 |
| Max. Negotiated Rate |
$379.54 |
| Rate for Payer: Aetna Commercial |
$358.45
|
| Rate for Payer: BCBS Trust/PPO |
$325.90
|
| Rate for Payer: BCN Commercial |
$325.90
|
| Rate for Payer: Cash Price |
$337.37
|
| Rate for Payer: Cofinity Commercial |
$362.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.37
|
| Rate for Payer: Healthscope Commercial |
$379.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$358.45
|
| Rate for Payer: PHP Commercial |
$358.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.10
|
| Rate for Payer: UHC Core |
$352.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.28
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
OP
|
$421.71
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$100.16 |
| Max. Negotiated Rate |
$379.54 |
| Rate for Payer: Aetna Commercial |
$358.45
|
| Rate for Payer: Aetna Medicare |
$109.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.78
|
| Rate for Payer: BCBS Complete |
$168.68
|
| Rate for Payer: BCBS MAPPO |
$105.43
|
| Rate for Payer: BCBS Trust/PPO |
$327.88
|
| Rate for Payer: BCCCP Commercial |
$160.76
|
| Rate for Payer: BCN Commercial |
$327.88
|
| Rate for Payer: BCN Medicare Advantage |
$105.43
|
| Rate for Payer: Cash Price |
$337.37
|
| Rate for Payer: Cash Price |
$337.37
|
| Rate for Payer: Cofinity Commercial |
$362.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.43
|
| Rate for Payer: Healthscope Commercial |
$379.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$358.45
|
| Rate for Payer: PACE Senior Care Partners |
$100.16
|
| Rate for Payer: PACE SWMI |
$105.43
|
| Rate for Payer: PHP Commercial |
$358.45
|
| Rate for Payer: PHP Medicare Advantage |
$105.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$366.89
|
| Rate for Payer: Priority Health Medicare |
$105.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.20
|
| Rate for Payer: Railroad Medicare Medicare |
$105.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.10
|
| Rate for Payer: UHC Core |
$352.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.43
|
| Rate for Payer: UHC Medicare Advantage |
$108.59
|
| Rate for Payer: VA VA |
$105.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.28
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
OP
|
$416.09
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$98.82 |
| Max. Negotiated Rate |
$374.48 |
| Rate for Payer: Aetna Commercial |
$353.68
|
| Rate for Payer: Aetna Medicare |
$108.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.03
|
| Rate for Payer: BCBS Complete |
$166.44
|
| Rate for Payer: BCBS MAPPO |
$104.02
|
| Rate for Payer: BCBS Trust/PPO |
$323.51
|
| Rate for Payer: BCCCP Commercial |
$130.78
|
| Rate for Payer: BCN Commercial |
$323.51
|
| Rate for Payer: BCN Medicare Advantage |
$104.02
|
| Rate for Payer: Cash Price |
$332.87
|
| Rate for Payer: Cash Price |
$332.87
|
| Rate for Payer: Cofinity Commercial |
$357.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.02
|
| Rate for Payer: Healthscope Commercial |
$374.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$353.68
|
| Rate for Payer: PACE Senior Care Partners |
$98.82
|
| Rate for Payer: PACE SWMI |
$104.02
|
| Rate for Payer: PHP Commercial |
$353.68
|
| Rate for Payer: PHP Medicare Advantage |
$104.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.00
|
| Rate for Payer: Priority Health Medicare |
$104.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.77
|
| Rate for Payer: Railroad Medicare Medicare |
$104.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.16
|
| Rate for Payer: UHC Core |
$347.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.02
|
| Rate for Payer: UHC Medicare Advantage |
$107.14
|
| Rate for Payer: VA VA |
$104.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.07
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
IP
|
$416.09
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$253.77 |
| Max. Negotiated Rate |
$374.48 |
| Rate for Payer: Aetna Commercial |
$353.68
|
| Rate for Payer: BCBS Trust/PPO |
$321.55
|
| Rate for Payer: BCN Commercial |
$321.55
|
| Rate for Payer: Cash Price |
$332.87
|
| Rate for Payer: Cofinity Commercial |
$357.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.87
|
| Rate for Payer: Healthscope Commercial |
$374.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$353.68
|
| Rate for Payer: PHP Commercial |
$353.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$362.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.16
|
| Rate for Payer: UHC Core |
$347.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.07
