|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$927.20 |
| Max. Negotiated Rate |
$3,513.59 |
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: Aetna Medicare |
$1,015.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,220.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,220.00
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$976.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,035.35
|
| Rate for Payer: BCN Commercial |
$3,035.35
|
| Rate for Payer: BCN Medicare Advantage |
$976.00
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,123.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$976.00
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,927.99
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,024.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PACE Senior Care Partners |
$927.20
|
| Rate for Payer: PACE SWMI |
$976.00
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: PHP Medicare Advantage |
$976.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,396.47
|
| Rate for Payer: Priority Health Medicare |
$976.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,381.04
|
| Rate for Payer: Railroad Medicare Medicare |
$976.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,435.51
|
| Rate for Payer: UHC Core |
$3,259.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$976.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,005.28
|
| Rate for Payer: VA VA |
$976.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,927.99
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna Medicare |
$832.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.65
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$800.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,489.62
|
| Rate for Payer: BCN Commercial |
$2,489.62
|
| Rate for Payer: BCN Medicare Advantage |
$800.52
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.52
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$840.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PACE Senior Care Partners |
$760.50
|
| Rate for Payer: PACE SWMI |
$800.52
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: PHP Medicare Advantage |
$800.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,785.82
|
| Rate for Payer: Priority Health Medicare |
$800.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,952.95
|
| Rate for Payer: Railroad Medicare Medicare |
$800.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,817.84
|
| Rate for Payer: UHC Core |
$2,673.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.52
|
| Rate for Payer: UHC Medicare Advantage |
$824.54
|
| Rate for Payer: VA VA |
$800.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,952.95 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,474.58
|
| Rate for Payer: BCN Commercial |
$2,474.58
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,785.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,952.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,817.84
|
| Rate for Payer: UHC Core |
$2,673.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$92.07 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: BCBS Trust/PPO |
$99.69
|
| Rate for Payer: BCBS Trust/PPO |
$116.66
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Commercial |
$116.66
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.52
|
| Rate for Payer: UHC Core |
$107.72
|
| Rate for Payer: UHC Core |
$126.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: Aetna Medicare |
$33.54
|
| Rate for Payer: Aetna Medicare |
$39.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.31
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS MAPPO |
$32.25
|
| Rate for Payer: BCBS MAPPO |
$37.74
|
| Rate for Payer: BCBS Trust/PPO |
$100.30
|
| Rate for Payer: BCBS Trust/PPO |
$117.37
|
| Rate for Payer: BCN Commercial |
$100.30
|
| Rate for Payer: BCN Commercial |
$117.37
|
| Rate for Payer: BCN Medicare Advantage |
$37.74
|
| Rate for Payer: BCN Medicare Advantage |
$32.25
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: PACE Senior Care Partners |
$35.85
|
| Rate for Payer: PACE Senior Care Partners |
$30.64
|
| Rate for Payer: PACE SWMI |
$32.25
|
| Rate for Payer: PACE SWMI |
$37.74
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: PHP Medicare Advantage |
$32.25
|
| Rate for Payer: PHP Medicare Advantage |
$37.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.23
|
| Rate for Payer: Priority Health Medicare |
$32.25
|
| Rate for Payer: Priority Health Medicare |
$37.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.07
|
| Rate for Payer: Railroad Medicare Medicare |
$37.74
|
| Rate for Payer: Railroad Medicare Medicare |
$32.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.52
|
| Rate for Payer: UHC Core |
$126.05
|
| Rate for Payer: UHC Core |
$107.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.74
|
| Rate for Payer: UHC Medicare Advantage |
$38.87
|
| Rate for Payer: UHC Medicare Advantage |
$33.22
|
| Rate for Payer: VA VA |
$32.25
|
| Rate for Payer: VA VA |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: Aetna Medicare |
$48.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.74
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$46.99
|
| Rate for Payer: BCBS Trust/PPO |
$146.14
|
| Rate for Payer: BCN Commercial |
$146.14
|
| Rate for Payer: BCN Medicare Advantage |
$46.99
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.99
