|
HC MENENCEPH CMPT 10
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 10
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.63
|
| Rate for Payer: Meridian Medicaid |
$10.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$9.98
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.51
|
| Rate for Payer: Meridian Medicaid |
$9.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.50
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$10.00
|
| Rate for Payer: Meridian Medicaid |
$10.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$9.98
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.51
|
| Rate for Payer: Meridian Medicaid |
$9.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$13.06 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Medicare |
$4.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$12.95
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$4.16
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: PACE Senior Care Partners |
$3.95
|
| Rate for Payer: PACE SWMI |
$4.16
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Medicare Advantage |
$4.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.49
|
| Rate for Payer: Priority Health Medicare |
$4.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.15
|
| Rate for Payer: Railroad Medicare Medicare |
$4.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.65
|
| Rate for Payer: UHC Core |
$13.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.16
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: VA VA |
$4.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$12.87
|
| Rate for Payer: BCN Commercial |
$12.87
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.15
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.65
|
| Rate for Payer: UHC Core |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 4
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
