|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
OP
|
$23.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Aetna Commercial |
$19.73
|
| Rate for Payer: Aetna Medicare |
$6.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.25
|
| Rate for Payer: BCBS Complete |
$4.30
|
| Rate for Payer: BCBS MAPPO |
$5.80
|
| Rate for Payer: BCBS Trust/PPO |
$19.08
|
| Rate for Payer: BCN Commercial |
$19.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.80
|
| Rate for Payer: Cash Price |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.80
|
| Rate for Payer: Healthscope Commercial |
$20.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.41
|
| Rate for Payer: Mclaren Medicaid |
$4.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.09
|
| Rate for Payer: Meridian Medicaid |
$4.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.73
|
| Rate for Payer: Nomi Health Commercial |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.41
|
| Rate for Payer: PACE Senior Care Partners |
$5.51
|
| Rate for Payer: PACE SWMI |
$5.80
|
| Rate for Payer: PHP Commercial |
$19.73
|
| Rate for Payer: PHP Medicare Advantage |
$5.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.19
|
| Rate for Payer: Priority Health Medicare |
$5.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.15
|
| Rate for Payer: Railroad Medicare Medicare |
$5.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.42
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Exchange |
$5.80
|
| Rate for Payer: UHC Medicaid |
$4.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.80
|
| Rate for Payer: UHCCP Medicaid |
$4.09
|
| Rate for Payer: VA VA |
$5.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.41
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
IP
|
$23.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Aetna Commercial |
$19.73
|
| Rate for Payer: BCBS Trust/PPO |
$19.17
|
| Rate for Payer: BCN Commercial |
$19.17
|
| Rate for Payer: Cash Price |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.57
|
| Rate for Payer: Healthscope Commercial |
$20.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.73
|
| Rate for Payer: Nomi Health Commercial |
$19.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.41
|
| Rate for Payer: PHP Commercial |
$19.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.42
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.41
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$4,175.67
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,906.27 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,448.69
|
| Rate for Payer: BCN Commercial |
$3,448.69
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$3,424.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,632.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,906.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,674.59
|
| Rate for Payer: UHC Core |
$3,486.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,175.67
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$736.17 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna Medicare |
$1,085.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,304.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,304.90
|
| Rate for Payer: BCBS Complete |
$772.92
|
| Rate for Payer: BCBS MAPPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,432.82
|
| Rate for Payer: BCN Commercial |
$3,432.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,043.92
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,043.92
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Mclaren Medicaid |
$736.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.11
|
| Rate for Payer: Meridian Medicaid |
$772.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,200.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,148.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$3,424.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PACE Senior Care Partners |
$991.72
|
| Rate for Payer: PACE SWMI |
$1,043.92
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,043.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,632.83
|
| Rate for Payer: Priority Health Medicare |
$1,054.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,906.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,043.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,674.59
|
| Rate for Payer: UHC Core |
$3,486.68
|
| Rate for Payer: UHC Exchange |
$1,043.92
|
| Rate for Payer: UHC Medicaid |
$736.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.92
|
| Rate for Payer: UHCCP Medicaid |
$736.17
|
| Rate for Payer: VA VA |
$1,043.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,401.31 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$3,541.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,256.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,256.44
|
| Rate for Payer: BCBS Complete |
$2,521.17
|
| Rate for Payer: BCBS MAPPO |
$3,405.15
|
| Rate for Payer: BCBS Trust/PPO |
$11,197.50
|
| Rate for Payer: BCN Commercial |
$11,197.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,405.15
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,405.15
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$2,401.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,575.41
|
| Rate for Payer: Meridian Medicaid |
$2,521.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,915.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,745.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Senior Care Partners |
$3,234.89
|
| Rate for Payer: PACE SWMI |
$3,405.15
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,405.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,401.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Medicare |
$3,439.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,405.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: UHC Exchange |
$3,405.15
|
| Rate for Payer: UHC Medicaid |
$2,401.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,405.15
