|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
IP
|
$438.74
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$305.36 |
| Max. Negotiated Rate |
$394.87 |
| Rate for Payer: Aetna Commercial |
$372.93
|
| Rate for Payer: BCBS Trust/PPO |
$362.36
|
| Rate for Payer: BCN Commercial |
$362.36
|
| Rate for Payer: Cash Price |
$350.99
|
| Rate for Payer: Cofinity Commercial |
$377.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.99
|
| Rate for Payer: Healthscope Commercial |
$394.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.93
|
| Rate for Payer: Nomi Health Commercial |
$359.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.06
|
| Rate for Payer: PHP Commercial |
$372.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$381.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.09
|
| Rate for Payer: UHC Core |
$366.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.06
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
OP
|
$438.74
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$77.35 |
| Max. Negotiated Rate |
$394.87 |
| Rate for Payer: Aetna Commercial |
$372.93
|
| Rate for Payer: Aetna Medicare |
$114.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.11
|
| Rate for Payer: BCBS Complete |
$81.21
|
| Rate for Payer: BCBS MAPPO |
$109.69
|
| Rate for Payer: BCBS Trust/PPO |
$360.69
|
| Rate for Payer: BCCCP Commercial |
$148.01
|
| Rate for Payer: BCN Commercial |
$360.69
|
| Rate for Payer: BCN Medicare Advantage |
$109.69
|
| Rate for Payer: Cash Price |
$350.99
|
| Rate for Payer: Cash Price |
$350.99
|
| Rate for Payer: Cofinity Commercial |
$377.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.69
|
| Rate for Payer: Healthscope Commercial |
$394.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.06
|
| Rate for Payer: Mclaren Medicaid |
$77.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.17
|
| Rate for Payer: Meridian Medicaid |
$81.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.93
|
| Rate for Payer: Nomi Health Commercial |
$359.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$329.06
|
| Rate for Payer: PACE Senior Care Partners |
$104.20
|
| Rate for Payer: PACE SWMI |
$109.69
|
| Rate for Payer: PHP Commercial |
$372.93
|
| Rate for Payer: PHP Medicare Advantage |
$109.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$381.70
|
| Rate for Payer: Priority Health Medicare |
$110.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.36
|
| Rate for Payer: Railroad Medicare Medicare |
$109.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.09
|
| Rate for Payer: UHC Core |
$366.35
|
| Rate for Payer: UHC Exchange |
$109.69
|
| Rate for Payer: UHC Medicaid |
$77.35
|
| Rate for Payer: UHC Medicare Advantage |
$109.69
|
| Rate for Payer: UHCCP Medicaid |
$77.35
|
| Rate for Payer: VA VA |
$109.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.06
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
OP
|
$432.90
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$76.32 |
| Max. Negotiated Rate |
$389.61 |
| Rate for Payer: Aetna Commercial |
$367.96
|
| Rate for Payer: Aetna Medicare |
$112.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$135.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$135.28
|
| Rate for Payer: BCBS Complete |
$80.13
|
| Rate for Payer: BCBS MAPPO |
$108.22
|
| Rate for Payer: BCBS Trust/PPO |
$355.89
|
| Rate for Payer: BCCCP Commercial |
$119.92
|
| Rate for Payer: BCN Commercial |
$355.89
|
| Rate for Payer: BCN Medicare Advantage |
$108.22
|
| Rate for Payer: Cash Price |
$346.32
|
| Rate for Payer: Cash Price |
$346.32
|
| Rate for Payer: Cofinity Commercial |
$372.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.22
|
| Rate for Payer: Healthscope Commercial |
$389.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.68
|
| Rate for Payer: Mclaren Medicaid |
$76.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.64
|
| Rate for Payer: Meridian Medicaid |
$80.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$119.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.96
|
| Rate for Payer: Nomi Health Commercial |
$354.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.68
|
| Rate for Payer: PACE Senior Care Partners |
$102.81
|
| Rate for Payer: PACE SWMI |
$108.22
|
| Rate for Payer: PHP Commercial |
$367.96
|
| Rate for Payer: PHP Medicare Advantage |
$108.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$376.62
|
| Rate for Payer: Priority Health Medicare |
$109.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.30
|
| Rate for Payer: Railroad Medicare Medicare |
$108.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.95
|
| Rate for Payer: UHC Core |
$361.47
|
| Rate for Payer: UHC Exchange |
$108.22
|
| Rate for Payer: UHC Medicaid |
$76.32
|
| Rate for Payer: UHC Medicare Advantage |
$108.22
|
| Rate for Payer: UHCCP Medicaid |
$76.32
|
| Rate for Payer: VA VA |
$108.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.68
