|
HC NM LUNG PERF DIFF FUNCT
|
Facility
|
OP
|
$850.11
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100037
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$149.87 |
| Max. Negotiated Rate |
$765.10 |
| Rate for Payer: Aetna Commercial |
$722.59
|
| Rate for Payer: Aetna Medicare |
$221.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.66
|
| Rate for Payer: BCBS Complete |
$157.36
|
| Rate for Payer: BCBS MAPPO |
$212.53
|
| Rate for Payer: BCBS Trust/PPO |
$698.88
|
| Rate for Payer: BCN Commercial |
$698.88
|
| Rate for Payer: BCN Medicare Advantage |
$212.53
|
| Rate for Payer: Cash Price |
$680.09
|
| Rate for Payer: Cofinity Commercial |
$731.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.53
|
| Rate for Payer: Healthscope Commercial |
$765.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.58
|
| Rate for Payer: Mclaren Medicaid |
$149.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.15
|
| Rate for Payer: Meridian Medicaid |
$157.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$233.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$722.59
|
| Rate for Payer: Nomi Health Commercial |
$697.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.58
|
| Rate for Payer: PACE Senior Care Partners |
$201.90
|
| Rate for Payer: PACE SWMI |
$212.53
|
| Rate for Payer: PHP Commercial |
$722.59
|
| Rate for Payer: PHP Medicare Advantage |
$212.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$149.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$739.60
|
| Rate for Payer: Priority Health Medicare |
$214.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.68
|
| Rate for Payer: Railroad Medicare Medicare |
$212.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.10
|
| Rate for Payer: UHC Core |
$709.84
|
| Rate for Payer: UHC Exchange |
$212.53
|
| Rate for Payer: UHC Medicaid |
$149.87
|
| Rate for Payer: UHC Medicare Advantage |
$212.53
|
| Rate for Payer: UHCCP Medicaid |
$149.87
|
| Rate for Payer: VA VA |
$212.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.58
|
|
|
HC NM LUNG PERF DIFF FUNCT
|
Facility
|
IP
|
$850.11
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100037
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$591.68 |
| Max. Negotiated Rate |
$765.10 |
| Rate for Payer: Aetna Commercial |
$722.59
|
| Rate for Payer: BCBS Trust/PPO |
$702.11
|
| Rate for Payer: BCN Commercial |
$702.11
|
| Rate for Payer: Cash Price |
$680.09
|
| Rate for Payer: Cofinity Commercial |
$731.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.09
|
| Rate for Payer: Healthscope Commercial |
$765.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$722.59
|
| Rate for Payer: Nomi Health Commercial |
$697.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$637.58
|
| Rate for Payer: PHP Commercial |
$722.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$739.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.10
|
| Rate for Payer: UHC Core |
$709.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.58
|
|
|
HC NM LUNG PERFUSION EG PARTICULATE
|
Facility
|
IP
|
$1,041.20
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
34100032
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$724.68 |
| Max. Negotiated Rate |
$937.08 |
| Rate for Payer: Aetna Commercial |
$885.02
|
| Rate for Payer: BCBS Trust/PPO |
$859.93
|
| Rate for Payer: BCN Commercial |
$859.93
|
| Rate for Payer: Cash Price |
$832.96
|
| Rate for Payer: Cofinity Commercial |
$895.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.96
|
| Rate for Payer: Healthscope Commercial |
$937.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.02
|
| Rate for Payer: Nomi Health Commercial |
$853.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.90
|
| Rate for Payer: PHP Commercial |
$885.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.26
|
| Rate for Payer: UHC Core |
$869.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.90
|
|
|
HC NM LUNG PERFUSION EG PARTICULATE
|
Facility
|
OP
|
$1,041.20
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
34100032
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$183.56 |
| Max. Negotiated Rate |
$937.08 |
| Rate for Payer: Aetna Commercial |
$885.02
|
| Rate for Payer: Aetna Medicare |
$270.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.38
|
| Rate for Payer: BCBS Complete |
$192.73
|
| Rate for Payer: BCBS MAPPO |
$260.30
|
| Rate for Payer: BCBS Trust/PPO |
$855.97
|
| Rate for Payer: BCN Commercial |
$855.97
|
| Rate for Payer: BCN Medicare Advantage |
$260.30
|
| Rate for Payer: Cash Price |
$832.96
|
| Rate for Payer: Cofinity Commercial |
$895.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.30
|
