|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
OP
|
$890.60
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$120.53 |
| Max. Negotiated Rate |
$801.54 |
| Rate for Payer: Aetna Commercial |
$757.01
|
| Rate for Payer: Aetna Medicare |
$231.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.31
|
| Rate for Payer: BCBS Complete |
$126.56
|
| Rate for Payer: BCBS MAPPO |
$222.65
|
| Rate for Payer: BCBS Trust/PPO |
$692.44
|
| Rate for Payer: BCN Commercial |
$692.44
|
| Rate for Payer: BCN Medicare Advantage |
$222.65
|
| Rate for Payer: Cash Price |
$712.48
|
| Rate for Payer: Cash Price |
$712.48
|
| Rate for Payer: Cofinity Commercial |
$765.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.65
|
| Rate for Payer: Healthscope Commercial |
$801.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.95
|
| Rate for Payer: Mclaren Medicaid |
$120.53
|
| Rate for Payer: Meridian Medicaid |
$126.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$757.01
|
| Rate for Payer: PACE Senior Care Partners |
$211.52
|
| Rate for Payer: PACE SWMI |
$222.65
|
| Rate for Payer: PHP Commercial |
$757.01
|
| Rate for Payer: PHP Medicare Advantage |
$222.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.82
|
| Rate for Payer: Priority Health Medicare |
$222.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.18
|
| Rate for Payer: Railroad Medicare Medicare |
$222.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.73
|
| Rate for Payer: UHC Core |
$743.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.65
|
| Rate for Payer: UHC Medicare Advantage |
$229.33
|
| Rate for Payer: VA VA |
$222.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.95
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$890.60
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$543.18 |
| Max. Negotiated Rate |
$801.54 |
| Rate for Payer: Aetna Commercial |
$757.01
|
| Rate for Payer: BCBS Trust/PPO |
$688.26
|
| Rate for Payer: BCN Commercial |
$688.26
|
| Rate for Payer: Cash Price |
$712.48
|
| Rate for Payer: Cofinity Commercial |
$765.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.48
|
| Rate for Payer: Healthscope Commercial |
$801.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$757.01
|
| Rate for Payer: PHP Commercial |
$757.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$543.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.73
|
| Rate for Payer: UHC Core |
$743.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.95
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,210.32
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
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 UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,210.32
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
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 UNI WO W CON
|
Facility
|
OP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Medicare |
$612.05
|
| Rate for Payer: Aetna Medicare |
$408.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$735.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$735.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.43
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$392.34
|
| Rate for Payer: BCBS MAPPO |
$588.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,830.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.19
|
| Rate for Payer: BCN Commercial |
$1,830.27
|
| Rate for Payer: BCN Commercial |
$1,220.19
|
| Rate for Payer: BCN Medicare Advantage |
$392.34
|
| Rate for Payer: BCN Medicare Advantage |
$588.51
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.34
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$617.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$676.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,000.94
|
| Rate for Payer: PACE Senior Care Partners |
$559.09
|
| Rate for Payer: PACE Senior Care Partners |
$372.73
|
| Rate for Payer: PACE SWMI |
$392.34
|
| Rate for Payer: PACE SWMI |
$588.51
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Medicare Advantage |
$588.51
|
| Rate for Payer: PHP Medicare Advantage |
$392.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,048.02
|
| Rate for Payer: Priority Health Medicare |
$392.34
|
| Rate for Payer: Priority Health Medicare |
$588.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.16
|
| Rate for Payer: Railroad Medicare Medicare |
$392.34
|
| Rate for Payer: Railroad Medicare Medicare |
$588.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.34
|
| Rate for Payer: UHC Medicare Advantage |
$404.11
|
| Rate for Payer: UHC Medicare Advantage |
$606.17
|
| Rate for Payer: VA VA |
$588.51
|
| Rate for Payer: VA VA |
$392.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$957.16 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.81
|
| Rate for Payer: BCN Commercial |
$1,819.21
|
| Rate for Payer: BCN Commercial |
$1,212.81
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,048.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$1,569.37
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$358.33 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Medicare |
$408.04
|
| Rate for Payer: Aetna Medicare |
$612.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$735.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$735.64
|
| Rate for Payer: BCBS Complete |
$941.62
|
| Rate for Payer: BCBS Complete |
$627.75
|
| Rate for Payer: BCBS MAPPO |
$392.34
|
| Rate for Payer: BCBS MAPPO |
$588.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,830.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,220.19
|
| Rate for Payer: BCCCP Commercial |
$358.33
|
| Rate for Payer: BCCCP Commercial |
$358.33
|
| Rate for Payer: BCN Commercial |
$1,830.27
|
| Rate for Payer: BCN Commercial |
$1,220.19
|
| Rate for Payer: BCN Medicare Advantage |
$392.34
|
| Rate for Payer: BCN Medicare Advantage |
$588.51
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.51
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$617.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$676.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,000.94
|
| Rate for Payer: PACE Senior Care Partners |
$372.73
|
| Rate for Payer: PACE Senior Care Partners |
$559.09
|
| Rate for Payer: PACE SWMI |
$392.34
|
| Rate for Payer: PACE SWMI |
$588.51
