|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,384.85
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,246.36 |
| Rate for Payer: Aetna Commercial |
$1,177.12
|
| Rate for Payer: Aetna Medicare |
$360.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$432.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$432.77
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$346.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.72
|
| Rate for Payer: BCN Commercial |
$1,076.72
|
| Rate for Payer: BCN Medicare Advantage |
$346.21
|
| Rate for Payer: Cash Price |
$1,107.88
|
| Rate for Payer: Cash Price |
$1,107.88
|
| Rate for Payer: Cofinity Commercial |
$1,190.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,107.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.21
|
| Rate for Payer: Healthscope Commercial |
$1,246.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,038.64
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$398.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,177.12
|
| Rate for Payer: PACE Senior Care Partners |
$328.90
|
| Rate for Payer: PACE SWMI |
$346.21
|
| Rate for Payer: PHP Commercial |
$1,177.12
|
| Rate for Payer: PHP Medicare Advantage |
$346.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,204.82
|
| Rate for Payer: Priority Health Medicare |
$346.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$844.62
|
| Rate for Payer: Railroad Medicare Medicare |
$346.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.67
|
| Rate for Payer: UHC Core |
$1,156.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.21
|
| Rate for Payer: UHC Medicare Advantage |
$356.60
|
| Rate for Payer: VA VA |
$346.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,038.64
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,821.50
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,110.93 |
| Max. Negotiated Rate |
$1,639.35 |
| Rate for Payer: Aetna Commercial |
$1,548.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,407.66
|
| Rate for Payer: BCN Commercial |
$1,407.66
|
| Rate for Payer: Cash Price |
$1,457.20
|
| Rate for Payer: Cofinity Commercial |
$1,566.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,457.20
|
| Rate for Payer: Healthscope Commercial |
$1,639.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,366.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,548.28
|
| Rate for Payer: PHP Commercial |
$1,548.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,275.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,584.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,110.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,602.92
|
| Rate for Payer: UHC Core |
$1,520.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,366.12
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,821.50
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$432.61 |
| Max. Negotiated Rate |
$1,639.35 |
| Rate for Payer: Aetna Commercial |
$1,548.28
|
| Rate for Payer: Aetna Medicare |
$473.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$569.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$569.22
|
| Rate for Payer: BCBS Complete |
$728.60
|
| Rate for Payer: BCBS MAPPO |
$455.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,416.22
|
| Rate for Payer: BCN Commercial |
$1,416.22
|
| Rate for Payer: BCN Medicare Advantage |
$455.38
|
| Rate for Payer: Cash Price |
$1,457.20
|
| Rate for Payer: Cofinity Commercial |
$1,566.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,457.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.38
|
| Rate for Payer: Healthscope Commercial |
$1,639.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,366.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$478.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$523.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,548.28
|
| Rate for Payer: PACE Senior Care Partners |
$432.61
|
| Rate for Payer: PACE SWMI |
$455.38
|
| Rate for Payer: PHP Commercial |
$1,548.28
|
| Rate for Payer: PHP Medicare Advantage |
$455.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,275.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,584.70
|
| Rate for Payer: Priority Health Medicare |
$455.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,110.93
|
| Rate for Payer: Railroad Medicare Medicare |
$455.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,602.92
|
| Rate for Payer: UHC Core |
$1,520.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.38
|
| Rate for Payer: UHC Medicare Advantage |
$469.04
|
| Rate for Payer: VA VA |
$455.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,366.12
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,517.90
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$360.50 |
| Max. Negotiated Rate |
$1,366.11 |
| Rate for Payer: Aetna Commercial |
$1,290.22
|
| Rate for Payer: Aetna Medicare |
$394.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$474.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$474.34
|
| Rate for Payer: BCBS Complete |
$607.16
|
| Rate for Payer: BCBS MAPPO |
$379.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,180.17
|
| Rate for Payer: BCN Commercial |
$1,180.17
|
| Rate for Payer: BCN Medicare Advantage |
$379.48
|
| Rate for Payer: Cash Price |
$1,214.32
|
| Rate for Payer: Cofinity Commercial |
$1,305.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.48
|
| Rate for Payer: Healthscope Commercial |
$1,366.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$398.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.22
|
| Rate for Payer: PACE Senior Care Partners |
$360.50
|
| Rate for Payer: PACE SWMI |
$379.48
|
| Rate for Payer: PHP Commercial |
$1,290.22
|
| Rate for Payer: PHP Medicare Advantage |
