|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$91.63 |
| Max. Negotiated Rate |
$126.87 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: BCBS Trust/PPO |
$115.07
|
| Rate for Payer: BCN Commercial |
$108.94
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health HMO/PPO |
$122.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.05
|
| Rate for Payer: UHC Core |
$117.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.73
|
|
|
HC EMCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$140.97
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200022
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$126.87 |
| Rate for Payer: Aetna Commercial |
$119.82
|
| Rate for Payer: Aetna Medicare |
$36.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.05
|
| Rate for Payer: BCBS Complete |
$56.39
|
| Rate for Payer: BCBS MAPPO |
$35.24
|
| Rate for Payer: BCBS Trust/PPO |
$115.89
|
| Rate for Payer: BCN Commercial |
$109.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.24
|
| Rate for Payer: Cash Price |
$112.78
|
| Rate for Payer: Cofinity Commercial |
$121.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.24
|
| Rate for Payer: Healthscope Commercial |
$126.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.82
|
| Rate for Payer: Nomi Health Commercial |
$115.60
|
| Rate for Payer: PACE Senior Care Partners |
$33.48
|
| Rate for Payer: PACE SWMI |
$35.24
|
| Rate for Payer: PHP Commercial |
$119.82
|
| Rate for Payer: PHP Medicare Advantage |
$35.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.63
|
| Rate for Payer: Priority Health HMO/PPO |
$122.64
|
| Rate for Payer: Priority Health Medicare |
$35.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.45
|
| Rate for Payer: Railroad Medicare Medicare |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.05
|
| Rate for Payer: UHC Core |
$117.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.24
|
| Rate for Payer: UHC Exchange |
$35.24
|
| Rate for Payer: UHC Medicare Advantage |
$35.24
|
| Rate for Payer: VA VA |
$35.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.73
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
IP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$228.18 |
| Max. Negotiated Rate |
$315.94 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: BCBS Trust/PPO |
$286.55
|
| Rate for Payer: BCN Commercial |
$271.28
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health HMO/PPO |
$305.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.92
|
| Rate for Payer: UHC Core |
$293.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.28
|
|
|
HC EMG ANAL SPHINCTER
|
Facility
|
OP
|
$351.04
|
|
|
Service Code
|
CPT 51785
|
| Hospital Charge Code |
92000002
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$83.37 |
| Max. Negotiated Rate |
$315.94 |
| Rate for Payer: Aetna Commercial |
$298.38
|
| Rate for Payer: Aetna Medicare |
$91.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.70
|
| Rate for Payer: BCBS Complete |
$184.65
|
| Rate for Payer: BCBS MAPPO |
$87.76
|
| Rate for Payer: BCBS Trust/PPO |
$288.59
|
| Rate for Payer: BCN Commercial |
$272.93
|
| Rate for Payer: BCN Medicare Advantage |
$87.76
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cash Price |
$280.83
|
| Rate for Payer: Cofinity Commercial |
$301.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.76
|
| Rate for Payer: Healthscope Commercial |
$315.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.28
|
| Rate for Payer: Mclaren Medicaid |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.15
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.38
|
| Rate for Payer: Nomi Health Commercial |
$287.85
|
| Rate for Payer: PACE Senior Care Partners |
$83.37
|
| Rate for Payer: PACE SWMI |
$87.76
|
| Rate for Payer: PHP Commercial |
$298.38
|
| Rate for Payer: PHP Medicare Advantage |
$87.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.18
|
| Rate for Payer: Priority Health HMO/PPO |
$305.40
|
| Rate for Payer: Priority Health Medicare |
$88.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.20
|
| Rate for Payer: Railroad Medicare Medicare |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.92
|
| Rate for Payer: UHC Core |
$293.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.76
|
| Rate for Payer: UHC Exchange |
$87.76
|
| Rate for Payer: UHC Medicare Advantage |
$87.76
|
| Rate for Payer: UHCCP Medicaid |
$175.84
|
| Rate for Payer: VA VA |
$87.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.28
|
|
|
HC EMG BLADDER
|
Facility
|
OP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.72 |
| Max. Negotiated Rate |
$328.61 |
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: Aetna Medicare |
$94.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.10
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$91.28
|
| Rate for Payer: BCBS Trust/PPO |
$300.17
|
| Rate for Payer: BCN Commercial |
$283.88
|
| Rate for Payer: BCN Medicare Advantage |
$91.28
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.28
