|
HC HIGH FLOW JET VENT
|
Facility
|
IP
|
$1,064.33
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$740.77 |
| Max. Negotiated Rate |
$957.90 |
| Rate for Payer: Aetna Commercial |
$904.68
|
| Rate for Payer: BCBS Trust/PPO |
$879.03
|
| Rate for Payer: BCN Commercial |
$879.03
|
| Rate for Payer: Cash Price |
$851.46
|
| Rate for Payer: Cofinity Commercial |
$915.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.46
|
| Rate for Payer: Healthscope Commercial |
$957.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$904.68
|
| Rate for Payer: Nomi Health Commercial |
$872.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$798.25
|
| Rate for Payer: PHP Commercial |
$904.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$925.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$740.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.61
|
| Rate for Payer: UHC Core |
$888.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.25
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
OP
|
$221.74
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.09 |
| Max. Negotiated Rate |
$199.57 |
| Rate for Payer: Aetna Commercial |
$188.48
|
| Rate for Payer: Aetna Medicare |
$57.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.29
|
| Rate for Payer: BCBS Complete |
$41.04
|
| Rate for Payer: BCBS MAPPO |
$55.44
|
| Rate for Payer: BCBS Trust/PPO |
$182.29
|
| Rate for Payer: BCN Commercial |
$182.29
|
| Rate for Payer: BCN Medicare Advantage |
$55.44
|
| Rate for Payer: Cash Price |
$177.39
|
| Rate for Payer: Cofinity Commercial |
$190.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.44
|
| Rate for Payer: Healthscope Commercial |
$199.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.31
|
| Rate for Payer: Mclaren Medicaid |
$39.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.21
|
| Rate for Payer: Meridian Medicaid |
$41.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.48
|
| Rate for Payer: Nomi Health Commercial |
$181.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.31
|
| Rate for Payer: PACE Senior Care Partners |
$52.66
|
| Rate for Payer: PACE SWMI |
$55.44
|
| Rate for Payer: PHP Commercial |
$188.48
|
| Rate for Payer: PHP Medicare Advantage |
$55.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.91
|
| Rate for Payer: Priority Health Medicare |
$55.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.33
|
| Rate for Payer: Railroad Medicare Medicare |
$55.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.13
|
| Rate for Payer: UHC Core |
$185.15
|
| Rate for Payer: UHC Exchange |
$55.44
|
| Rate for Payer: UHC Medicaid |
$39.09
|
| Rate for Payer: UHC Medicare Advantage |
$55.44
|
| Rate for Payer: UHCCP Medicaid |
$39.09
|
| Rate for Payer: VA VA |
$55.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.31
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
IP
|
$221.74
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$154.33 |
| Max. Negotiated Rate |
$199.57 |
| Rate for Payer: Aetna Commercial |
$188.48
|
| Rate for Payer: BCBS Trust/PPO |
$183.14
|
| Rate for Payer: BCN Commercial |
$183.14
|
| Rate for Payer: Cash Price |
$177.39
|
| Rate for Payer: Cofinity Commercial |
$190.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.39
|
| Rate for Payer: Healthscope Commercial |
$199.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.48
|
| Rate for Payer: Nomi Health Commercial |
$181.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.31
|
| Rate for Payer: PHP Commercial |
$188.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.13
|
| Rate for Payer: UHC Core |
$185.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.31
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
IP
|
$1,572.71
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,094.61 |
| Max. Negotiated Rate |
$1,415.44 |
| Rate for Payer: Aetna Commercial |
$1,336.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,298.90
|
| Rate for Payer: BCN Commercial |
$1,298.90
|
| Rate for Payer: Cash Price |
$1,258.17
|
| Rate for Payer: Cofinity Commercial |
$1,352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,258.17
|
| Rate for Payer: Healthscope Commercial |
$1,415.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,179.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.80
|
| Rate for Payer: Nomi Health Commercial |
$1,289.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,179.53
|
| Rate for Payer: PHP Commercial |
$1,336.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,368.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,383.98
|
| Rate for Payer: UHC Core |