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.97
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.77
|
| Rate for Payer: PACE Senior Care Partners |
$44.64
|
| Rate for Payer: PACE SWMI |
$46.99
|
| Rate for Payer: PHP Commercial |
$159.77
|
| Rate for Payer: PHP Medicare Advantage |
$46.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.53
|
| Rate for Payer: Priority Health Medicare |
$46.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.64
|
| Rate for Payer: Railroad Medicare Medicare |
$46.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.40
|
| Rate for Payer: UHC Core |
$156.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.99
|
| Rate for Payer: UHC Medicare Advantage |
$48.40
|
| Rate for Payer: VA VA |
$46.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.97
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$114.64 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: BCBS Trust/PPO |
$145.26
|
| Rate for Payer: BCN Commercial |
$145.26
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.37
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.77
|
| Rate for Payer: PHP Commercial |
$159.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$163.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.40
|
| Rate for Payer: UHC Core |
$156.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.97
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$162.52 |
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: Aetna Medicare |
$46.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.43
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$45.14
|
| Rate for Payer: BCBS Trust/PPO |
$140.40
|
| Rate for Payer: BCN Commercial |
$140.40
|
| Rate for Payer: BCN Medicare Advantage |
$45.14
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.14
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.44
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.49
|
| Rate for Payer: PACE Senior Care Partners |
$42.89
|
| Rate for Payer: PACE SWMI |
$45.14
|
| Rate for Payer: PHP Commercial |
$153.49
|
| Rate for Payer: PHP Medicare Advantage |
$45.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.10
|
| Rate for Payer: Priority Health Medicare |
$45.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.14
|
| Rate for Payer: Railroad Medicare Medicare |
$45.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.91
|
| Rate for Payer: UHC Core |
$150.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.14
|
| Rate for Payer: UHC Medicare Advantage |
$46.50
|
| Rate for Payer: VA VA |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.44
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$110.14 |
| Max. Negotiated Rate |
$162.52 |
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: BCBS Trust/PPO |
$139.55
|
| Rate for Payer: BCN Commercial |
$139.55
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.46
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.49
|
| Rate for Payer: PHP Commercial |
$153.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.91
|
| Rate for Payer: UHC Core |
$150.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.44
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: BCBS Trust/PPO |
$9.35
|
| Rate for Payer: BCN Commercial |
$9.35
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.65
|
| Rate for Payer: UHC Core |
$10.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: Aetna Medicare |
$3.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.78
|
| Rate for Payer: BCBS Complete |
$2.54
|
| Rate for Payer: BCBS MAPPO |
$3.02
|
| Rate for Payer: BCBS Trust/PPO |
$9.41
|
| Rate for Payer: BCN Commercial |
$9.41
|
| Rate for Payer: BCN Medicare Advantage |
$3.02
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.02
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Mclaren Medicaid |
$2.42
|
| Rate for Payer: Meridian Medicaid |
$2.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PACE Senior Care Partners |
$2.87
|
| Rate for Payer: PACE SWMI |
$3.02
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.53
|
| Rate for Payer: Priority Health Medicare |
$3.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$3.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.65
|
| Rate for Payer: UHC Core |
$10.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.02
|
| Rate for Payer: UHC Medicare Advantage |
$3.12
|
| Rate for Payer: VA VA |
$3.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$43.20
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.93 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$33.59
|
| Rate for Payer: BCN Commercial |
$33.59
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.40
|
| Rate for Payer: Mclaren Medicaid |
$4.93
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PACE Senior Care Partners |
$10.26
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.58
|
| Rate for Payer: Priority Health Medicare |
$10.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.35
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Core |
$36.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.80
|
| Rate for Payer: UHC Medicare Advantage |
$11.12
|
| Rate for Payer: VA VA |
$10.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.40
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$43.20
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$33.38
|
| Rate for Payer: BCN Commercial |
$33.38
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.72