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
IP
|
$432.90
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$301.30 |
| Max. Negotiated Rate |
$389.61 |
| Rate for Payer: Aetna Commercial |
$367.96
|
| Rate for Payer: BCBS Trust/PPO |
$357.53
|
| Rate for Payer: BCN Commercial |
$357.53
|
| Rate for Payer: Cash Price |
$346.32
|
| Rate for Payer: Cofinity Commercial |
$372.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.32
|
| Rate for Payer: Healthscope Commercial |
$389.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$324.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.96
|
| Rate for Payer: Nomi Health Commercial |
$354.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$324.68
|
| Rate for Payer: PHP Commercial |
$367.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$376.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.95
|
| Rate for Payer: UHC Core |
$361.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$324.68
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
IP
|
$756.38
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$526.44 |
| Max. Negotiated Rate |
$680.74 |
| Rate for Payer: Aetna Commercial |
$642.92
|
| Rate for Payer: BCBS Trust/PPO |
$624.69
|
| Rate for Payer: BCN Commercial |
$624.69
|
| Rate for Payer: Cash Price |
$605.10
|
| Rate for Payer: Cofinity Commercial |
$650.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.10
|
| Rate for Payer: Healthscope Commercial |
$680.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$567.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.92
|
| Rate for Payer: Nomi Health Commercial |
$620.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.28
|
| Rate for Payer: PHP Commercial |
$642.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$658.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.61
|
| Rate for Payer: UHC Core |
$631.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$567.28
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
OP
|
$756.38
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$680.74 |
| Rate for Payer: Aetna Commercial |
$642.92
|
| Rate for Payer: Aetna Medicare |
$196.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.37
|
| Rate for Payer: BCBS Complete |
$140.01
|
| Rate for Payer: BCBS MAPPO |
$189.09
|
| Rate for Payer: BCBS Trust/PPO |
$621.82
|
| Rate for Payer: BCCCP Commercial |
$92.31
|
| Rate for Payer: BCN Commercial |
$621.82
|
| Rate for Payer: BCN Medicare Advantage |
$189.09
|
| Rate for Payer: Cash Price |
$605.10
|
| Rate for Payer: Cash Price |
$605.10
|
| Rate for Payer: Cofinity Commercial |
$650.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.09
|
| Rate for Payer: Healthscope Commercial |
$680.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$567.28
|
| Rate for Payer: Mclaren Medicaid |
$133.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.55
|
| Rate for Payer: Meridian Medicaid |
$140.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.92
|
| Rate for Payer: Nomi Health Commercial |
$620.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$567.28
|
| Rate for Payer: PACE Senior Care Partners |
$179.64
|
| Rate for Payer: PACE SWMI |
$189.09
|
| Rate for Payer: PHP Commercial |
$642.92
|
| Rate for Payer: PHP Medicare Advantage |
$189.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$658.05
|
| Rate for Payer: Priority Health Medicare |
$190.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.44
|
| Rate for Payer: Railroad Medicare Medicare |
$189.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.61
|
| Rate for Payer: UHC Core |
$631.58
|
| Rate for Payer: UHC Exchange |
$189.09
|
| Rate for Payer: UHC Medicaid |
$133.35
|
| Rate for Payer: UHC Medicare Advantage |
$189.09
|
| Rate for Payer: UHCCP Medicaid |
$133.35
|
| Rate for Payer: VA VA |
$189.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$567.28
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
IP
|
$404.51
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$364.06 |
| Rate for Payer: Aetna Commercial |
$343.83
|
| Rate for Payer: BCBS Trust/PPO |
$334.08
|
| Rate for Payer: BCN Commercial |
$334.08
|
| Rate for Payer: Cash Price |
$323.61
|
| Rate for Payer: Cofinity Commercial |
$347.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.61
|
| Rate for Payer: Healthscope Commercial |
$364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.83
|
| Rate for Payer: Nomi Health Commercial |
$331.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: PHP Commercial |
$343.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.97
|
| Rate for Payer: UHC Core |
$337.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
OP
|
$404.51
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$364.06 |
| Rate for Payer: Aetna Commercial |
$343.83
|
| Rate for Payer: Aetna Medicare |
$105.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.41
|
| Rate for Payer: BCBS Complete |