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.84
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.84
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.72
|
| Rate for Payer: PACE SWMI |
$91.28
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: PHP Medicare Advantage |
$91.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health HMO/PPO |
$317.65
|
| Rate for Payer: Priority Health Medicare |
$92.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.63
|
| Rate for Payer: Railroad Medicare Medicare |
$91.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.31
|
| Rate for Payer: UHC Core |
$304.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.28
|
| Rate for Payer: UHC Exchange |
$91.28
|
| Rate for Payer: UHC Medicare Advantage |
$91.28
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$91.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.84
|
|
|
HC EMG BLADDER
|
Facility
|
IP
|
$365.12
|
|
|
Service Code
|
CPT 51784
|
| Hospital Charge Code |
92000001
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$237.33 |
| Max. Negotiated Rate |
$328.61 |
| Rate for Payer: Aetna Commercial |
$310.35
|
| Rate for Payer: BCBS Trust/PPO |
$298.05
|
| Rate for Payer: BCN Commercial |
$282.16
|
| Rate for Payer: Cash Price |
$292.10
|
| Rate for Payer: Cofinity Commercial |
$314.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.10
|
| Rate for Payer: Healthscope Commercial |
$328.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.35
|
| Rate for Payer: Nomi Health Commercial |
$299.40
|
| Rate for Payer: PHP Commercial |
$310.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.33
|
| Rate for Payer: Priority Health HMO/PPO |
$317.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.31
|
| Rate for Payer: UHC Core |
$304.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.84
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
OP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$221.73 |
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: Aetna Medicare |
$64.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.99
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$61.59
|
| Rate for Payer: BCBS Trust/PPO |
$202.54
|
| Rate for Payer: BCN Commercial |
$191.55
|
| Rate for Payer: BCN Medicare Advantage |
$61.59
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.78
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.67
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: PACE Senior Care Partners |
$58.51
|
| Rate for Payer: PACE SWMI |
$61.59
|
| Rate for Payer: PHP Commercial |
$209.41
|
| Rate for Payer: PHP Medicare Advantage |
$61.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health HMO/PPO |
$214.34
|
| Rate for Payer: Priority Health Medicare |
$62.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.07
|
| Rate for Payer: Railroad Medicare Medicare |
$61.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.81
|
| Rate for Payer: UHC Core |
$205.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.59
|
| Rate for Payer: UHC Exchange |
$61.59
|
| Rate for Payer: UHC Medicare Advantage |
$61.59
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$61.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.78
|
|
|
HC EMG BLINK REFLEX
|
Facility
|
IP
|
$246.37
|
|
|
Service Code
|
CPT 95933
|
| Hospital Charge Code |
92200019
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$160.14 |
| Max. Negotiated Rate |
$221.73 |
| Rate for Payer: Aetna Commercial |
$209.41
|
| Rate for Payer: BCBS Trust/PPO |
$201.11
|
| Rate for Payer: BCN Commercial |
$190.39
|
| Rate for Payer: Cash Price |
$197.10
|
| Rate for Payer: Cofinity Commercial |
$211.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$221.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.41
|
| Rate for Payer: Nomi Health Commercial |
$202.02
|
| Rate for Payer: PHP Commercial |
$209.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.14
|
| Rate for Payer: Priority Health HMO/PPO |
$214.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.81
|
| Rate for Payer: UHC Core |
$205.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.78
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
OP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$145.36 |
| Max. Negotiated Rate |
$550.85 |
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: Aetna Medicare |
$159.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.27
|
| Rate for Payer: BCBS Complete |
$244.82
|
| Rate for Payer: BCBS MAPPO |
$153.01
|
| Rate for Payer: BCBS Trust/PPO |
$503.17
|
| Rate for Payer: BCN Commercial |
$475.87
|
| Rate for Payer: BCN Medicare Advantage |
$153.01
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.01
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: PACE Senior Care Partners |
$145.36
|
| Rate for Payer: PACE SWMI |
$153.01
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: PHP Medicare Advantage |
$153.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health HMO/PPO |
$532.48
|
| Rate for Payer: Priority Health Medicare |
