|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: Aetna Medicare |
$16.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.48
|
| Rate for Payer: BCBS Complete |
$16.10
|
| Rate for Payer: BCBS MAPPO |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$48.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.58
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.58
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Mclaren Medicaid |
$15.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.36
|
| Rate for Payer: Meridian Medicaid |
$16.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: Nomi Health Commercial |
$51.11
|
| Rate for Payer: PACE Senior Care Partners |
$14.80
|
| Rate for Payer: PACE SWMI |
$15.58
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: PHP Medicare Advantage |
$15.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health HMO/PPO |
$54.23
|
| Rate for Payer: Priority Health Medicare |
$15.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.85
|
| Rate for Payer: UHC Core |
$52.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.58
|
| Rate for Payer: UHC Exchange |
$15.58
|
| Rate for Payer: UHC Medicare Advantage |
$15.58
|
| Rate for Payer: UHCCP Medicaid |
$15.33
|
| Rate for Payer: VA VA |
$15.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.51 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: BCBS Trust/PPO |
$50.88
|
| Rate for Payer: BCN Commercial |
$48.17
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: Nomi Health Commercial |
$51.11
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health HMO/PPO |
$54.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.85
|
| Rate for Payer: UHC Core |
$52.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.94 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$226.27
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$215.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$226.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$215.48
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$75.12 |
| Rate for Payer: Aetna Commercial |
$70.95
|
| Rate for Payer: Aetna Medicare |
$21.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.08
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$20.87
|
| Rate for Payer: BCBS Trust/PPO |
$68.62
|
| Rate for Payer: BCN Commercial |
$64.90
|
| Rate for Payer: BCN Medicare Advantage |
$20.87
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.87
|
| Rate for Payer: Healthscope Commercial |
$75.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.91
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| Rate for Payer: PACE Senior Care Partners |
$19.82
|
| Rate for Payer: PACE SWMI |
$20.87
|
| Rate for Payer: PHP Commercial |
$70.95
|
| Rate for Payer: PHP Medicare Advantage |
$20.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO |
$72.62
|
| Rate for Payer: Priority Health Medicare |
$21.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.92
|
| Rate for Payer: Railroad Medicare Medicare |
$20.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.45
|
| Rate for Payer: UHC Core |
$69.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.87
|
| Rate for Payer: UHC Exchange |
$20.87
|
| Rate for Payer: UHC Medicare Advantage |
$20.87
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$20.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.26 |
| Max. Negotiated Rate |
$75.12 |
| Rate for Payer: Aetna Commercial |
$70.95
|
| Rate for Payer: BCBS Trust/PPO |
$68.14
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Healthscope Commercial |
$75.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| Rate for Payer: PHP Commercial |
$70.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO |
$72.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.45
|
| Rate for Payer: UHC Core |
$69.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$73.04 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: Aetna Medicare |
$21.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.36
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$20.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.71
|
| Rate for Payer: BCN Commercial |
$63.09
|
| Rate for Payer: BCN Medicare Advantage |
$20.29
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.29
|
| Rate for Payer: Healthscope Commercial |
$73.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.30
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: PACE Senior Care Partners |
$19.27
|
| Rate for Payer: PACE SWMI |
$20.29
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: PHP Medicare Advantage |
$20.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: Priority Health HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$20.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.37
|
| Rate for Payer: Railroad Medicare Medicare |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.29
|
| Rate for Payer: UHC Exchange |
$20.29
|
| Rate for Payer: UHC Medicare Advantage |
$20.29
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.75 |
| Max. Negotiated Rate |
$73.04 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: BCBS Trust/PPO |
$66.24
|
| Rate for Payer: BCN Commercial |
$62.71
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$73.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: Priority Health HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$208.16
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: Aetna Medicare |
$66.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.69
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$209.64
|
| Rate for Payer: BCN Commercial |
$198.26
|
| Rate for Payer: BCN Medicare Advantage |
$63.75
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.75
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.94
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.75
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: PHP Medicare Advantage |
$63.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$221.85
|
| Rate for Payer: Priority Health Medicare |
$64.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.85
|
| Rate for Payer: Railroad Medicare Medicare |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.75
|
| Rate for Payer: UHC Exchange |
$63.75
|
| Rate for Payer: UHC Medicare Advantage |
$63.75
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$63.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: BCBS Trust/PPO |
$58.60
|
| Rate for Payer: BCN Commercial |
$55.48
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$18.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.43
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$59.02
|
| Rate for Payer: BCN Commercial |
$55.82
|
| Rate for Payer: BCN Medicare Advantage |
$17.95
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.84
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PACE Senior Care Partners |
$17.05
|
| Rate for Payer: PACE SWMI |
$17.95
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$17.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Medicare |
$18.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: Railroad Medicare Medicare |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.95
|
| Rate for Payer: UHC Exchange |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$17.95
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: BCBS Trust/PPO |
$58.60
|
| Rate for Payer: BCN Commercial |
$55.48
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$18.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.43
