|
HC MENENCEPH CMPT 10
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 15
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200319
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 16
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200357
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT17
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200358
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.79 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$12.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$12.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$12.18
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
OP
|
$16.98
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$15.28 |
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: Aetna Medicare |
$4.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.31
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$4.24
|
| Rate for Payer: BCBS Trust/PPO |
$13.96
|
| Rate for Payer: BCN Commercial |
$13.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.24
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.24
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.74
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.46
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: Nomi Health Commercial |
$13.92
|
| Rate for Payer: PACE Senior Care Partners |
$4.03
|
| Rate for Payer: PACE SWMI |
$4.24
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: PHP Medicare Advantage |
$4.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.04
|
| Rate for Payer: Priority Health HMO/PPO |
$14.77
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.38
|
| Rate for Payer: Railroad Medicare Medicare |
$4.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.94
|
| Rate for Payer: UHC Core |
$14.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.24
|
| Rate for Payer: UHC Exchange |
$4.24
|
| Rate for Payer: UHC Medicare Advantage |
$4.24
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$4.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.74
|
|
|
HC MENENCEPH CMPT 18
|
Facility
|
IP
|
$16.98
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$15.28 |
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.12
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: Nomi Health Commercial |
$13.92
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.04
|
| Rate for Payer: Priority Health HMO/PPO |
$14.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.94
|
| Rate for Payer: UHC Core |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.74
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 19
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200360
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$9.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 2
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$9.42
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 3
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 4
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 4
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$3.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.42
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$11.63
|
| Rate for Payer: BCN Commercial |
$11.00
|
| Rate for Payer: BCN Medicare Advantage |
$3.54
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.54
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.71
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Senior Care Partners |
$3.36
|
| Rate for Payer: PACE SWMI |
$3.54
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$3.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.45
|
| Rate for Payer: UHC Core |
$11.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.54
|
| Rate for Payer: UHC Exchange |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.54
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$3.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