| Rate for Payer: Healthscope Commercial |
$937.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.90
|
| Rate for Payer: Mclaren Medicaid |
$183.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.31
|
| Rate for Payer: Meridian Medicaid |
$192.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.02
|
| Rate for Payer: Nomi Health Commercial |
$853.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.90
|
| Rate for Payer: PACE Senior Care Partners |
$247.28
|
| Rate for Payer: PACE SWMI |
$260.30
|
| Rate for Payer: PHP Commercial |
$885.02
|
| Rate for Payer: PHP Medicare Advantage |
$260.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.84
|
| Rate for Payer: Priority Health Medicare |
$262.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.68
|
| Rate for Payer: Railroad Medicare Medicare |
$260.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.26
|
| Rate for Payer: UHC Core |
$869.40
|
| Rate for Payer: UHC Exchange |
$260.30
|
| Rate for Payer: UHC Medicaid |
$183.56
|
| Rate for Payer: UHC Medicare Advantage |
$260.30
|
| Rate for Payer: UHCCP Medicaid |
$183.56
|
| Rate for Payer: VA VA |
$260.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.90
|
|
|
HC NM LYMPHATIC SENTINAL NODE IMAGING
|
Facility
|
OP
|
$1,340.69
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
34100012
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$236.36 |
| Max. Negotiated Rate |
$1,206.62 |
| Rate for Payer: Aetna Commercial |
$1,139.59
|
| Rate for Payer: Aetna Medicare |
$348.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$418.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$418.97
|
| Rate for Payer: BCBS Complete |
$248.16
|
| Rate for Payer: BCBS MAPPO |
$335.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.18
|
| Rate for Payer: BCN Commercial |
$1,102.18
|
| Rate for Payer: BCN Medicare Advantage |
$335.17
|
| Rate for Payer: Cash Price |
$1,072.55
|
| Rate for Payer: Cofinity Commercial |
$1,152.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.17
|
| Rate for Payer: Healthscope Commercial |
$1,206.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.52
|
| Rate for Payer: Mclaren Medicaid |
$236.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.93
|
| Rate for Payer: Meridian Medicaid |
$248.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.59
|
| Rate for Payer: Nomi Health Commercial |
$1,099.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.52
|
| Rate for Payer: PACE Senior Care Partners |
$318.41
|
| Rate for Payer: PACE SWMI |
$335.17
|
| Rate for Payer: PHP Commercial |
$1,139.59
|
| Rate for Payer: PHP Medicare Advantage |
$335.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,166.40
|
| Rate for Payer: Priority Health Medicare |
$338.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.12
|
| Rate for Payer: Railroad Medicare Medicare |
$335.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,179.81
|
| Rate for Payer: UHC Core |
$1,119.48
|
| Rate for Payer: UHC Exchange |
$335.17
|
| Rate for Payer: UHC Medicaid |
$236.36
|
| Rate for Payer: UHC Medicare Advantage |
$335.17
|
| Rate for Payer: UHCCP Medicaid |
$236.36
|
| Rate for Payer: VA VA |
$335.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.52
|
|
|
HC NM LYMPHATIC SENTINAL NODE IMAGING
|
Facility
|
IP
|
$1,340.69
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
34100012
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$933.12 |
| Max. Negotiated Rate |
$1,206.62 |
| Rate for Payer: Aetna Commercial |
$1,139.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.28
|
| Rate for Payer: BCN Commercial |
$1,107.28
|
| Rate for Payer: Cash Price |
$1,072.55
|
| Rate for Payer: Cofinity Commercial |
$1,152.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.55
|
| Rate for Payer: Healthscope Commercial |
$1,206.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,139.59
|
| Rate for Payer: Nomi Health Commercial |
$1,099.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,005.52
|
| Rate for Payer: PHP Commercial |
$1,139.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,166.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,179.81
|
| Rate for Payer: UHC Core |
$1,119.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.52
|
|
|
HC NM MECKELS OR ABD
|
Facility
|
IP
|
$1,168.96
|
|
|
Service Code
|
CPT 78290
|
| Hospital Charge Code |
34100021
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$813.60 |
| Max. Negotiated Rate |
$1,052.06 |
| Rate for Payer: Aetna Commercial |
$993.62
|
| Rate for Payer: BCBS Trust/PPO |
$965.44
|
| Rate for Payer: BCN Commercial |
$965.44
|
| Rate for Payer: Cash Price |
$935.17
|
| Rate for Payer: Cofinity Commercial |