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Medicare Advantage |
$588.51
|
| Rate for Payer: PHP Medicare Advantage |
$392.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,048.02
|
| Rate for Payer: Priority Health Medicare |
$392.34
|
| Rate for Payer: Priority Health Medicare |
$588.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.16
|
| Rate for Payer: Railroad Medicare Medicare |
$588.51
|
| Rate for Payer: Railroad Medicare Medicare |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.51
|
| Rate for Payer: UHC Medicare Advantage |
$606.17
|
| Rate for Payer: UHC Medicare Advantage |
$404.11
|
| Rate for Payer: VA VA |
$392.34
|
| Rate for Payer: VA VA |
$588.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$2,354.05
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,435.74 |
| Max. Negotiated Rate |
$2,118.64 |
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.21
|
| Rate for Payer: BCN Commercial |
$1,212.81
|
| Rate for Payer: BCN Commercial |
$1,819.21
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,647.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,098.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,048.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,365.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,435.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
IP
|
$2,091.10
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
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 WO CON BIL
|
Facility
|
OP
|
$2,091.10
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| 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 |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$522.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,625.83
|
| Rate for Payer: BCCCP Commercial |
$233.67
|
| 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 |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| 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 |
$160.74
|
| 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 WO CON UNI
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Aetna Commercial |
$1,307.30
|
| Rate for Payer: Aetna Medicare |
$399.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.62
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$384.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.80
|
| Rate for Payer: BCCCP Commercial |
$225.34
|
| Rate for Payer: BCN Commercial |
$1,195.80
|
| Rate for Payer: BCN Medicare Advantage |
$384.50
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cofinity Commercial |
$1,322.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.50
|
| Rate for Payer: Healthscope Commercial |
$1,384.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.50
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$442.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,307.30
|
| Rate for Payer: PACE Senior Care Partners |
$365.28
|
| Rate for Payer: PACE SWMI |
$384.50
|
| Rate for Payer: PHP Commercial |
$1,307.30
|
| Rate for Payer: PHP Medicare Advantage |
$384.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.06
|
| Rate for Payer: Priority Health Medicare |
$384.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$938.03
|
| Rate for Payer: Railroad Medicare Medicare |
$384.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.44
|
| Rate for Payer: UHC Core |
$1,284.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.50
|
| Rate for Payer: UHC Medicare Advantage |
$396.04
|
| Rate for Payer: VA VA |
$384.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.50
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$938.03 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Aetna Commercial |
$1,307.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.57
|
| Rate for Payer: BCN Commercial |
$1,188.57
|
| Rate for Payer: Cash Price |
$1,230.40
|
| Rate for Payer: Cofinity Commercial |
$1,322.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.40
|
| Rate for Payer: Healthscope Commercial |
$1,384.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,307.30
|
| Rate for Payer: PHP Commercial |
$1,307.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,338.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$938.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.44
|
| Rate for Payer: UHC Core |
$1,284.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.50
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$548.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.81
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$527.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.61
|
| Rate for Payer: BCN Commercial |
$1,641.61
|
| Rate for Payer: BCN Medicare Advantage |
$527.85
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.85
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$554.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$607.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PACE Senior Care Partners |
$501.46
|
| Rate for Payer: PACE SWMI |
$527.85
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$527.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.92
|
| Rate for Payer: Priority Health Medicare |
$527.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,287.74
|
| Rate for Payer: Railroad Medicare Medicare |
$527.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.85
|
| Rate for Payer: UHC Medicare Advantage |
$543.69
|
| Rate for Payer: VA VA |
$527.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,287.74 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.69
|
| Rate for Payer: BCN Commercial |
$1,631.69
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,287.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$971.55
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$592.55 |
| Max. Negotiated Rate |
$874.40 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: BCBS Trust/PPO |
$750.81
|
| Rate for Payer: BCN Commercial |
$750.81
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cofinity Commercial |
$835.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.24
|
| Rate for Payer: Healthscope Commercial |
$874.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$825.82
|
| Rate for Payer: PHP Commercial |
$825.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.96
|
| Rate for Payer: UHC Core |
