|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
IP
|
$203.86
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.51 |
| Max. Negotiated Rate |
$183.47 |
| Rate for Payer: Aetna Commercial |
$173.28
|
| Rate for Payer: BCBS Trust/PPO |
$166.41
|
| Rate for Payer: BCN Commercial |
$157.54
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cofinity Commercial |
$175.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.09
|
| Rate for Payer: Healthscope Commercial |
$183.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.28
|
| Rate for Payer: Nomi Health Commercial |
$167.17
|
| Rate for Payer: PHP Commercial |
$173.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.51
|
| Rate for Payer: Priority Health HMO/PPO |
$177.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.40
|
| Rate for Payer: UHC Core |
$170.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.90
|
|
|
HC FLUID CREATININE
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FLUID CREATININE
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100498
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
OP
|
$108.20
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$97.38 |
| Rate for Payer: Aetna Commercial |
$91.97
|
| Rate for Payer: Aetna Medicare |
$28.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.81
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$27.05
|
| Rate for Payer: BCBS Trust/PPO |
$88.95
|
| Rate for Payer: BCN Commercial |
$84.13
|
| Rate for Payer: BCN Medicare Advantage |
$27.05
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$93.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.05
|
| Rate for Payer: Healthscope Commercial |
$97.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: PACE Senior Care Partners |
$25.70
|
| Rate for Payer: PACE SWMI |
$27.05
|
| Rate for Payer: PHP Commercial |
$91.97
|
| Rate for Payer: PHP Medicare Advantage |
$27.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.33
|
| Rate for Payer: Priority Health HMO/PPO |
$94.13
|
| Rate for Payer: Priority Health Medicare |
$27.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.49
|
| Rate for Payer: Railroad Medicare Medicare |
$27.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.22
|
| Rate for Payer: UHC Core |
$90.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.05
|
| Rate for Payer: UHC Exchange |
$27.05
|
| Rate for Payer: UHC Medicare Advantage |
$27.05
|
| Rate for Payer: VA VA |
$27.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.15
|
|
|
HC FLUIDOTHERAPY
|
Facility
|
IP
|
$108.20
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000051
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$70.33 |
| Max. Negotiated Rate |
$97.38 |
| Rate for Payer: Aetna Commercial |
$91.97
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$83.62
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$93.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$97.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$88.72
|
| Rate for Payer: PHP Commercial |
$91.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.33
|
| Rate for Payer: Priority Health HMO/PPO |
$94.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.22
|
| Rate for Payer: UHC Core |
$90.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.15
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.77 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: BCBS Trust/PPO |
$91.38
|
| Rate for Payer: BCN Commercial |
$86.51
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC FLUID SMEAR AND INTERPRETATION
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100002
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.98
|
| Rate for Payer: BCBS Complete |
$29.80
|
| Rate for Payer: BCBS MAPPO |
$27.99
|
| Rate for Payer: BCBS Trust/PPO |
$92.03
|
| Rate for Payer: BCN Commercial |
$87.04
|
| Rate for Payer: BCN Medicare Advantage |
$27.99
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.99
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Mclaren Medicaid |
$28.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.39
|
| Rate for Payer: Meridian Medicaid |
$29.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PACE Senior Care Partners |
$26.59
|
| Rate for Payer: PACE SWMI |
$27.99
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$27.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Medicare |
$28.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: Railroad Medicare Medicare |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.99
|
| Rate for Payer: UHC Exchange |
$27.99
|
| Rate for Payer: UHC Medicare Advantage |
$27.99
|
| Rate for Payer: UHCCP Medicaid |
$28.38
|
| Rate for Payer: VA VA |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.77 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: BCBS Trust/PPO |
$91.38
|
| Rate for Payer: BCN Commercial |
$86.51
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC FLUID SMEAR WITH INTERPRETATION
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 88108
|
| Hospital Charge Code |
31100030
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.98
|
| Rate for Payer: BCBS Complete |
$29.80
|
| Rate for Payer: BCBS MAPPO |
$27.99
|
| Rate for Payer: BCBS Trust/PPO |
$92.03
|
| Rate for Payer: BCN Commercial |
$87.04
|
| Rate for Payer: BCN Medicare Advantage |
$27.99
