|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.86
|
| Rate for Payer: BCN Commercial |
$22.86
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: Aetna Medicare |
$7.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.24
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$23.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.40
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.40
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PACE Senior Care Partners |
$7.03
|
| Rate for Payer: PACE SWMI |
$7.40
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Medicare |
$7.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.40
|
| Rate for Payer: UHC Medicare Advantage |
$7.62
|
| Rate for Payer: VA VA |
$7.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$34.02
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.75 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Aetna Commercial |
$28.92
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$27.22
|
| Rate for Payer: Cofinity Commercial |
$29.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.22
|
| Rate for Payer: Healthscope Commercial |
$30.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.92
|
| Rate for Payer: PHP Commercial |
$28.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.94
|
| Rate for Payer: UHC Core |
$28.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.52
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$34.02
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$30.62 |
| Rate for Payer: Aetna Commercial |
$28.92
|
| Rate for Payer: Aetna Medicare |
$8.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.63
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$8.50
|
| Rate for Payer: BCBS Trust/PPO |
$26.45
|
| Rate for Payer: BCN Commercial |
$26.45
|
| Rate for Payer: BCN Medicare Advantage |
$8.50
|
| Rate for Payer: Cash Price |
$27.22
|
| Rate for Payer: Cash Price |
$27.22
|
| Rate for Payer: Cofinity Commercial |
$29.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.50
|
| Rate for Payer: Healthscope Commercial |
$30.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.52
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.92
|
| Rate for Payer: PACE Senior Care Partners |
$8.08
|
| Rate for Payer: PACE SWMI |
$8.50
|
| Rate for Payer: PHP Commercial |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$8.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.60
|
| Rate for Payer: Priority Health Medicare |
$8.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.75
|
| Rate for Payer: Railroad Medicare Medicare |
$8.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.94
|
| Rate for Payer: UHC Core |
$28.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.50
|
| Rate for Payer: UHC Medicare Advantage |
$8.76
|
| Rate for Payer: VA VA |
$8.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.52
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$143.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$128.79 |
| Rate for Payer: Aetna Commercial |
$121.64
|
| Rate for Payer: Aetna Medicare |
$37.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.72
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$35.78
|
| Rate for Payer: BCBS Trust/PPO |
$111.26
|
| Rate for Payer: BCN Commercial |
$111.26
|
| Rate for Payer: BCN Medicare Advantage |
$35.78
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$123.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.78
|
| Rate for Payer: Healthscope Commercial |
$128.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.32
|
| Rate for Payer: Mclaren Medicaid |
$9.53
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: PACE Senior Care Partners |
$33.99
|
| Rate for Payer: PACE SWMI |
$35.78
|
| Rate for Payer: PHP Commercial |
$121.64
|
| Rate for Payer: PHP Medicare Advantage |
$35.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.50
|
| Rate for Payer: Priority Health Medicare |
$35.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.28
|
| Rate for Payer: Railroad Medicare Medicare |
$35.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.93
|
| Rate for Payer: UHC Core |
$119.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.78
|
| Rate for Payer: UHC Medicare Advantage |
$36.85
|
| Rate for Payer: VA VA |
$35.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.32
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$143.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.28 |
| Max. Negotiated Rate |
$128.79 |
| Rate for Payer: Aetna Commercial |
$121.64
|
| Rate for Payer: BCBS Trust/PPO |
$110.59
|
| Rate for Payer: BCN Commercial |
$110.59
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$123.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Healthscope Commercial |
$128.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: PHP Commercial |
$121.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.93
|
| Rate for Payer: UHC Core |
$119.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.32
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| 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 |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$41.24
|
| Rate for Payer: BCN Commercial |
$41.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Mclaren Medicaid |
$9.53
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Medicare |
$13.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.66
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.35 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.99
|
| Rate for Payer: BCN Commercial |
$40.99
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.53 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$37.27
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$9.53
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$37.05
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$26.04
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$23.44 |
| Rate for Payer: Aetna Commercial |
$22.13
|
| Rate for Payer: Aetna Medicare |
$6.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.14
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$6.51
|
| Rate for Payer: BCBS Trust/PPO |
$20.25
|
| Rate for Payer: BCN Commercial |
$20.25
|
| Rate for Payer: BCN Medicare Advantage |
$6.51
|
| Rate for Payer: Cash Price |
$20.83
|
| Rate for Payer: Cash Price |
$20.83
|
| Rate for Payer: Cofinity Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.51
|
| Rate for Payer: Healthscope Commercial |
$23.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.53
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.13
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.51
|
| Rate for Payer: PHP Commercial |
$22.13
|
| Rate for Payer: PHP Medicare Advantage |
$6.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Medicare |
$6.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.88
