|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
IP
|
$1,330.39
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$864.75 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,086.00
|
| Rate for Payer: BCN Commercial |
$1,028.13
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$997.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,157.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$891.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.74
|
| Rate for Payer: UHC Core |
$1,110.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$997.79
|
|
|
HC MALONEY/BOUGIE DILATATION
|
Facility
|
OP
|
$1,330.39
|
|
| Hospital Charge Code |
36000074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.97 |
| Max. Negotiated Rate |
$1,197.35 |
| Rate for Payer: Aetna Commercial |
$1,130.83
|
| Rate for Payer: Aetna Medicare |
$345.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$415.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$415.75
|
| Rate for Payer: BCBS Complete |
$532.16
|
| Rate for Payer: BCBS MAPPO |
$332.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.71
|
| Rate for Payer: BCN Commercial |
$1,034.38
|
| Rate for Payer: BCN Medicare Advantage |
$332.60
|
| Rate for Payer: Cash Price |
$1,064.31
|
| Rate for Payer: Cofinity Commercial |
$1,144.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.60
|
| Rate for Payer: Healthscope Commercial |
$1,197.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$997.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,130.83
|
| Rate for Payer: Nomi Health Commercial |
$1,090.92
|
| Rate for Payer: PACE Senior Care Partners |
$315.97
|
| Rate for Payer: PACE SWMI |
$332.60
|
| Rate for Payer: PHP Commercial |
$1,130.83
|
| Rate for Payer: PHP Medicare Advantage |
$332.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$864.75
|
| Rate for Payer: Priority Health HMO/PPO |
$1,157.44
|
| Rate for Payer: Priority Health Medicare |
$335.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$891.36
|
| Rate for Payer: Railroad Medicare Medicare |
$332.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,170.74
|
| Rate for Payer: UHC Core |
$1,110.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.60
|
| Rate for Payer: UHC Exchange |
$332.60
|
| Rate for Payer: UHC Medicare Advantage |
$332.60
|
| Rate for Payer: VA VA |
$332.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$997.79
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
IP
|
$430.14
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$279.59 |
| Max. Negotiated Rate |
$387.13 |
| Rate for Payer: Aetna Commercial |
$365.62
|
| Rate for Payer: BCBS Trust/PPO |
$351.12
|
| Rate for Payer: BCN Commercial |
$332.41
|
| Rate for Payer: Cash Price |
$344.11
|
| Rate for Payer: Cofinity Commercial |
$369.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.11
|
| Rate for Payer: Healthscope Commercial |
$387.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.62
|
| Rate for Payer: Nomi Health Commercial |
$352.71
|
| Rate for Payer: PHP Commercial |
$365.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.59
|
| Rate for Payer: Priority Health HMO/PPO |
$374.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.52
|
| Rate for Payer: UHC Core |
$359.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.61
|
|
|
HC MAMM BILAT DIAGNOSTIC W CAD
|
Facility
|
OP
|
$430.14
|
|
|
Service Code
|
HCPCS 77066
|
| Hospital Charge Code |
40100004
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$102.16 |
| Max. Negotiated Rate |
$387.13 |
| Rate for Payer: Aetna Commercial |
$365.62
|
| Rate for Payer: Aetna Medicare |
$111.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.42
|
| Rate for Payer: BCBS Complete |
$172.06
|
| Rate for Payer: BCBS MAPPO |
$107.53
|
| Rate for Payer: BCBS Trust/PPO |
$353.62
|
| Rate for Payer: BCN Commercial |
$334.43
|
| Rate for Payer: BCN Medicare Advantage |
$107.53
|
| Rate for Payer: Cash Price |
$344.11
|
| Rate for Payer: Cofinity Commercial |
$369.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.53
|
| Rate for Payer: Healthscope Commercial |
$387.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.62
|
| Rate for Payer: Nomi Health Commercial |
$352.71
|
| Rate for Payer: PACE Senior Care Partners |
$102.16
|
| Rate for Payer: PACE SWMI |
$107.53
|
| Rate for Payer: PHP Commercial |
$365.62
|
| Rate for Payer: PHP Medicare Advantage |
$107.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.59
|
| Rate for Payer: Priority Health HMO/PPO |
$374.22
|
| Rate for Payer: Priority Health Medicare |
$108.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.19
