|
HC RADXF UNL NM CNS 78699
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78699
|
| Hospital Charge Code |
34100043
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM ENDOCR 78099
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78099
|
| Hospital Charge Code |
34100008
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GI PROC 78299
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78299
|
| Hospital Charge Code |
34100022
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM GU 78799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78799
|
| Hospital Charge Code |
34100051
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
IP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$448.66 |
| Max. Negotiated Rate |
$662.07 |
| Rate for Payer: Aetna Commercial |
$625.29
|
| Rate for Payer: BCBS Trust/PPO |
$568.49
|
| Rate for Payer: BCN Commercial |
$568.49
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$632.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Healthscope Commercial |
$662.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: PHP Commercial |
$625.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.35
|
| Rate for Payer: UHC Core |
$614.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.72
|
|
|
HC RADXF UNL NM H R L 78199
|
Facility
|
OP
|
$735.63
|
|
|
Service Code
|
CPT 78199
|
| Hospital Charge Code |
34100013
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$174.71 |
| Max. Negotiated Rate |
$662.07 |
| Rate for Payer: Aetna Commercial |
$625.29
|
| Rate for Payer: Aetna Medicare |
$191.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$229.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$229.88
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$183.91
|
| Rate for Payer: BCBS Trust/PPO |
$571.95
|
| Rate for Payer: BCN Commercial |
$571.95
|
| Rate for Payer: BCN Medicare Advantage |
$183.91
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cash Price |
$588.50
|
| Rate for Payer: Cofinity Commercial |
$632.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$588.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.91
|
| Rate for Payer: Healthscope Commercial |
$662.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.72
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$193.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$625.29
|
| Rate for Payer: PACE Senior Care Partners |
$174.71
|
| Rate for Payer: PACE SWMI |
$183.91
|
| Rate for Payer: PHP Commercial |
$625.29
|
| Rate for Payer: PHP Medicare Advantage |
$183.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$640.00
|
| Rate for Payer: Priority Health Medicare |
$183.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$448.66
|
| Rate for Payer: Railroad Medicare Medicare |
$183.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.35
|
| Rate for Payer: UHC Core |
$614.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.91
|
| Rate for Payer: UHC Medicare Advantage |
$189.42
|
| Rate for Payer: VA VA |
$183.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.72
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
OP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$270.56 |
| Max. Negotiated Rate |
$1,696.85 |
| Rate for Payer: Aetna Commercial |
$1,602.58
|
| Rate for Payer: Aetna Medicare |
$490.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$589.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$589.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$471.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,465.89
|
| Rate for Payer: BCN Commercial |
$1,465.89
|
| Rate for Payer: BCN Medicare Advantage |
$471.35
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,621.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$471.35
|
| Rate for Payer: Healthscope Commercial |
$1,696.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.04
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$494.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$542.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: PACE Senior Care Partners |
$447.78
|
| Rate for Payer: PACE SWMI |
$471.35
|
| Rate for Payer: PHP Commercial |
$1,602.58
|
| Rate for Payer: PHP Medicare Advantage |
$471.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.29
|
| Rate for Payer: Priority Health Medicare |
$471.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,149.90
|
| Rate for Payer: Railroad Medicare Medicare |
$471.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.14
|
| Rate for Payer: UHC Core |
$1,574.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$471.35
|
| Rate for Payer: UHC Medicare Advantage |
$485.49
|
| Rate for Payer: VA VA |
$471.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.04
|
|
|
HC RADXF UNL NM MUSCSKL 78399
|
Facility
|
IP
|
$1,885.39
|
|
|
Service Code
|
CPT 78399
|
| Hospital Charge Code |
34100028
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,149.90 |
| Max. Negotiated Rate |
$1,696.85 |
| Rate for Payer: Aetna Commercial |
$1,602.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.03
|
| Rate for Payer: BCN Commercial |
$1,457.03
|
| Rate for Payer: Cash Price |
$1,508.31
|
| Rate for Payer: Cofinity Commercial |
$1,621.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,508.31
|
| Rate for Payer: Healthscope Commercial |
$1,696.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,602.58
|
| Rate for Payer: PHP Commercial |
$1,602.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,319.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,640.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,149.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.14
|
| Rate for Payer: UHC Core |
$1,574.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.04
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$163.20 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$171.36
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$163.20
|
| Rate for Payer: Meridian Medicaid |
$171.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$480.45 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$187.09 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.18
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$196.94
|
| Rate for Payer: BCBS Trust/PPO |
