|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,114.36
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,471.59 |
| Max. Negotiated Rate |
$1,902.92 |
| Rate for Payer: Aetna Commercial |
$1,797.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.25
|
| Rate for Payer: BCN Commercial |
$1,746.25
|
| Rate for Payer: Cash Price |
$1,691.49
|
| Rate for Payer: Cofinity Commercial |
$1,818.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,691.49
|
| Rate for Payer: Healthscope Commercial |
$1,902.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,585.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,797.21
|
| Rate for Payer: Nomi Health Commercial |
$1,733.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,585.77
|
| Rate for Payer: PHP Commercial |
$1,797.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,839.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,471.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,860.64
|
| Rate for Payer: UHC Core |
$1,765.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,585.77
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
IP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$2,247.41 |
| Max. Negotiated Rate |
$2,906.14 |
| Rate for Payer: Aetna Commercial |
$2,744.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,666.86
|
| Rate for Payer: BCN Commercial |
$2,666.86
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Commercial |
$2,776.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Healthscope Commercial |
$2,906.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,421.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,744.68
|
| Rate for Payer: Nomi Health Commercial |
$2,647.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: PHP Commercial |
$2,744.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,809.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,247.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,841.56
|
| Rate for Payer: UHC Core |
$2,696.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,421.78
|
|
|
HC MR BRAIN WO W CON
|
Facility
|
OP
|
$3,229.04
|
|
|
Service Code
|
CPT 70553
|
| Hospital Charge Code |
61100003
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$569.28 |
| Max. Negotiated Rate |
$2,906.14 |
| Rate for Payer: Aetna Commercial |
$2,744.68
|
| Rate for Payer: Aetna Medicare |
$839.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,009.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,009.08
|
| Rate for Payer: BCBS Complete |
$597.70
|
| Rate for Payer: BCBS MAPPO |
$807.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,654.59
|
| Rate for Payer: BCN Commercial |
$2,654.59
|
| Rate for Payer: BCN Medicare Advantage |
$807.26
|
| Rate for Payer: Cash Price |
$2,583.23
|
| Rate for Payer: Cofinity Commercial |
$2,776.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,583.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$807.26
|
| Rate for Payer: Healthscope Commercial |
$2,906.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,421.78
|
| Rate for Payer: Mclaren Medicaid |
$569.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$847.62
|
| Rate for Payer: Meridian Medicaid |
$597.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$928.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$887.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,744.68
|
| Rate for Payer: Nomi Health Commercial |
$2,647.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,421.78
|
| Rate for Payer: PACE Senior Care Partners |
$766.90
|
| Rate for Payer: PACE SWMI |
$807.26
|
| Rate for Payer: PHP Commercial |
$2,744.68
|
| Rate for Payer: PHP Medicare Advantage |
$807.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,809.26
|
| Rate for Payer: Priority Health Medicare |
$815.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,247.41
|
| Rate for Payer: Railroad Medicare Medicare |
$807.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,841.56
|
| Rate for Payer: UHC Core |
$2,696.25
|
| Rate for Payer: UHC Exchange |
$807.26
|
| Rate for Payer: UHC Medicaid |
$569.28
|
| Rate for Payer: UHC Medicare Advantage |
$807.26
|
| Rate for Payer: UHCCP Medicaid |
$569.28
|
| Rate for Payer: VA VA |
$807.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,421.78
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna Medicare |
$327.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$393.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$393.51
|
| Rate for Payer: BCBS Complete |
$233.08
|
| Rate for Payer: BCBS MAPPO |
$314.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.20
|
| Rate for Payer: BCN Commercial |
$1,035.20
|
| Rate for Payer: BCN Medicare Advantage |
$314.81
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.81
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$944.41
