|
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
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
OP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$107.85 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: Aetna Medicare |
$118.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.90
|
| Rate for Payer: BCBS Complete |
$181.64
|
| Rate for Payer: BCBS MAPPO |
$113.52
|
| Rate for Payer: BCBS Trust/PPO |
$373.31
|
| Rate for Payer: BCN Commercial |
$353.05
|
| Rate for Payer: BCN Medicare Advantage |
$113.52
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.52
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: Nomi Health Commercial |
$372.35
|
| Rate for Payer: PACE Senior Care Partners |
$107.85
|
| Rate for Payer: PACE SWMI |
$113.52
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: PHP Medicare Advantage |
$113.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health HMO/PPO |
$395.06
|
| Rate for Payer: Priority Health Medicare |
$114.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.24
|
| Rate for Payer: Railroad Medicare Medicare |
$113.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.60
|
| Rate for Payer: UHC Core |
$379.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.52
|
| Rate for Payer: UHC Exchange |
$113.52
|
| Rate for Payer: UHC Medicare Advantage |
$113.52
|
| Rate for Payer: VA VA |
$113.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.57
|
|
|
HC EMG NEEDLE EXAM WITH NCV COMPLETE
|
Facility
|
IP
|
$454.09
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
92200023
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$295.16 |
| Max. Negotiated Rate |
$408.68 |
| Rate for Payer: Aetna Commercial |
$385.98
|
| Rate for Payer: BCBS Trust/PPO |
$370.67
|
| Rate for Payer: BCN Commercial |
$350.92
|
| Rate for Payer: Cash Price |
$363.27
|
| Rate for Payer: Cofinity Commercial |
$390.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.27
|
| Rate for Payer: Healthscope Commercial |
$408.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.98
|
| Rate for Payer: Nomi Health Commercial |
$372.35
|
| Rate for Payer: PHP Commercial |
$385.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.16
|
| Rate for Payer: Priority Health HMO/PPO |
$395.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.60
|
| Rate for Payer: UHC Core |
$379.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.57
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
OP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$358.33 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: Aetna Medicare |
$103.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.42
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$99.53
|
| Rate for Payer: BCBS Trust/PPO |
$327.31
|
| Rate for Payer: BCN Commercial |
$309.55
|
| Rate for Payer: BCN Medicare Advantage |
$99.53
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.53
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.61
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.51
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: Nomi Health Commercial |
$326.47
|
| Rate for Payer: PACE Senior Care Partners |
$94.56
|
| Rate for Payer: PACE SWMI |
$99.53
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: PHP Medicare Advantage |
$99.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health HMO/PPO |
$346.38
|
| Rate for Payer: Priority Health Medicare |
$100.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.75
|
| Rate for Payer: Railroad Medicare Medicare |
$99.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.36
|
| Rate for Payer: UHC Core |
$332.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.53
|
| Rate for Payer: UHC Exchange |
$99.53
|
| Rate for Payer: UHC Medicare Advantage |
$99.53
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$99.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.61
|
|
|
HC EMG NEEDLE FROM LARYNX
|
Facility
|
IP
|
$398.14
|
|
|
Service Code
|
CPT 95865
|
| Hospital Charge Code |
92200005
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$258.79 |
| Max. Negotiated Rate |
$358.33 |
| Rate for Payer: Aetna Commercial |
$338.42
|
| Rate for Payer: BCBS Trust/PPO |
$325.00
|
| Rate for Payer: BCN Commercial |
$307.68
|
| Rate for Payer: Cash Price |
$318.51
|
| Rate for Payer: Cofinity Commercial |
$342.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.51
|
| Rate for Payer: Healthscope Commercial |
$358.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.42
|
| Rate for Payer: Nomi Health Commercial |
$326.47
|
| Rate for Payer: PHP Commercial |
$338.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.79
|
| Rate for Payer: Priority Health HMO/PPO |
$346.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.36
|
| Rate for Payer: UHC Core |
$332.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.61
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
IP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$285.36 |
| Max. Negotiated Rate |
$395.11 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: BCBS Trust/PPO |
$358.36
|
| Rate for Payer: BCN Commercial |
$339.27