|
| Rate for Payer: Railroad Medicare Medicare |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.92
|
| Rate for Payer: UHC Core |
$21.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.51
|
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: VA VA |
$6.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.53
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$26.04
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$23.44 |
| Rate for Payer: Aetna Commercial |
$22.13
|
| Rate for Payer: BCBS Trust/PPO |
$20.12
|
| Rate for Payer: BCN Commercial |
$20.12
|
| Rate for Payer: Cash Price |
$20.83
|
| Rate for Payer: Cofinity Commercial |
$22.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.83
|
| Rate for Payer: Healthscope Commercial |
$23.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.13
|
| Rate for Payer: PHP Commercial |
$22.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.92
|
| Rate for Payer: UHC Core |
$21.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.53
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$19.52
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: Aetna Medicare |
$5.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.10
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$4.88
|
| Rate for Payer: BCBS Trust/PPO |
$15.18
|
| Rate for Payer: BCN Commercial |
$15.18
|
| Rate for Payer: BCN Medicare Advantage |
$4.88
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.88
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.59
|
| Rate for Payer: PACE Senior Care Partners |
$4.64
|
| Rate for Payer: PACE SWMI |
$4.88
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Medicare Advantage |
$4.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.98
|
| Rate for Payer: Priority Health Medicare |
$4.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.91
|
| Rate for Payer: Railroad Medicare Medicare |
$4.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.18
|
| Rate for Payer: UHC Core |
$16.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.88
|
| Rate for Payer: UHC Medicare Advantage |
$5.03
|
| Rate for Payer: VA VA |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$19.52
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.91 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$15.09
|
| Rate for Payer: BCN Commercial |
$15.09
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.59
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.18
|
| Rate for Payer: UHC Core |
$16.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.30 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna Medicare |
$160.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.50
|
| Rate for Payer: BCBS Complete |
$168.25
|
| Rate for Payer: BCBS MAPPO |
$154.00
|
| Rate for Payer: BCBS Trust/PPO |
$478.94
|
| Rate for Payer: BCN Commercial |
$478.94
|
| Rate for Payer: BCN Medicare Advantage |
$154.00
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.00
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Mclaren Medicaid |
$160.23
|
| Rate for Payer: Meridian Medicaid |
$168.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PACE Senior Care Partners |
$146.30
|
| Rate for Payer: PACE SWMI |
$154.00
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: PHP Medicare Advantage |
$154.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.92
|
| Rate for Payer: Priority Health Medicare |
$154.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.70
|
| Rate for Payer: Railroad Medicare Medicare |
$154.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.00
|
| Rate for Payer: UHC Medicare Advantage |
$158.62
|
| Rate for Payer: VA VA |
$154.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.70 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: BCBS Trust/PPO |
$476.04
|
| Rate for Payer: BCN Commercial |
$476.04
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.08
|
| Rate for Payer: UHC Core |
$514.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$742.77
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$453.02 |
| Max. Negotiated Rate |
$668.49 |
| Rate for Payer: Aetna Commercial |
$631.35
|
| Rate for Payer: BCBS Trust/PPO |
$574.01
|
| Rate for Payer: BCN Commercial |
$574.01
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cofinity Commercial |
$638.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.22
|
| Rate for Payer: Healthscope Commercial |
$668.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$631.35
|
| Rate for Payer: PHP Commercial |
$631.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$653.64
|
| Rate for Payer: UHC Core |
$620.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.08
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$742.77
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.41 |
| Max. Negotiated Rate |
$668.49 |
| Rate for Payer: Aetna Commercial |
$631.35
|
| Rate for Payer: Aetna Medicare |
$193.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$232.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$232.12
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$185.69
|
| Rate for Payer: BCBS Trust/PPO |
$577.50
|
| Rate for Payer: BCN Commercial |
$577.50
|
| Rate for Payer: BCN Medicare Advantage |
$185.69
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cofinity Commercial |
$638.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.69
|
| Rate for Payer: Healthscope Commercial |
$668.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.08
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$194.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$631.35
|
| Rate for Payer: PACE Senior Care Partners |
$176.41
|
| Rate for Payer: PACE SWMI |
$185.69
|
| Rate for Payer: PHP Commercial |
$631.35
|
| Rate for Payer: PHP Medicare Advantage |
$185.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$646.21
|
| Rate for Payer: Priority Health Medicare |
$185.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$453.02
|
| Rate for Payer: Railroad Medicare Medicare |
$185.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$653.64
|
| Rate for Payer: UHC Core |
$620.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.69
|
| Rate for Payer: UHC Medicare Advantage |
$191.26
|
| Rate for Payer: VA VA |
$185.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.08
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$266.48
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.53 |
| Max. Negotiated Rate |
$239.83 |
| Rate for Payer: Aetna Commercial |
$226.51
|
| Rate for Payer: BCBS Trust/PPO |
$205.94
|
| Rate for Payer: BCN Commercial |
$205.94
|
| Rate for Payer: Cash Price |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$229.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.18
|
| Rate for Payer: Healthscope Commercial |