$1,005.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.17
|
| Rate for Payer: Healthscope Commercial |
$1,052.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$876.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.62
|
| Rate for Payer: Nomi Health Commercial |
$958.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$876.72
|
| Rate for Payer: PHP Commercial |
$993.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,017.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.68
|
| Rate for Payer: UHC Core |
$976.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$876.72
|
|
|
HC NM MECKELS OR ABD
|
Facility
|
OP
|
$1,168.96
|
|
|
Service Code
|
CPT 78290
|
| Hospital Charge Code |
34100021
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$206.09 |
| Max. Negotiated Rate |
$1,052.06 |
| Rate for Payer: Aetna Commercial |
$993.62
|
| Rate for Payer: Aetna Medicare |
$303.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$365.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$365.30
|
| Rate for Payer: BCBS Complete |
$216.37
|
| Rate for Payer: BCBS MAPPO |
$292.24
|
| Rate for Payer: BCBS Trust/PPO |
$961.00
|
| Rate for Payer: BCN Commercial |
$961.00
|
| Rate for Payer: BCN Medicare Advantage |
$292.24
|
| Rate for Payer: Cash Price |
$935.17
|
| Rate for Payer: Cofinity Commercial |
$1,005.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$935.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$292.24
|
| Rate for Payer: Healthscope Commercial |
$1,052.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$876.72
|
| Rate for Payer: Mclaren Medicaid |
$206.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$306.85
|
| Rate for Payer: Meridian Medicaid |
$216.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$336.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$321.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$993.62
|
| Rate for Payer: Nomi Health Commercial |
$958.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$876.72
|
| Rate for Payer: PACE Senior Care Partners |
$277.63
|
| Rate for Payer: PACE SWMI |
$292.24
|
| Rate for Payer: PHP Commercial |
$993.62
|
| Rate for Payer: PHP Medicare Advantage |
$292.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$206.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,017.00
|
| Rate for Payer: Priority Health Medicare |
$295.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$813.60
|
| Rate for Payer: Railroad Medicare Medicare |
$292.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,028.68
|
| Rate for Payer: UHC Core |
$976.08
|
| Rate for Payer: UHC Exchange |
$292.24
|
| Rate for Payer: UHC Medicaid |
$206.09
|
| Rate for Payer: UHC Medicare Advantage |
$292.24
|
| Rate for Payer: UHCCP Medicaid |
$206.09
|
| Rate for Payer: VA VA |
$292.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$876.72
|
|
|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
OP
|
$5,230.77
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$922.18 |
| Max. Negotiated Rate |
$4,707.69 |
| Rate for Payer: Aetna Commercial |
$4,446.15
|
| Rate for Payer: Aetna Medicare |
$1,360.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,634.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,634.62
|
| Rate for Payer: BCBS Complete |
$968.22
|
| Rate for Payer: BCBS MAPPO |
$1,307.69
|
| Rate for Payer: BCBS Trust/PPO |
$4,300.22
|
| Rate for Payer: BCN Commercial |
$4,300.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,307.69
|
| Rate for Payer: Cash Price |
$4,184.62
|
| Rate for Payer: Cofinity Commercial |
$4,498.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,184.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,307.69
|
| Rate for Payer: Healthscope Commercial |
$4,707.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,923.08
|
| Rate for Payer: Mclaren Medicaid |
$922.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,373.08
|
| Rate for Payer: Meridian Medicaid |
$968.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,503.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,438.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,446.15
|
| Rate for Payer: Nomi Health Commercial |
$4,289.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,923.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,242.31
|
| Rate for Payer: PACE SWMI |
$1,307.69
|
| Rate for Payer: PHP Commercial |
$4,446.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,307.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$922.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,550.77
|
| Rate for Payer: Priority Health Medicare |
$1,320.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,640.62
|
| Rate for Payer: Railroad Medicare Medicare |