|
| Rate for Payer: Railroad Medicare Medicare |
$107.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.52
|
| Rate for Payer: UHC Core |
$359.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.53
|
| Rate for Payer: UHC Exchange |
$107.53
|
| Rate for Payer: UHC Medicare Advantage |
$107.53
|
| Rate for Payer: VA VA |
$107.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.61
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
IP
|
$424.41
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$275.87 |
| Max. Negotiated Rate |
$381.97 |
| Rate for Payer: Aetna Commercial |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$346.45
|
| Rate for Payer: BCN Commercial |
$327.98
|
| Rate for Payer: Cash Price |
$339.53
|
| Rate for Payer: Cofinity Commercial |
$364.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.53
|
| Rate for Payer: Healthscope Commercial |
$381.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$348.02
|
| Rate for Payer: PHP Commercial |
$360.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.87
|
| Rate for Payer: Priority Health HMO/PPO |
$369.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.48
|
| Rate for Payer: UHC Core |
$354.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.31
|
|
|
HC MAMM BILAT SCREEN WITH CAD
|
Facility
|
OP
|
$424.41
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300006
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$100.80 |
| Max. Negotiated Rate |
$381.97 |
| Rate for Payer: Aetna Commercial |
$360.75
|
| Rate for Payer: Aetna Medicare |
$110.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.63
|
| Rate for Payer: BCBS Complete |
$169.76
|
| Rate for Payer: BCBS MAPPO |
$106.10
|
| Rate for Payer: BCBS Trust/PPO |
$348.91
|
| Rate for Payer: BCN Commercial |
$329.98
|
| Rate for Payer: BCN Medicare Advantage |
$106.10
|
| Rate for Payer: Cash Price |
$339.53
|
| Rate for Payer: Cofinity Commercial |
$364.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.10
|
| Rate for Payer: Healthscope Commercial |
$381.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.75
|
| Rate for Payer: Nomi Health Commercial |
$348.02
|
| Rate for Payer: PACE Senior Care Partners |
$100.80
|
| Rate for Payer: PACE SWMI |
$106.10
|
| Rate for Payer: PHP Commercial |
$360.75
|
| Rate for Payer: PHP Medicare Advantage |
$106.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.87
|
| Rate for Payer: Priority Health HMO/PPO |
$369.24
|
| Rate for Payer: Priority Health Medicare |
$107.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.35
|
| Rate for Payer: Railroad Medicare Medicare |
$106.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.48
|
| Rate for Payer: UHC Core |
$354.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.10
|
| Rate for Payer: UHC Exchange |
$106.10
|
| Rate for Payer: UHC Medicare Advantage |
$106.10
|
| Rate for Payer: VA VA |
$106.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.31
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
OP
|
$720.36
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.09 |
| Max. Negotiated Rate |
$648.32 |
| Rate for Payer: Aetna Commercial |
$612.31
|
| Rate for Payer: Aetna Medicare |
$187.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.11
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$180.09
|
| Rate for Payer: BCBS Trust/PPO |
$592.21
|
| Rate for Payer: BCN Commercial |
$560.08
|
| Rate for Payer: BCN Medicare Advantage |
$180.09
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cofinity Commercial |
$619.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.09
|
| Rate for Payer: Healthscope Commercial |
$648.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.27
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.09
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.31
|
| Rate for Payer: Nomi Health Commercial |
$590.70
|
| Rate for Payer: PACE Senior Care Partners |
$171.09
|
| Rate for Payer: PACE SWMI |
$180.09
|
| Rate for Payer: PHP Commercial |
$612.31
|
| Rate for Payer: PHP Medicare Advantage |
$180.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.23
|
| Rate for Payer: Priority Health HMO/PPO |
$626.71
|
| Rate for Payer: Priority Health Medicare |
$181.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$482.64
|
| Rate for Payer: Railroad Medicare Medicare |
$180.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.92
|
| Rate for Payer: UHC Core |
$601.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.09
|
| Rate for Payer: UHC Exchange |
$180.09
|
| Rate for Payer: UHC Medicare Advantage |
$180.09