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Core |
$36.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.40
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$545.70
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$89.01 |
| Max. Negotiated Rate |
$491.13 |
| Rate for Payer: Aetna Commercial |
$463.84
|
| Rate for Payer: Aetna Commercial |
$702.10
|
| Rate for Payer: Aetna Medicare |
$214.76
|
| Rate for Payer: Aetna Medicare |
$141.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.53
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS MAPPO |
$206.50
|
| Rate for Payer: BCBS MAPPO |
$136.42
|
| Rate for Payer: BCBS Trust/PPO |
$424.28
|
| Rate for Payer: BCBS Trust/PPO |
$642.22
|
| Rate for Payer: BCN Commercial |
$424.28
|
| Rate for Payer: BCN Commercial |
$642.22
|
| Rate for Payer: BCN Medicare Advantage |
$206.50
|
| Rate for Payer: BCN Medicare Advantage |
$136.42
|
| Rate for Payer: Cash Price |
$436.56
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$436.56
|
| Rate for Payer: Cofinity Commercial |
$469.30
|
| Rate for Payer: Cofinity Commercial |
$710.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.50
|
| Rate for Payer: Healthscope Commercial |
$743.40
|
| Rate for Payer: Healthscope Commercial |
$491.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.28
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$216.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.10
|
| Rate for Payer: PACE Senior Care Partners |
$196.18
|
| Rate for Payer: PACE Senior Care Partners |
$129.60
|
| Rate for Payer: PACE SWMI |
$136.42
|
| Rate for Payer: PACE SWMI |
$206.50
|
| Rate for Payer: PHP Commercial |
$463.84
|
| Rate for Payer: PHP Commercial |
$702.10
|
| Rate for Payer: PHP Medicare Advantage |
$206.50
|
| Rate for Payer: PHP Medicare Advantage |
$136.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$718.62
|
| Rate for Payer: Priority Health Medicare |
$206.50
|
| Rate for Payer: Priority Health Medicare |
$136.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.78
|
| Rate for Payer: Railroad Medicare Medicare |
$206.50
|
| Rate for Payer: Railroad Medicare Medicare |
$136.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.22
|
| Rate for Payer: UHC Core |
$689.71
|
| Rate for Payer: UHC Core |
$455.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.50
|
| Rate for Payer: UHC Medicare Advantage |
$140.52
|
| Rate for Payer: UHC Medicare Advantage |
$212.70
|
| Rate for Payer: VA VA |
$206.50
|
| Rate for Payer: VA VA |
$136.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.50
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$545.70
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$332.82 |
| Max. Negotiated Rate |
$491.13 |
| Rate for Payer: Aetna Commercial |
$463.84
|
| Rate for Payer: Aetna Commercial |
$702.10
|
| Rate for Payer: BCBS Trust/PPO |
$421.72
|
| Rate for Payer: BCBS Trust/PPO |
$638.33
|
| Rate for Payer: BCN Commercial |
$638.33
|
| Rate for Payer: BCN Commercial |
$421.72
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$436.56
|
| Rate for Payer: Cofinity Commercial |
$469.30
|
| Rate for Payer: Cofinity Commercial |
$710.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.80
|
| Rate for Payer: Healthscope Commercial |
$743.40
|
| Rate for Payer: Healthscope Commercial |
$491.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$619.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.10
|
| Rate for Payer: PHP Commercial |
$702.10
|
| Rate for Payer: PHP Commercial |
$463.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$718.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$474.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.22
|
| Rate for Payer: UHC Core |
$455.66
|
| Rate for Payer: UHC Core |
$689.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$619.50
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$483.91
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$295.14 |
| Max. Negotiated Rate |
$435.52 |
| Rate for Payer: Aetna Commercial |
$411.32
|
| Rate for Payer: BCBS Trust/PPO |
$373.97
|
| Rate for Payer: BCN Commercial |
$373.97
|
| Rate for Payer: Cash Price |
$387.13
|
| Rate for Payer: Cofinity Commercial |
$416.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.13
|
| Rate for Payer: Healthscope Commercial |
$435.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$362.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.32
|
| Rate for Payer: PHP Commercial |
$411.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.84
|
| Rate for Payer: UHC Core |
$404.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$362.93
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
OP
|
$483.91
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$114.93 |
| Max. Negotiated Rate |
$435.52 |
| Rate for Payer: Aetna Commercial |
$411.32
|
| Rate for Payer: Aetna Medicare |
$125.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.22
|
| Rate for Payer: BCBS Complete |
$193.56
|
| Rate for Payer: BCBS MAPPO |
$120.98
|
| Rate for Payer: BCBS Trust/PPO |
$376.24
|
| Rate for Payer: BCN Commercial |
$376.24
|
| Rate for Payer: BCN Medicare Advantage |
$120.98
|
| Rate for Payer: Cash Price |
$387.13
|
| Rate for Payer: Cofinity Commercial |
$416.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.98
|
| Rate for Payer: Healthscope Commercial |
$435.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$362.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.32