$811.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.66
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$971.55
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$230.74 |
| Max. Negotiated Rate |
$874.40 |
| Rate for Payer: Aetna Commercial |
$825.82
|
| Rate for Payer: Aetna Medicare |
$252.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.61
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$242.89
|
| Rate for Payer: BCBS Trust/PPO |
$755.38
|
| Rate for Payer: BCN Commercial |
$755.38
|
| Rate for Payer: BCN Medicare Advantage |
$242.89
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cash Price |
$777.24
|
| Rate for Payer: Cofinity Commercial |
$835.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.89
|
| Rate for Payer: Healthscope Commercial |
$874.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.66
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$825.82
|
| Rate for Payer: PACE Senior Care Partners |
$230.74
|
| Rate for Payer: PACE SWMI |
$242.89
|
| Rate for Payer: PHP Commercial |
$825.82
|
| Rate for Payer: PHP Medicare Advantage |
$242.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$680.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$845.25
|
| Rate for Payer: Priority Health Medicare |
$242.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.55
|
| Rate for Payer: Railroad Medicare Medicare |
$242.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.96
|
| Rate for Payer: UHC Core |
$811.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$242.89
|
| Rate for Payer: UHC Medicare Advantage |
$250.17
|
| Rate for Payer: VA VA |
$242.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.66
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,215.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$288.56 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: Aetna Medicare |
$315.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.69
|
| Rate for Payer: BCBS Complete |
$486.00
|
| Rate for Payer: BCBS MAPPO |
$303.75
|
| Rate for Payer: BCBS Trust/PPO |
$944.66
|
| Rate for Payer: BCN Commercial |
$944.66
|
| Rate for Payer: BCN Medicare Advantage |
$303.75
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.75
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,032.75
|
| Rate for Payer: PACE Senior Care Partners |
$288.56
|
| Rate for Payer: PACE SWMI |
$303.75
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: PHP Medicare Advantage |
$303.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.05
|
| Rate for Payer: Priority Health Medicare |
$303.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$741.03
|
| Rate for Payer: Railroad Medicare Medicare |
$303.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.20
|
| Rate for Payer: UHC Core |
$1,014.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.75
|
| Rate for Payer: UHC Medicare Advantage |
$312.86
|
| Rate for Payer: VA VA |
$303.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,215.00
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$741.03 |
| Max. Negotiated Rate |
$1,093.50 |
| Rate for Payer: Aetna Commercial |
$1,032.75
|
| Rate for Payer: BCBS Trust/PPO |
$938.95
|
| Rate for Payer: BCN Commercial |
$938.95
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cofinity Commercial |
$1,044.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$972.00
|
| Rate for Payer: Healthscope Commercial |
$1,093.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$911.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,032.75
|
| Rate for Payer: PHP Commercial |
$1,032.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,057.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$741.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.20
|
| Rate for Payer: UHC Core |
$1,014.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$911.25
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,287.25
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$525.24 |
| Max. Negotiated Rate |
$2,058.52 |
| Rate for Payer: Aetna Commercial |
$1,944.16
|
| Rate for Payer: Aetna Medicare |
$594.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$714.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$714.77
|
| Rate for Payer: BCBS Complete |
$551.50
|
| Rate for Payer: BCBS MAPPO |
$571.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,778.34
|
| Rate for Payer: BCN Commercial |
$1,778.34
|
| Rate for Payer: BCN Medicare Advantage |
$571.81
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cofinity Commercial |
$1,967.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$571.81
|
| Rate for Payer: Healthscope Commercial |
$2,058.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,715.44
|
| Rate for Payer: Mclaren Medicaid |
$525.24
|
| Rate for Payer: Meridian Medicaid |
$551.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$600.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$657.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.16
|
| Rate for Payer: PACE Senior Care Partners |
$543.22
|
| Rate for Payer: PACE SWMI |
$571.81
|
| Rate for Payer: PHP Commercial |
$1,944.16
|
| Rate for Payer: PHP Medicare Advantage |
$571.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$525.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,989.91
|
| Rate for Payer: Priority Health Medicare |
$571.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.99
|
| Rate for Payer: Railroad Medicare Medicare |
$571.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,012.78
|
| Rate for Payer: UHC Core |
$1,909.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$571.81
|
| Rate for Payer: UHC Medicare Advantage |
$588.97
|
| Rate for Payer: VA VA |
$571.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,715.44
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,287.25
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,394.99 |
| Max. Negotiated Rate |
$2,058.52 |
| Rate for Payer: Aetna Commercial |
$1,944.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.59
|
| Rate for Payer: BCN Commercial |
$1,767.59
|
| Rate for Payer: Cash Price |
$1,829.80
|
| Rate for Payer: Cofinity Commercial |
$1,967.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,829.80
|
| Rate for Payer: Healthscope Commercial |
$2,058.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,715.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,944.16