$74.87
|
| Rate for Payer: BCBS MAPPO |
$101.13
|
| Rate for Payer: BCBS Trust/PPO |
$332.55
|
| Rate for Payer: BCCCP Commercial |
$25.13
|
| Rate for Payer: BCN Commercial |
$332.55
|
| Rate for Payer: BCN Medicare Advantage |
$101.13
|
| Rate for Payer: Cash Price |
$323.61
|
| Rate for Payer: Cash Price |
$323.61
|
| Rate for Payer: Cofinity Commercial |
$347.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.13
|
| Rate for Payer: Healthscope Commercial |
$364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Mclaren Medicaid |
$71.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.18
|
| Rate for Payer: Meridian Medicaid |
$74.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.83
|
| Rate for Payer: Nomi Health Commercial |
$331.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: PACE Senior Care Partners |
$96.07
|
| Rate for Payer: PACE SWMI |
$101.13
|
| Rate for Payer: PHP Commercial |
$343.83
|
| Rate for Payer: PHP Medicare Advantage |
$101.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.92
|
| Rate for Payer: Priority Health Medicare |
$102.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.54
|
| Rate for Payer: Railroad Medicare Medicare |
$101.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.97
|
| Rate for Payer: UHC Core |
$337.77
|
| Rate for Payer: UHC Exchange |
$101.13
|
| Rate for Payer: UHC Medicaid |
$71.32
|
| Rate for Payer: UHC Medicare Advantage |
$101.13
|
| Rate for Payer: UHCCP Medicaid |
$71.32
|
| Rate for Payer: VA VA |
$101.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
OP
|
$2,842.32
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$501.10 |
| Max. Negotiated Rate |
$2,558.09 |
| Rate for Payer: Aetna Commercial |
$2,415.97
|
| Rate for Payer: Aetna Medicare |
$739.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$888.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$888.23
|
| Rate for Payer: BCBS Complete |
$526.11
|
| Rate for Payer: BCBS MAPPO |
$710.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,336.67
|
| Rate for Payer: BCN Commercial |
$2,336.67
|
| Rate for Payer: BCN Medicare Advantage |
$710.58
|
| Rate for Payer: Cash Price |
$2,273.86
|
| Rate for Payer: Cofinity Commercial |
$2,444.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,273.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$710.58
|
| Rate for Payer: Healthscope Commercial |
$2,558.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,131.74
|
| Rate for Payer: Mclaren Medicaid |
$501.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$746.11
|
| Rate for Payer: Meridian Medicaid |
$526.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$817.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$781.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,415.97
|
| Rate for Payer: Nomi Health Commercial |
$2,330.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,131.74
|
| Rate for Payer: PACE Senior Care Partners |
$675.05
|
| Rate for Payer: PACE SWMI |
$710.58
|
| Rate for Payer: PHP Commercial |
$2,415.97
|
| Rate for Payer: PHP Medicare Advantage |
$710.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$501.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,472.82
|
| Rate for Payer: Priority Health Medicare |
$717.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,978.25
|
| Rate for Payer: Railroad Medicare Medicare |
$710.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,501.24
|
| Rate for Payer: UHC Core |
$2,373.34
|
| Rate for Payer: UHC Exchange |
$710.58
|
| Rate for Payer: UHC Medicaid |
$501.10
|
| Rate for Payer: UHC Medicare Advantage |
$710.58
|
| Rate for Payer: UHCCP Medicaid |
$501.10
|
| Rate for Payer: VA VA |
$710.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,131.74
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
IP
|
$2,842.32
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,978.25 |
| Max. Negotiated Rate |
$2,558.09 |
| Rate for Payer: Aetna Commercial |
$2,415.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,347.47
|
| Rate for Payer: BCN Commercial |
$2,347.47
|
| Rate for Payer: Cash Price |
$2,273.86
|
| Rate for Payer: Cofinity Commercial |
$2,444.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,273.86
|
| Rate for Payer: Healthscope Commercial |
$2,558.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,131.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,415.97
|
| Rate for Payer: Nomi Health Commercial |
$2,330.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,131.74
|
| Rate for Payer: PHP Commercial |
$2,415.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,472.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,978.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,501.24
|
| Rate for Payer: UHC Core |
$2,373.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,131.74
|
|
|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
OP
|
$1,200.83