|
| Rate for Payer: PACE Senior Care Partners |
$114.93
|
| Rate for Payer: PACE SWMI |
$120.98
|
| Rate for Payer: PHP Commercial |
$411.32
|
| Rate for Payer: PHP Medicare Advantage |
$120.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.00
|
| Rate for Payer: Priority Health Medicare |
$120.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.14
|
| Rate for Payer: Railroad Medicare Medicare |
$120.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.84
|
| Rate for Payer: UHC Core |
$404.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.98
|
| Rate for Payer: UHC Medicare Advantage |
$124.61
|
| Rate for Payer: VA VA |
$120.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$362.93
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,556.52
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$949.32 |
| Max. Negotiated Rate |
$1,400.87 |
| Rate for Payer: Aetna Commercial |
$1,323.04
|
| Rate for Payer: Aetna Commercial |
$1,987.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,806.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,202.88
|
| Rate for Payer: BCN Commercial |
$1,806.81
|
| Rate for Payer: BCN Commercial |
$1,202.88
|
| Rate for Payer: Cash Price |
$1,245.22
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cofinity Commercial |
$1,338.61
|
| Rate for Payer: Cofinity Commercial |
$2,010.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,870.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.22
|
| Rate for Payer: Healthscope Commercial |
$1,400.87
|
| Rate for Payer: Healthscope Commercial |
$2,104.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,753.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,987.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,323.04
|
| Rate for Payer: PHP Commercial |
$1,987.30
|
| Rate for Payer: PHP Commercial |
$1,323.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,034.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,425.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,057.44
|
| Rate for Payer: UHC Core |
$1,299.69
|
| Rate for Payer: UHC Core |
$1,952.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,753.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.39
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$2,338.00
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$386.16 |
| Max. Negotiated Rate |
$2,104.20 |
| Rate for Payer: Aetna Commercial |
$1,987.30
|
| Rate for Payer: Aetna Commercial |
$1,323.04
|
| Rate for Payer: Aetna Medicare |
$607.88
|
| Rate for Payer: Aetna Medicare |
$404.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$730.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$730.62
|
| Rate for Payer: BCBS Complete |
$405.47
|
| Rate for Payer: BCBS Complete |
$405.47
|
| Rate for Payer: BCBS MAPPO |
$389.13
|
| Rate for Payer: BCBS MAPPO |
$584.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,210.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,817.80
|
| Rate for Payer: BCN Commercial |
$1,817.80
|
| Rate for Payer: BCN Commercial |
$1,210.19
|
| Rate for Payer: BCN Medicare Advantage |
$584.50
|
| Rate for Payer: BCN Medicare Advantage |
$389.13
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,245.22
|
| Rate for Payer: Cash Price |
$1,870.40
|
| Rate for Payer: Cash Price |
$1,245.22
|
| Rate for Payer: Cofinity Commercial |
$2,010.68
|
| Rate for Payer: Cofinity Commercial |
$1,338.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,870.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$584.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.13
|
| Rate for Payer: Healthscope Commercial |
$1,400.87
|
| Rate for Payer: Healthscope Commercial |
$2,104.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,753.50
|
| Rate for Payer: Mclaren Medicaid |
$386.16
|
| Rate for Payer: Mclaren Medicaid |
$386.16
|
| Rate for Payer: Meridian Medicaid |
$405.47
|
| Rate for Payer: Meridian Medicaid |
$405.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$408.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$613.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$672.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,987.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,323.04
|
| Rate for Payer: PACE Senior Care Partners |
$369.67
|
| Rate for Payer: PACE Senior Care Partners |
$555.28
|
| Rate for Payer: PACE SWMI |
$584.50
|
| Rate for Payer: PACE SWMI |
$389.13
|
| Rate for Payer: PHP Commercial |
$1,323.04
|
| Rate for Payer: PHP Commercial |
$1,987.30
|
| Rate for Payer: PHP Medicare Advantage |
$389.13
|
| Rate for Payer: PHP Medicare Advantage |
$584.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,636.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,034.06
|
| Rate for Payer: Priority Health Medicare |
$389.13
|
| Rate for Payer: Priority Health Medicare |
$584.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,425.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.32
|
| Rate for Payer: Railroad Medicare Medicare |
$584.50
|
| Rate for Payer: Railroad Medicare Medicare |
$389.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,057.44
|
| Rate for Payer: UHC Core |
$1,299.69
|
| Rate for Payer: UHC Core |
$1,952.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$584.50
|
| Rate for Payer: UHC Medicare Advantage |
$602.04
|
| Rate for Payer: UHC Medicare Advantage |
$400.80
|
| Rate for Payer: VA VA |
$389.13
|