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: Nomi Health Commercial |
$359.99
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health HMO/PPO |
$381.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.33
|
| Rate for Payer: UHC Core |
$366.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.26
|
|
|
HC EMG REPETITIVE STIMULATION
|
Facility
|
OP
|
$439.01
|
|
|
Service Code
|
CPT 95937
|
| Hospital Charge Code |
92200021
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$104.26 |
| Max. Negotiated Rate |
$395.11 |
| Rate for Payer: Aetna Commercial |
$373.16
|
| Rate for Payer: Aetna Medicare |
$114.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.19
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$109.75
|
| Rate for Payer: BCBS Trust/PPO |
$360.91
|
| Rate for Payer: BCN Commercial |
$341.33
|
| Rate for Payer: BCN Medicare Advantage |
$109.75
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cash Price |
$351.21
|
| Rate for Payer: Cofinity Commercial |
$377.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.75
|
| Rate for Payer: Healthscope Commercial |
$395.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.26
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.24
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$373.16
|
| Rate for Payer: Nomi Health Commercial |
$359.99
|
| Rate for Payer: PACE Senior Care Partners |
$104.26
|
| Rate for Payer: PACE SWMI |
$109.75
|
| Rate for Payer: PHP Commercial |
$373.16
|
| Rate for Payer: PHP Medicare Advantage |
$109.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.36
|
| Rate for Payer: Priority Health HMO/PPO |
$381.94
|
| Rate for Payer: Priority Health Medicare |
$110.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.14
|
| Rate for Payer: Railroad Medicare Medicare |
$109.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.33
|
| Rate for Payer: UHC Core |
$366.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.75
|
| Rate for Payer: UHC Exchange |
$109.75
|
| Rate for Payer: UHC Medicare Advantage |
$109.75
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$109.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.26
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna Medicare |
$119.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.61
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$114.89
|
| Rate for Payer: BCBS Trust/PPO |
$377.80
|
| Rate for Payer: BCN Commercial |
$357.30
|
| Rate for Payer: BCN Medicare Advantage |
$114.89
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.89
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.63
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: PACE Senior Care Partners |
$109.14
|
| Rate for Payer: PACE SWMI |
$114.89
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: PHP Medicare Advantage |
$114.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO |
$399.81
|
| Rate for Payer: Priority Health Medicare |
$116.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.90
|
| Rate for Payer: Railroad Medicare Medicare |
$114.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.40
|
| Rate for Payer: UHC Core |
$383.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.89
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicare Advantage |
$114.89
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$114.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC EMG SINGLE FIBER
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 95872
|
| Hospital Charge Code |
92200010
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$298.71 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: BCBS Trust/PPO |
$375.13
|
| Rate for Payer: BCN Commercial |
$355.14
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO |
$399.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.40
|
| Rate for Payer: UHC Core |
$383.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
IP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$180.62 |
| Max. Negotiated Rate |
$250.08 |
| Rate for Payer: Aetna Commercial |
$236.19
|
| Rate for Payer: BCBS Trust/PPO |
$226.83
|
| Rate for Payer: BCN Commercial |
$214.74
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$238.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Healthscope Commercial |
$250.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: Nomi Health Commercial |
$227.85
|
| Rate for Payer: PHP Commercial |
$236.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: Priority Health HMO/PPO |
$241.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.53
|
| Rate for Payer: UHC Core |
$232.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.40
|
|
|
HC EMG SURFACE FROM LARYNX
|
Facility
|
OP
|
$277.87
|
|
|
Service Code
|
CPT 95999
|
| Hospital Charge Code |
92000010
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$65.99 |
| Max. Negotiated Rate |
$250.08 |
| Rate for Payer: Aetna Commercial |
$236.19
|
| Rate for Payer: Aetna Medicare |
$72.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.83
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$69.47
|
| Rate for Payer: BCBS Trust/PPO |
$228.44
|
| Rate for Payer: BCN Commercial |
$216.04
|
| Rate for Payer: BCN Medicare Advantage |