$379.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,320.57
|
| Rate for Payer: Priority Health Medicare |
$379.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.77
|
| Rate for Payer: Railroad Medicare Medicare |
$379.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,335.75
|
| Rate for Payer: UHC Core |
$1,267.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.48
|
| Rate for Payer: UHC Medicare Advantage |
$390.86
|
| Rate for Payer: VA VA |
$379.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.42
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,517.90
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$925.77 |
| Max. Negotiated Rate |
$1,366.11 |
| Rate for Payer: Aetna Commercial |
$1,290.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.03
|
| Rate for Payer: BCN Commercial |
$1,173.03
|
| Rate for Payer: Cash Price |
$1,214.32
|
| Rate for Payer: Cofinity Commercial |
$1,305.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.32
|
| Rate for Payer: Healthscope Commercial |
$1,366.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,290.22
|
| Rate for Payer: PHP Commercial |
$1,290.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,062.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,320.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$925.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,335.75
|
| Rate for Payer: UHC Core |
$1,267.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.42
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
OP
|
$2,319.50
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$550.88 |
| Max. Negotiated Rate |
$2,087.55 |
| Rate for Payer: Aetna Commercial |
$1,971.58
|
| Rate for Payer: Aetna Medicare |
$603.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$724.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$724.84
|
| Rate for Payer: BCBS Complete |
$927.80
|
| Rate for Payer: BCBS MAPPO |
$579.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.41
|
| Rate for Payer: BCN Commercial |
$1,803.41
|
| Rate for Payer: BCN Medicare Advantage |
$579.88
|
| Rate for Payer: Cash Price |
$1,855.60
|
| Rate for Payer: Cofinity Commercial |
$1,994.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,855.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$579.88
|
| Rate for Payer: Healthscope Commercial |
$2,087.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,739.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$608.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$666.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,971.58
|
| Rate for Payer: PACE Senior Care Partners |
$550.88
|
| Rate for Payer: PACE SWMI |
$579.88
|
| Rate for Payer: PHP Commercial |
$1,971.58
|
| Rate for Payer: PHP Medicare Advantage |
$579.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,623.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,017.96
|
| Rate for Payer: Priority Health Medicare |
$579.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.66
|
| Rate for Payer: Railroad Medicare Medicare |
$579.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,041.16
|
| Rate for Payer: UHC Core |
$1,936.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$579.88
|
| Rate for Payer: UHC Medicare Advantage |
$597.27
|
| Rate for Payer: VA VA |
$579.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,739.62
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
IP
|
$2,319.50
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,414.66 |
| Max. Negotiated Rate |
$2,087.55 |
| Rate for Payer: Aetna Commercial |
$1,971.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,792.51
|
| Rate for Payer: BCN Commercial |
$1,792.51
|
| Rate for Payer: Cash Price |
$1,855.60
|
| Rate for Payer: Cofinity Commercial |
$1,994.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,855.60
|
| Rate for Payer: Healthscope Commercial |
$2,087.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,739.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,971.58
|
| Rate for Payer: PHP Commercial |
$1,971.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,623.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,017.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,041.16
|
| Rate for Payer: UHC Core |
$1,936.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,739.62
|
|
|
HC MR BRAIN W CON
|
Facility
|
OP
|
$2,438.51
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,194.66 |
| Rate for Payer: Aetna Commercial |
$2,072.73
|
| Rate for Payer: Aetna Medicare |
$634.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$762.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$762.03
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$609.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,895.94
|
| Rate for Payer: BCN Commercial |
$1,895.94
|
| Rate for Payer: BCN Medicare Advantage |
$609.63
|
| Rate for Payer: Cash Price |
$1,950.81
|
| Rate for Payer: Cash Price |
$1,950.81
|
| Rate for Payer: Cofinity Commercial |
$2,097.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.63
|
| Rate for Payer: Healthscope Commercial |
$2,194.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,828.88
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$640.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$701.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,072.73
|
| Rate for Payer: PACE Senior Care Partners |
$579.15
|
| Rate for Payer: PACE SWMI |
$609.63
|
| Rate for Payer: PHP Commercial |
$2,072.73
|
| Rate for Payer: PHP Medicare Advantage |
$609.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,706.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.50
|
| Rate for Payer: Priority Health Medicare |
$609.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,487.25