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$180.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.27
|
|
|
HC MAMMO BREAST ASP CYST
|
Facility
|
IP
|
$720.36
|
|
|
Service Code
|
CPT 19000
|
| Hospital Charge Code |
36100008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$468.23 |
| Max. Negotiated Rate |
$648.32 |
| Rate for Payer: Aetna Commercial |
$612.31
|
| Rate for Payer: BCBS Trust/PPO |
$588.03
|
| Rate for Payer: BCN Commercial |
$556.69
|
| Rate for Payer: Cash Price |
$576.29
|
| Rate for Payer: Cofinity Commercial |
$619.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.29
|
| Rate for Payer: Healthscope Commercial |
$648.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.31
|
| Rate for Payer: Nomi Health Commercial |
$590.70
|
| Rate for Payer: PHP Commercial |
$612.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.23
|
| Rate for Payer: Priority Health HMO/PPO |
$626.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$482.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.92
|
| Rate for Payer: UHC Core |
$601.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.27
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
OP
|
$396.58
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.19 |
| Max. Negotiated Rate |
$356.92 |
| Rate for Payer: Aetna Commercial |
$337.09
|
| Rate for Payer: Aetna Medicare |
$103.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.93
|
| Rate for Payer: BCBS Complete |
$158.63
|
| Rate for Payer: BCBS MAPPO |
$99.14
|
| Rate for Payer: BCBS Trust/PPO |
$326.03
|
| Rate for Payer: BCN Commercial |
$308.34
|
| Rate for Payer: BCN Medicare Advantage |
$99.14
|
| Rate for Payer: Cash Price |
$317.26
|
| Rate for Payer: Cofinity Commercial |
$341.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.14
|
| Rate for Payer: Healthscope Commercial |
$356.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.09
|
| Rate for Payer: Nomi Health Commercial |
$325.20
|
| Rate for Payer: PACE Senior Care Partners |
$94.19
|
| Rate for Payer: PACE SWMI |
$99.14
|
| Rate for Payer: PHP Commercial |
$337.09
|
| Rate for Payer: PHP Medicare Advantage |
$99.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.78
|
| Rate for Payer: Priority Health HMO/PPO |
$345.02
|
| Rate for Payer: Priority Health Medicare |
$100.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.71
|
| Rate for Payer: Railroad Medicare Medicare |
$99.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.99
|
| Rate for Payer: UHC Core |
$331.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.14
|
| Rate for Payer: UHC Exchange |
$99.14
|
| Rate for Payer: UHC Medicare Advantage |
$99.14
|
| Rate for Payer: VA VA |
$99.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.44
|
|
|
HC MAMMO BREAST ASP CYST ADD LESION
|
Facility
|
IP
|
$396.58
|
|
|
Service Code
|
CPT 19001
|
| Hospital Charge Code |
36100009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.78 |
| Max. Negotiated Rate |
$356.92 |
| Rate for Payer: Aetna Commercial |
$337.09
|
| Rate for Payer: BCBS Trust/PPO |
$323.73
|
| Rate for Payer: BCN Commercial |
$306.48
|
| Rate for Payer: Cash Price |
$317.26
|
| Rate for Payer: Cofinity Commercial |
$341.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.26
|
| Rate for Payer: Healthscope Commercial |
$356.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.09
|
| Rate for Payer: Nomi Health Commercial |
$325.20
|
| Rate for Payer: PHP Commercial |
$337.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.78
|
| Rate for Payer: Priority Health HMO/PPO |
$345.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.99
|
| Rate for Payer: UHC Core |
$331.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.44
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
IP
|
$2,786.59
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,811.28 |
| Max. Negotiated Rate |
$2,507.93 |
| Rate for Payer: Aetna Commercial |
$2,368.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,274.69
|
| Rate for Payer: BCN Commercial |
$2,153.48
|
| Rate for Payer: Cash Price |
$2,229.27
|
| Rate for Payer: Cofinity Commercial |
$2,396.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,229.27
|
| Rate for Payer: Healthscope Commercial |
$2,507.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,089.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,368.60
|
| Rate for Payer: Nomi Health Commercial |
$2,285.00
|
| Rate for Payer: PHP Commercial |
$2,368.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.28
|
| Rate for Payer: Priority Health HMO/PPO |
