|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
OP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: Aetna Medicare |
$24.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.64
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$23.71
|
| Rate for Payer: BCBS Trust/PPO |
$77.98
|
| Rate for Payer: BCN Commercial |
$73.75
|
| Rate for Payer: BCN Medicare Advantage |
$23.71
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.71
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.14
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.90
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.63
|
| Rate for Payer: Nomi Health Commercial |
$77.79
|
| Rate for Payer: PACE Senior Care Partners |
$22.53
|
| Rate for Payer: PACE SWMI |
$23.71
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.66
|
| Rate for Payer: Priority Health HMO/PPO |
$82.53
|
| Rate for Payer: Priority Health Medicare |
$23.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.56
|
| Rate for Payer: Railroad Medicare Medicare |
$23.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.48
|
| Rate for Payer: UHC Core |
$79.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.71
|
| Rate for Payer: UHC Exchange |
$23.71
|
| Rate for Payer: UHC Medicare Advantage |
$23.71
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$23.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.14
|
|
|
HC ENCEPHALOPATHY EVAL, S CMPT 2
|
Facility
|
IP
|
$94.86
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200484
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.43
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.63
|
| Rate for Payer: Nomi Health Commercial |
$77.79
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.66
|
| Rate for Payer: Priority Health HMO/PPO |
$82.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.48
|
| Rate for Payer: UHC Core |
$79.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.14
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
OP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$188.38 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: Aetna Medicare |
$54.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.41
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$52.33
|
| Rate for Payer: BCBS Trust/PPO |
$172.07
|
| Rate for Payer: BCN Commercial |
$162.74
|
| Rate for Payer: BCN Medicare Advantage |
$52.33
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$180.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.33
|
| Rate for Payer: Healthscope Commercial |
$188.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.98
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.94
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: Nomi Health Commercial |
$171.63
|
| Rate for Payer: PACE Senior Care Partners |
$49.71
|
| Rate for Payer: PACE SWMI |
$52.33
|
| Rate for Payer: PHP Commercial |
$177.91
|
| Rate for Payer: PHP Medicare Advantage |
$52.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: Priority Health HMO/PPO |
$182.10
|
| Rate for Payer: Priority Health Medicare |
$52.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.24
|
| Rate for Payer: Railroad Medicare Medicare |
$52.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.19
|
| Rate for Payer: UHC Core |
$174.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.33
|
| Rate for Payer: UHC Exchange |
$52.33
|
| Rate for Payer: UHC Medicare Advantage |
$52.33
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: VA VA |
$52.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.98
|
|
|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$209.31
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$136.05 |
| Max. Negotiated Rate |
$188.38 |
| Rate for Payer: Aetna Commercial |
$177.91
|
| Rate for Payer: BCBS Trust/PPO |
$170.86
|
| Rate for Payer: BCN Commercial |
$161.75
|
| Rate for Payer: Cash Price |
$167.45
|
| Rate for Payer: Cofinity Commercial |
$180.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.45
|
| Rate for Payer: Healthscope Commercial |
$188.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.91
|
| Rate for Payer: Nomi Health Commercial |
$171.63
|
| Rate for Payer: PHP Commercial |
$177.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.05
|
| Rate for Payer: Priority Health HMO/PPO |
$182.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.19
|
| Rate for Payer: UHC Core |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.98
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: Aetna Medicare |
$40.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.45
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$38.76
|
| Rate for Payer: BCBS Trust/PPO |
$127.46
|
| Rate for Payer: BCN Commercial |
$120.54
|
| Rate for Payer: BCN Medicare Advantage |
$38.76
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.76
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.28
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.70
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: Nomi Health Commercial |
$127.13
|
| Rate for Payer: PACE Senior Care Partners |
$36.82
|
| Rate for Payer: PACE SWMI |
$38.76
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: PHP Medicare Advantage |
$38.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: Priority Health HMO/PPO |
$134.88
|
| Rate for Payer: Priority Health Medicare |
$39.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.88
|
| Rate for Payer: Railroad Medicare Medicare |
$38.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.44
|
| Rate for Payer: UHC Core |
$129.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.76
|
| Rate for Payer: UHC Exchange |
$38.76
|
| Rate for Payer: UHC Medicare Advantage |
$38.76
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: VA VA |
$38.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.28
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$155.04
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.78 |
| Max. Negotiated Rate |
$139.54 |
| Rate for Payer: Aetna Commercial |