$1,313.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,179.53
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
OP
|
$1,572.71
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$277.27 |
| Max. Negotiated Rate |
$1,415.44 |
| Rate for Payer: Aetna Commercial |
$1,336.80
|
| Rate for Payer: Aetna Medicare |
$408.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$491.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$491.47
|
| Rate for Payer: BCBS Complete |
$291.11
|
| Rate for Payer: BCBS MAPPO |
$393.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,292.92
|
| Rate for Payer: BCN Commercial |
$1,292.92
|
| Rate for Payer: BCN Medicare Advantage |
$393.18
|
| Rate for Payer: Cash Price |
$1,258.17
|
| Rate for Payer: Cofinity Commercial |
$1,352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,258.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.18
|
| Rate for Payer: Healthscope Commercial |
$1,415.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,179.53
|
| Rate for Payer: Mclaren Medicaid |
$277.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$412.84
|
| Rate for Payer: Meridian Medicaid |
$291.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$432.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,336.80
|
| Rate for Payer: Nomi Health Commercial |
$1,289.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,179.53
|
| Rate for Payer: PACE Senior Care Partners |
$373.52
|
| Rate for Payer: PACE SWMI |
$393.18
|
| Rate for Payer: PHP Commercial |
$1,336.80
|
| Rate for Payer: PHP Medicare Advantage |
$393.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,368.26
|
| Rate for Payer: Priority Health Medicare |
$397.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,094.61
|
| Rate for Payer: Railroad Medicare Medicare |
$393.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,383.98
|
| Rate for Payer: UHC Core |
$1,313.21
|
| Rate for Payer: UHC Exchange |
$393.18
|
| Rate for Payer: UHC Medicaid |
$277.27
|
| Rate for Payer: UHC Medicare Advantage |
$393.18
|
| Rate for Payer: UHCCP Medicaid |
$277.27
|
| Rate for Payer: VA VA |
$393.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,179.53
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
OP
|
$399.26
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$359.33 |
| Rate for Payer: Aetna Commercial |
$339.37
|
| Rate for Payer: Aetna Medicare |
$103.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.77
|
| Rate for Payer: BCBS Complete |
$73.90
|
| Rate for Payer: BCBS MAPPO |
$99.81
|
| Rate for Payer: BCBS Trust/PPO |
$328.23
|
| Rate for Payer: BCN Commercial |
$328.23
|
| Rate for Payer: BCN Medicare Advantage |
$99.81
|
| Rate for Payer: Cash Price |
$319.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.81
|
| Rate for Payer: Healthscope Commercial |
$359.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.44
|
| Rate for Payer: Mclaren Medicaid |
$70.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.81
|
| Rate for Payer: Meridian Medicaid |
$73.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.37
|
| Rate for Payer: Nomi Health Commercial |
$327.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.44
|
| Rate for Payer: PACE Senior Care Partners |
$94.82
|
| Rate for Payer: PACE SWMI |
$99.81
|
| Rate for Payer: PHP Commercial |
$339.37
|
| Rate for Payer: PHP Medicare Advantage |
$99.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$347.36
|
| Rate for Payer: Priority Health Medicare |
$100.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.88
|
| Rate for Payer: Railroad Medicare Medicare |
$99.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.35
|
| Rate for Payer: UHC Core |
$333.38
|
| Rate for Payer: UHC Exchange |
$99.81
|
| Rate for Payer: UHC Medicaid |
$70.39
|
| Rate for Payer: UHC Medicare Advantage |
$99.81
|
| Rate for Payer: UHCCP Medicaid |
$70.39
|
| Rate for Payer: VA VA |
$99.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.44
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
IP
|
$399.26
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$277.88 |
| Max. Negotiated Rate |
$359.33 |
| Rate for Payer: Aetna Commercial |
$339.37
|
| Rate for Payer: BCBS Trust/PPO |
$329.75
|
| Rate for Payer: BCN Commercial |
$329.75
|
| Rate for Payer: Cash Price |
$319.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.41
|
| Rate for Payer: Healthscope Commercial |
$359.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.37
|
| Rate for Payer: Nomi Health Commercial |
$327.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.44
|
| Rate for Payer: PHP Commercial |