| Rate for Payer: VA VA |
$584.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,753.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.39
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.23
|
| Rate for Payer: BCN Commercial |
$50.23
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.44 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$16.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.31
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$16.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$50.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$16.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.25
|
| Rate for Payer: UHC Medicare Advantage |
$16.74
|
| Rate for Payer: VA VA |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC SPEECH EVAL
|
Facility
|
IP
|
$575.48
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$350.99 |
| Max. Negotiated Rate |
$517.93 |
| Rate for Payer: Aetna Commercial |
$489.16
|
| Rate for Payer: BCBS Trust/PPO |
$444.73
|
| Rate for Payer: BCN Commercial |
$444.73
|
| Rate for Payer: Cash Price |
$460.38
|
| Rate for Payer: Cofinity Commercial |
$494.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.38
|
| Rate for Payer: Healthscope Commercial |
$517.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$431.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$489.16
|
| Rate for Payer: PHP Commercial |
$489.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$500.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$506.42
|
| Rate for Payer: UHC Core |
$480.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$431.61
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$575.48
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$136.68 |
| Max. Negotiated Rate |
$517.93 |
| Rate for Payer: Aetna Commercial |
$489.16
|
| Rate for Payer: Aetna Medicare |
$149.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.84
|
| Rate for Payer: BCBS Complete |
$230.19
|
| Rate for Payer: BCBS MAPPO |
$143.87
|
| Rate for Payer: BCBS Trust/PPO |
$447.44
|
| Rate for Payer: BCN Commercial |
$447.44
|
| Rate for Payer: BCN Medicare Advantage |
$143.87
|
| Rate for Payer: Cash Price |
$460.38
|
| Rate for Payer: Cofinity Commercial |
$494.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.87
|
| Rate for Payer: Healthscope Commercial |
$517.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$431.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$489.16
|
| Rate for Payer: PACE Senior Care Partners |
$136.68
|
| Rate for Payer: PACE SWMI |
$143.87
|
| Rate for Payer: PHP Commercial |
$489.16
|
| Rate for Payer: PHP Medicare Advantage |
$143.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$500.67
|
| Rate for Payer: Priority Health Medicare |
$143.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.99
|
| Rate for Payer: Railroad Medicare Medicare |
$143.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$506.42
|
| Rate for Payer: UHC Core |
$480.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.87
|
| Rate for Payer: UHC Medicare Advantage |
$148.19
|
| Rate for Payer: VA VA |
$143.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$431.61
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
IP
|
$289.77
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$176.73 |
| Max. Negotiated Rate |
$260.79 |
| Rate for Payer: Aetna Commercial |
$246.30
|
| Rate for Payer: BCBS Trust/PPO |
$223.93
|
| Rate for Payer: BCN Commercial |
$223.93
|
| Rate for Payer: Cash Price |
$231.82
|
| Rate for Payer: Cofinity Commercial |
$249.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.82
|
| Rate for Payer: Healthscope Commercial |
$260.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.30
|
| Rate for Payer: PHP Commercial |
$246.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.00
|
| Rate for Payer: UHC Core |
$241.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.33
|
|
|
HC SPEECH FLUENCY EVAL
|
Facility
|
OP
|
$289.77
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
44400012
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$68.82 |
| Max. Negotiated Rate |
$260.79 |
| Rate for Payer: Aetna Commercial |
$246.30
|
| Rate for Payer: Aetna Medicare |
$75.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.55
|
| Rate for Payer: BCBS Complete |
$115.91
|
| Rate for Payer: BCBS MAPPO |
$72.44
|
| Rate for Payer: BCBS Trust/PPO |
$225.30
|
| Rate for Payer: BCN Commercial |
$225.30
|
| Rate for Payer: BCN Medicare Advantage |
$72.44
|
| Rate for Payer: Cash Price |
$231.82
|
| Rate for Payer: Cofinity Commercial |
$249.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.44
|
| Rate for Payer: Healthscope Commercial |
$260.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.30
|
| Rate for Payer: PACE Senior Care Partners |
$68.82
|
| Rate for Payer: PACE SWMI |
$72.44
|
| Rate for Payer: PHP Commercial |
$246.30
|
| Rate for Payer: PHP Medicare Advantage |
$72.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.10
|
| Rate for Payer: Priority Health Medicare |
$72.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.73
|
| Rate for Payer: Railroad Medicare Medicare |
$72.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.00
|
| Rate for Payer: UHC Core |
$241.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.44
|
| Rate for Payer: UHC Medicare Advantage |
$74.62
|
| Rate for Payer: VA VA |
$72.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.33
|
|