$1,307.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,603.08
|
| Rate for Payer: UHC Core |
$4,367.69
|
| Rate for Payer: UHC Exchange |
$1,307.69
|
| Rate for Payer: UHC Medicaid |
$922.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,307.69
|
| Rate for Payer: UHCCP Medicaid |
$922.18
|
| Rate for Payer: VA VA |
$1,307.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,923.08
|
|
|
HC NM MYOCARD PERF SPECT EF WM MU
|
Facility
|
IP
|
$5,230.77
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
34100029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$3,640.62 |
| Max. Negotiated Rate |
$4,707.69 |
| Rate for Payer: Aetna Commercial |
$4,446.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,320.09
|
| Rate for Payer: BCN Commercial |
$4,320.09
|
| Rate for Payer: Cash Price |
$4,184.62
|
| Rate for Payer: Cofinity Commercial |
$4,498.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,184.62
|
| Rate for Payer: Healthscope Commercial |
$4,707.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,923.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,446.15
|
| Rate for Payer: Nomi Health Commercial |
$4,289.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,923.08
|
| Rate for Payer: PHP Commercial |
$4,446.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,550.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,640.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,603.08
|
| Rate for Payer: UHC Core |
$4,367.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,923.08
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
IP
|
$1,868.13
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,300.22 |
| Max. Negotiated Rate |
$1,681.32 |
| Rate for Payer: Aetna Commercial |
$1,587.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,542.89
|
| Rate for Payer: BCN Commercial |
$1,542.89
|
| Rate for Payer: Cash Price |
$1,494.50
|
| Rate for Payer: Cofinity Commercial |
$1,606.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,494.50
|
| Rate for Payer: Healthscope Commercial |
$1,681.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,401.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,587.91
|
| Rate for Payer: Nomi Health Commercial |
$1,531.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.10
|
| Rate for Payer: PHP Commercial |
$1,587.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,625.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,643.95
|
| Rate for Payer: UHC Core |
$1,559.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,401.10
|
|
|
HC NM MYOCARD PERF SPECT EF WM SI
|
Facility
|
OP
|
$1,868.13
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
34100067
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$329.35 |
| Max. Negotiated Rate |
$1,681.32 |
| Rate for Payer: Aetna Commercial |
$1,587.91
|
| Rate for Payer: Aetna Medicare |
$485.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$583.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$583.79
|
| Rate for Payer: BCBS Complete |
$345.79
|
| Rate for Payer: BCBS MAPPO |
$467.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.79
|
| Rate for Payer: BCN Commercial |
$1,535.79
|
| Rate for Payer: BCN Medicare Advantage |
$467.03
|
| Rate for Payer: Cash Price |
$1,494.50
|
| Rate for Payer: Cofinity Commercial |
$1,606.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,494.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$467.03
|
| Rate for Payer: Healthscope Commercial |
$1,681.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,401.10
|
| Rate for Payer: Mclaren Medicaid |
$329.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$490.38
|
| Rate for Payer: Meridian Medicaid |
$345.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$537.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$513.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,587.91
|
| Rate for Payer: Nomi Health Commercial |
$1,531.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,401.10
|
| Rate for Payer: PACE Senior Care Partners |
$443.68
|
| Rate for Payer: PACE SWMI |
$467.03
|
| Rate for Payer: PHP Commercial |
$1,587.91
|
| Rate for Payer: PHP Medicare Advantage |
$467.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$329.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,625.27
|
| Rate for Payer: Priority Health Medicare |
$471.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,300.22
|
| Rate for Payer: Railroad Medicare Medicare |
$467.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,643.95
|
| Rate for Payer: UHC Core |
$1,559.89
|
| Rate for Payer: UHC Exchange |
$467.03
|
| Rate for Payer: UHC Medicaid |
$329.35
|
| Rate for Payer: UHC Medicare Advantage |