|
| Rate for Payer: UHCCP Medicaid |
$2,401.31
|
| Rate for Payer: VA VA |
$3,405.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,479.94 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: BCBS Trust/PPO |
$11,249.25
|
| Rate for Payer: BCN Commercial |
$11,249.25
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,479.94 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: BCBS Trust/PPO |
$11,249.25
|
| Rate for Payer: BCN Commercial |
$11,249.25
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,401.31 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$3,541.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,256.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,256.44
|
| Rate for Payer: BCBS Complete |
$2,521.17
|
| Rate for Payer: BCBS MAPPO |
$3,405.15
|
| Rate for Payer: BCBS Trust/PPO |
$11,197.50
|
| Rate for Payer: BCN Commercial |
$11,197.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,405.15
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,405.15
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$2,401.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,575.41
|
| Rate for Payer: Meridian Medicaid |
$2,521.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,915.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,745.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Senior Care Partners |
$3,234.89
|
| Rate for Payer: PACE SWMI |
$3,405.15
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,405.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,401.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Medicare |
$3,439.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,405.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: UHC Exchange |
$3,405.15
|
| Rate for Payer: UHC Medicaid |
$2,401.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,405.15
|
| Rate for Payer: UHCCP Medicaid |
$2,401.31
|
| Rate for Payer: VA VA |
$3,405.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,401.31 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$3,541.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,256.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,256.44
|
| Rate for Payer: BCBS Complete |
$2,521.17
|
| Rate for Payer: BCBS MAPPO |
$3,405.15
|
| Rate for Payer: BCBS Trust/PPO |
$11,197.50
|
| Rate for Payer: BCN Commercial |
$11,197.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,405.15
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,405.15
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$2,401.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,575.41
|
| Rate for Payer: Meridian Medicaid |
$2,521.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,915.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,745.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Senior Care Partners |
$3,234.89
|
| Rate for Payer: PACE SWMI |
$3,405.15
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$3,405.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,401.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Medicare |
$3,439.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,405.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: UHC Exchange |
$3,405.15
|
| Rate for Payer: UHC Medicaid |
$2,401.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,405.15
|
| Rate for Payer: UHCCP Medicaid |
$2,401.31
|
| Rate for Payer: VA VA |
$3,405.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,479.94 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: BCBS Trust/PPO |
$11,249.25
|
| Rate for Payer: BCN Commercial |
$11,249.25
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$11,168.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,849.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,479.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,986.13
|
| Rate for Payer: UHC Core |
$11,373.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
OP
|
$4,175.67
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$736.17 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna Medicare |
$1,085.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,304.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,304.90
|
| Rate for Payer: BCBS Complete |
$772.92
|
| Rate for Payer: BCBS MAPPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,432.82
|
| Rate for Payer: BCN Commercial |
$3,432.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,043.92
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,043.92
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Mclaren Medicaid |
$736.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,096.11
|
| Rate for Payer: Meridian Medicaid |
$772.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,200.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,148.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$3,424.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PACE Senior Care Partners |
$991.72
|
| Rate for Payer: PACE SWMI |
$1,043.92
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,043.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,632.83
|
| Rate for Payer: Priority Health Medicare |
$1,054.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,906.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,043.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,674.59
|
| Rate for Payer: UHC Core |
$3,486.68
|
| Rate for Payer: UHC Exchange |
$1,043.92
|
| Rate for Payer: UHC Medicaid |
$736.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.92
|
| Rate for Payer: UHCCP Medicaid |
$736.17
|
| Rate for Payer: VA VA |
$1,043.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
IP
|
$4,175.67
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,906.27 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,448.69
|
| Rate for Payer: BCN Commercial |
$3,448.69