$131.78
|
| Rate for Payer: BCBS Trust/PPO |
$126.56
|
| Rate for Payer: BCN Commercial |
$119.81
|
| Rate for Payer: Cash Price |
$124.03
|
| Rate for Payer: Cofinity Commercial |
$133.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.03
|
| Rate for Payer: Healthscope Commercial |
$139.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.78
|
| Rate for Payer: Nomi Health Commercial |
$127.13
|
| Rate for Payer: PHP Commercial |
$131.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.78
|
| Rate for Payer: Priority Health HMO/PPO |
$134.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.44
|
| Rate for Payer: UHC Core |
$129.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.28
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.58
|
| Rate for Payer: BCN Commercial |
$58.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.66
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PACE Senior Care Partners |
$17.79
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Medicare |
$18.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.73
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.15
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$27.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.47
|
| Rate for Payer: BCBS Complete |
$22.18
|
| Rate for Payer: BCBS MAPPO |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$21.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.11
|
| Rate for Payer: Meridian Medicaid |
$22.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Senior Care Partners |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.77
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$26.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Medicare |
$27.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: Railroad Medicare Medicare |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.77
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$21.12
|
| Rate for Payer: VA VA |
$26.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: BCBS Trust/PPO |
$87.43
|
| Rate for Payer: BCN Commercial |
$82.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC ENDO BIOPSY
|
Facility
|
OP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$68.28 |
| Max. Negotiated Rate |
$258.74 |
| Rate for Payer: Aetna Commercial |
$244.37
|
| Rate for Payer: Aetna Medicare |
$74.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.84
|
| Rate for Payer: BCBS Complete |
$115.00
|
| Rate for Payer: BCBS MAPPO |
$71.87
|
| Rate for Payer: BCBS Trust/PPO |
$236.35
|
| Rate for Payer: BCN Commercial |
$223.52
|
| Rate for Payer: BCN Medicare Advantage |
$71.87
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$247.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.87
|
| Rate for Payer: Healthscope Commercial |
$258.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: PACE Senior Care Partners |
$68.28
|
| Rate for Payer: PACE SWMI |
$71.87
|
| Rate for Payer: PHP Commercial |
$244.37
|
| Rate for Payer: PHP Medicare Advantage |
$71.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health HMO/PPO |
$250.12
|
| Rate for Payer: Priority Health Medicare |
$72.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.62
|
| Rate for Payer: Railroad Medicare Medicare |
$71.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.99
|
| Rate for Payer: UHC Core |
$240.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.87
|
| Rate for Payer: UHC Exchange |
$71.87
|
| Rate for Payer: UHC Medicare Advantage |
$71.87
|
| Rate for Payer: VA VA |
$71.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.62
|
|
|
HC ENDO BIOPSY
|
Facility
|
IP
|
$287.49
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$186.87 |
| Max. Negotiated Rate |
$258.74 |
| Rate for Payer: Aetna Commercial |
$244.37
|
| Rate for Payer: BCBS Trust/PPO |
$234.68
|
| Rate for Payer: BCN Commercial |
$222.17
|
| Rate for Payer: Cash Price |
$229.99
|
| Rate for Payer: Cofinity Commercial |
$247.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.99
|
| Rate for Payer: Healthscope Commercial |
$258.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.37
|
| Rate for Payer: Nomi Health Commercial |
$235.74
|
| Rate for Payer: PHP Commercial |
$244.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.87
|
| Rate for Payer: Priority Health HMO/PPO |
$250.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.99
|
| Rate for Payer: UHC Core |
$240.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.62
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$439.57 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: BCBS Trust/PPO |
$552.03
|
| Rate for Payer: BCN Commercial |
$522.61
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.61 |
| Max. Negotiated Rate |
$661.07 |
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna Medicare |
$175.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.33
|
| Rate for Payer: BCBS Complete |
$661.07
|
| Rate for Payer: BCBS MAPPO |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$555.95
|
| Rate for Payer: BCN Commercial |
$525.79
|
| Rate for Payer: BCN Medicare Advantage |
$169.06
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.06
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Mclaren Medicaid |
$629.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.52
|
| Rate for Payer: Meridian Medicaid |
$661.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$554.53
|
| Rate for Payer: PACE Senior Care Partners |
$160.61
|
| Rate for Payer: PACE SWMI |
$169.06
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: PHP Medicare Advantage |
$169.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$439.57
|
| Rate for Payer: Priority Health HMO/PPO |
$588.35
|
| Rate for Payer: Priority Health Medicare |
$170.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.09
|
| Rate for Payer: Railroad Medicare Medicare |
$169.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$595.11
|
| Rate for Payer: UHC Core |
$564.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.06
|