$467.03
|
| Rate for Payer: UHCCP Medicaid |
$329.35
|
| Rate for Payer: VA VA |
$467.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,401.10
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$19.26
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$85.53
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$18.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$19.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicaid |
$18.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$18.34
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC NMO/AQP4 FACS TITER SERUM
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200395
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$72.41 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$85.93
|
| Rate for Payer: BCN Commercial |
$85.93
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
OP
|
$358.94
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.28 |
| Max. Negotiated Rate |
$323.05 |
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna Medicare |
$93.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.17
|
| Rate for Payer: BCBS Complete |
$66.44
|
| Rate for Payer: BCBS MAPPO |
$89.73
|
| Rate for Payer: BCBS Trust/PPO |
$295.08
|
| Rate for Payer: BCN Commercial |
$295.08
|
| Rate for Payer: BCN Medicare Advantage |
$89.73
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$308.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.73
|
| Rate for Payer: Healthscope Commercial |
$323.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.20
|
| Rate for Payer: Mclaren Medicaid |
$63.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.22
|
| Rate for Payer: Meridian Medicaid |
$66.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: Nomi Health Commercial |
$294.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.20
|
| Rate for Payer: PACE Senior Care Partners |
$85.25
|
| Rate for Payer: PACE SWMI |
$89.73
|
| Rate for Payer: PHP Commercial |
$305.10
|
| Rate for Payer: PHP Medicare Advantage |
$89.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.28
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.82
|
| Rate for Payer: Railroad Medicare Medicare |
$89.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.87
|
| Rate for Payer: UHC Core |
$299.71
|
| Rate for Payer: UHC Exchange |
$89.73
|
| Rate for Payer: UHC Medicaid |
$63.28
|
| Rate for Payer: UHC Medicare Advantage |
$89.73
|
| Rate for Payer: UHCCP Medicaid |
$63.28
|
| Rate for Payer: VA VA |
$89.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.20
|
|
|
HC NMO/AQP4-IGG CBA, S
|
Facility
|
IP
|
$358.94
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200422
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$249.82 |
| Max. Negotiated Rate |
$323.05 |
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: BCBS Trust/PPO |
$296.45
|
| Rate for Payer: BCN Commercial |
$296.45
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$308.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Healthscope Commercial |
$323.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: Nomi Health Commercial |
$294.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.20
|
| Rate for Payer: PHP Commercial |
$305.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$312.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.87
|
| Rate for Payer: UHC Core |
$299.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.20
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
IP
|
$357.90
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$249.10 |
| Max. Negotiated Rate |
$322.11 |
| Rate for Payer: Aetna Commercial |
$304.21
|
| Rate for Payer: BCBS Trust/PPO |
$295.59
|
| Rate for Payer: BCN Commercial |
$295.59
|
| Rate for Payer: Cash Price |
$286.32
|
| Rate for Payer: Cofinity Commercial |
$307.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.32
|
| Rate for Payer: Healthscope Commercial |
$322.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.21
|
| Rate for Payer: Nomi Health Commercial |
$293.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.43
|
| Rate for Payer: PHP Commercial |
$304.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.95
|
| Rate for Payer: UHC Core |
$298.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.43
|
|
|
HC NMO/AQUAPO 4 IGG CBA
|
Facility
|
OP
|
$357.90
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200394
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.10 |
| Max. Negotiated Rate |
$322.11 |
| Rate for Payer: Aetna Commercial |
$304.21
|
| Rate for Payer: Aetna Medicare |
$93.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.84
|
| Rate for Payer: BCBS Complete |
$66.25
|
| Rate for Payer: BCBS MAPPO |