|
| Rate for Payer: Mclaren Medicaid |
$222.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.55
|
| Rate for Payer: Meridian Medicaid |
$233.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$362.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PACE Senior Care Partners |
$299.06
|
| Rate for Payer: PACE SWMI |
$314.81
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: PHP Medicare Advantage |
$314.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.52
|
| Rate for Payer: Priority Health Medicare |
$317.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.42
|
| Rate for Payer: Railroad Medicare Medicare |
$314.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.11
|
| Rate for Payer: UHC Core |
$1,051.45
|
| Rate for Payer: UHC Exchange |
$314.81
|
| Rate for Payer: UHC Medicaid |
$222.00
|
| Rate for Payer: UHC Medicare Advantage |
$314.81
|
| Rate for Payer: UHCCP Medicaid |
$222.00
|
| Rate for Payer: VA VA |
$314.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$944.41
|
|
|
HC MR BREAST BIL SCREEN W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000087
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$876.42 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.99
|
| Rate for Payer: BCN Commercial |
$1,039.99
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$944.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.11
|
| Rate for Payer: UHC Core |
$1,051.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$944.41
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
OP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$226.44 |
| Max. Negotiated Rate |
$1,155.96 |
| Rate for Payer: Aetna Commercial |
$1,091.74
|
| Rate for Payer: Aetna Medicare |
$333.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$401.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$401.38
|
| Rate for Payer: BCBS Complete |
$237.74
|
| Rate for Payer: BCBS MAPPO |
$321.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,055.91
|
| Rate for Payer: BCN Commercial |
$1,055.91
|
| Rate for Payer: BCN Medicare Advantage |
$321.10
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Commercial |
$1,104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.10
|
| Rate for Payer: Healthscope Commercial |
$1,155.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.30
|
| Rate for Payer: Mclaren Medicaid |
$226.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.15
|
| Rate for Payer: Meridian Medicaid |
$237.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,091.74
|
| Rate for Payer: Nomi Health Commercial |
$1,053.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: PACE Senior Care Partners |
$305.05
|
| Rate for Payer: PACE SWMI |
$321.10
|
| Rate for Payer: PHP Commercial |
$1,091.74
|
| Rate for Payer: PHP Medicare Advantage |
$321.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,117.43
|
| Rate for Payer: Priority Health Medicare |
$324.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$893.94
|
| Rate for Payer: Railroad Medicare Medicare |
$321.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.27
|
| Rate for Payer: UHC Core |
$1,072.47
|
| Rate for Payer: UHC Exchange |
$321.10
|
| Rate for Payer: UHC Medicaid |
$226.44
|
| Rate for Payer: UHC Medicare Advantage |
$321.10
|
| Rate for Payer: UHCCP Medicaid |
$226.44
|
| Rate for Payer: VA VA |
$321.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.30
|
|
|
HC MR BREAST BIL SCREEN WO W CON
|
Facility
|
IP
|
$1,284.40
|
|
|
Service Code
|
HCPCS C8908
|
| Hospital Charge Code |
61000088
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$893.94 |
| Max. Negotiated Rate |
$1,155.96 |
| Rate for Payer: Aetna Commercial |
$1,091.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.79
|
| Rate for Payer: BCN Commercial |
$1,060.79
|
| Rate for Payer: Cash Price |
$1,027.52
|
| Rate for Payer: Cofinity Commercial |
$1,104.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.52
|
| Rate for Payer: Healthscope Commercial |
$1,155.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,091.74
|
| Rate for Payer: Nomi Health Commercial |
$1,053.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$963.30
|
| Rate for Payer: PHP Commercial |
$1,091.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,117.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$893.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,130.27
|
| Rate for Payer: UHC Core |
$1,072.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.30
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,514.20 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.81
|
| Rate for Payer: BCN Commercial |
$1,796.81
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,892.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.51
|
| Rate for Payer: UHC Core |
$1,816.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.68