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$3,424.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,632.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,906.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,674.59
|
| Rate for Payer: UHC Core |
$3,486.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
OP
|
$107.78
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna Medicare |
$28.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.68
|
| Rate for Payer: BCBS Complete |
$19.95
|
| Rate for Payer: BCBS MAPPO |
$26.95
|
| Rate for Payer: BCBS Trust/PPO |
$88.61
|
| Rate for Payer: BCN Commercial |
$88.61
|
| Rate for Payer: BCN Medicare Advantage |
$26.95
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: Mclaren Medicaid |
$19.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.29
|
| Rate for Payer: Meridian Medicaid |
$19.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Nomi Health Commercial |
$88.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PACE Senior Care Partners |
$25.60
|
| Rate for Payer: PACE SWMI |
$26.95
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: PHP Medicare Advantage |
$26.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.77
|
| Rate for Payer: Priority Health Medicare |
$27.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: Railroad Medicare Medicare |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.85
|
| Rate for Payer: UHC Core |
$90.00
|
| Rate for Payer: UHC Exchange |
$26.95
|
| Rate for Payer: UHC Medicaid |
$19.00
|
| Rate for Payer: UHC Medicare Advantage |
$26.95
|
| Rate for Payer: UHCCP Medicaid |
$19.00
|
| Rate for Payer: VA VA |
$26.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
IP
|
$107.78
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$75.01 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: BCBS Trust/PPO |
$89.02
|
| Rate for Payer: BCN Commercial |
$89.02
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Nomi Health Commercial |
$88.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.85
|
| Rate for Payer: UHC Core |
$90.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
OP
|
$12,420.34
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,189.71 |
| Max. Negotiated Rate |
$11,178.31 |
| Rate for Payer: Aetna Commercial |
$10,557.29
|
| Rate for Payer: Aetna Medicare |
$3,229.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,881.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,881.36
|
| Rate for Payer: BCBS Complete |
$2,299.00
|
| Rate for Payer: BCBS MAPPO |
$3,105.09
|
| Rate for Payer: BCBS Trust/PPO |
$10,210.76
|
| Rate for Payer: BCN Commercial |
$10,210.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,105.09
|
| Rate for Payer: Cash Price |
$9,936.27
|
| Rate for Payer: Cofinity Commercial |
$10,681.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,936.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,105.09
|
| Rate for Payer: Healthscope Commercial |
$11,178.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,315.25
|
| Rate for Payer: Mclaren Medicaid |
$2,189.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,260.34
|
| Rate for Payer: Meridian Medicaid |
$2,299.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,570.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,415.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,557.29
|
| Rate for Payer: Nomi Health Commercial |
$10,184.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,315.25
|
| Rate for Payer: PACE Senior Care Partners |
$2,949.83
|
| Rate for Payer: PACE SWMI |
$3,105.09
|
| Rate for Payer: PHP Commercial |
$10,557.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,105.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,189.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,805.70
|
| Rate for Payer: Priority Health Medicare |
$3,136.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,644.56
|
| Rate for Payer: Railroad Medicare Medicare |
$3,105.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,929.90
|
| Rate for Payer: UHC Core |
$10,370.98
|
| Rate for Payer: UHC Exchange |
$3,105.09
|
| Rate for Payer: UHC Medicaid |
$2,189.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,105.09
|
| Rate for Payer: UHCCP Medicaid |
$2,189.71
|
| Rate for Payer: VA VA |
$3,105.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,315.25
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
IP
|
$12,420.34
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8,644.56 |
| Max. Negotiated Rate |
$11,178.31 |
| Rate for Payer: Aetna Commercial |
$10,557.29
|
| Rate for Payer: BCBS Trust/PPO |
$10,257.96
|
| Rate for Payer: BCN Commercial |
$10,257.96
|
| Rate for Payer: Cash Price |
$9,936.27
|
| Rate for Payer: Cofinity Commercial |
$10,681.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,936.27
|
| Rate for Payer: Healthscope Commercial |
$11,178.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,315.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,557.29
|
| Rate for Payer: Nomi Health Commercial |
$10,184.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,315.25
|
| Rate for Payer: PHP Commercial |
$10,557.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,805.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,644.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,929.90
|
| Rate for Payer: UHC Core |
$10,370.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,315.25
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$178.18 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: BCBS Trust/PPO |
$211.43
|
| Rate for Payer: BCN Commercial |
$211.43
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Nomi Health Commercial |
$209.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.28
|
| Rate for Payer: UHC Core |
$213.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.00
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$45.13 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna Medicare |
$66.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.00
|