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.22 |
| Max. Negotiated Rate |
$1,080.75 |
| Rate for Payer: Aetna Commercial |
$1,020.71
|
| Rate for Payer: Aetna Medicare |
$312.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.26
|
| Rate for Payer: BCBS Complete |
$222.27
|
| Rate for Payer: BCBS MAPPO |
$300.21
|
| Rate for Payer: BCBS Trust/PPO |
$987.20
|
| Rate for Payer: BCCCP Commercial |
$153.22
|
| Rate for Payer: BCN Commercial |
$987.20
|
| Rate for Payer: BCN Medicare Advantage |
$300.21
|
| Rate for Payer: Cash Price |
$960.66
|
| Rate for Payer: Cash Price |
$960.66
|
| Rate for Payer: Cofinity Commercial |
$1,032.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.21
|
| Rate for Payer: Healthscope Commercial |
$1,080.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.62
|
| Rate for Payer: Mclaren Medicaid |
$211.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.22
|
| Rate for Payer: Meridian Medicaid |
$222.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,020.71
|
| Rate for Payer: Nomi Health Commercial |
$984.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.62
|
| Rate for Payer: PACE Senior Care Partners |
$285.20
|
| Rate for Payer: PACE SWMI |
$300.21
|
| Rate for Payer: PHP Commercial |
$1,020.71
|
| Rate for Payer: PHP Medicare Advantage |
$300.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,044.72
|
| Rate for Payer: Priority Health Medicare |
$303.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.78
|
| Rate for Payer: Railroad Medicare Medicare |
$300.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.73
|
| Rate for Payer: UHC Core |
$1,002.69
|
| Rate for Payer: UHC Exchange |
$300.21
|
| Rate for Payer: UHC Medicaid |
$211.71
|
| Rate for Payer: UHC Medicare Advantage |
$300.21
|
| Rate for Payer: UHCCP Medicaid |
$211.71
|
| Rate for Payer: VA VA |
$300.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.62
|
|
|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
IP
|
$1,200.83
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$835.78 |
| Max. Negotiated Rate |
$1,080.75 |
| Rate for Payer: Aetna Commercial |
$1,020.71
|
| Rate for Payer: BCBS Trust/PPO |
$991.77
|
| Rate for Payer: BCN Commercial |
$991.77
|
| Rate for Payer: Cash Price |
$960.66
|
| Rate for Payer: Cofinity Commercial |
$1,032.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$960.66
|
| Rate for Payer: Healthscope Commercial |
$1,080.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$900.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,020.71
|
| Rate for Payer: Nomi Health Commercial |
$984.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$900.62
|
| Rate for Payer: PHP Commercial |
$1,020.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,044.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$835.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,056.73
|
| Rate for Payer: UHC Core |
$1,002.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$900.62
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
IP
|
$380.25
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$264.65 |
| Max. Negotiated Rate |
$342.23 |
| Rate for Payer: Aetna Commercial |
$323.21
|
| Rate for Payer: BCBS Trust/PPO |
$314.05
|
| Rate for Payer: BCN Commercial |
$314.05
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cofinity Commercial |
$327.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.20
|
| Rate for Payer: Healthscope Commercial |
$342.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.21
|
| Rate for Payer: Nomi Health Commercial |
$311.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.19
|
| Rate for Payer: PHP Commercial |
$323.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.62
|
| Rate for Payer: UHC Core |
$317.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.19
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
OP
|
$380.25
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$67.04 |
| Max. Negotiated Rate |
$342.23 |
| Rate for Payer: Aetna Commercial |
$323.21
|
| Rate for Payer: Aetna Medicare |
$98.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.83
|
| Rate for Payer: BCBS Complete |
$70.38
|
| Rate for Payer: BCBS MAPPO |
$95.06
|
| Rate for Payer: BCBS Trust/PPO |
$312.60
|
| Rate for Payer: BCCCP Commercial |
$117.70
|
| Rate for Payer: BCN Commercial |
$312.60
|
| Rate for Payer: BCN Medicare Advantage |
$95.06
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cofinity Commercial |
$327.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.06
|
| Rate for Payer: Healthscope Commercial |
$342.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.19
|
| Rate for Payer: Mclaren Medicaid |
$67.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.82
|
| Rate for Payer: Meridian Medicaid |
$70.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.21
|
| Rate for Payer: Nomi Health Commercial |
$311.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.19
|