|
|
|
HC MR BREAST BIL W CON
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
HCPCS C8906
|
| Hospital Charge Code |
61000058
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$383.55 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna Medicare |
$565.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$679.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$679.87
|
| Rate for Payer: BCBS Complete |
$402.70
|
| Rate for Payer: BCBS MAPPO |
$543.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,788.54
|
| Rate for Payer: BCN Commercial |
$1,788.54
|
| Rate for Payer: BCN Medicare Advantage |
$543.89
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.89
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.68
|
| Rate for Payer: Mclaren Medicaid |
$383.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.09
|
| Rate for Payer: Meridian Medicaid |
$402.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$625.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PACE Senior Care Partners |
$516.70
|
| Rate for Payer: PACE SWMI |
$543.89
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: PHP Medicare Advantage |
$543.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,892.75
|
| Rate for Payer: Priority Health Medicare |
$549.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.20
|
| Rate for Payer: Railroad Medicare Medicare |
$543.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.51
|
| Rate for Payer: UHC Core |
$1,816.61
|
| Rate for Payer: UHC Exchange |
$543.89
|
| Rate for Payer: UHC Medicaid |
$383.55
|
| Rate for Payer: UHC Medicare Advantage |
$543.89
|
| Rate for Payer: UHCCP Medicaid |
$383.55
|
| Rate for Payer: VA VA |
$543.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.68
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
OP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$324.98 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Aetna Commercial |
$1,886.23
|
| Rate for Payer: Aetna Medicare |
$576.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$693.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$693.47
|
| Rate for Payer: BCBS Complete |
$410.75
|
| Rate for Payer: BCBS MAPPO |
$554.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,824.31
|
| Rate for Payer: BCCCP Commercial |
$324.98
|
| Rate for Payer: BCN Commercial |
$1,824.31
|
| Rate for Payer: BCN Medicare Advantage |
$554.77
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Commercial |
$1,908.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.77
|
| Rate for Payer: Healthscope Commercial |
$1,997.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.32
|
| Rate for Payer: Mclaren Medicaid |
$391.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.51
|
| Rate for Payer: Meridian Medicaid |
$410.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$637.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$610.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Nomi Health Commercial |
$1,819.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: PACE Senior Care Partners |
$527.03
|
| Rate for Payer: PACE SWMI |
$554.77
|
| Rate for Payer: PHP Commercial |
$1,886.23
|
| Rate for Payer: PHP Medicare Advantage |
$554.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$391.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,930.61
|
| Rate for Payer: Priority Health Medicare |
$560.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,544.49
|
| Rate for Payer: Railroad Medicare Medicare |
$554.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.80
|
| Rate for Payer: UHC Core |
$1,852.94
|
| Rate for Payer: UHC Exchange |
$554.77
|
| Rate for Payer: UHC Medicaid |
$391.23
|
| Rate for Payer: UHC Medicare Advantage |
$554.77
|
| Rate for Payer: UHCCP Medicaid |
$391.23
|
| Rate for Payer: VA VA |
$554.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.32
|
|
|
HC MR BREAST BIL WO W CON
|
Facility
|
IP
|
$2,219.09
|
|
|
Service Code
|
HCPCS 77049
|
| Hospital Charge Code |
61000059
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,544.49 |
| Max. Negotiated Rate |
$1,997.18 |
| Rate for Payer: Aetna Commercial |
$1,886.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.75
|
| Rate for Payer: BCN Commercial |
$1,832.75
|
| Rate for Payer: Cash Price |
$1,775.27
|
| Rate for Payer: Cofinity Commercial |
$1,908.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.27
|
| Rate for Payer: Healthscope Commercial |
$1,997.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.23
|
| Rate for Payer: Nomi Health Commercial |
$1,819.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,664.32
|
| Rate for Payer: PHP Commercial |
$1,886.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,930.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,544.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.80