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.99
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Mclaren Medicaid |
$28.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.39
|
| Rate for Payer: Meridian Medicaid |
$29.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: PACE Senior Care Partners |
$26.59
|
| Rate for Payer: PACE SWMI |
$27.99
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$27.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.77
|
| Rate for Payer: Priority Health HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Medicare |
$28.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: Railroad Medicare Medicare |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.99
|
| Rate for Payer: UHC Exchange |
$27.99
|
| Rate for Payer: UHC Medicare Advantage |
$27.99
|
| Rate for Payer: UHCCP Medicaid |
$28.38
|
| Rate for Payer: VA VA |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
IP
|
$118.69
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.15 |
| Max. Negotiated Rate |
$106.82 |
| Rate for Payer: Aetna Commercial |
$100.89
|
| Rate for Payer: BCBS Trust/PPO |
$96.89
|
| Rate for Payer: BCN Commercial |
$91.72
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Cofinity Commercial |
$102.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.95
|
| Rate for Payer: Healthscope Commercial |
$106.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.89
|
| Rate for Payer: Nomi Health Commercial |
$97.33
|
| Rate for Payer: PHP Commercial |
$100.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.15
|
| Rate for Payer: Priority Health HMO/PPO |
$103.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.45
|
| Rate for Payer: UHC Core |
$99.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.02
|
|
|
HC FLUTTER VALVE SUPPLY
|
Facility
|
OP
|
$118.69
|
|
| Hospital Charge Code |
27000078
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$106.82 |
| Rate for Payer: Aetna Commercial |
$100.89
|
| Rate for Payer: Aetna Medicare |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.09
|
| Rate for Payer: BCBS Complete |
$47.48
|
| Rate for Payer: BCBS MAPPO |
$29.67
|
| Rate for Payer: BCBS Trust/PPO |
$97.58
|
| Rate for Payer: BCN Commercial |
$92.28
|
| Rate for Payer: BCN Medicare Advantage |
$29.67
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Cofinity Commercial |
$102.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.67
|
| Rate for Payer: Healthscope Commercial |
$106.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.89
|
| Rate for Payer: Nomi Health Commercial |
$97.33
|
| Rate for Payer: PACE Senior Care Partners |
$28.19
|
| Rate for Payer: PACE SWMI |
$29.67
|
| Rate for Payer: PHP Commercial |
$100.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.15
|
| Rate for Payer: Priority Health HMO/PPO |
$103.26
|
| Rate for Payer: Priority Health Medicare |
$29.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.52
|
| Rate for Payer: Railroad Medicare Medicare |
$29.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.45
|
| Rate for Payer: UHC Core |
$99.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.67
|
| Rate for Payer: UHC Exchange |
$29.67
|
| Rate for Payer: UHC Medicare Advantage |
$29.67
|
| Rate for Payer: VA VA |
$29.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.02
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.18 |
| 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 |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| 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 Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| 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 Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC FLU VAC,SPLIT VIRUS, PT 3 YRS OR OLDER, IM
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT Q2038
|
| Hospital Charge Code |
63600113
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| 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: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| 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 FNA BX 1ST LESION CT GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: BCBS Trust/PPO |
$741.42
|
| Rate for Payer: BCN Commercial |
$701.91
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION CT GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
36100558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.71 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: Aetna Medicare |
$236.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.83
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$746.69
|
| Rate for Payer: BCN Commercial |
$706.18
|
| Rate for Payer: BCN Medicare Advantage |
$227.07
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.07
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.42
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Senior Care Partners |
$215.71
|
| Rate for Payer: PACE SWMI |
$227.07
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: PHP Medicare Advantage |
$227.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Medicare |
$229.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: Railroad Medicare Medicare |
$227.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.07
|
| Rate for Payer: UHC Exchange |
$227.07
|
| Rate for Payer: UHC Medicare Advantage |
$227.07