$2,424.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,867.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,452.20
|
| Rate for Payer: UHC Core |
$2,326.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,089.94
|
|
|
HC MAMMO BREAST GUIDED MASTOTOMY
|
Facility
|
OP
|
$2,786.59
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
36100010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$661.82 |
| Max. Negotiated Rate |
$2,507.93 |
| Rate for Payer: Aetna Commercial |
$2,368.60
|
| Rate for Payer: Aetna Medicare |
$724.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$870.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$870.81
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$696.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,290.86
|
| Rate for Payer: BCN Commercial |
$2,166.57
|
| Rate for Payer: BCN Medicare Advantage |
$696.65
|
| Rate for Payer: Cash Price |
$2,229.27
|
| Rate for Payer: Cash Price |
$2,229.27
|
| Rate for Payer: Cofinity Commercial |
$2,396.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,229.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$696.65
|
| Rate for Payer: Healthscope Commercial |
$2,507.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,089.94
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$731.48
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$801.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,368.60
|
| Rate for Payer: Nomi Health Commercial |
$2,285.00
|
| Rate for Payer: PACE Senior Care Partners |
$661.82
|
| Rate for Payer: PACE SWMI |
$696.65
|
| Rate for Payer: PHP Commercial |
$2,368.60
|
| Rate for Payer: PHP Medicare Advantage |
$696.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,811.28
|
| Rate for Payer: Priority Health HMO/PPO |
$2,424.33
|
| Rate for Payer: Priority Health Medicare |
$703.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,867.02
|
| Rate for Payer: Railroad Medicare Medicare |
$696.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,452.20
|
| Rate for Payer: UHC Core |
$2,326.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$696.65
|
| Rate for Payer: UHC Exchange |
$696.65
|
| Rate for Payer: UHC Medicare Advantage |
$696.65
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$696.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,089.94
|
|
|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
OP
|
$1,177.28
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$279.60 |
| Max. Negotiated Rate |
$1,059.55 |
| Rate for Payer: Aetna Commercial |
$1,000.69
|
| Rate for Payer: Aetna Medicare |
$306.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.90
|
| Rate for Payer: BCBS Complete |
$470.91
|
| Rate for Payer: BCBS MAPPO |
$294.32
|
| Rate for Payer: BCBS Trust/PPO |
$967.84
|
| Rate for Payer: BCN Commercial |
$915.34
|
| Rate for Payer: BCN Medicare Advantage |
$294.32
|
| Rate for Payer: Cash Price |
$941.82
|
| Rate for Payer: Cofinity Commercial |
$1,012.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$941.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.32
|
| Rate for Payer: Healthscope Commercial |
$1,059.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,000.69
|
| Rate for Payer: Nomi Health Commercial |
$965.37
|
| Rate for Payer: PACE Senior Care Partners |
$279.60
|
| Rate for Payer: PACE SWMI |
$294.32
|
| Rate for Payer: PHP Commercial |
$1,000.69
|
| Rate for Payer: PHP Medicare Advantage |
$294.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$765.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,024.23
|
| Rate for Payer: Priority Health Medicare |
$297.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$788.78
|
| Rate for Payer: Railroad Medicare Medicare |
$294.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,036.01
|
| Rate for Payer: UHC Core |
$983.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.32
|
| Rate for Payer: UHC Exchange |
$294.32
|
| Rate for Payer: UHC Medicare Advantage |
$294.32
|
| Rate for Payer: VA VA |
$294.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.96
|
|
|
HC MAMMO BREAST INJECTION DUCTOGRAM
|
Facility
|
IP
|
$1,177.28
|
|
|
Service Code
|
CPT 19030
|
| Hospital Charge Code |
36100011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$765.23 |
| Max. Negotiated Rate |
$1,059.55 |
| Rate for Payer: Aetna Commercial |
$1,000.69
|
| Rate for Payer: BCBS Trust/PPO |
$961.01
|
| Rate for Payer: BCN Commercial |
$909.80
|
| Rate for Payer: Cash Price |
$941.82
|
| Rate for Payer: Cofinity Commercial |
$1,012.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$941.82
|
| Rate for Payer: Healthscope Commercial |