|
| Rate for Payer: UHC Core |
$1,852.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.32
|
|
|
HC MR BREAST CAD
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC MR BREAST CAD
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
HCPCS C8937
|
| Hospital Charge Code |
61000092
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$644.90 |
| Max. Negotiated Rate |
$833.92 |
| Rate for Payer: Aetna Commercial |
$787.59
|
| Rate for Payer: BCBS Trust/PPO |
$765.26
|
| Rate for Payer: BCN Commercial |
$765.26
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Commercial |
$796.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Healthscope Commercial |
$833.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Nomi Health Commercial |
$759.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: PHP Commercial |
$787.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$806.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$815.39
|
| Rate for Payer: UHC Core |
$773.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.93
|
|
|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
OP
|
$926.58
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$163.36 |
| Max. Negotiated Rate |
$833.92 |
| Rate for Payer: Aetna Commercial |
$787.59
|
| Rate for Payer: Aetna Medicare |
$240.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$289.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$289.56
|
| Rate for Payer: BCBS Complete |
$171.51
|
| Rate for Payer: BCBS MAPPO |
$231.65
|
| Rate for Payer: BCBS Trust/PPO |
$761.74
|
| Rate for Payer: BCN Commercial |
$761.74
|
| Rate for Payer: BCN Medicare Advantage |
$231.65
|
| Rate for Payer: Cash Price |
$741.26
|
| Rate for Payer: Cofinity Commercial |
$796.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$741.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.65
|
| Rate for Payer: Healthscope Commercial |
$833.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.93
|
| Rate for Payer: Mclaren Medicaid |
$163.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.23
|
| Rate for Payer: Meridian Medicaid |
$171.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$266.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$254.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.59
|
| Rate for Payer: Nomi Health Commercial |
$759.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.93
|
| Rate for Payer: PACE Senior Care Partners |
$220.06
|
| Rate for Payer: PACE SWMI |
$231.65
|
| Rate for Payer: PHP Commercial |
$787.59
|
| Rate for Payer: PHP Medicare Advantage |
$231.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$806.12
|
| Rate for Payer: Priority Health Medicare |
$233.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.90
|
| Rate for Payer: Railroad Medicare Medicare |
$231.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$815.39
|
| Rate for Payer: UHC Core |
$773.69
|
| Rate for Payer: UHC Exchange |
$231.65
|
| Rate for Payer: UHC Medicaid |
$163.36
|
| Rate for Payer: UHC Medicare Advantage |
$231.65
|
| Rate for Payer: UHCCP Medicaid |
$163.36
|
| Rate for Payer: VA VA |
$231.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.93
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$876.42 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.99
|
| Rate for Payer: BCN Commercial |
$1,039.99
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$944.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.11
|
| Rate for Payer: UHC Core |
$1,051.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$944.41
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,259.22
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$1,133.30 |
| Rate for Payer: Aetna Commercial |
$1,070.34
|
| Rate for Payer: Aetna Medicare |
$327.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$393.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$393.51
|
| Rate for Payer: BCBS Complete |
$233.08
|
| Rate for Payer: BCBS MAPPO |
$314.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,035.20
|
| Rate for Payer: BCN Commercial |
$1,035.20
|
| Rate for Payer: BCN Medicare Advantage |
$314.81
|
| Rate for Payer: Cash Price |
$1,007.38
|
| Rate for Payer: Cofinity Commercial |
$1,082.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,007.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.81
|
| Rate for Payer: Healthscope Commercial |
$1,133.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$944.41
|
| Rate for Payer: Mclaren Medicaid |
$222.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.55
|
| Rate for Payer: Meridian Medicaid |
$233.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$362.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,070.34
|
| Rate for Payer: Nomi Health Commercial |
$1,032.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$944.41