$339.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$347.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.35
|
| Rate for Payer: UHC Core |
$333.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.44
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
OP
|
$491.40
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$86.63 |
| Max. Negotiated Rate |
$442.26 |
| Rate for Payer: Aetna Commercial |
$417.69
|
| Rate for Payer: Aetna Medicare |
$127.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.56
|
| Rate for Payer: BCBS Complete |
$90.96
|
| Rate for Payer: BCBS MAPPO |
$122.85
|
| Rate for Payer: BCBS Trust/PPO |
$403.98
|
| Rate for Payer: BCN Commercial |
$403.98
|
| Rate for Payer: BCN Medicare Advantage |
$122.85
|
| Rate for Payer: Cash Price |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$422.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.85
|
| Rate for Payer: Healthscope Commercial |
$442.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.55
|
| Rate for Payer: Mclaren Medicaid |
$86.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.99
|
| Rate for Payer: Meridian Medicaid |
$90.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.69
|
| Rate for Payer: Nomi Health Commercial |
$402.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.55
|
| Rate for Payer: PACE Senior Care Partners |
$116.71
|
| Rate for Payer: PACE SWMI |
$122.85
|
| Rate for Payer: PHP Commercial |
$417.69
|
| Rate for Payer: PHP Medicare Advantage |
$122.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$427.52
|
| Rate for Payer: Priority Health Medicare |
$124.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.01
|
| Rate for Payer: Railroad Medicare Medicare |
$122.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.43
|
| Rate for Payer: UHC Core |
$410.32
|
| Rate for Payer: UHC Exchange |
$122.85
|
| Rate for Payer: UHC Medicaid |
$86.63
|
| Rate for Payer: UHC Medicare Advantage |
$122.85
|
| Rate for Payer: UHCCP Medicaid |
$86.63
|
| Rate for Payer: VA VA |
$122.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.55
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
IP
|
$491.40
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$342.01 |
| Max. Negotiated Rate |
$442.26 |
| Rate for Payer: Aetna Commercial |
$417.69
|
| Rate for Payer: BCBS Trust/PPO |
$405.85
|
| Rate for Payer: BCN Commercial |
$405.85
|
| Rate for Payer: Cash Price |
$393.12
|
| Rate for Payer: Cofinity Commercial |
$422.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$393.12
|
| Rate for Payer: Healthscope Commercial |
$442.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.69
|
| Rate for Payer: Nomi Health Commercial |
$402.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.55
|
| Rate for Payer: PHP Commercial |
$417.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$427.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.43
|
| Rate for Payer: UHC Core |
$410.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.55
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$552.83
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.46 |
| Max. Negotiated Rate |
$497.55 |
| Rate for Payer: Aetna Commercial |
$469.91
|
| Rate for Payer: Aetna Medicare |
$143.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.76
|
| Rate for Payer: BCBS Complete |
$102.33
|
| Rate for Payer: BCBS MAPPO |
$138.21
|
| Rate for Payer: BCBS Trust/PPO |
$454.48
|
| Rate for Payer: BCN Commercial |
$454.48
|
| Rate for Payer: BCN Medicare Advantage |
$138.21
|
| Rate for Payer: Cash Price |
$442.26
|
| Rate for Payer: Cofinity Commercial |
$475.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.21
|
| Rate for Payer: Healthscope Commercial |
$497.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.62
|
| Rate for Payer: Mclaren Medicaid |
$97.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.12
|
| Rate for Payer: Meridian Medicaid |
$102.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.91
|
| Rate for Payer: Nomi Health Commercial |
$453.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.62
|
| Rate for Payer: PACE Senior Care Partners |
$131.30
|
| Rate for Payer: PACE SWMI |
$138.21
|
| Rate for Payer: PHP Commercial |
$469.91
|
| Rate for Payer: PHP Medicare Advantage |
$138.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$480.96
|
| Rate for Payer: Priority Health Medicare |
$139.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.77
|
| Rate for Payer: Railroad Medicare Medicare |
$138.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.49
|
| Rate for Payer: UHC Core |
$461.61
|