$1,059.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,000.69
|
| Rate for Payer: Nomi Health Commercial |
$965.37
|
| Rate for Payer: PHP Commercial |
$1,000.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$765.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,024.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$788.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,036.01
|
| Rate for Payer: UHC Core |
$983.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.96
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
OP
|
$372.79
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$88.54 |
| Max. Negotiated Rate |
$335.51 |
| Rate for Payer: Aetna Commercial |
$316.87
|
| Rate for Payer: Aetna Medicare |
$96.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.50
|
| Rate for Payer: BCBS Complete |
$149.12
|
| Rate for Payer: BCBS MAPPO |
$93.20
|
| Rate for Payer: BCBS Trust/PPO |
$306.47
|
| Rate for Payer: BCN Commercial |
$289.84
|
| Rate for Payer: BCN Medicare Advantage |
$93.20
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Cofinity Commercial |
$320.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.20
|
| Rate for Payer: Healthscope Commercial |
$335.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.87
|
| Rate for Payer: Nomi Health Commercial |
$305.69
|
| Rate for Payer: PACE Senior Care Partners |
$88.54
|
| Rate for Payer: PACE SWMI |
$93.20
|
| Rate for Payer: PHP Commercial |
$316.87
|
| Rate for Payer: PHP Medicare Advantage |
$93.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.31
|
| Rate for Payer: Priority Health HMO/PPO |
$324.33
|
| Rate for Payer: Priority Health Medicare |
$94.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.77
|
| Rate for Payer: Railroad Medicare Medicare |
$93.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.06
|
| Rate for Payer: UHC Core |
$311.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.20
|
| Rate for Payer: UHC Exchange |
$93.20
|
| Rate for Payer: UHC Medicare Advantage |
$93.20
|
| Rate for Payer: VA VA |
$93.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.59
|
|
|
HC MAMMO DIAGNOSTIC UNI WITH CAD
|
Facility
|
IP
|
$372.79
|
|
|
Service Code
|
CPT 77065
|
| Hospital Charge Code |
40100005
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$242.31 |
| Max. Negotiated Rate |
$335.51 |
| Rate for Payer: Aetna Commercial |
$316.87
|
| Rate for Payer: BCBS Trust/PPO |
$304.31
|
| Rate for Payer: BCN Commercial |
$288.09
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Cofinity Commercial |
$320.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.23
|
| Rate for Payer: Healthscope Commercial |
$335.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.87
|
| Rate for Payer: Nomi Health Commercial |
$305.69
|
| Rate for Payer: PHP Commercial |
$316.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.31
|
| Rate for Payer: Priority Health HMO/PPO |
$324.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.06
|
| Rate for Payer: UHC Core |
$311.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.59
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
IP
|
$592.06
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$384.84 |
| Max. Negotiated Rate |
$532.85 |
| Rate for Payer: Aetna Commercial |
$503.25
|
| Rate for Payer: BCBS Trust/PPO |
$483.30
|
| Rate for Payer: BCN Commercial |
$457.54
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cofinity Commercial |
$509.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.65
|
| Rate for Payer: Healthscope Commercial |
$532.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.25
|
| Rate for Payer: Nomi Health Commercial |
$485.49
|
| Rate for Payer: PHP Commercial |
$503.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.84
|
| Rate for Payer: Priority Health HMO/PPO |
$515.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.01
|
| Rate for Payer: UHC Core |
$494.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.05
|
|
|
HC MAMMO DUCTOGRAM MULTIPLE
|
Facility
|
OP
|
$592.06
|
|
|
Service Code
|
CPT 77054
|
| Hospital Charge Code |
32000251
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$140.61 |
| Max. Negotiated Rate |
$532.85 |
| Rate for Payer: Aetna Commercial |
$503.25
|
| Rate for Payer: Aetna Medicare |
$153.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.02
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$148.01
|
| Rate for Payer: BCBS Trust/PPO |
$486.73
|
| Rate for Payer: BCN Commercial |
$460.33
|
| Rate for Payer: BCN Medicare Advantage |
$148.01
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cash Price |
$473.65
|