|
| Rate for Payer: PACE Senior Care Partners |
$299.06
|
| Rate for Payer: PACE SWMI |
$314.81
|
| Rate for Payer: PHP Commercial |
$1,070.34
|
| Rate for Payer: PHP Medicare Advantage |
$314.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,095.52
|
| Rate for Payer: Priority Health Medicare |
$317.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.42
|
| Rate for Payer: Railroad Medicare Medicare |
$314.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,108.11
|
| Rate for Payer: UHC Core |
$1,051.45
|
| Rate for Payer: UHC Exchange |
$314.81
|
| Rate for Payer: UHC Medicaid |
$222.00
|
| Rate for Payer: UHC Medicare Advantage |
$314.81
|
| Rate for Payer: UHCCP Medicaid |
$222.00
|
| Rate for Payer: VA VA |
$314.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$944.41
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$1,600.76
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,114.13 |
| Max. Negotiated Rate |
$1,440.68 |
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,322.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.09
|
| Rate for Payer: BCN Commercial |
$1,322.07
|
| Rate for Payer: BCN Commercial |
$1,983.09
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,088.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,114.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,671.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.99
|
| Rate for Payer: UHC Core |
$1,336.63
|
| Rate for Payer: UHC Core |
$2,004.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.85
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
OP
|
$1,600.76
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$282.21 |
| Max. Negotiated Rate |
$1,440.68 |
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna Medicare |
$624.29
|
| Rate for Payer: Aetna Medicare |
$416.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$750.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$500.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$500.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$750.35
|
| Rate for Payer: BCBS Complete |
$296.30
|
| Rate for Payer: BCBS Complete |
$444.45
|
| Rate for Payer: BCBS MAPPO |
$400.19
|
| Rate for Payer: BCBS MAPPO |
$600.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.97
|
| Rate for Payer: BCN Commercial |
$1,973.97
|
| Rate for Payer: BCN Commercial |
$1,315.98
|
| Rate for Payer: BCN Medicare Advantage |
$600.28
|
| Rate for Payer: BCN Medicare Advantage |
$400.19
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.19
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.85
|
| Rate for Payer: Mclaren Medicaid |
$423.32
|
| Rate for Payer: Mclaren Medicaid |
$282.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.20
|
| Rate for Payer: Meridian Medicaid |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$444.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$690.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: PACE Senior Care Partners |
$570.27
|
| Rate for Payer: PACE Senior Care Partners |
$380.18
|
| Rate for Payer: PACE SWMI |
$600.28
|
| Rate for Payer: PACE SWMI |
$400.19
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: PHP Medicare Advantage |
$400.19
|
| Rate for Payer: PHP Medicare Advantage |
$600.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,088.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.66
|
| Rate for Payer: Priority Health Medicare |
$606.29
|
| Rate for Payer: Priority Health Medicare |
$404.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,114.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,671.19
|
| Rate for Payer: Railroad Medicare Medicare |
$400.19
|
| Rate for Payer: Railroad Medicare Medicare |
$600.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.99
|
| Rate for Payer: UHC Core |
$2,004.94
|
| Rate for Payer: UHC Core |
$1,336.63
|
| Rate for Payer: UHC Exchange |
$600.28
|
| Rate for Payer: UHC Exchange |
$400.19
|
| Rate for Payer: UHC Medicaid |
$423.32
|
| Rate for Payer: UHC Medicaid |
$282.21
|
| Rate for Payer: UHC Medicare Advantage |
$400.19
|
| Rate for Payer: UHC Medicare Advantage |
$600.28
|
| Rate for Payer: UHCCP Medicaid |
$282.21
|
| Rate for Payer: UHCCP Medicaid |
$423.32
|
| Rate for Payer: VA VA |
$400.19
|
| Rate for Payer: VA VA |
$600.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.57
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$2,401.13
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$318.72 |
| Max. Negotiated Rate |
$2,161.02 |
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Medicare |
$624.29
|
| Rate for Payer: Aetna Medicare |
$416.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$750.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$500.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$750.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$500.24