$69.47
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cash Price |
$222.30
|
| Rate for Payer: Cofinity Commercial |
$238.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.47
|
| Rate for Payer: Healthscope Commercial |
$250.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.40
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.94
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.19
|
| Rate for Payer: Nomi Health Commercial |
$227.85
|
| Rate for Payer: PACE Senior Care Partners |
$65.99
|
| Rate for Payer: PACE SWMI |
$69.47
|
| Rate for Payer: PHP Commercial |
$236.19
|
| Rate for Payer: PHP Medicare Advantage |
$69.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.62
|
| Rate for Payer: Priority Health HMO/PPO |
$241.75
|
| Rate for Payer: Priority Health Medicare |
$70.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.17
|
| Rate for Payer: Railroad Medicare Medicare |
$69.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.53
|
| Rate for Payer: UHC Core |
$232.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.47
|
| Rate for Payer: UHC Exchange |
$69.47
|
| Rate for Payer: UHC Medicare Advantage |
$69.47
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$69.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.40
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
IP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$341.38 |
| Max. Negotiated Rate |
$472.68 |
| Rate for Payer: Aetna Commercial |
$446.42
|
| Rate for Payer: BCBS Trust/PPO |
$428.72
|
| Rate for Payer: BCN Commercial |
$405.87
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$451.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Healthscope Commercial |
$472.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: Nomi Health Commercial |
$430.66
|
| Rate for Payer: PHP Commercial |
$446.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health HMO/PPO |
$456.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.18
|
| Rate for Payer: UHC Core |
$438.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.90
|
|
|
HC EMG THORACIC PSP. NEEDLE EXAM
|
Facility
|
OP
|
$525.20
|
|
|
Service Code
|
CPT 95869
|
| Hospital Charge Code |
92200008
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$124.73 |
| Max. Negotiated Rate |
$472.68 |
| Rate for Payer: Aetna Commercial |
$446.42
|
| Rate for Payer: Aetna Medicare |
$136.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.12
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$131.30
|
| Rate for Payer: BCBS Trust/PPO |
$431.77
|
| Rate for Payer: BCN Commercial |
$408.34
|
| Rate for Payer: BCN Medicare Advantage |
$131.30
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cash Price |
$420.16
|
| Rate for Payer: Cofinity Commercial |
$451.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.30
|
| Rate for Payer: Healthscope Commercial |
$472.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.90
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.87
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$151.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.42
|
| Rate for Payer: Nomi Health Commercial |
$430.66
|
| Rate for Payer: PACE Senior Care Partners |
$124.73
|
| Rate for Payer: PACE SWMI |
$131.30
|
| Rate for Payer: PHP Commercial |
$446.42
|
| Rate for Payer: PHP Medicare Advantage |
$131.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.38
|
| Rate for Payer: Priority Health HMO/PPO |
$456.92
|
| Rate for Payer: Priority Health Medicare |
$132.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.88
|
| Rate for Payer: Railroad Medicare Medicare |
$131.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.18
|
| Rate for Payer: UHC Core |
$438.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.30
|
| Rate for Payer: UHC Exchange |
$131.30
|
| Rate for Payer: UHC Medicare Advantage |
$131.30
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$131.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.90
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
IP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$379.90 |
| Max. Negotiated Rate |
$526.01 |
| Rate for Payer: Aetna Commercial |
$496.79
|
| Rate for Payer: BCBS Trust/PPO |
$477.09
|
| Rate for Payer: BCN Commercial |
$451.67
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$502.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Healthscope Commercial |
$526.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: Nomi Health Commercial |
$479.26
|
| Rate for Payer: PHP Commercial |
$496.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health HMO/PPO |
$508.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.32
|
| Rate for Payer: UHC Core |
$488.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.35
|
|
|
HC EMR RENAL BIOPSY (BILL ONLY)
|
Facility
|
OP
|
$584.46
|
|
|
Service Code
|
CPT 88348
|
| Hospital Charge Code |
31200008
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$620.19 |
| Rate for Payer: Aetna Commercial |
$496.79
|
| Rate for Payer: Aetna Medicare |
$151.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.64
|
| Rate for Payer: BCBS Complete |
$620.19
|