| Rate for Payer: UHC Exchange |
$138.21
|
| Rate for Payer: UHC Medicaid |
$97.46
|
| Rate for Payer: UHC Medicare Advantage |
$138.21
|
| Rate for Payer: UHCCP Medicaid |
$97.46
|
| Rate for Payer: VA VA |
$138.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.62
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
IP
|
$552.83
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$384.77 |
| Max. Negotiated Rate |
$497.55 |
| Rate for Payer: Aetna Commercial |
$469.91
|
| Rate for Payer: BCBS Trust/PPO |
$456.58
|
| Rate for Payer: BCN Commercial |
$456.58
|
| Rate for Payer: Cash Price |
$442.26
|
| Rate for Payer: Cofinity Commercial |
$475.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.26
|
| Rate for Payer: Healthscope Commercial |
$497.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.91
|
| Rate for Payer: Nomi Health Commercial |
$453.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.62
|
| Rate for Payer: PHP Commercial |
$469.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$480.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.49
|
| Rate for Payer: UHC Core |
$461.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.62
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$153.55
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.87 |
| Max. Negotiated Rate |
$138.19 |
| Rate for Payer: Aetna Commercial |
$130.52
|
| Rate for Payer: BCBS Trust/PPO |
$126.82
|
| Rate for Payer: BCN Commercial |
$126.82
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$132.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Healthscope Commercial |
$138.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: PHP Commercial |
$130.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.12
|
| Rate for Payer: UHC Core |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.16
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$153.55
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.07 |
| Max. Negotiated Rate |
$138.19 |
| Rate for Payer: Aetna Commercial |
$130.52
|
| Rate for Payer: Aetna Medicare |
$39.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.98
|
| Rate for Payer: BCBS Complete |
$28.42
|
| Rate for Payer: BCBS MAPPO |
$38.39
|
| Rate for Payer: BCBS Trust/PPO |
$126.23
|
| Rate for Payer: BCN Commercial |
$126.23
|
| Rate for Payer: BCN Medicare Advantage |
$38.39
|
| Rate for Payer: Cash Price |
$122.84
|
| Rate for Payer: Cofinity Commercial |
$132.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.39
|
| Rate for Payer: Healthscope Commercial |
$138.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.16
|
| Rate for Payer: Mclaren Medicaid |
$27.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.31
|
| Rate for Payer: Meridian Medicaid |
$28.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.52
|
| Rate for Payer: Nomi Health Commercial |
$125.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.16
|
| Rate for Payer: PACE Senior Care Partners |
$36.47
|
| Rate for Payer: PACE SWMI |
$38.39
|
| Rate for Payer: PHP Commercial |
$130.52
|
| Rate for Payer: PHP Medicare Advantage |
$38.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.59
|
| Rate for Payer: Priority Health Medicare |
$38.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.87
|
| Rate for Payer: Railroad Medicare Medicare |
$38.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.12
|
| Rate for Payer: UHC Core |
$128.21
|
| Rate for Payer: UHC Exchange |
$38.39
|
| Rate for Payer: UHC Medicaid |
$27.07
|
| Rate for Payer: UHC Medicare Advantage |
$38.39
|
| Rate for Payer: UHCCP Medicaid |
$27.07
|
| Rate for Payer: VA VA |
$38.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.16
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$307.12
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.76 |
| Max. Negotiated Rate |
$276.41 |
| Rate for Payer: Aetna Commercial |
$261.05
|
| Rate for Payer: BCBS Trust/PPO |
$253.65
|
| Rate for Payer: BCN Commercial |
$253.65
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Cofinity Commercial |
$264.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.70
|
| Rate for Payer: Healthscope Commercial |
$276.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.05
|
| Rate for Payer: Nomi Health Commercial |
$251.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.34
|
| Rate for Payer: PHP Commercial |
$261.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.27
|
| Rate for Payer: UHC Core |
$256.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.34
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$307.12
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.15 |