|
| Rate for Payer: BCBS Complete |
$296.30
|
| Rate for Payer: BCBS Complete |
$444.45
|
| Rate for Payer: BCBS MAPPO |
$400.19
|
| Rate for Payer: BCBS MAPPO |
$600.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.97
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCN Commercial |
$1,315.98
|
| Rate for Payer: BCN Commercial |
$1,973.97
|
| Rate for Payer: BCN Medicare Advantage |
$600.28
|
| Rate for Payer: BCN Medicare Advantage |
$400.19
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.19
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.57
|
| Rate for Payer: Mclaren Medicaid |
$423.32
|
| Rate for Payer: Mclaren Medicaid |
$282.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.30
|
| Rate for Payer: Meridian Medicaid |
$296.30
|
| Rate for Payer: Meridian Medicaid |
$444.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$690.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$660.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: PACE Senior Care Partners |
$380.18
|
| Rate for Payer: PACE Senior Care Partners |
$570.27
|
| Rate for Payer: PACE SWMI |
$600.28
|
| Rate for Payer: PACE SWMI |
$400.19
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: PHP Medicare Advantage |
$600.28
|
| Rate for Payer: PHP Medicare Advantage |
$400.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$423.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,088.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.66
|
| Rate for Payer: Priority Health Medicare |
$606.29
|
| Rate for Payer: Priority Health Medicare |
$404.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,114.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,671.19
|
| Rate for Payer: Railroad Medicare Medicare |
$600.28
|
| Rate for Payer: Railroad Medicare Medicare |
$400.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.67
|
| Rate for Payer: UHC Core |
$1,336.63
|
| Rate for Payer: UHC Core |
$2,004.94
|
| Rate for Payer: UHC Exchange |
$600.28
|
| Rate for Payer: UHC Exchange |
$400.19
|
| Rate for Payer: UHC Medicaid |
$423.32
|
| Rate for Payer: UHC Medicaid |
$282.21
|
| Rate for Payer: UHC Medicare Advantage |
$600.28
|
| Rate for Payer: UHC Medicare Advantage |
$400.19
|
| Rate for Payer: UHCCP Medicaid |
$282.21
|
| Rate for Payer: UHCCP Medicaid |
$423.32
|
| Rate for Payer: VA VA |
$400.19
|
| Rate for Payer: VA VA |
$600.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.57
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$1,600.76
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,114.13 |
| Max. Negotiated Rate |
$1,440.68 |
| Rate for Payer: Aetna Commercial |
$1,360.65
|
| Rate for Payer: Aetna Commercial |
$2,040.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,322.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,983.09
|
| Rate for Payer: BCN Commercial |
$1,322.07
|
| Rate for Payer: BCN Commercial |
$1,983.09
|
| Rate for Payer: Cash Price |
$1,280.61
|
| Rate for Payer: Cash Price |
$1,920.90
|
| Rate for Payer: Cofinity Commercial |
$2,064.97
|
| Rate for Payer: Cofinity Commercial |
$1,376.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.61
|
| Rate for Payer: Healthscope Commercial |
$1,440.68
|
| Rate for Payer: Healthscope Commercial |
$2,161.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,040.96
|
| Rate for Payer: Nomi Health Commercial |
$1,312.62
|
| Rate for Payer: Nomi Health Commercial |
$1,968.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,800.85
|
| Rate for Payer: PHP Commercial |
$2,040.96
|
| Rate for Payer: PHP Commercial |
$1,360.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,088.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,114.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,671.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,112.99
|
| Rate for Payer: UHC Core |
$1,336.63
|
| Rate for Payer: UHC Core |
$2,004.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.85
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
OP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$207.57 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: Aetna Medicare |
$565.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$679.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$679.87
|
| Rate for Payer: BCBS Complete |
$402.70
|
| Rate for Payer: BCBS MAPPO |
$543.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,788.54
|
| Rate for Payer: BCCCP Commercial |
$207.57
|
| Rate for Payer: BCN Commercial |
$1,788.54
|
| Rate for Payer: BCN Medicare Advantage |
$543.89
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.89
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.68
|
| Rate for Payer: Mclaren Medicaid |
$383.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.09
|
| Rate for Payer: Meridian Medicaid |