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$227.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.71 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: Aetna Medicare |
$236.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.83
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$746.69
|
| Rate for Payer: BCN Commercial |
$706.18
|
| Rate for Payer: BCN Medicare Advantage |
$227.07
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.07
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.42
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Senior Care Partners |
$215.71
|
| Rate for Payer: PACE SWMI |
$227.07
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: PHP Medicare Advantage |
$227.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Medicare |
$229.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: Railroad Medicare Medicare |
$227.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.07
|
| Rate for Payer: UHC Exchange |
$227.07
|
| Rate for Payer: UHC Medicare Advantage |
$227.07
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$227.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: BCBS Trust/PPO |
$741.42
|
| Rate for Payer: BCN Commercial |
$701.91
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$908.27
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.38 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: BCBS Trust/PPO |
$741.42
|
| Rate for Payer: BCN Commercial |
$701.91
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$908.27
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.71 |
| Max. Negotiated Rate |
$817.44 |
| Rate for Payer: Aetna Commercial |
$772.03
|
| Rate for Payer: Aetna Medicare |
$236.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.83
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$227.07
|
| Rate for Payer: BCBS Trust/PPO |
$746.69
|
| Rate for Payer: BCN Commercial |
$706.18
|
| Rate for Payer: BCN Medicare Advantage |
$227.07
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cash Price |
$726.62
|
| Rate for Payer: Cofinity Commercial |
$781.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.07
|
| Rate for Payer: Healthscope Commercial |
$817.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.20
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.42
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.03
|
| Rate for Payer: Nomi Health Commercial |
$744.78
|
| Rate for Payer: PACE Senior Care Partners |
$215.71
|
| Rate for Payer: PACE SWMI |
$227.07
|
| Rate for Payer: PHP Commercial |
$772.03
|
| Rate for Payer: PHP Medicare Advantage |
$227.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.38
|
| Rate for Payer: Priority Health HMO/PPO |
$790.19
|
| Rate for Payer: Priority Health Medicare |
$229.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.54
|
| Rate for Payer: Railroad Medicare Medicare |
$227.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.28
|
| Rate for Payer: UHC Core |
$758.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.07
|
| Rate for Payer: UHC Exchange |
$227.07
|
| Rate for Payer: UHC Medicare Advantage |
$227.07
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$227.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.20
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$1,068.55
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.78 |
| Max. Negotiated Rate |
$961.70 |
| Rate for Payer: Aetna Commercial |
$908.27
|
| Rate for Payer: Aetna Medicare |
$277.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$333.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$333.92
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$267.14
|
| Rate for Payer: BCBS Trust/PPO |
$878.45
|
| Rate for Payer: BCN Commercial |
$830.80
|
| Rate for Payer: BCN Medicare Advantage |
$267.14
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cofinity Commercial |
$918.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.14
|
| Rate for Payer: Healthscope Commercial |
$961.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.41
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.49
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.27
|
| Rate for Payer: Nomi Health Commercial |
$876.21
|
| Rate for Payer: PACE Senior Care Partners |
$253.78
|
| Rate for Payer: PACE SWMI |
$267.14
|
| Rate for Payer: PHP Commercial |
$908.27
|
| Rate for Payer: PHP Medicare Advantage |
$267.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.56
|
| Rate for Payer: Priority Health HMO/PPO |
$929.64
|
| Rate for Payer: Priority Health Medicare |
$269.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$715.93
|
| Rate for Payer: Railroad Medicare Medicare |
$267.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.32
|
| Rate for Payer: UHC Core |
$892.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.14
|
| Rate for Payer: UHC Exchange |
$267.14
|
| Rate for Payer: UHC Medicare Advantage |
$267.14
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$267.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.41
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$1,068.55
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$694.56 |
| Max. Negotiated Rate |
$961.70 |
| Rate for Payer: Aetna Commercial |
$908.27
|
| Rate for Payer: BCBS Trust/PPO |
$872.26
|
| Rate for Payer: BCN Commercial |
$825.78
|
| Rate for Payer: Cash Price |