| Rate for Payer: PACE Senior Care Partners |
$90.31
|
| Rate for Payer: PACE SWMI |
$95.06
|
| Rate for Payer: PHP Commercial |
$323.21
|
| Rate for Payer: PHP Medicare Advantage |
$95.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.82
|
| Rate for Payer: Priority Health Medicare |
$96.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.65
|
| Rate for Payer: Railroad Medicare Medicare |
$95.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.62
|
| Rate for Payer: UHC Core |
$317.51
|
| Rate for Payer: UHC Exchange |
$95.06
|
| Rate for Payer: UHC Medicaid |
$67.04
|
| Rate for Payer: UHC Medicare Advantage |
$95.06
|
| Rate for Payer: UHCCP Medicaid |
$67.04
|
| Rate for Payer: VA VA |
$95.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.19
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
OP
|
$603.90
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.89 |
| Max. Negotiated Rate |
$543.51 |
| Rate for Payer: Aetna Commercial |
$513.32
|
| Rate for Payer: Aetna Medicare |
$157.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.72
|
| Rate for Payer: BCBS Complete |
$111.78
|
| Rate for Payer: BCBS MAPPO |
$150.97
|
| Rate for Payer: BCBS Trust/PPO |
$496.47
|
| Rate for Payer: BCCCP Commercial |
$64.89
|
| Rate for Payer: BCN Commercial |
$496.47
|
| Rate for Payer: BCN Medicare Advantage |
$150.97
|
| Rate for Payer: Cash Price |
$483.12
|
| Rate for Payer: Cash Price |
$483.12
|
| Rate for Payer: Cofinity Commercial |
$519.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.97
|
| Rate for Payer: Healthscope Commercial |
$543.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.93
|
| Rate for Payer: Mclaren Medicaid |
$106.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.52
|
| Rate for Payer: Meridian Medicaid |
$111.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$166.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.32
|
| Rate for Payer: Nomi Health Commercial |
$495.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.93
|
| Rate for Payer: PACE Senior Care Partners |
$143.43
|
| Rate for Payer: PACE SWMI |
$150.97
|
| Rate for Payer: PHP Commercial |
$513.32
|
| Rate for Payer: PHP Medicare Advantage |
$150.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$525.39
|
| Rate for Payer: Priority Health Medicare |
$152.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.31
|
| Rate for Payer: Railroad Medicare Medicare |
$150.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.43
|
| Rate for Payer: UHC Core |
$504.26
|
| Rate for Payer: UHC Exchange |
$150.97
|
| Rate for Payer: UHC Medicaid |
$106.47
|
| Rate for Payer: UHC Medicare Advantage |
$150.97
|
| Rate for Payer: UHCCP Medicaid |
$106.47
|
| Rate for Payer: VA VA |
$150.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.93
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
IP
|
$603.90
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$420.31 |
| Max. Negotiated Rate |
$543.51 |
| Rate for Payer: Aetna Commercial |
$513.32
|
| Rate for Payer: BCBS Trust/PPO |
$498.76
|
| Rate for Payer: BCN Commercial |
$498.76
|
| Rate for Payer: Cash Price |
$483.12
|
| Rate for Payer: Cofinity Commercial |
$519.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.12
|
| Rate for Payer: Healthscope Commercial |
$543.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.32
|
| Rate for Payer: Nomi Health Commercial |
$495.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.93
|
| Rate for Payer: PHP Commercial |
$513.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$525.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.43
|
| Rate for Payer: UHC Core |
$504.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.93
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
IP
|
$728.76
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$507.22 |
| Max. Negotiated Rate |
$655.88 |
| Rate for Payer: Aetna Commercial |
$619.45
|
| Rate for Payer: BCBS Trust/PPO |
$601.88
|
| Rate for Payer: BCN Commercial |
$601.88
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$626.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.01
|
| Rate for Payer: Healthscope Commercial |
$655.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.45
|
| Rate for Payer: Nomi Health Commercial |
$597.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.57
|
| Rate for Payer: PHP Commercial |
$619.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$634.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.31
|
| Rate for Payer: UHC Core |
$608.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.57
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
OP
|
$728.76
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$50.35 |
| Max. Negotiated Rate |
$655.88 |
| Rate for Payer: Aetna Commercial |
$619.45
|
| Rate for Payer: Aetna Medicare |
$189.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.74
|
| Rate for Payer: BCBS Complete |
$134.89
|
| Rate for Payer: BCBS MAPPO |