| Max. Negotiated Rate |
$276.41 |
| Rate for Payer: Aetna Commercial |
$261.05
|
| Rate for Payer: Aetna Medicare |
$79.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.97
|
| Rate for Payer: BCBS Complete |
$56.85
|
| Rate for Payer: BCBS MAPPO |
$76.78
|
| Rate for Payer: BCBS Trust/PPO |
$252.48
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$76.78
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Cofinity Commercial |
$264.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.78
|
| Rate for Payer: Healthscope Commercial |
$276.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.34
|
| Rate for Payer: Mclaren Medicaid |
$54.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.62
|
| Rate for Payer: Meridian Medicaid |
$56.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.05
|
| Rate for Payer: Nomi Health Commercial |
$251.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.34
|
| Rate for Payer: PACE Senior Care Partners |
$72.94
|
| Rate for Payer: PACE SWMI |
$76.78
|
| Rate for Payer: PHP Commercial |
$261.05
|
| Rate for Payer: PHP Medicare Advantage |
$76.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.19
|
| Rate for Payer: Priority Health Medicare |
$77.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.76
|
| Rate for Payer: Railroad Medicare Medicare |
$76.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.27
|
| Rate for Payer: UHC Core |
$256.45
|
| Rate for Payer: UHC Exchange |
$76.78
|
| Rate for Payer: UHC Medicaid |
$54.15
|
| Rate for Payer: UHC Medicare Advantage |
$76.78
|
| Rate for Payer: UHCCP Medicaid |
$54.15
|
| Rate for Payer: VA VA |
$76.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.34
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$399.26
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$277.88 |
| Max. Negotiated Rate |
$359.33 |
| Rate for Payer: Aetna Commercial |
$339.37
|
| Rate for Payer: BCBS Trust/PPO |
$329.75
|
| Rate for Payer: BCN Commercial |
$329.75
|
| Rate for Payer: Cash Price |
$319.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.41
|
| Rate for Payer: Healthscope Commercial |
$359.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.37
|
| Rate for Payer: Nomi Health Commercial |
$327.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.44
|
| Rate for Payer: PHP Commercial |
$339.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$347.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.35
|
| Rate for Payer: UHC Core |
$333.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.44
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$399.26
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$359.33 |
| Rate for Payer: Aetna Commercial |
$339.37
|
| Rate for Payer: Aetna Medicare |
$103.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.77
|
| Rate for Payer: BCBS Complete |
$73.90
|
| Rate for Payer: BCBS MAPPO |
$99.81
|
| Rate for Payer: BCBS Trust/PPO |
$328.23
|
| Rate for Payer: BCN Commercial |
$328.23
|
| Rate for Payer: BCN Medicare Advantage |
$99.81
|
| Rate for Payer: Cash Price |
$319.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.81
|
| Rate for Payer: Healthscope Commercial |
$359.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.44
|
| Rate for Payer: Mclaren Medicaid |
$70.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.81
|
| Rate for Payer: Meridian Medicaid |
$73.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$339.37
|
| Rate for Payer: Nomi Health Commercial |
$327.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$299.44
|
| Rate for Payer: PACE Senior Care Partners |
$94.82
|
| Rate for Payer: PACE SWMI |
$99.81
|
| Rate for Payer: PHP Commercial |
$339.37
|
| Rate for Payer: PHP Medicare Advantage |
$99.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$347.36
|
| Rate for Payer: Priority Health Medicare |
$100.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.88
|
| Rate for Payer: Railroad Medicare Medicare |
$99.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.35
|
| Rate for Payer: UHC Core |
$333.38
|
| Rate for Payer: UHC Exchange |
$99.81
|
| Rate for Payer: UHC Medicaid |
$70.39
|
| Rate for Payer: UHC Medicare Advantage |
$99.81
|
| Rate for Payer: UHCCP Medicaid |
$70.39
|
| Rate for Payer: VA VA |
$99.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.44
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,470.83
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.31 |
| Max. Negotiated Rate |
$1,323.75 |
| Rate for Payer: Aetna Commercial |
$1,250.21
|
| Rate for Payer: Aetna Medicare |