| Rate for Payer: BCBS MAPPO |
$146.12
|
| Rate for Payer: BCBS Trust/PPO |
$480.48
|
| Rate for Payer: BCN Commercial |
$454.42
|
| Rate for Payer: BCN Medicare Advantage |
$146.12
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cash Price |
$467.57
|
| Rate for Payer: Cofinity Commercial |
$502.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.12
|
| Rate for Payer: Healthscope Commercial |
$526.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.35
|
| Rate for Payer: Mclaren Medicaid |
$590.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.42
|
| Rate for Payer: Meridian Medicaid |
$620.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.79
|
| Rate for Payer: Nomi Health Commercial |
$479.26
|
| Rate for Payer: PACE Senior Care Partners |
$138.81
|
| Rate for Payer: PACE SWMI |
$146.12
|
| Rate for Payer: PHP Commercial |
$496.79
|
| Rate for Payer: PHP Medicare Advantage |
$146.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.90
|
| Rate for Payer: Priority Health HMO/PPO |
$508.48
|
| Rate for Payer: Priority Health Medicare |
$147.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.59
|
| Rate for Payer: Railroad Medicare Medicare |
$146.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.32
|
| Rate for Payer: UHC Core |
$488.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.12
|
| Rate for Payer: UHC Exchange |
$146.12
|
| Rate for Payer: UHC Medicare Advantage |
$146.12
|
| Rate for Payer: UHCCP Medicaid |
$590.62
|
| Rate for Payer: VA VA |
$146.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.35
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
OP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$29.79 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.34
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.28
|
| Rate for Payer: BCBS Trust/PPO |
$27.21
|
| Rate for Payer: BCN Commercial |
$25.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.28
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.28
|
| Rate for Payer: Healthscope Commercial |
$29.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.82
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.69
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.14
|
| Rate for Payer: PACE Senior Care Partners |
$7.86
|
| Rate for Payer: PACE SWMI |
$8.28
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: PHP Medicare Advantage |
$8.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.80
|
| Rate for Payer: Priority Health Medicare |
$8.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: Railroad Medicare Medicare |
$8.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.13
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.28
|
| Rate for Payer: UHC Exchange |
$8.28
|
| Rate for Payer: UHC Medicare Advantage |
$8.28
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.82
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB PANEL
|
Facility
|
IP
|
$33.10
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200170
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$29.79 |
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: BCBS Trust/PPO |
$27.02
|
| Rate for Payer: BCN Commercial |
$25.58
|
| Rate for Payer: Cash Price |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.48
|
| Rate for Payer: Healthscope Commercial |
$29.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Nomi Health Commercial |
$27.14
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.52
|
| Rate for Payer: Priority Health HMO/PPO |
$28.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.13
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.82
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC ENA EXTRACTABLE NUCLEAR AB SCREEN
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200169
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
OP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna Medicare |
$40.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.13
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$38.51
|
| Rate for Payer: BCBS Trust/PPO |
$126.62
|
| Rate for Payer: BCN Commercial |
$119.75
|
| Rate for Payer: BCN Medicare Advantage |
$38.51
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.51
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.52
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.43
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: Nomi Health Commercial |
$126.30
|
| Rate for Payer: PACE Senior Care Partners |
$36.58
|
| Rate for Payer: PACE SWMI |
$38.51
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: PHP Medicare Advantage |
$38.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: Priority Health HMO/PPO |
$134.00
|
| Rate for Payer: Priority Health Medicare |
$38.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.19
|
| Rate for Payer: Railroad Medicare Medicare |
$38.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.54
|
| Rate for Payer: UHC Core |
$128.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.51
|
| Rate for Payer: UHC Exchange |
$38.51
|
| Rate for Payer: UHC Medicare Advantage |
$38.51
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: VA VA |