| Rate for Payer: Cofinity Commercial |
$509.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.01
|
| Rate for Payer: Healthscope Commercial |
$532.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.05
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.42
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.25
|
| Rate for Payer: Nomi Health Commercial |
$485.49
|
| Rate for Payer: PACE Senior Care Partners |
$140.61
|
| Rate for Payer: PACE SWMI |
$148.01
|
| Rate for Payer: PHP Commercial |
$503.25
|
| Rate for Payer: PHP Medicare Advantage |
$148.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.84
|
| Rate for Payer: Priority Health HMO/PPO |
$515.09
|
| Rate for Payer: Priority Health Medicare |
$149.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.68
|
| Rate for Payer: Railroad Medicare Medicare |
$148.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.01
|
| Rate for Payer: UHC Core |
$494.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.01
|
| Rate for Payer: UHC Exchange |
$148.01
|
| Rate for Payer: UHC Medicare Advantage |
$148.01
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$148.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.05
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
OP
|
$714.47
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.69 |
| Max. Negotiated Rate |
$643.02 |
| Rate for Payer: Aetna Commercial |
$607.30
|
| Rate for Payer: Aetna Medicare |
$185.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.27
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$178.62
|
| Rate for Payer: BCBS Trust/PPO |
$587.37
|
| Rate for Payer: BCN Commercial |
$555.50
|
| Rate for Payer: BCN Medicare Advantage |
$178.62
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$614.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.62
|
| Rate for Payer: Healthscope Commercial |
$643.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.85
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.55
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.30
|
| Rate for Payer: Nomi Health Commercial |
$585.87
|
| Rate for Payer: PACE Senior Care Partners |
$169.69
|
| Rate for Payer: PACE SWMI |
$178.62
|
| Rate for Payer: PHP Commercial |
$607.30
|
| Rate for Payer: PHP Medicare Advantage |
$178.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.41
|
| Rate for Payer: Priority Health HMO/PPO |
$621.59
|
| Rate for Payer: Priority Health Medicare |
$180.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.69
|
| Rate for Payer: Railroad Medicare Medicare |
$178.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.73
|
| Rate for Payer: UHC Core |
$596.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.62
|
| Rate for Payer: UHC Exchange |
$178.62
|
| Rate for Payer: UHC Medicare Advantage |
$178.62
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$178.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.85
|
|
|
HC MAMMO DUCTOGRAM SINGLE
|
Facility
|
IP
|
$714.47
|
|
|
Service Code
|
CPT 77053
|
| Hospital Charge Code |
32000250
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$464.41 |
| Max. Negotiated Rate |
$643.02 |
| Rate for Payer: Aetna Commercial |
$607.30
|
| Rate for Payer: BCBS Trust/PPO |
$583.22
|
| Rate for Payer: BCN Commercial |
$552.14
|
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Cofinity Commercial |
$614.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.58
|
| Rate for Payer: Healthscope Commercial |
$643.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$607.30
|
| Rate for Payer: Nomi Health Commercial |
$585.87
|
| Rate for Payer: PHP Commercial |
$607.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.41
|
| Rate for Payer: Priority Health HMO/PPO |
$621.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.73
|
| Rate for Payer: UHC Core |
$596.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.85
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$75.73 |
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: Aetna Medicare |
$21.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.30
|
| Rate for Payer: BCBS Complete |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$21.04
|
| Rate for Payer: BCBS Trust/PPO |
$69.18
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$21.04
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.04
|
| Rate for Payer: Healthscope Commercial |
$75.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: Nomi Health Commercial |
$69.00
|
| Rate for Payer: PACE Senior Care Partners |
$19.99
|
| Rate for Payer: PACE SWMI |
$21.04