|
| Rate for Payer: Railroad Medicare Medicare |
$609.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,145.89
|
| Rate for Payer: UHC Core |
$2,036.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$609.63
|
| Rate for Payer: UHC Medicare Advantage |
$627.92
|
| Rate for Payer: VA VA |
$609.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,828.88
|
|
|
HC MR BRAIN W CON
|
Facility
|
IP
|
$2,438.51
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,487.25 |
| Max. Negotiated Rate |
$2,194.66 |
| Rate for Payer: Aetna Commercial |
$2,072.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,884.48
|
| Rate for Payer: BCN Commercial |
$1,884.48
|
| Rate for Payer: Cash Price |
$1,950.81
|
| Rate for Payer: Cofinity Commercial |
$2,097.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,950.81
|
| Rate for Payer: Healthscope Commercial |
$2,194.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,828.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,072.73
|
| Rate for Payer: PHP Commercial |
$2,072.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,706.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,121.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,487.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,145.89
|
| Rate for Payer: UHC Core |
$2,036.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,828.88
|
|
|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,032.25
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,239.47 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.52
|
| Rate for Payer: BCN Commercial |
$1,570.52
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,727.41
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,768.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR BRAIN WO CON
|
Facility
|
OP
|
$2,032.25
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna Medicare |
$528.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.08
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$508.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,580.07
|
| Rate for Payer: BCN Commercial |
$1,580.07
|
| Rate for Payer: BCN Medicare Advantage |
$508.06
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.06
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$533.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$584.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,727.41
|
| Rate for Payer: PACE Senior Care Partners |
$482.66
|
| Rate for Payer: PACE SWMI |
$508.06
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: PHP Medicare Advantage |
$508.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,422.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,768.06
|
| Rate for Payer: Priority Health Medicare |
$508.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.47
|
| Rate for Payer: Railroad Medicare Medicare |
$508.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.06
|
| Rate for Payer: UHC Medicare Advantage |
$523.30
|
| Rate for Payer: VA VA |
$508.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
OP
|
$3,103.66
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,793.29 |
| Rate for Payer: Aetna Commercial |
$2,638.11
|
| Rate for Payer: Aetna Medicare |
$806.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$775.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,413.10
|
| Rate for Payer: BCN Commercial |
$2,413.10
|
| Rate for Payer: BCN Medicare Advantage |
$775.92
|
| Rate for Payer: Cash Price |
$2,482.93
|
| Rate for Payer: Cash Price |
$2,482.93
|
| Rate for Payer: Cofinity Commercial |
$2,669.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,482.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.92
|
| Rate for Payer: Healthscope Commercial |
$2,793.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,327.74
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$892.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,638.11
|
| Rate for Payer: PACE Senior Care Partners |
$737.12
|
| Rate for Payer: PACE SWMI |
$775.92
|
| Rate for Payer: PHP Commercial |
$2,638.11
|
| Rate for Payer: PHP Medicare Advantage |
$775.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,700.18
|
| Rate for Payer: Priority Health Medicare |
$775.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,892.92
|
| Rate for Payer: Railroad Medicare Medicare |
$775.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,731.22
|
| Rate for Payer: UHC Core |
$2,591.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.92
|
| Rate for Payer: UHC Medicare Advantage |
$799.19
|
| Rate for Payer: VA VA |
$775.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,327.74
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
IP
|
$3,103.66
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,892.92 |
| Max. Negotiated Rate |
$2,793.29 |
| Rate for Payer: Aetna Commercial |
$2,638.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,398.51
|
| Rate for Payer: BCN Commercial |
$2,398.51
|
| Rate for Payer: Cash Price |
$2,482.93
|
| Rate for Payer: Cofinity Commercial |
$2,669.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,482.93
|
| Rate for Payer: Healthscope Commercial |
$2,793.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,327.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,638.11
|
| Rate for Payer: PHP Commercial |
$2,638.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,172.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,700.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,892.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,731.22
|
| Rate for Payer: UHC Core |
$2,591.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,327.74
|
|
|
HC MR BREAST ABBREVIATED WO W CON
|
Facility
|
IP
|
$283.77
|
|
|
Service Code
|