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
IP
|
$600.30
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.12 |
| Max. Negotiated Rate |
$540.27 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: BCBS Trust/PPO |
$463.91
|
| Rate for Payer: BCN Commercial |
$463.91
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$516.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Healthscope Commercial |
$540.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.26
|
| Rate for Payer: UHC Core |
$501.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.22
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
OP
|
$600.30
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.62 |
| Max. Negotiated Rate |
$540.27 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna Medicare |
$156.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.59
|
| Rate for Payer: BCBS Complete |
$484.61
|
| Rate for Payer: BCBS MAPPO |
$150.08
|
| Rate for Payer: BCBS Trust/PPO |
$466.73
|
| Rate for Payer: BCCCP Commercial |
$105.62
|
| Rate for Payer: BCN Commercial |
$466.73
|
| Rate for Payer: BCN Medicare Advantage |
$150.08
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cash Price |
$480.24
|
| Rate for Payer: Cofinity Commercial |
$516.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.08
|
| Rate for Payer: Healthscope Commercial |
$540.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.22
|
| Rate for Payer: Mclaren Medicaid |
$461.54
|
| Rate for Payer: Meridian Medicaid |
$484.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.26
|
| Rate for Payer: PACE Senior Care Partners |
$142.57
|
| Rate for Payer: PACE SWMI |
$150.08
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: PHP Medicare Advantage |
$150.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.26
|
| Rate for Payer: Priority Health Medicare |
$150.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.12
|
| Rate for Payer: Railroad Medicare Medicare |
$150.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.26
|
| Rate for Payer: UHC Core |
$501.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.08
|
| Rate for Payer: UHC Medicare Advantage |
$154.58
|
| Rate for Payer: VA VA |
$150.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.22
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
IP
|
$388.80
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.13 |
| Max. Negotiated Rate |
$349.92 |
| Rate for Payer: Aetna Commercial |
$330.48
|
| Rate for Payer: BCBS Trust/PPO |
$300.46
|
| Rate for Payer: BCN Commercial |
$300.46
|
| Rate for Payer: Cash Price |
$311.04
|
| Rate for Payer: Cofinity Commercial |
$334.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.04
|
| Rate for Payer: Healthscope Commercial |
$349.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.48
|
| Rate for Payer: PHP Commercial |
$330.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.14
|
| Rate for Payer: UHC Core |
$324.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.60
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
OP
|
$388.80
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$27.25 |
| Max. Negotiated Rate |
$349.92 |
| Rate for Payer: Aetna Commercial |
$330.48
|
| Rate for Payer: Aetna Medicare |
$101.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.50
|
| Rate for Payer: BCBS Complete |
$155.52
|
| Rate for Payer: BCBS MAPPO |
$97.20
|
| Rate for Payer: BCBS Trust/PPO |
$302.29
|
| Rate for Payer: BCCCP Commercial |
$27.25
|
| Rate for Payer: BCN Commercial |
$302.29
|
| Rate for Payer: BCN Medicare Advantage |
$97.20
|
| Rate for Payer: Cash Price |
$311.04
|
| Rate for Payer: Cash Price |
$311.04
|
| Rate for Payer: Cofinity Commercial |
$334.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.20
|
| Rate for Payer: Healthscope Commercial |
$349.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.48
|
| Rate for Payer: PACE Senior Care Partners |
$92.34
|
| Rate for Payer: PACE SWMI |
$97.20
|
| Rate for Payer: PHP Commercial |
$330.48
|
| Rate for Payer: PHP Medicare Advantage |
$97.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$338.26
|
| Rate for Payer: Priority Health Medicare |
$97.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$237.13
|
| Rate for Payer: Railroad Medicare Medicare |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.14
|
| Rate for Payer: UHC Core |
$324.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.20
|
| Rate for Payer: UHC Medicare Advantage |
$100.12
|
| Rate for Payer: VA VA |
$97.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.60