$38.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.52
|
|
|
HC ENCEPHALOPATHY EVAL, CSF
|
Facility
|
IP
|
$154.02
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100723
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.11 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: BCBS Trust/PPO |
$125.73
|
| Rate for Payer: BCN Commercial |
$119.03
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.92
|
| Rate for Payer: Nomi Health Commercial |
$126.30
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.11
|
| Rate for Payer: Priority Health HMO/PPO |
$134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.54
|
| Rate for Payer: UHC Core |
$128.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.52
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
OP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$60.32 |
| Rate for Payer: Aetna Commercial |
$56.97
|
| Rate for Payer: Aetna Medicare |
$17.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.94
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$55.10
|
| Rate for Payer: BCN Commercial |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$16.75
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$57.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$60.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.27
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.59
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.97
|
| Rate for Payer: Nomi Health Commercial |
$54.96
|
| Rate for Payer: PACE Senior Care Partners |
$15.92
|
| Rate for Payer: PACE SWMI |
$16.75
|
| Rate for Payer: PHP Commercial |
$56.97
|
| Rate for Payer: PHP Medicare Advantage |
$16.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.56
|
| Rate for Payer: Priority Health HMO/PPO |
$58.31
|
| Rate for Payer: Priority Health Medicare |
$16.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.90
|
| Rate for Payer: Railroad Medicare Medicare |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.98
|
| Rate for Payer: UHC Core |
$55.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.75
|
| Rate for Payer: UHC Exchange |
$16.75
|
| Rate for Payer: UHC Medicare Advantage |
$16.75
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$16.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.27
|
|
|
HC ENCEPHALOPATHY EVAL, CSF CMPT 1
|
Facility
|
IP
|
$67.02
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.56 |
| Max. Negotiated Rate |
$60.32 |
| Rate for Payer: Aetna Commercial |
$56.97
|
| Rate for Payer: BCBS Trust/PPO |
$54.71
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: Cash Price |
$53.62
|
| Rate for Payer: Cofinity Commercial |
$57.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.62
|
| Rate for Payer: Healthscope Commercial |
$60.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.97
|
| Rate for Payer: Nomi Health Commercial |
$54.96
|
| Rate for Payer: PHP Commercial |
$56.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.56
|
| Rate for Payer: Priority Health HMO/PPO |
$58.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.98
|
| Rate for Payer: UHC Core |
$55.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.27
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
OP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$139.04 |
| Rate for Payer: Aetna Commercial |
$131.32
|
| Rate for Payer: Aetna Medicare |
$40.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$127.01
|
| Rate for Payer: BCN Commercial |
$120.12
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$132.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$139.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.87
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: PACE Senior Care Partners |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$131.32
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: Priority Health HMO/PPO |
$134.41
|
| Rate for Payer: Priority Health Medicare |
$39.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.51
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.95
|
| Rate for Payer: UHC Core |
$129.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$38.62
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.87
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 1
|
Facility
|
IP
|
$154.49
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100722
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.42 |
| Max. Negotiated Rate |
$139.04 |
| Rate for Payer: Aetna Commercial |
$131.32
|
| Rate for Payer: BCBS Trust/PPO |
$126.11
|
| Rate for Payer: BCN Commercial |
$119.39
|
| Rate for Payer: Cash Price |
$123.59
|
| Rate for Payer: Cofinity Commercial |
$132.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.59
|
| Rate for Payer: Healthscope Commercial |
$139.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.32
|
| Rate for Payer: Nomi Health Commercial |
$126.68
|
| Rate for Payer: PHP Commercial |
$131.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.42
|
| Rate for Payer: Priority Health HMO/PPO |
$134.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.95
|
| Rate for Payer: UHC Core |
$129.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.87
|
|