CPT 77049
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$173.07 |
| Max. Negotiated Rate |
$255.39 |
| Rate for Payer: Aetna Commercial |
$241.20
|
| Rate for Payer: BCBS Trust/PPO |
$219.30
|
| Rate for Payer: BCN Commercial |
$219.30
|
| Rate for Payer: Cash Price |
$227.02
|
| Rate for Payer: Cofinity Commercial |
$244.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.02
|
| Rate for Payer: Healthscope Commercial |
$255.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.20
|
| Rate for Payer: PHP Commercial |
$241.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.72
|
| Rate for Payer: UHC Core |
$236.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.83
|
|
|
HC MR BREAST ABBREVIATED WO W CON
|
Facility
|
OP
|
$283.77
|
|
|
Service Code
|
CPT 77049
|
| Hospital Charge Code |
61000093
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$67.40 |
| Max. Negotiated Rate |
$366.01 |
| Rate for Payer: Aetna Commercial |
$241.20
|
| Rate for Payer: Aetna Medicare |
$73.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.68
|
| Rate for Payer: BCBS Complete |
$113.51
|
| Rate for Payer: BCBS MAPPO |
$70.94
|
| Rate for Payer: BCBS Trust/PPO |
$220.63
|
| Rate for Payer: BCCCP Commercial |
$366.01
|
| Rate for Payer: BCN Commercial |
$220.63
|
| Rate for Payer: BCN Medicare Advantage |
$70.94
|
| Rate for Payer: Cash Price |
$227.02
|
| Rate for Payer: Cash Price |
$227.02
|
| Rate for Payer: Cofinity Commercial |
$244.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.94
|
| Rate for Payer: Healthscope Commercial |
$255.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$74.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.20
|
| Rate for Payer: PACE Senior Care Partners |
$67.40
|
| Rate for Payer: PACE SWMI |
$70.94
|
| Rate for Payer: PHP Commercial |
$241.20
|
| Rate for Payer: PHP Medicare Advantage |
$70.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.88
|
| Rate for Payer: Priority Health Medicare |
$70.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.07
|
| Rate for Payer: Railroad Medicare Medicare |
$70.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.72
|
| Rate for Payer: UHC Core |
$236.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.94
|
| Rate for Payer: UHC Medicare Advantage |
$73.07
|
| Rate for Payer: VA VA |
$70.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.83
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
OP
|
$1,210.32
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,089.29 |
| Rate for Payer: Aetna Commercial |
$1,028.77
|
| Rate for Payer: Aetna Medicare |
$314.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.22
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$302.58
|
| Rate for Payer: BCBS Trust/PPO |
$941.02
|
| Rate for Payer: BCN Commercial |
$941.02
|
| Rate for Payer: BCN Medicare Advantage |
$302.58
|
| Rate for Payer: Cash Price |
$968.26
|
| Rate for Payer: Cash Price |
$968.26
|
| Rate for Payer: Cofinity Commercial |
$1,040.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.58
|
| Rate for Payer: Healthscope Commercial |
$1,089.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.74
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$317.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,028.77
|
| Rate for Payer: PACE Senior Care Partners |
$287.45
|
| Rate for Payer: PACE SWMI |
$302.58
|
| Rate for Payer: PHP Commercial |
$1,028.77
|
| Rate for Payer: PHP Medicare Advantage |
$302.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,052.98
|
| Rate for Payer: Priority Health Medicare |
$302.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.17
|
| Rate for Payer: Railroad Medicare Medicare |
$302.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.08
|
| Rate for Payer: UHC Core |
$1,010.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.58
|
| Rate for Payer: UHC Medicare Advantage |
$311.66
|
| Rate for Payer: VA VA |
$302.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.74
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
IP
|
$1,210.32
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$738.17 |
| Max. Negotiated Rate |
$1,089.29 |
| Rate for Payer: Aetna Commercial |
$1,028.77
|
| Rate for Payer: BCBS Trust/PPO |
$935.34
|
| Rate for Payer: BCN Commercial |
$935.34
|
| Rate for Payer: Cash Price |
$968.26
|
| Rate for Payer: Cofinity Commercial |
$1,040.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.26
|
| Rate for Payer: Healthscope Commercial |
$1,089.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,028.77
|
| Rate for Payer: PHP Commercial |
$1,028.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,052.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$738.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.08
|
| Rate for Payer: UHC Core |
$1,010.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.74
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
OP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna Commercial |
$1,049.35
|
| Rate for Payer: Aetna Medicare |
$320.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.79
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$308.63
|
| Rate for Payer: BCBS Trust/PPO |
$959.85
|
| Rate for Payer: BCN Commercial |
$959.85
|
| Rate for Payer: BCN Medicare Advantage |
$308.63
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,061.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.63
|
| Rate for Payer: Healthscope Commercial |
$1,111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.90
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$324.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,049.35
|
| Rate for Payer: PACE Senior Care Partners |
$293.20
|
| Rate for Payer: PACE SWMI |
$308.63
|
| Rate for Payer: PHP Commercial |