$382.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$459.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$459.63
|
| Rate for Payer: BCBS Complete |
$272.25
|
| Rate for Payer: BCBS MAPPO |
$367.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.17
|
| Rate for Payer: BCN Commercial |
$1,209.17
|
| Rate for Payer: BCN Medicare Advantage |
$367.71
|
| Rate for Payer: Cash Price |
$1,176.66
|
| Rate for Payer: Cofinity Commercial |
$1,264.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$367.71
|
| Rate for Payer: Healthscope Commercial |
$1,323.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,103.12
|
| Rate for Payer: Mclaren Medicaid |
$259.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$386.09
|
| Rate for Payer: Meridian Medicaid |
$272.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$422.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$404.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.21
|
| Rate for Payer: Nomi Health Commercial |
$1,206.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.12
|
| Rate for Payer: PACE Senior Care Partners |
$349.32
|
| Rate for Payer: PACE SWMI |
$367.71
|
| Rate for Payer: PHP Commercial |
$1,250.21
|
| Rate for Payer: PHP Medicare Advantage |
$367.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,279.62
|
| Rate for Payer: Priority Health Medicare |
$371.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,023.70
|
| Rate for Payer: Railroad Medicare Medicare |
$367.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,294.33
|
| Rate for Payer: UHC Core |
$1,228.14
|
| Rate for Payer: UHC Exchange |
$367.71
|
| Rate for Payer: UHC Medicaid |
$259.31
|
| Rate for Payer: UHC Medicare Advantage |
$367.71
|
| Rate for Payer: UHCCP Medicaid |
$259.31
|
| Rate for Payer: VA VA |
$367.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,103.12
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,470.83
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,023.70 |
| Max. Negotiated Rate |
$1,323.75 |
| Rate for Payer: Aetna Commercial |
$1,250.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,214.76
|
| Rate for Payer: BCN Commercial |
$1,214.76
|
| Rate for Payer: Cash Price |
$1,176.66
|
| Rate for Payer: Cofinity Commercial |
$1,264.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.66
|
| Rate for Payer: Healthscope Commercial |
$1,323.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,103.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,250.21
|
| Rate for Payer: Nomi Health Commercial |
$1,206.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,103.12
|
| Rate for Payer: PHP Commercial |
$1,250.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,279.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,023.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,294.33
|
| Rate for Payer: UHC Core |
$1,228.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,103.12
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HISTOPLASMA AB
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$15.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.18
|
| Rate for Payer: BCBS Complete |
$11.36
|
| Rate for Payer: BCBS MAPPO |
$15.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.46
|
| Rate for Payer: BCN Commercial |
$50.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.35
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.35
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Mclaren Medicaid |
$10.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.11
|
| Rate for Payer: Meridian Medicaid |
$11.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PACE Senior Care Partners |
$14.58
|
| Rate for Payer: PACE SWMI |
$15.35
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: PHP Medicare Advantage |
$15.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: UHC Exchange |
$15.35
|
| Rate for Payer: UHC Medicaid |
$10.82
|
| Rate for Payer: UHC Medicare Advantage |
$15.35
|
| Rate for Payer: UHCCP Medicaid |
$10.82
|
| Rate for Payer: VA VA |
$15.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HISTOPLASMA AB
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.72 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: BCBS Trust/PPO |
$50.69
|
| Rate for Payer: BCN Commercial |
$50.69
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.48
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$21.38
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$4.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicaid |
$4.59
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$4.59
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