| Rate for Payer: UHC Exchange |
$169.06
|
| Rate for Payer: UHC Medicare Advantage |
$169.06
|
| Rate for Payer: UHCCP Medicaid |
$629.55
|
| Rate for Payer: VA VA |
$169.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC ENDO CLIPPING
|
Facility
|
OP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$76.79 |
| Max. Negotiated Rate |
$291.01 |
| Rate for Payer: Aetna Commercial |
$274.84
|
| Rate for Payer: Aetna Medicare |
$84.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.04
|
| Rate for Payer: BCBS Complete |
$129.34
|
| Rate for Payer: BCBS MAPPO |
$80.83
|
| Rate for Payer: BCBS Trust/PPO |
$265.82
|
| Rate for Payer: BCN Commercial |
$251.40
|
| Rate for Payer: BCN Medicare Advantage |
$80.83
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$278.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.83
|
| Rate for Payer: Healthscope Commercial |
$291.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: PACE Senior Care Partners |
$76.79
|
| Rate for Payer: PACE SWMI |
$80.83
|
| Rate for Payer: PHP Commercial |
$274.84
|
| Rate for Payer: PHP Medicare Advantage |
$80.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health HMO/PPO |
$281.31
|
| Rate for Payer: Priority Health Medicare |
$81.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.64
|
| Rate for Payer: Railroad Medicare Medicare |
$80.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.54
|
| Rate for Payer: UHC Core |
$269.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.83
|
| Rate for Payer: UHC Exchange |
$80.83
|
| Rate for Payer: UHC Medicare Advantage |
$80.83
|
| Rate for Payer: VA VA |
$80.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.50
|
|
|
HC ENDO CLIPPING
|
Facility
|
IP
|
$323.34
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.17 |
| Max. Negotiated Rate |
$291.01 |
| Rate for Payer: Aetna Commercial |
$274.84
|
| Rate for Payer: BCBS Trust/PPO |
$263.94
|
| Rate for Payer: BCN Commercial |
$249.88
|
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Cofinity Commercial |
$278.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.67
|
| Rate for Payer: Healthscope Commercial |
$291.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.84
|
| Rate for Payer: Nomi Health Commercial |
$265.14
|
| Rate for Payer: PHP Commercial |
$274.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.17
|
| Rate for Payer: Priority Health HMO/PPO |
$281.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$284.54
|
| Rate for Payer: UHC Core |
$269.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.50
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
IP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,173.55 |
| Max. Negotiated Rate |
$1,624.91 |
| Rate for Payer: Aetna Commercial |
$1,534.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,473.80
|
| Rate for Payer: BCN Commercial |
$1,395.26
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,552.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Healthscope Commercial |
$1,624.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PHP Commercial |
$1,534.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,570.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,209.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.80
|
| Rate for Payer: UHC Core |
$1,507.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.10
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
OP
|
$1,805.46
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$428.80 |
| Max. Negotiated Rate |
$1,624.91 |
| Rate for Payer: Aetna Commercial |
$1,534.64
|
| Rate for Payer: Aetna Medicare |
$469.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$564.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$564.21
|
| Rate for Payer: BCBS Complete |
$722.18
|
| Rate for Payer: BCBS MAPPO |
$451.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.27
|
| Rate for Payer: BCN Commercial |
$1,403.75
|
| Rate for Payer: BCN Medicare Advantage |
$451.37
|
| Rate for Payer: Cash Price |
$1,444.37
|
| Rate for Payer: Cofinity Commercial |
$1,552.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.37
|
| Rate for Payer: Healthscope Commercial |
$1,624.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$473.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$519.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,534.64
|
| Rate for Payer: Nomi Health Commercial |
$1,480.48
|
| Rate for Payer: PACE Senior Care Partners |
$428.80
|
| Rate for Payer: PACE SWMI |
$451.37
|
| Rate for Payer: PHP Commercial |
$1,534.64
|
| Rate for Payer: PHP Medicare Advantage |
$451.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.55
|
| Rate for Payer: Priority Health HMO/PPO |
$1,570.75
|
| Rate for Payer: Priority Health Medicare |
$455.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,209.66
|
| Rate for Payer: Railroad Medicare Medicare |
$451.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,588.80
|
| Rate for Payer: UHC Core |
$1,507.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$451.37
|
| Rate for Payer: UHC Exchange |
$451.37
|
| Rate for Payer: UHC Medicare Advantage |
$451.37
|
| Rate for Payer: VA VA |
$451.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.10
|
|
|
HC ENDO DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.97 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: Aetna Medicare |
$345.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$415.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$415.75
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: BCBS MAPPO |
$332.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.71
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: BCN Medicare Advantage |
$332.60
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.60
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$997.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: PACE Senior Care Partners |
$315.97
|
| Rate for Payer: PACE SWMI |
$332.60
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: PHP Medicare Advantage |