$854.84
|
| Rate for Payer: Cofinity Commercial |
$918.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.84
|
| Rate for Payer: Healthscope Commercial |
$961.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.27
|
| Rate for Payer: Nomi Health Commercial |
$876.21
|
| Rate for Payer: PHP Commercial |
$908.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.56
|
| Rate for Payer: Priority Health HMO/PPO |
$929.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$715.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$940.32
|
| Rate for Payer: UHC Core |
$892.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.41
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$150.86
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$35.83 |
| Max. Negotiated Rate |
$135.77 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: Aetna Medicare |
$39.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.14
|
| Rate for Payer: BCBS Complete |
$60.34
|
| Rate for Payer: BCBS MAPPO |
$37.72
|
| Rate for Payer: BCBS Trust/PPO |
$124.02
|
| Rate for Payer: BCN Commercial |
$117.29
|
| Rate for Payer: BCN Medicare Advantage |
$37.72
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.72
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: PACE Senior Care Partners |
$35.83
|
| Rate for Payer: PACE SWMI |
$37.72
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: PHP Medicare Advantage |
$37.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO |
$131.25
|
| Rate for Payer: Priority Health Medicare |
$38.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.08
|
| Rate for Payer: Railroad Medicare Medicare |
$37.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.76
|
| Rate for Payer: UHC Core |
$125.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.72
|
| Rate for Payer: UHC Exchange |
$37.72
|
| Rate for Payer: UHC Medicare Advantage |
$37.72
|
| Rate for Payer: VA VA |
$37.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.14
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$150.86
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.06 |
| Max. Negotiated Rate |
$135.77 |
| Rate for Payer: Aetna Commercial |
$128.23
|
| Rate for Payer: BCBS Trust/PPO |
$123.15
|
| Rate for Payer: BCN Commercial |
$116.58
|
| Rate for Payer: Cash Price |
$120.69
|
| Rate for Payer: Cofinity Commercial |
$129.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.69
|
| Rate for Payer: Healthscope Commercial |
$135.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.23
|
| Rate for Payer: Nomi Health Commercial |
$123.71
|
| Rate for Payer: PHP Commercial |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.06
|
| Rate for Payer: Priority Health HMO/PPO |
$131.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.76
|
| Rate for Payer: UHC Core |
$125.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.14
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
OP
|
$165.94
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$149.35 |
| Rate for Payer: Aetna Commercial |
$141.05
|
| Rate for Payer: Aetna Medicare |
$43.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.86
|
| Rate for Payer: BCBS Complete |
$66.38
|
| Rate for Payer: BCBS MAPPO |
$41.48
|
| Rate for Payer: BCBS Trust/PPO |
$136.42
|
| Rate for Payer: BCN Commercial |
$129.02
|
| Rate for Payer: BCN Medicare Advantage |
$41.48
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Cofinity Commercial |
$142.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.48
|
| Rate for Payer: Healthscope Commercial |
$149.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.05
|
| Rate for Payer: Nomi Health Commercial |
$136.07
|
| Rate for Payer: PACE Senior Care Partners |
$39.41
|
| Rate for Payer: PACE SWMI |
$41.48
|
| Rate for Payer: PHP Commercial |
$141.05
|
| Rate for Payer: PHP Medicare Advantage |
$41.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.86
|
| Rate for Payer: Priority Health HMO/PPO |
$144.37
|
| Rate for Payer: Priority Health Medicare |
$41.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.18
|
| Rate for Payer: Railroad Medicare Medicare |
$41.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.03
|
| Rate for Payer: UHC Core |
$138.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.48
|
| Rate for Payer: UHC Exchange |
$41.48
|
| Rate for Payer: UHC Medicare Advantage |
$41.48
|
| Rate for Payer: VA VA |
$41.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.45
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$165.94
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.86 |
| Max. Negotiated Rate |
$149.35 |
| Rate for Payer: Aetna Commercial |
$141.05
|
| Rate for Payer: BCBS Trust/PPO |
$135.46
|
| Rate for Payer: BCN Commercial |
$128.24
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Cofinity Commercial |
$142.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.75
|
| Rate for Payer: Healthscope Commercial |
$149.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.05
|
| Rate for Payer: Nomi Health Commercial |
$136.07
|
| Rate for Payer: PHP Commercial |
$141.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.86
|
| Rate for Payer: Priority Health HMO/PPO |
$144.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.03
|
| Rate for Payer: UHC Core |
$138.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.45
|
|