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
OP
|
$2,731.95
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.84 |
| Max. Negotiated Rate |
$2,458.76 |
| Rate for Payer: Aetna Commercial |
$2,322.16
|
| Rate for Payer: Aetna Medicare |
$710.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$853.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$853.73
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$682.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.09
|
| Rate for Payer: BCN Commercial |
$2,124.09
|
| Rate for Payer: BCN Medicare Advantage |
$682.99
|
| Rate for Payer: Cash Price |
$2,185.56
|
| Rate for Payer: Cash Price |
$2,185.56
|
| Rate for Payer: Cofinity Commercial |
$2,349.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,185.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.99
|
| Rate for Payer: Healthscope Commercial |
$2,458.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,048.96
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$717.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$785.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,322.16
|
| Rate for Payer: PACE Senior Care Partners |
$648.84
|
| Rate for Payer: PACE SWMI |
$682.99
|
| Rate for Payer: PHP Commercial |
$2,322.16
|
| Rate for Payer: PHP Medicare Advantage |
$682.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,376.80
|
| Rate for Payer: Priority Health Medicare |
$682.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,666.22
|
| Rate for Payer: Railroad Medicare Medicare |
$682.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,404.12
|
| Rate for Payer: UHC Core |
$2,281.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.99
|
| Rate for Payer: UHC Medicare Advantage |
$703.48
|
| Rate for Payer: VA VA |
$682.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,048.96
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
IP
|
$2,731.95
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,666.22 |
| Max. Negotiated Rate |
$2,458.76 |
| Rate for Payer: Aetna Commercial |
$2,322.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.25
|
| Rate for Payer: BCN Commercial |
$2,111.25
|
| Rate for Payer: Cash Price |
$2,185.56
|
| Rate for Payer: Cofinity Commercial |
$2,349.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,185.56
|
| Rate for Payer: Healthscope Commercial |
$2,458.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,048.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,322.16
|
| Rate for Payer: PHP Commercial |
$2,322.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,376.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,666.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,404.12
|
| Rate for Payer: UHC Core |
$2,281.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,048.96
|
|
|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
OP
|
$1,154.20
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.06 |
| Max. Negotiated Rate |
$1,038.78 |
| Rate for Payer: Aetna Commercial |
$981.07
|
| Rate for Payer: Aetna Medicare |
$300.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$360.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$360.69
|
| Rate for Payer: BCBS Complete |
$461.68
|
| Rate for Payer: BCBS MAPPO |
$288.55
|
| Rate for Payer: BCBS Trust/PPO |
$897.39
|
| Rate for Payer: BCCCP Commercial |
$171.06
|
| Rate for Payer: BCN Commercial |
$897.39
|
| Rate for Payer: BCN Medicare Advantage |
$288.55
|
| Rate for Payer: Cash Price |
$923.36
|
| Rate for Payer: Cash Price |
$923.36
|
| Rate for Payer: Cofinity Commercial |
$992.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.55
|
| Rate for Payer: Healthscope Commercial |
$1,038.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$865.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$302.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$981.07
|
| Rate for Payer: PACE Senior Care Partners |
$274.12
|
| Rate for Payer: PACE SWMI |
$288.55
|
| Rate for Payer: PHP Commercial |
$981.07
|
| Rate for Payer: PHP Medicare Advantage |
$288.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,004.15
|
| Rate for Payer: Priority Health Medicare |
$288.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$703.95
|
| Rate for Payer: Railroad Medicare Medicare |
$288.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.70
|
| Rate for Payer: UHC Core |
$963.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.55
|
| Rate for Payer: UHC Medicare Advantage |
$297.21
|
| Rate for Payer: VA VA |
$288.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$865.65
|
|