$182.19
|
| Rate for Payer: BCBS Trust/PPO |
$599.11
|
| Rate for Payer: BCCCP Commercial |
$50.35
|
| Rate for Payer: BCN Commercial |
$599.11
|
| Rate for Payer: BCN Medicare Advantage |
$182.19
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cash Price |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$626.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.19
|
| Rate for Payer: Healthscope Commercial |
$655.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.57
|
| Rate for Payer: Mclaren Medicaid |
$128.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.30
|
| Rate for Payer: Meridian Medicaid |
$134.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.45
|
| Rate for Payer: Nomi Health Commercial |
$597.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.57
|
| Rate for Payer: PACE Senior Care Partners |
$173.08
|
| Rate for Payer: PACE SWMI |
$182.19
|
| Rate for Payer: PHP Commercial |
$619.45
|
| Rate for Payer: PHP Medicare Advantage |
$182.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$634.02
|
| Rate for Payer: Priority Health Medicare |
$184.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.22
|
| Rate for Payer: Railroad Medicare Medicare |
$182.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.31
|
| Rate for Payer: UHC Core |
$608.51
|
| Rate for Payer: UHC Exchange |
$182.19
|
| Rate for Payer: UHC Medicaid |
$128.48
|
| Rate for Payer: UHC Medicare Advantage |
$182.19
|
| Rate for Payer: UHCCP Medicaid |
$128.48
|
| Rate for Payer: VA VA |
$182.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.57
|
|
|
HC MANGANESE BLOOD
|
Facility
|
IP
|
$190.00
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
30100770
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$132.24 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: BCBS Trust/PPO |
$156.92
|
| Rate for Payer: BCN Commercial |
$156.92
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.20
|
| Rate for Payer: UHC Core |
$158.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
HC MANGANESE BLOOD
|
Facility
|
OP
|
$190.00
|
|
|
Service Code
|
CPT 83785
|
| Hospital Charge Code |
30100770
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.50 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare |
$49.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.38
|
| Rate for Payer: BCBS Complete |
$35.17
|
| Rate for Payer: BCBS MAPPO |
$47.50
|
| Rate for Payer: BCBS Trust/PPO |
$156.20
|
| Rate for Payer: BCN Commercial |
$156.20
|
| Rate for Payer: BCN Medicare Advantage |
$47.50
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$163.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.50
|
| Rate for Payer: Healthscope Commercial |
$171.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.50
|
| Rate for Payer: Mclaren Medicaid |
$33.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.88
|
| Rate for Payer: Meridian Medicaid |
$35.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.50
|
| Rate for Payer: Nomi Health Commercial |
$155.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$142.50
|
| Rate for Payer: PACE Senior Care Partners |
$45.12
|
| Rate for Payer: PACE SWMI |
$47.50
|
| Rate for Payer: PHP Commercial |
$161.50
|
| Rate for Payer: PHP Medicare Advantage |
$47.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$165.30
|
| Rate for Payer: Priority Health Medicare |
$47.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.24
|
| Rate for Payer: Railroad Medicare Medicare |
$47.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.20
|
| Rate for Payer: UHC Core |
$158.65
|
| Rate for Payer: UHC Exchange |
$47.50
|
| Rate for Payer: UHC Medicaid |
$33.50
|
| Rate for Payer: UHC Medicare Advantage |
$47.50
|
| Rate for Payer: UHCCP Medicaid |
$33.50
|
| Rate for Payer: VA VA |
$47.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.50
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$85.83
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.74 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$70.89
|
| Rate for Payer: BCN Commercial |
$70.89
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$73.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Healthscope Commercial |
$77.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: Nomi Health Commercial |
$70.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.37
|
| Rate for Payer: PHP Commercial |
$72.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.53
|
| Rate for Payer: UHC Core |
$71.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.37
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$85.83
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna Medicare |
$22.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.82
|
| Rate for Payer: BCBS Complete |
$15.89
|
| Rate for Payer: BCBS MAPPO |
$21.46
|
| Rate for Payer: BCBS Trust/PPO |
$70.56
|
| Rate for Payer: BCN Commercial |
$70.56
|
| Rate for Payer: BCN Medicare Advantage |