$154.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.07
|
| Rate for Payer: Railroad Medicare Medicare |
$153.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.60
|
| Rate for Payer: UHC Core |
$511.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.01
|
| Rate for Payer: UHC Exchange |
$153.01
|
| Rate for Payer: UHC Medicare Advantage |
$153.01
|
| Rate for Payer: VA VA |
$153.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.04
|
|
|
HC EMG CRANIAL CERV THOR LUMB PARASPINE NDL EXAM W NCS UNI
|
Facility
|
IP
|
$612.05
|
|
|
Service Code
|
CPT 95887
|
| Hospital Charge Code |
92200024
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$397.83 |
| Max. Negotiated Rate |
$550.85 |
| Rate for Payer: Aetna Commercial |
$520.24
|
| Rate for Payer: BCBS Trust/PPO |
$499.62
|
| Rate for Payer: BCN Commercial |
$472.99
|
| Rate for Payer: Cash Price |
$489.64
|
| Rate for Payer: Cofinity Commercial |
$526.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.64
|
| Rate for Payer: Healthscope Commercial |
$550.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.24
|
| Rate for Payer: Nomi Health Commercial |
$501.88
|
| Rate for Payer: PHP Commercial |
$520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.83
|
| Rate for Payer: Priority Health HMO/PPO |
$532.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.60
|
| Rate for Payer: UHC Core |
$511.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.04
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
OP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: Aetna Medicare |
$48.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.56
|
| Rate for Payer: BCBS Complete |
$74.95
|
| Rate for Payer: BCBS MAPPO |
$46.84
|
| Rate for Payer: BCBS Trust/PPO |
$154.05
|
| Rate for Payer: BCN Commercial |
$145.69
|
| Rate for Payer: BCN Medicare Advantage |
$46.84
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.84
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: PACE Senior Care Partners |
$44.50
|
| Rate for Payer: PACE SWMI |
$46.84
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: PHP Medicare Advantage |
$46.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO |
$163.02
|
| Rate for Payer: Priority Health Medicare |
$47.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.54
|
| Rate for Payer: Railroad Medicare Medicare |
$46.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.89
|
| Rate for Payer: UHC Core |
$156.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.84
|
| Rate for Payer: UHC Exchange |
$46.84
|
| Rate for Payer: UHC Medicare Advantage |
$46.84
|
| Rate for Payer: VA VA |
$46.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.53
|
|
|
HC EMG NDL GUIDANCE NERVE DEST WITH CHEMODENERVATION
|
Facility
|
IP
|
$187.38
|
|
|
Service Code
|
CPT 95874
|
| Hospital Charge Code |
92200034
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$168.64 |
| Rate for Payer: Aetna Commercial |
$159.27
|
| Rate for Payer: BCBS Trust/PPO |
$152.96
|
| Rate for Payer: BCN Commercial |
$144.81
|
| Rate for Payer: Cash Price |
$149.90
|
| Rate for Payer: Cofinity Commercial |
$161.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.90
|
| Rate for Payer: Healthscope Commercial |
$168.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.27
|
| Rate for Payer: Nomi Health Commercial |
$153.65
|
| Rate for Payer: PHP Commercial |
$159.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO |
$163.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.89
|
| Rate for Payer: UHC Core |
$156.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.53
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
OP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: Aetna Medicare |
$155.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.62
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$149.29
|
| Rate for Payer: BCBS Trust/PPO |
$490.94
|
| Rate for Payer: BCN Commercial |
$464.31
|
| Rate for Payer: BCN Medicare Advantage |
$149.29
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.29
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.88
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.76
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: Nomi Health Commercial |
$489.69
|
| Rate for Payer: PACE Senior Care Partners |
$141.83
|
| Rate for Payer: PACE SWMI |
$149.29
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$149.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health HMO/PPO |
$519.55
|
| Rate for Payer: Priority Health Medicare |
$150.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.11
|
| Rate for Payer: Railroad Medicare Medicare |
$149.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.52
|
| Rate for Payer: UHC Core |
$498.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.29
|
| Rate for Payer: UHC Exchange |
$149.29
|
| Rate for Payer: UHC Medicare Advantage |
$149.29
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$149.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.88
|
|
|
HC EMG NEEDLE EXAM-1 EXT.