$239.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.51
|
| Rate for Payer: PHP Commercial |
$226.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.50
|
| Rate for Payer: UHC Core |
$222.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.86
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$266.48
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$63.29 |
| Max. Negotiated Rate |
$239.83 |
| Rate for Payer: Aetna Commercial |
$226.51
|
| Rate for Payer: Aetna Medicare |
$69.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.28
|
| Rate for Payer: BCBS Complete |
$106.59
|
| Rate for Payer: BCBS MAPPO |
$66.62
|
| Rate for Payer: BCBS Trust/PPO |
$207.19
|
| Rate for Payer: BCN Commercial |
$207.19
|
| Rate for Payer: BCN Medicare Advantage |
$66.62
|
| Rate for Payer: Cash Price |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$229.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.62
|
| Rate for Payer: Healthscope Commercial |
$239.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.51
|
| Rate for Payer: PACE Senior Care Partners |
$63.29
|
| Rate for Payer: PACE SWMI |
$66.62
|
| Rate for Payer: PHP Commercial |
$226.51
|
| Rate for Payer: PHP Medicare Advantage |
$66.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$231.84
|
| Rate for Payer: Priority Health Medicare |
$66.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.53
|
| Rate for Payer: Railroad Medicare Medicare |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$234.50
|
| Rate for Payer: UHC Core |
$222.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.62
|
| Rate for Payer: UHC Medicare Advantage |
$68.62
|
| Rate for Payer: VA VA |
$66.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.86
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$321.66
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$76.39 |
| Max. Negotiated Rate |
$289.49 |
| Rate for Payer: Aetna Commercial |
$273.41
|
| Rate for Payer: Aetna Medicare |
$83.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.52
|
| Rate for Payer: BCBS Complete |
$128.66
|
| Rate for Payer: BCBS MAPPO |
$80.42
|
| Rate for Payer: BCBS Trust/PPO |
$250.09
|
| Rate for Payer: BCN Commercial |
$250.09
|
| Rate for Payer: BCN Medicare Advantage |
$80.42
|
| Rate for Payer: Cash Price |
$257.33
|
| Rate for Payer: Cofinity Commercial |
$276.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.42
|
| Rate for Payer: Healthscope Commercial |
$289.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.41
|
| Rate for Payer: PACE Senior Care Partners |
$76.39
|
| Rate for Payer: PACE SWMI |
$80.42
|
| Rate for Payer: PHP Commercial |
$273.41
|
| Rate for Payer: PHP Medicare Advantage |
$80.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.84
|
| Rate for Payer: Priority Health Medicare |
$80.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.18
|
| Rate for Payer: Railroad Medicare Medicare |
$80.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.06
|
| Rate for Payer: UHC Core |
$268.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.42
|
| Rate for Payer: UHC Medicare Advantage |
$82.83
|
| Rate for Payer: VA VA |
$80.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.24
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$321.66
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$196.18 |
| Max. Negotiated Rate |
$289.49 |
| Rate for Payer: Aetna Commercial |
$273.41
|
| Rate for Payer: BCBS Trust/PPO |
$248.58
|
| Rate for Payer: BCN Commercial |
$248.58
|
| Rate for Payer: Cash Price |
$257.33
|
| Rate for Payer: Cofinity Commercial |
$276.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.33
|
| Rate for Payer: Healthscope Commercial |
$289.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.41
|
| Rate for Payer: PHP Commercial |
$273.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.06
|
| Rate for Payer: UHC Core |
$268.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.24
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
OP
|
$194.91
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$175.42 |
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: Aetna Medicare |
$50.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.91
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$48.73
|
| Rate for Payer: BCBS Trust/PPO |
$151.54
|
| Rate for Payer: BCN Commercial |
$151.54
|
| Rate for Payer: BCN Medicare Advantage |
$48.73
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cofinity Commercial |
$167.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.73
|
| Rate for Payer: Healthscope Commercial |
$175.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.18
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.67
|
| Rate for Payer: PACE Senior Care Partners |
$46.29
|
| Rate for Payer: PACE SWMI |
$48.73
|
| Rate for Payer: PHP Commercial |
$165.67
|
| Rate for Payer: PHP Medicare Advantage |
$48.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.57
|
| Rate for Payer: Priority Health Medicare |
$48.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.88
|
| Rate for Payer: Railroad Medicare Medicare |
$48.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.52
|
| Rate for Payer: UHC Core |
$162.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.73
|
| Rate for Payer: UHC Medicare Advantage |
$50.19
|
| Rate for Payer: VA VA |
$48.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.18
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
IP
|
$194.91
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.88 |
| Max. Negotiated Rate |
$175.42 |
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: BCBS Trust/PPO |
$150.63
|
| Rate for Payer: BCN Commercial |
$150.63
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cofinity Commercial |
$167.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.93
|
| Rate for Payer: Healthscope Commercial |
$175.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.67
|
| Rate for Payer: PHP Commercial |
$165.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.52
|
| Rate for Payer: UHC Core |
$162.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.18
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
IP
|
$250.88
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.01 |
| Max. Negotiated Rate |
$225.79 |
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: BCBS Trust/PPO |
$193.88
|
| Rate for Payer: BCN Commercial |
$193.88
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cofinity Commercial |
$215.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.70
|
| Rate for Payer: Healthscope Commercial |
$225.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.25
|
| Rate for Payer: PHP Commercial |
$213.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.77
|
| Rate for Payer: UHC Core |
$209.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.16
|
|