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$59.02
|
| Rate for Payer: BCN Commercial |
$55.82
|
| Rate for Payer: BCN Medicare Advantage |
$17.95
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.84
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PACE Senior Care Partners |
$17.05
|
| Rate for Payer: PACE SWMI |
$17.95
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$17.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Medicare |
$18.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: Railroad Medicare Medicare |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.95
|
| Rate for Payer: UHC Exchange |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$17.95
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$18.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.43
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$59.02
|
| Rate for Payer: BCN Commercial |
$55.82
|
| Rate for Payer: BCN Medicare Advantage |
$17.95
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.84
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PACE Senior Care Partners |
$17.05
|
| Rate for Payer: PACE SWMI |
$17.95
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$17.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Medicare |
$18.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: Railroad Medicare Medicare |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.95
|
| Rate for Payer: UHC Exchange |
$17.95
|
| Rate for Payer: UHC Medicare Advantage |
$17.95
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: BCBS Trust/PPO |
$58.60
|
| Rate for Payer: BCN Commercial |
$55.48
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.66
|
| Rate for Payer: Priority Health HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$6.57
|
| Rate for Payer: BCBS MAPPO |
$11.44
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$11.44
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$6.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$6.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.44
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.44
|
| Rate for Payer: UHC Exchange |
$11.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.44
|
| Rate for Payer: UHCCP Medicaid |
$6.25
|
| Rate for Payer: VA VA |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.37
|
| Rate for Payer: BCN Commercial |
$35.38
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,231.63
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,200.56 |
| Max. Negotiated Rate |
$15,508.47 |
| Rate for Payer: Aetna Commercial |
$14,646.89
|
| Rate for Payer: BCBS Trust/PPO |
$14,066.18
|
| Rate for Payer: BCN Commercial |
$13,316.60
|
| Rate for Payer: Cash Price |
$13,785.30
|
| Rate for Payer: Cofinity Commercial |
$14,819.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,785.30
|
| Rate for Payer: Healthscope Commercial |
$15,508.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,923.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,646.89
|
| Rate for Payer: Nomi Health Commercial |
$14,129.94
|
| Rate for Payer: PHP Commercial |
$14,646.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,200.56
|
| Rate for Payer: Priority Health HMO/PPO |
$14,991.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,545.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,163.83
|
| Rate for Payer: UHC Core |
$14,388.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,923.72
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,231.63
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,092.51 |
| Max. Negotiated Rate |
$15,508.47 |
| Rate for Payer: Aetna Commercial |
$14,646.89
|
| Rate for Payer: Aetna Medicare |
$4,480.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,384.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,384.88
|
| Rate for Payer: BCBS Complete |
$6,892.65
|
| Rate for Payer: BCBS MAPPO |
$4,307.91
|
| Rate for Payer: BCBS Trust/PPO |
$14,166.12
|
| Rate for Payer: BCN Commercial |
$13,397.59
|
| Rate for Payer: BCN Medicare Advantage |
$4,307.91
|
| Rate for Payer: Cash Price |
$13,785.30
|
| Rate for Payer: Cofinity Commercial |
$14,819.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,785.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,307.91
|
| Rate for Payer: Healthscope Commercial |
$15,508.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,923.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,523.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,954.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,646.89
|
| Rate for Payer: Nomi Health Commercial |
$14,129.94
|
| Rate for Payer: PACE Senior Care Partners |
$4,092.51
|
| Rate for Payer: PACE SWMI |
$4,307.91
|
| Rate for Payer: PHP Commercial |
$14,646.89
|
| Rate for Payer: PHP Medicare Advantage |
$4,307.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,200.56
|
| Rate for Payer: Priority Health HMO/PPO |
$14,991.52
|
| Rate for Payer: Priority Health Medicare |
$4,350.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,545.19
|
| Rate for Payer: Railroad Medicare Medicare |
$4,307.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,163.83
|
| Rate for Payer: UHC Core |
$14,388.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,307.91
|
| Rate for Payer: UHC Exchange |
$4,307.91
|
| Rate for Payer: UHC Medicare Advantage |
$4,307.91
|
| Rate for Payer: VA VA |
$4,307.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,923.72
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,615.28
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,183.63 |
| Max. Negotiated Rate |
$15,853.75 |
| Rate for Payer: Aetna Commercial |
$14,972.99
|
| Rate for Payer: Aetna Medicare |
$4,579.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,504.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,504.78
|
| Rate for Payer: BCBS Complete |
$7,046.11
|
| Rate for Payer: BCBS MAPPO |
$4,403.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,481.52
|
| Rate for Payer: BCN Commercial |
$13,695.88
|
| Rate for Payer: BCN Medicare Advantage |
$4,403.82
|
| Rate for Payer: Cash Price |
$14,092.22
|
| Rate for Payer: Cofinity Commercial |
$15,149.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,092.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,403.82
|
| Rate for Payer: Healthscope Commercial |
$15,853.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,211.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,624.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,064.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,972.99
|
| Rate for Payer: Nomi Health Commercial |
$14,444.53
|
| Rate for Payer: PACE Senior Care Partners |
$4,183.63
|
| Rate for Payer: PACE SWMI |
$4,403.82
|
| Rate for Payer: PHP Commercial |
$14,972.99
|
| Rate for Payer: PHP Medicare Advantage |
$4,403.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,449.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15,325.29
|
| Rate for Payer: Priority Health Medicare |
$4,447.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,802.24
|
| Rate for Payer: Railroad Medicare Medicare |
$4,403.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,501.45
|
| Rate for Payer: UHC Core |
$14,708.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,403.82
|
| Rate for Payer: UHC Exchange |
$4,403.82
|
| Rate for Payer: UHC Medicare Advantage |
$4,403.82
|
| Rate for Payer: VA VA |
$4,403.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,211.46
|
|