|
Facility
|
IP
|
$597.18
|
|
|
Service Code
|
CPT 95860
|
| Hospital Charge Code |
92200001
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$388.17 |
| Max. Negotiated Rate |
$537.46 |
| Rate for Payer: Aetna Commercial |
$507.60
|
| Rate for Payer: BCBS Trust/PPO |
$487.48
|
| Rate for Payer: BCN Commercial |
$461.50
|
| Rate for Payer: Cash Price |
$477.74
|
| Rate for Payer: Cofinity Commercial |
$513.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.74
|
| Rate for Payer: Healthscope Commercial |
$537.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.60
|
| Rate for Payer: Nomi Health Commercial |
$489.69
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.17
|
| Rate for Payer: Priority Health HMO/PPO |
$519.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$400.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.52
|
| Rate for Payer: UHC Core |
$498.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.88
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
OP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: Aetna Medicare |
$183.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.19
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$176.15
|
| Rate for Payer: BCBS Trust/PPO |
$579.25
|
| Rate for Payer: BCN Commercial |
$547.83
|
| Rate for Payer: BCN Medicare Advantage |
$176.15
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.15
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.45
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.96
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: Nomi Health Commercial |
$577.77
|
| Rate for Payer: PACE Senior Care Partners |
$167.34
|
| Rate for Payer: PACE SWMI |
$176.15
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: PHP Medicare Advantage |
$176.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health HMO/PPO |
$613.00
|
| Rate for Payer: Priority Health Medicare |
$177.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.08
|
| Rate for Payer: Railroad Medicare Medicare |
$176.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.05
|
| Rate for Payer: UHC Core |
$588.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.15
|
| Rate for Payer: UHC Exchange |
$176.15
|
| Rate for Payer: UHC Medicare Advantage |
$176.15
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$176.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.45
|
|
|
HC EMG NEEDLE EXAM 2 EXT
|
Facility
|
IP
|
$704.60
|
|
|
Service Code
|
CPT 95861
|
| Hospital Charge Code |
92200002
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$457.99 |
| Max. Negotiated Rate |
$634.14 |
| Rate for Payer: Aetna Commercial |
$598.91
|
| Rate for Payer: BCBS Trust/PPO |
$575.16
|
| Rate for Payer: BCN Commercial |
$544.51
|
| Rate for Payer: Cash Price |
$563.68
|
| Rate for Payer: Cofinity Commercial |
$605.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.68
|
| Rate for Payer: Healthscope Commercial |
$634.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.91
|
| Rate for Payer: Nomi Health Commercial |
$577.77
|
| Rate for Payer: PHP Commercial |
$598.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.99
|
| Rate for Payer: Priority Health HMO/PPO |
$613.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.05
|
| Rate for Payer: UHC Core |
$588.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.45
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
OP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: Aetna Medicare |
$169.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.48
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$162.78
|
| Rate for Payer: BCBS Trust/PPO |
$535.29
|
| Rate for Payer: BCN Commercial |
$506.25
|
| Rate for Payer: BCN Medicare Advantage |
$162.78
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.78
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.35
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.92
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: Nomi Health Commercial |
$533.93
|
| Rate for Payer: PACE Senior Care Partners |
$154.64
|
| Rate for Payer: PACE SWMI |
$162.78
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: PHP Medicare Advantage |
$162.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health HMO/PPO |
$566.48
|
| Rate for Payer: Priority Health Medicare |
$164.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$436.26
|
| Rate for Payer: Railroad Medicare Medicare |
$162.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.99
|
| Rate for Payer: UHC Core |
$543.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.78
|
| Rate for Payer: UHC Exchange |
$162.78
|
| Rate for Payer: UHC Medicare Advantage |
$162.78
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$162.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.35
|
|
|
HC EMG NEEDLE EXAM 3 EXT
|
Facility
|
IP
|
$651.13
|
|
|
Service Code
|
CPT 95863
|
| Hospital Charge Code |
92200003
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$423.23 |
| Max. Negotiated Rate |
$586.02 |
| Rate for Payer: Aetna Commercial |
$553.46
|
| Rate for Payer: BCBS Trust/PPO |
$531.52
|
| Rate for Payer: BCN Commercial |
$503.19
|
| Rate for Payer: Cash Price |
$520.90
|
| Rate for Payer: Cofinity Commercial |
$559.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.90
|
| Rate for Payer: Healthscope Commercial |
$586.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$488.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.46
|
| Rate for Payer: Nomi Health Commercial |
$533.93
|
| Rate for Payer: PHP Commercial |
$553.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$423.23
|
| Rate for Payer: Priority Health HMO/PPO |
$566.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$436.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.99
|
| Rate for Payer: UHC Core |
$543.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$488.35
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$212.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.17
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$204.13
|
| Rate for Payer: BCBS Trust/PPO |
$671.28
|
| Rate for Payer: BCN Commercial |
$634.86
|
| Rate for Payer: BCN Medicare Advantage |
$204.13
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.13
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.34
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Senior Care Partners |
$193.93
|