$89.47
|
| Rate for Payer: BCBS Trust/PPO |
$294.23
|
| Rate for Payer: BCN Commercial |
$294.23
|
| Rate for Payer: BCN Medicare Advantage |
$89.47
|
| Rate for Payer: Cash Price |
$286.32
|
| Rate for Payer: Cofinity Commercial |
$307.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.47
|
| Rate for Payer: Healthscope Commercial |
$322.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.43
|
| Rate for Payer: Mclaren Medicaid |
$63.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.95
|
| Rate for Payer: Meridian Medicaid |
$66.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.21
|
| Rate for Payer: Nomi Health Commercial |
$293.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.43
|
| Rate for Payer: PACE Senior Care Partners |
$85.00
|
| Rate for Payer: PACE SWMI |
$89.47
|
| Rate for Payer: PHP Commercial |
$304.21
|
| Rate for Payer: PHP Medicare Advantage |
$89.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.37
|
| Rate for Payer: Priority Health Medicare |
$90.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.10
|
| Rate for Payer: Railroad Medicare Medicare |
$89.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.95
|
| Rate for Payer: UHC Core |
$298.85
|
| Rate for Payer: UHC Exchange |
$89.47
|
| Rate for Payer: UHC Medicaid |
$63.10
|
| Rate for Payer: UHC Medicare Advantage |
$89.47
|
| Rate for Payer: UHCCP Medicaid |
$63.10
|
| Rate for Payer: VA VA |
$89.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.43
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
OP
|
$937.08
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$165.21 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna Medicare |
$243.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.84
|
| Rate for Payer: BCBS Complete |
$173.45
|
| Rate for Payer: BCBS MAPPO |
$234.27
|
| Rate for Payer: BCBS Trust/PPO |
$770.37
|
| Rate for Payer: BCN Commercial |
$770.37
|
| Rate for Payer: BCN Medicare Advantage |
$234.27
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.27
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Mclaren Medicaid |
$165.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.98
|
| Rate for Payer: Meridian Medicaid |
$173.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$257.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PACE Senior Care Partners |
$222.56
|
| Rate for Payer: PACE SWMI |
$234.27
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: PHP Medicare Advantage |
$234.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.26
|
| Rate for Payer: Priority Health Medicare |
$236.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.21
|
| Rate for Payer: Railroad Medicare Medicare |
$234.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.63
|
| Rate for Payer: UHC Core |
$782.46
|
| Rate for Payer: UHC Exchange |
$234.27
|
| Rate for Payer: UHC Medicaid |
$165.21
|
| Rate for Payer: UHC Medicare Advantage |
$234.27
|
| Rate for Payer: UHCCP Medicaid |
$165.21
|
| Rate for Payer: VA VA |
$234.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC NM PARATHYROID SCAN
|
Facility
|
IP
|
$937.08
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
34100007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$652.21 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: BCBS Trust/PPO |
$773.93
|
| Rate for Payer: BCN Commercial |
$773.93
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$768.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$815.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$824.63
|
| Rate for Payer: UHC Core |
$782.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.11
|
| Rate for Payer: BCBS Complete |
$77.07
|
| Rate for Payer: BCBS MAPPO |
$104.09
|
| Rate for Payer: BCBS Trust/PPO |
$342.29
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$73.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.29
|
| Rate for Payer: Meridian Medicaid |
$77.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Senior Care Partners |
$98.89
|
| Rate for Payer: PACE SWMI |
$104.09
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: Railroad Medicare Medicare |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$104.09
|
| Rate for Payer: UHC Medicaid |
$73.40
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
| Rate for Payer: UHCCP Medicaid |
$73.40
|
| Rate for Payer: VA VA |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC NM PARATHYROID SESTAMIBI INJ O
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 78808
|
| Hospital Charge Code |
34100060
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
OP
|
$1,052.76
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$185.60 |
| Max. Negotiated Rate |
$947.48 |