$21.46
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$73.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$77.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.37
|
| Rate for Payer: Mclaren Medicaid |
$15.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.53
|
| Rate for Payer: Meridian Medicaid |
$15.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: Nomi Health Commercial |
$70.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.37
|
| Rate for Payer: PACE Senior Care Partners |
$20.38
|
| Rate for Payer: PACE SWMI |
$21.46
|
| Rate for Payer: PHP Commercial |
$72.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.67
|
| Rate for Payer: Priority Health Medicare |
$21.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.74
|
| Rate for Payer: Railroad Medicare Medicare |
$21.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.53
|
| Rate for Payer: UHC Core |
$71.67
|
| Rate for Payer: UHC Exchange |
$21.46
|
| Rate for Payer: UHC Medicaid |
$15.13
|
| Rate for Payer: UHC Medicare Advantage |
$21.46
|
| Rate for Payer: UHCCP Medicaid |
$15.13
|
| Rate for Payer: VA VA |
$21.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.37
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,896.47 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,437.07
|
| Rate for Payer: BCN Commercial |
$3,437.07
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$3,412.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,620.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,896.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$733.69 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna Medicare |
$1,082.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,300.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,300.50
|
| Rate for Payer: BCBS Complete |
$770.31
|
| Rate for Payer: BCBS MAPPO |
$1,040.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,421.25
|
| Rate for Payer: BCN Commercial |
$3,421.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.40
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.40
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Mclaren Medicaid |
$733.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,092.42
|
| Rate for Payer: Meridian Medicaid |
$770.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,196.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,144.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$3,412.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PACE Senior Care Partners |
$988.38
|
| Rate for Payer: PACE SWMI |
$1,040.40
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,620.59
|
| Rate for Payer: Priority Health Medicare |
$1,050.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,896.47
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,662.21
|
| Rate for Payer: UHC Core |
$3,474.94
|
| Rate for Payer: UHC Exchange |
$1,040.40
|
| Rate for Payer: UHC Medicaid |
$733.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,040.40
|
| Rate for Payer: UHCCP Medicaid |
$733.69
|
| Rate for Payer: VA VA |
$1,040.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$504.07
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.87 |
| Max. Negotiated Rate |
$453.66 |
| Rate for Payer: Aetna Commercial |
$428.46
|
| Rate for Payer: Aetna Medicare |
$131.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.52
|
| Rate for Payer: BCBS Complete |
$93.30
|
| Rate for Payer: BCBS MAPPO |
$126.02
|
| Rate for Payer: BCBS Trust/PPO |
$414.40
|
| Rate for Payer: BCN Commercial |
$414.40
|
| Rate for Payer: BCN Medicare Advantage |
$126.02
|
| Rate for Payer: Cash Price |
$403.26
|
| Rate for Payer: Cofinity Commercial |
$433.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.02
|
| Rate for Payer: Healthscope Commercial |
$453.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.05
|
| Rate for Payer: Mclaren Medicaid |
$88.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.32
|
| Rate for Payer: Meridian Medicaid |
$93.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.46
|
| Rate for Payer: Nomi Health Commercial |
$413.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.05
|
| Rate for Payer: PACE Senior Care Partners |
$119.72
|
| Rate for Payer: PACE SWMI |
$126.02
|
| Rate for Payer: PHP Commercial |
$428.46
|
| Rate for Payer: PHP Medicare Advantage |
$126.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.54
|
| Rate for Payer: Priority Health Medicare |
$127.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.83
|
| Rate for Payer: Railroad Medicare Medicare |
$126.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.58
|
| Rate for Payer: UHC Core |
$420.90
|
| Rate for Payer: UHC Exchange |
$126.02
|
| Rate for Payer: UHC Medicaid |
$88.87
|
| Rate for Payer: UHC Medicare Advantage |
$126.02
|
| Rate for Payer: UHCCP Medicaid |
$88.87
|
| Rate for Payer: VA VA |
$126.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.05
|
|