$402.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$625.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PACE Senior Care Partners |
$516.70
|
| Rate for Payer: PACE SWMI |
$543.89
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: PHP Medicare Advantage |
$543.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,892.75
|
| Rate for Payer: Priority Health Medicare |
$549.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.20
|
| Rate for Payer: Railroad Medicare Medicare |
$543.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.51
|
| Rate for Payer: UHC Core |
$1,816.61
|
| Rate for Payer: UHC Exchange |
$543.89
|
| Rate for Payer: UHC Medicaid |
$383.55
|
| Rate for Payer: UHC Medicare Advantage |
$543.89
|
| Rate for Payer: UHCCP Medicaid |
$383.55
|
| Rate for Payer: VA VA |
$543.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.68
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
IP
|
$2,175.58
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,514.20 |
| Max. Negotiated Rate |
$1,958.02 |
| Rate for Payer: Aetna Commercial |
$1,849.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.81
|
| Rate for Payer: BCN Commercial |
$1,796.81
|
| Rate for Payer: Cash Price |
$1,740.46
|
| Rate for Payer: Cofinity Commercial |
$1,871.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.46
|
| Rate for Payer: Healthscope Commercial |
$1,958.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,849.24
|
| Rate for Payer: Nomi Health Commercial |
$1,783.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,631.68
|
| Rate for Payer: PHP Commercial |
$1,849.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,892.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,514.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,914.51
|
| Rate for Payer: UHC Core |
$1,816.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.68
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$201.08 |
| Max. Negotiated Rate |
$1,440.13 |
| Rate for Payer: Aetna Commercial |
$1,360.12
|
| Rate for Payer: Aetna Medicare |
$416.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$500.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$500.04
|
| Rate for Payer: BCBS Complete |
$296.19
|
| Rate for Payer: BCBS MAPPO |
$400.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.48
|
| Rate for Payer: BCCCP Commercial |
$201.08
|
| Rate for Payer: BCN Commercial |
$1,315.48
|
| Rate for Payer: BCN Medicare Advantage |
$400.04
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Commercial |
$1,376.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$400.04
|
| Rate for Payer: Healthscope Commercial |
$1,440.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.11
|
| Rate for Payer: Mclaren Medicaid |
$282.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$420.04
|
| Rate for Payer: Meridian Medicaid |
$296.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$460.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$440.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.12
|
| Rate for Payer: Nomi Health Commercial |
$1,312.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| Rate for Payer: PACE Senior Care Partners |
$380.03
|
| Rate for Payer: PACE SWMI |
$400.04
|
| Rate for Payer: PHP Commercial |
$1,360.12
|
| Rate for Payer: PHP Medicare Advantage |
$400.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.12
|
| Rate for Payer: Priority Health Medicare |
$404.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.70
|
| Rate for Payer: Railroad Medicare Medicare |
$400.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.12
|
| Rate for Payer: UHC Core |
$1,336.12
|
| Rate for Payer: UHC Exchange |
$400.04
|
| Rate for Payer: UHC Medicaid |
$282.10
|
| Rate for Payer: UHC Medicare Advantage |
$400.04
|
| Rate for Payer: UHCCP Medicaid |
$282.10
|
| Rate for Payer: VA VA |
$400.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.11
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,600.14
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,113.70 |
| Max. Negotiated Rate |
$1,440.13 |
| Rate for Payer: Aetna Commercial |
$1,360.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,321.56
|
| Rate for Payer: BCN Commercial |
$1,321.56
|
| Rate for Payer: Cash Price |
$1,280.11
|
| Rate for Payer: Cofinity Commercial |
$1,376.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.11
|
| Rate for Payer: Healthscope Commercial |
$1,440.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.12
|
| Rate for Payer: Nomi Health Commercial |
$1,312.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.11
|
| Rate for Payer: PHP Commercial |
$1,360.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,392.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,408.12
|
| Rate for Payer: UHC Core |
$1,336.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.11
|
|