| Rate for Payer: Aetna Commercial |
$894.85
|
| Rate for Payer: Aetna Medicare |
$273.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.99
|
| Rate for Payer: BCBS Complete |
$194.87
|
| Rate for Payer: BCBS MAPPO |
$263.19
|
| Rate for Payer: BCBS Trust/PPO |
$865.47
|
| Rate for Payer: BCN Commercial |
$865.47
|
| Rate for Payer: BCN Medicare Advantage |
$263.19
|
| Rate for Payer: Cash Price |
$842.21
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.19
|
| Rate for Payer: Healthscope Commercial |
$947.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.57
|
| Rate for Payer: Mclaren Medicaid |
$185.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.35
|
| Rate for Payer: Meridian Medicaid |
$194.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.85
|
| Rate for Payer: Nomi Health Commercial |
$863.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.57
|
| Rate for Payer: PACE Senior Care Partners |
$250.03
|
| Rate for Payer: PACE SWMI |
$263.19
|
| Rate for Payer: PHP Commercial |
$894.85
|
| Rate for Payer: PHP Medicare Advantage |
$263.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$915.90
|
| Rate for Payer: Priority Health Medicare |
$265.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.72
|
| Rate for Payer: Railroad Medicare Medicare |
$263.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$926.43
|
| Rate for Payer: UHC Core |
$879.05
|
| Rate for Payer: UHC Exchange |
$263.19
|
| Rate for Payer: UHC Medicaid |
$185.60
|
| Rate for Payer: UHC Medicare Advantage |
$263.19
|
| Rate for Payer: UHCCP Medicaid |
$185.60
|
| Rate for Payer: VA VA |
$263.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.57
|
|
|
HC NM PARATHYROID SPECT SCAN
|
Facility
|
IP
|
$1,052.76
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
34100077
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$732.72 |
| Max. Negotiated Rate |
$947.48 |
| Rate for Payer: Aetna Commercial |
$894.85
|
| Rate for Payer: BCBS Trust/PPO |
$869.47
|
| Rate for Payer: BCN Commercial |
$869.47
|
| Rate for Payer: Cash Price |
$842.21
|
| Rate for Payer: Cofinity Commercial |
$905.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.21
|
| Rate for Payer: Healthscope Commercial |
$947.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.85
|
| Rate for Payer: Nomi Health Commercial |
$863.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$789.57
|
| Rate for Payer: PHP Commercial |
$894.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$915.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$926.43
|
| Rate for Payer: UHC Core |
$879.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.57
|
|
|
HC NM PERFUSION QUANTITATIVE DIFF
|
Facility
|
OP
|
$1,243.56
|
|
|
Service Code
|
CPT 78597
|
| Hospital Charge Code |
34100069
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$219.24 |
| Max. Negotiated Rate |
$1,119.20 |
| Rate for Payer: Aetna Commercial |
$1,057.03
|
| Rate for Payer: Aetna Medicare |
$323.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$388.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$388.61
|
| Rate for Payer: BCBS Complete |
$230.18
|
| Rate for Payer: BCBS MAPPO |
$310.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,022.33
|
| Rate for Payer: BCN Commercial |
$1,022.33
|
| Rate for Payer: BCN Medicare Advantage |
$310.89
|
| Rate for Payer: Cash Price |
$994.85
|
| Rate for Payer: Cofinity Commercial |
$1,069.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.89
|
| Rate for Payer: Healthscope Commercial |
$1,119.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.67
|
| Rate for Payer: Mclaren Medicaid |
$219.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.43
|
| Rate for Payer: Meridian Medicaid |
$230.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,057.03
|
| Rate for Payer: Nomi Health Commercial |
$1,019.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$932.67
|
| Rate for Payer: PACE Senior Care Partners |
$295.35
|
| Rate for Payer: PACE SWMI |
$310.89
|
| Rate for Payer: PHP Commercial |
$1,057.03
|
| Rate for Payer: PHP Medicare Advantage |
$310.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,081.90
|
| Rate for Payer: Priority Health Medicare |
$314.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$865.52
|
| Rate for Payer: Railroad Medicare Medicare |
$310.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,094.33
|
| Rate for Payer: UHC Core |
$1,038.37
|
| Rate for Payer: UHC Exchange |
$310.89
|
| Rate for Payer: UHC Medicaid |
$219.24
|
| Rate for Payer: UHC Medicare Advantage |
$310.89
|
| Rate for Payer: UHCCP Medicaid |
$219.24
|
| Rate for Payer: VA VA |
$310.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.67
|
|