| Rate for Payer: BCBS Complete |
$47.39
|
| Rate for Payer: BCBS MAPPO |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$210.46
|
| Rate for Payer: BCN Commercial |
$210.46
|
| Rate for Payer: BCN Medicare Advantage |
$64.00
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.00
|
| Rate for Payer: Mclaren Medicaid |
$45.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.20
|
| Rate for Payer: Meridian Medicaid |
$47.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Nomi Health Commercial |
$209.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PACE Senior Care Partners |
$60.80
|
| Rate for Payer: PACE SWMI |
$64.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: PHP Medicare Advantage |
$64.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.72
|
| Rate for Payer: Priority Health Medicare |
$64.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.18
|
| Rate for Payer: Railroad Medicare Medicare |
$64.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.28
|
| Rate for Payer: UHC Core |
$213.76
|
| Rate for Payer: UHC Exchange |
$64.00
|
| Rate for Payer: UHC Medicaid |
$45.13
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: UHCCP Medicaid |
$45.13
|
| Rate for Payer: VA VA |
$64.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.00
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
IP
|
$69.49
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$62.54 |
| Rate for Payer: Aetna Commercial |
$59.07
|
| Rate for Payer: BCBS Trust/PPO |
$57.39
|
| Rate for Payer: BCN Commercial |
$57.39
|
| Rate for Payer: Cash Price |
$55.59
|
| Rate for Payer: Cofinity Commercial |
$59.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.59
|
| Rate for Payer: Healthscope Commercial |
$62.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.07
|
| Rate for Payer: Nomi Health Commercial |
$56.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.12
|
| Rate for Payer: PHP Commercial |
$59.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.15
|
| Rate for Payer: UHC Core |
$58.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.12
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
OP
|
$69.49
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$62.54 |
| Rate for Payer: Aetna Commercial |
$59.07
|
| Rate for Payer: Aetna Medicare |
$18.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.72
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$17.37
|
| Rate for Payer: BCBS Trust/PPO |
$57.13
|
| Rate for Payer: BCN Commercial |
$57.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.37
|
| Rate for Payer: Cash Price |
$55.59
|
| Rate for Payer: Cofinity Commercial |
$59.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.37
|
| Rate for Payer: Healthscope Commercial |
$62.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.12
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.24
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.07
|
| Rate for Payer: Nomi Health Commercial |
$56.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.12
|
| Rate for Payer: PACE Senior Care Partners |
$16.50
|
| Rate for Payer: PACE SWMI |
$17.37
|
| Rate for Payer: PHP Commercial |
$59.07
|
| Rate for Payer: PHP Medicare Advantage |
$17.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.46
|
| Rate for Payer: Priority Health Medicare |
$17.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.37
|
| Rate for Payer: Railroad Medicare Medicare |
$17.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.15
|
| Rate for Payer: UHC Core |
$58.02
|
| Rate for Payer: UHC Exchange |
$17.37
|
| Rate for Payer: UHC Medicaid |
$12.25
|
| Rate for Payer: UHC Medicare Advantage |
$17.37
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$17.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.12
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
IP
|
$48.82
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$33.98 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: BCBS Trust/PPO |
$40.32
|
| Rate for Payer: BCN Commercial |
$40.32
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Nomi Health Commercial |
$40.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.96
|
| Rate for Payer: UHC Core |
$40.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
OP
|
$48.82
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna Medicare |
$12.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.26
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$40.13
|
| Rate for Payer: BCN Commercial |
$40.13
|
| Rate for Payer: BCN Medicare Advantage |
$12.21
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.21
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.82
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Nomi Health Commercial |
$40.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.59
|
| Rate for Payer: PACE SWMI |
$12.21
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicare Advantage |
$12.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.47
|
| Rate for Payer: Priority Health Medicare |
$12.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.98
|
| Rate for Payer: Railroad Medicare Medicare |
$12.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.96
|
| Rate for Payer: UHC Core |
$40.76
|
| Rate for Payer: UHC Exchange |
$12.21
|
| Rate for Payer: UHC Medicaid |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$12.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.26
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.21
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.21
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.82
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.60
|
| Rate for Payer: PACE SWMI |
$12.21
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Medicare |
$12.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$12.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: UHC Exchange |
$12.21
|
| Rate for Payer: UHC Medicaid |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