$1,049.35
|
| Rate for Payer: PHP Medicare Advantage |
$308.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.04
|
| Rate for Payer: Priority Health Medicare |
$308.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.94
|
| Rate for Payer: Railroad Medicare Medicare |
$308.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.39
|
| Rate for Payer: UHC Core |
$1,030.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.63
|
| Rate for Payer: UHC Medicare Advantage |
$317.89
|
| Rate for Payer: VA VA |
$308.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.90
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
IP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$752.94 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna Commercial |
$1,049.35
|
| Rate for Payer: BCBS Trust/PPO |
$954.04
|
| Rate for Payer: BCN Commercial |
$954.04
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,061.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Healthscope Commercial |
$1,111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,049.35
|
| Rate for Payer: PHP Commercial |
$1,049.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,074.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.39
|
| Rate for Payer: UHC Core |
$1,030.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.90
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
IP
|
$2,091.10
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,275.36 |
| Max. Negotiated Rate |
$1,881.99 |
| Rate for Payer: Aetna Commercial |
$1,777.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,616.00
|
| Rate for Payer: BCN Commercial |
$1,616.00
|
| Rate for Payer: Cash Price |
$1,672.88
|
| Rate for Payer: Cofinity Commercial |
$1,798.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.88
|
| Rate for Payer: Healthscope Commercial |
$1,881.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,777.44
|
| Rate for Payer: PHP Commercial |
$1,777.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,819.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,840.17
|
| Rate for Payer: UHC Core |
$1,746.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.32
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
OP
|
$2,091.10
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,881.99 |
| Rate for Payer: Aetna Commercial |
$1,777.44
|
| Rate for Payer: Aetna Medicare |
$543.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$653.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$653.47
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$522.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.83
|
| Rate for Payer: BCN Commercial |
$1,625.83
|
| Rate for Payer: BCN Medicare Advantage |
$522.78
|
| Rate for Payer: Cash Price |
$1,672.88
|
| Rate for Payer: Cash Price |
$1,672.88
|
| Rate for Payer: Cofinity Commercial |
$1,798.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.78
|
| Rate for Payer: Healthscope Commercial |
$1,881.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.32
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$548.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$601.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,777.44
|
| Rate for Payer: PACE Senior Care Partners |
$496.64
|
| Rate for Payer: PACE SWMI |
$522.78
|
| Rate for Payer: PHP Commercial |
$1,777.44
|
| Rate for Payer: PHP Medicare Advantage |
$522.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,819.26
|
| Rate for Payer: Priority Health Medicare |
$522.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,275.36
|
| Rate for Payer: Railroad Medicare Medicare |
$522.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,840.17
|
| Rate for Payer: UHC Core |
$1,746.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$522.78
|
| Rate for Payer: UHC Medicare Advantage |
$538.46
|
| Rate for Payer: VA VA |
$522.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.32
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,300.87 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,648.32
|
| Rate for Payer: BCN Commercial |
$1,648.32
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,812.98
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$366.01 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Medicare |
$554.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$666.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$666.54
|
| Rate for Payer: BCBS Complete |
$853.17
|
| Rate for Payer: BCBS MAPPO |
$533.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.35
|
| Rate for Payer: BCCCP Commercial |
$366.01
|
| Rate for Payer: BCN Commercial |
$1,658.35
|
| Rate for Payer: BCN Medicare Advantage |
$533.23
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.23
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$559.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$613.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,812.98
|
| Rate for Payer: PACE Senior Care Partners |
$506.57
|
| Rate for Payer: PACE SWMI |
$533.23
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Medicare Advantage |
$533.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,493.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,855.64
|
| Rate for Payer: Priority Health Medicare |
$533.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.87
|
| Rate for Payer: Railroad Medicare Medicare |
$533.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$533.23
|
| Rate for Payer: UHC Medicare Advantage |
$549.23
|
| Rate for Payer: VA VA |
$533.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST CAD
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$16.32
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC MR BREAST CAD
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