$612.48
|
| Rate for Payer: BCN Commercial |
$612.48
|
| Rate for Payer: BCN Medicare Advantage |
$196.94
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.94
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Senior Care Partners |
$187.09
|
| Rate for Payer: PACE SWMI |
$196.94
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$196.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.35
|
| Rate for Payer: Priority Health Medicare |
$196.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$480.45
|
| Rate for Payer: Railroad Medicare Medicare |
$196.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$693.23
|
| Rate for Payer: UHC Core |
$657.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.94
|
| Rate for Payer: UHC Medicare Advantage |
$202.85
|
| Rate for Payer: VA VA |
$196.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$129.91 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: BCBS Trust/PPO |
$164.61
|
| Rate for Payer: BCN Commercial |
$164.61
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$183.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Healthscope Commercial |
$191.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: PHP Commercial |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.44
|
| Rate for Payer: UHC Core |
$177.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.75
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$50.59 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: Aetna Medicare |
$55.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.56
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$53.25
|
| Rate for Payer: BCBS Trust/PPO |
$165.61
|
| Rate for Payer: BCN Commercial |
$165.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.25
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$183.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.25
|
| Rate for Payer: Healthscope Commercial |
$191.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.75
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: PACE Senior Care Partners |
$50.59
|
| Rate for Payer: PACE SWMI |
$53.25
|
| Rate for Payer: PHP Commercial |
$181.05
|
| Rate for Payer: PHP Medicare Advantage |
$53.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.31
|
| Rate for Payer: Priority Health Medicare |
$53.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.91
|
| Rate for Payer: Railroad Medicare Medicare |
$53.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.44
|
| Rate for Payer: UHC Core |
$177.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.25
|
| Rate for Payer: UHC Medicare Advantage |
$54.85
|
| Rate for Payer: VA VA |
$53.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.75
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna Medicare |
$38.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.25
|
| Rate for Payer: BCBS Complete |
$18.88
|
| Rate for Payer: BCBS MAPPO |
$37.00
|
| Rate for Payer: BCBS Trust/PPO |
$115.07
|
| Rate for Payer: BCN Commercial |
$115.07
|
| Rate for Payer: BCN Medicare Advantage |
$37.00
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.00
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Mclaren Medicaid |
$17.99
|
| Rate for Payer: Meridian Medicaid |
$18.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PACE Senior Care Partners |
$35.15
|
| Rate for Payer: PACE SWMI |
$37.00
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: PHP Medicare Advantage |
$37.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.76
|
| Rate for Payer: Priority Health Medicare |
$37.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.24
|
| Rate for Payer: UHC Core |
$123.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$38.11
|
| Rate for Payer: VA VA |
$37.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$90.27 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: BCBS Trust/PPO |
$114.37
|
| Rate for Payer: BCN Commercial |
$114.37
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.24
|
| Rate for Payer: UHC Core |
$123.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.91 |
| Max. Negotiated Rate |
$477.14 |
| Rate for Payer: Aetna Commercial |
$450.63
|
| Rate for Payer: Aetna Medicare |
$137.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.67
|
| Rate for Payer: BCBS Complete |
$274.44
|
| Rate for Payer: BCBS MAPPO |
$132.54
|
| Rate for Payer: BCBS Trust/PPO |
$412.19
|
| Rate for Payer: BCN Commercial |
$412.19
|
| Rate for Payer: BCN Medicare Advantage |
$132.54
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$455.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.54
|
| Rate for Payer: Healthscope Commercial |
$477.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.61
|
| Rate for Payer: Mclaren Medicaid |
$261.37
|
| Rate for Payer: Meridian Medicaid |
$274.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: PACE Senior Care Partners |
$125.91
|
| Rate for Payer: PACE SWMI |
$132.54
|
| Rate for Payer: PHP Commercial |
$450.63
|
| Rate for Payer: PHP Medicare Advantage |
$132.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.23
|
| Rate for Payer: Priority Health Medicare |
$132.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.34
|
| Rate for Payer: Railroad Medicare Medicare |
$132.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.53
|
| Rate for Payer: UHC Core |
$442.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.54
|
| Rate for Payer: UHC Medicare Advantage |
$136.51
|
| Rate for Payer: VA VA |
$132.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.61
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$323.34 |
| Max. Negotiated Rate |
$477.14 |
| Rate for Payer: Aetna Commercial |
$450.63
|
| Rate for Payer: BCBS Trust/PPO |
$409.70
|
| Rate for Payer: BCN Commercial |
$409.70
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$455.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Healthscope Commercial |
$477.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: PHP Commercial |
$450.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$461.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$323.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.53
|
| Rate for Payer: UHC Core |
$442.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.61
|
|