|
| Rate for Payer: PHP Commercial |
$1,944.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,989.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,012.78
|
| Rate for Payer: UHC Core |
$1,909.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,715.44
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$1,992.40
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,215.16 |
| Max. Negotiated Rate |
$1,793.16 |
| Rate for Payer: Aetna Commercial |
$1,693.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,539.73
|
| Rate for Payer: BCN Commercial |
$1,539.73
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cofinity Commercial |
$1,713.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,593.92
|
| Rate for Payer: Healthscope Commercial |
$1,793.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,693.54
|
| Rate for Payer: PHP Commercial |
$1,693.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,733.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,215.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,753.31
|
| Rate for Payer: UHC Core |
$1,663.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.30
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$1,992.40
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,793.16 |
| Rate for Payer: Aetna Commercial |
$1,693.54
|
| Rate for Payer: Aetna Medicare |
$518.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$622.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$622.62
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$498.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,549.09
|
| Rate for Payer: BCN Commercial |
$1,549.09
|
| Rate for Payer: BCN Medicare Advantage |
$498.10
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cash Price |
$1,593.92
|
| Rate for Payer: Cofinity Commercial |
$1,713.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,593.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.10
|
| Rate for Payer: Healthscope Commercial |
$1,793.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,494.30
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$523.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$572.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,693.54
|
| Rate for Payer: PACE Senior Care Partners |
$473.20
|
| Rate for Payer: PACE SWMI |
$498.10
|
| Rate for Payer: PHP Commercial |
$1,693.54
|
| Rate for Payer: PHP Medicare Advantage |
$498.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,733.39
|
| Rate for Payer: Priority Health Medicare |
$498.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,215.16
|
| Rate for Payer: Railroad Medicare Medicare |
$498.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,753.31
|
| Rate for Payer: UHC Core |
$1,663.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.10
|
| Rate for Payer: UHC Medicare Advantage |
$513.04
|
| Rate for Payer: VA VA |
$498.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,494.30
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$2,992.94
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,693.65 |
| Rate for Payer: Aetna Commercial |
$2,544.00
|
| Rate for Payer: Aetna Medicare |
$778.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$935.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$935.29
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$748.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,327.01
|
| Rate for Payer: BCN Commercial |
$2,327.01
|
| Rate for Payer: BCN Medicare Advantage |
$748.24
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cofinity Commercial |
$2,573.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.24
|
| Rate for Payer: Healthscope Commercial |
$2,693.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.70
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$785.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,544.00
|
| Rate for Payer: PACE Senior Care Partners |
$710.82
|
| Rate for Payer: PACE SWMI |
$748.24
|
| Rate for Payer: PHP Commercial |
$2,544.00
|
| Rate for Payer: PHP Medicare Advantage |
$748.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,095.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.86
|
| Rate for Payer: Priority Health Medicare |
$748.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.39
|
| Rate for Payer: Railroad Medicare Medicare |
$748.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.79
|
| Rate for Payer: UHC Core |
$2,499.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.24
|
| Rate for Payer: UHC Medicare Advantage |
$770.68
|
| Rate for Payer: VA VA |
$748.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.70
|
|
|
HC MR CHEST WO W CON
|
Facility
|
IP
|
$2,992.94
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,825.39 |
| Max. Negotiated Rate |
$2,693.65 |
| Rate for Payer: Aetna Commercial |
$2,544.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,312.94
|
| Rate for Payer: BCN Commercial |
$2,312.94
|
| Rate for Payer: Cash Price |
$2,394.35
|
| Rate for Payer: Cofinity Commercial |
$2,573.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.35
|
| Rate for Payer: Healthscope Commercial |
$2,693.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,544.00
|
| Rate for Payer: PHP Commercial |
$2,544.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,095.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.79
|
| Rate for Payer: UHC Core |
$2,499.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.70
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$352.92
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$215.25 |
| Max. Negotiated Rate |
$317.63 |
| Rate for Payer: Aetna Commercial |
$299.98
|
| Rate for Payer: BCBS Trust/PPO |
$272.74
|
| Rate for Payer: BCN Commercial |
$272.74
|
| Rate for Payer: Cash Price |
$282.34
|
| Rate for Payer: Cofinity Commercial |
$303.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.34
|
| Rate for Payer: Healthscope Commercial |
$317.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.98
|
| Rate for Payer: PHP Commercial |
$299.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$215.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.57
|
| Rate for Payer: UHC Core |
$294.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.69
|
|