$332.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,157.44
|
| Rate for Payer: Priority Health Medicare |
$335.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$891.36
|
| Rate for Payer: Railroad Medicare Medicare |
$332.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.74
|
| Rate for Payer: UHC Core |
$1,110.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.60
|
| Rate for Payer: UHC Exchange |
$332.60
|
| Rate for Payer: UHC Medicare Advantage |
$332.60
|
| Rate for Payer: VA VA |
$332.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$997.79
|
|
|
HC ENDO DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$864.75 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.00
|
| Rate for Payer: BCN Commercial |
$1,028.13
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$997.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,157.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$891.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.74
|
| Rate for Payer: UHC Core |
$1,110.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$997.79
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
OP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$255.20 |
| Max. Negotiated Rate |
$967.08 |
| Rate for Payer: Aetna Commercial |
$913.35
|
| Rate for Payer: Aetna Medicare |
$279.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.79
|
| Rate for Payer: BCBS Complete |
$429.81
|
| Rate for Payer: BCBS MAPPO |
$268.63
|
| Rate for Payer: BCBS Trust/PPO |
$883.37
|
| Rate for Payer: BCN Commercial |
$835.45
|
| Rate for Payer: BCN Medicare Advantage |
$268.63
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$924.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.63
|
| Rate for Payer: Healthscope Commercial |
$967.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: Nomi Health Commercial |
$881.11
|
| Rate for Payer: PACE Senior Care Partners |
$255.20
|
| Rate for Payer: PACE SWMI |
$268.63
|
| Rate for Payer: PHP Commercial |
$913.35
|
| Rate for Payer: PHP Medicare Advantage |
$268.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: Priority Health HMO/PPO |
$934.84
|
| Rate for Payer: Priority Health Medicare |
$271.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.94
|
| Rate for Payer: Railroad Medicare Medicare |
$268.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.59
|
| Rate for Payer: UHC Core |
$897.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.63
|
| Rate for Payer: UHC Exchange |
$268.63
|
| Rate for Payer: UHC Medicare Advantage |
$268.63
|
| Rate for Payer: VA VA |
$268.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.90
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
IP
|
$1,074.53
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$698.44 |
| Max. Negotiated Rate |
$967.08 |
| Rate for Payer: Aetna Commercial |
$913.35
|
| Rate for Payer: BCBS Trust/PPO |
$877.14
|
| Rate for Payer: BCN Commercial |
$830.40
|
| Rate for Payer: Cash Price |
$859.62
|
| Rate for Payer: Cofinity Commercial |
$924.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.62
|
| Rate for Payer: Healthscope Commercial |
$967.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.35
|
| Rate for Payer: Nomi Health Commercial |
$881.11
|
| Rate for Payer: PHP Commercial |
$913.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.44
|
| Rate for Payer: Priority Health HMO/PPO |
$934.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$719.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.59
|
| Rate for Payer: UHC Core |
$897.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.90
|
|
|
HC ENDOFORM 2X2
|
Facility
|
OP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$35.12 |
| Rate for Payer: Aetna Commercial |
$33.17
|
| Rate for Payer: Aetna Medicare |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.19
|
| Rate for Payer: BCBS Complete |
$15.61
|
| Rate for Payer: BCBS MAPPO |
$9.76
|
| Rate for Payer: BCBS Trust/PPO |
$32.08
|
| Rate for Payer: BCN Commercial |
$30.34
|
| Rate for Payer: BCN Medicare Advantage |
$9.76
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.76
|
| Rate for Payer: Healthscope Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: PACE Senior Care Partners |
$9.27
|
| Rate for Payer: PACE SWMI |
$9.76
|
| Rate for Payer: PHP Commercial |
$33.17
|
| Rate for Payer: PHP Medicare Advantage |
$9.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO |
$33.95
|
| Rate for Payer: Priority Health Medicare |
$9.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.34
|
| Rate for Payer: UHC Core |
$32.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.76
|
| Rate for Payer: UHC Exchange |
$9.76
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.27
|
|
|
HC ENDOFORM 2X2
|
Facility
|
IP
|
$39.02
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.36 |
| Max. Negotiated Rate |
$35.12 |
| Rate for Payer: Aetna Commercial |
$33.17
|
| Rate for Payer: BCBS Trust/PPO |
$31.85
|
| Rate for Payer: BCN Commercial |
$30.15
|
| Rate for Payer: Cash Price |
$31.22
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.17
|
| Rate for Payer: Nomi Health Commercial |
$32.00
|
| Rate for Payer: PHP Commercial |
$33.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.36
|
| Rate for Payer: Priority Health HMO/PPO |
$33.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.34
|
| Rate for Payer: UHC Core |
$32.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.27
|
|
|
HC ENDOFORM 4X4
|
Facility
|
IP
|
$135.72
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.22 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: BCBS Trust/PPO |
$110.79
|
| Rate for Payer: BCN Commercial |
$104.88
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.36
|
| Rate for Payer: Nomi Health Commercial |
$111.29
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.22
|
| Rate for Payer: Priority Health HMO/PPO |
$118.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.43
|
| Rate for Payer: UHC Core |
$113.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.79
|
|