| Rate for Payer: PACE SWMI |
$204.13
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$204.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Medicare |
$206.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: Railroad Medicare Medicare |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.13
|
| Rate for Payer: UHC Exchange |
$204.13
|
| Rate for Payer: UHC Medicare Advantage |
$204.13
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$204.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC EMG NEEDLE EXAM 4 EXT
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95864
|
| Hospital Charge Code |
92200004
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: BCBS Trust/PPO |
$666.54
|
| Rate for Payer: BCN Commercial |
$631.02
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
OP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$193.93 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: Aetna Medicare |
$212.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.17
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$204.13
|
| Rate for Payer: BCBS Trust/PPO |
$671.28
|
| Rate for Payer: BCN Commercial |
$634.86
|
| Rate for Payer: BCN Medicare Advantage |
$204.13
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.13
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.34
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PACE Senior Care Partners |
$193.93
|
| Rate for Payer: PACE SWMI |
$204.13
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: PHP Medicare Advantage |
$204.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Medicare |
$206.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: Railroad Medicare Medicare |
$204.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.13
|
| Rate for Payer: UHC Exchange |
$204.13
|
| Rate for Payer: UHC Medicare Advantage |
$204.13
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$204.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL BILAT NCS
|
Facility
|
IP
|
$816.54
|
|
|
Service Code
|
CPT 95868
|
| Hospital Charge Code |
92200007
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$530.75 |
| Max. Negotiated Rate |
$734.89 |
| Rate for Payer: Aetna Commercial |
$694.06
|
| Rate for Payer: BCBS Trust/PPO |
$666.54
|
| Rate for Payer: BCN Commercial |
$631.02
|
| Rate for Payer: Cash Price |
$653.23
|
| Rate for Payer: Cofinity Commercial |
$702.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.23
|
| Rate for Payer: Healthscope Commercial |
$734.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.06
|
| Rate for Payer: Nomi Health Commercial |
$669.56
|
| Rate for Payer: PHP Commercial |
$694.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.75
|
| Rate for Payer: Priority Health HMO/PPO |
$710.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.56
|
| Rate for Payer: UHC Core |
$681.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.40
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
OP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$174.55 |
| Max. Negotiated Rate |
$661.44 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: Aetna Medicare |
$191.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.67
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$183.73
|
| Rate for Payer: BCBS Trust/PPO |
$604.19
|
| Rate for Payer: BCN Commercial |
$571.41
|
| Rate for Payer: BCN Medicare Advantage |
$183.73
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.73
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.20
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.92
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PACE Senior Care Partners |
$174.55
|
| Rate for Payer: PACE SWMI |
$183.73
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: PHP Medicare Advantage |
$183.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health HMO/PPO |
$639.39
|
| Rate for Payer: Priority Health Medicare |
$185.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.40
|
| Rate for Payer: Railroad Medicare Medicare |
$183.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.74
|
| Rate for Payer: UHC Core |
$613.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.73
|
| Rate for Payer: UHC Exchange |
$183.73
|
| Rate for Payer: UHC Medicare Advantage |
$183.73
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$183.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.20
|
|
|
HC EMG NEEDLE EXAM CRANIAL UNILAT WO NCS
|
Facility
|
IP
|
$734.93
|
|
|
Service Code
|
CPT 95867
|
| Hospital Charge Code |
92200006
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$477.70 |
| Max. Negotiated Rate |
$661.44 |
| Rate for Payer: Aetna Commercial |
$624.69
|
| Rate for Payer: BCBS Trust/PPO |
$599.92
|
| Rate for Payer: BCN Commercial |
$567.95
|
| Rate for Payer: Cash Price |
$587.94
|
| Rate for Payer: Cofinity Commercial |
$632.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.94
|
| Rate for Payer: Healthscope Commercial |
$661.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.69
|
| Rate for Payer: Nomi Health Commercial |
$602.64
|
| Rate for Payer: PHP Commercial |
$624.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.70
|
| Rate for Payer: Priority Health HMO/PPO |
$639.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$492.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.74
|
| Rate for Payer: UHC Core |
$613.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.20
|
|
|
HC EMG NEEDLE EXAM WITH NCS LIMITED
|
Facility
|
IP
|
$374.98
|
|
|
Service Code
|
CPT 95885
|
| Hospital Charge Code |
92200022
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$243.74 |
| Max. Negotiated Rate |
$337.48 |
| Rate for Payer: Aetna Commercial |
$318.73
|
| Rate for Payer: BCBS Trust/PPO |
$306.10
|
| Rate for Payer: BCN Commercial |
$289.78
|
| Rate for Payer: Cash Price |
$299.98
|
| Rate for Payer: Cofinity Commercial |
$322.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.98
|
| Rate for Payer: Healthscope Commercial |
$337.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.73
|
| Rate for Payer: Nomi Health Commercial |
$307.48
|
| Rate for Payer: PHP Commercial |
$318.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.74
|
| Rate for Payer: Priority Health HMO/PPO |
$326.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.98
|
| Rate for Payer: UHC Core |
$313.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.24
|
|