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: PHP Medicare Advantage |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health HMO/PPO |
$73.21
|
| Rate for Payer: Priority Health Medicare |
$21.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: Railroad Medicare Medicare |
$21.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.05
|
| Rate for Payer: UHC Core |
$70.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.04
|
| Rate for Payer: UHC Exchange |
$21.04
|
| Rate for Payer: UHC Medicare Advantage |
$21.04
|
| Rate for Payer: VA VA |
$21.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.70 |
| Max. Negotiated Rate |
$75.73 |
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$68.69
|
| Rate for Payer: BCN Commercial |
$65.03
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$75.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: Nomi Health Commercial |
$69.00
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health HMO/PPO |
$73.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.05
|
| Rate for Payer: UHC Core |
$70.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,652.00 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,330.50
|
| Rate for Payer: BCN Commercial |
$3,153.02
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,549.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,590.40
|
| Rate for Payer: UHC Core |
$3,406.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$969.00 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna Medicare |
$1,060.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,275.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,275.00
|
| Rate for Payer: BCBS Complete |
$1,215.03
|
| Rate for Payer: BCBS MAPPO |
$1,020.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,354.17
|
| Rate for Payer: BCN Commercial |
$3,172.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Mclaren Medicaid |
$1,157.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.00
|
| Rate for Payer: Meridian Medicaid |
$1,215.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,173.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: Nomi Health Commercial |
$3,345.60
|
| Rate for Payer: PACE Senior Care Partners |
$969.00
|
| Rate for Payer: PACE SWMI |
$1,020.00
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,157.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health HMO/PPO |
$3,549.60
|
| Rate for Payer: Priority Health Medicare |
$1,030.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,590.40
|
| Rate for Payer: UHC Core |
$3,406.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,020.00
|
| Rate for Payer: UHC Exchange |
$1,020.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,020.00
|
| Rate for Payer: UHCCP Medicaid |
$1,157.10
|
| Rate for Payer: VA VA |
$1,020.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$494.19
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.37 |
| Max. Negotiated Rate |
$444.77 |
| Rate for Payer: Aetna Commercial |
$420.06
|
| Rate for Payer: Aetna Medicare |
$128.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.43
|
| Rate for Payer: BCBS Complete |
$182.12
|
| Rate for Payer: BCBS MAPPO |
$123.55
|
| Rate for Payer: BCBS Trust/PPO |
$406.27
|
| Rate for Payer: BCN Commercial |
$384.23
|
| Rate for Payer: BCN Medicare Advantage |
$123.55
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cofinity Commercial |
$425.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.55
|
| Rate for Payer: Healthscope Commercial |
$444.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.64
|
| Rate for Payer: Mclaren Medicaid |
$173.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.72
|
| Rate for Payer: Meridian Medicaid |
$182.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.06
|
| Rate for Payer: Nomi Health Commercial |
$405.24
|
| Rate for Payer: PACE Senior Care Partners |
$117.37
|
| Rate for Payer: PACE SWMI |
$123.55
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: PHP Medicare Advantage |
$123.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.22
|
| Rate for Payer: Priority Health HMO/PPO |
$429.95
|
| Rate for Payer: Priority Health Medicare |
$124.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.11
|
| Rate for Payer: Railroad Medicare Medicare |
$123.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.89
|
| Rate for Payer: UHC Core |
$412.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.55
|
| Rate for Payer: UHC Exchange |
$123.55
|
| Rate for Payer: UHC Medicare Advantage |
$123.55
|
| Rate for Payer: UHCCP Medicaid |
$173.43
|
| Rate for Payer: VA VA |
$123.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.64
|
|
