|
HC MR BREAST UNI SCREEN W CON
|
Facility
|
IP
|
$908.41
|
|
|
Service Code
|
HCPCS C8903
|
| Hospital Charge Code |
61000085
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$590.47 |
| Max. Negotiated Rate |
$817.57 |
| Rate for Payer: Aetna Commercial |
$772.15
|
| Rate for Payer: BCBS Trust/PPO |
$741.54
|
| Rate for Payer: BCN Commercial |
$702.02
|
| Rate for Payer: Cash Price |
$726.73
|
| Rate for Payer: Cofinity Commercial |
$781.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.73
|
| Rate for Payer: Healthscope Commercial |
$817.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$772.15
|
| Rate for Payer: Nomi Health Commercial |
$744.90
|
| Rate for Payer: PHP Commercial |
$772.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.47
|
| Rate for Payer: Priority Health HMO/PPO |
$790.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$799.40
|
| Rate for Payer: UHC Core |
$758.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.31
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
OP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna Commercial |
$1,049.35
|
| Rate for Payer: Aetna Medicare |
$320.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.79
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$308.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.91
|
| Rate for Payer: BCN Commercial |
$959.85
|
| Rate for Payer: BCN Medicare Advantage |
$308.63
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,061.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.63
|
| Rate for Payer: Healthscope Commercial |
$1,111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.90
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.06
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.35
|
| Rate for Payer: Nomi Health Commercial |
$1,012.31
|
| Rate for Payer: PACE Senior Care Partners |
$293.20
|
| Rate for Payer: PACE SWMI |
$308.63
|
| Rate for Payer: PHP Commercial |
$1,049.35
|
| Rate for Payer: PHP Medicare Advantage |
$308.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,074.04
|
| Rate for Payer: Priority Health Medicare |
$311.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.14
|
| Rate for Payer: Railroad Medicare Medicare |
$308.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.39
|
| Rate for Payer: UHC Core |
$1,030.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.63
|
| Rate for Payer: UHC Exchange |
$308.63
|
| Rate for Payer: UHC Medicare Advantage |
$308.63
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$308.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.90
|
|
|
HC MR BREAST UNI SCREEN WO W CON
|
Facility
|
IP
|
$1,234.53
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000086
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$802.44 |
| Max. Negotiated Rate |
$1,111.08 |
| Rate for Payer: Aetna Commercial |
$1,049.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.75
|
| Rate for Payer: BCN Commercial |
$954.04
|
| Rate for Payer: Cash Price |
$987.62
|
| Rate for Payer: Cofinity Commercial |
$1,061.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.62
|
| Rate for Payer: Healthscope Commercial |
$1,111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.35
|
| Rate for Payer: Nomi Health Commercial |
$1,012.31
|
| Rate for Payer: PHP Commercial |
$1,049.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,074.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.39
|
| Rate for Payer: UHC Core |
$1,030.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.90
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
OP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Medicare |
$408.04
|
| Rate for Payer: Aetna Medicare |
$612.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$735.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$735.64
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$588.51
|
| Rate for Payer: BCBS MAPPO |
$392.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.26
|
| Rate for Payer: BCN Commercial |
$1,220.19
|
| Rate for Payer: BCN Commercial |
$1,830.27
|
| Rate for Payer: BCN Medicare Advantage |
$392.34
|
| Rate for Payer: BCN Medicare Advantage |
$588.51
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.51
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.96
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$676.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Nomi Health Commercial |
$1,286.88
|
| Rate for Payer: Nomi Health Commercial |
$1,930.32
|
| Rate for Payer: PACE Senior Care Partners |
$372.73
|
| Rate for Payer: PACE Senior Care Partners |
$559.09
|
| Rate for Payer: PACE SWMI |
$392.34
|
| Rate for Payer: PACE SWMI |
$588.51
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Medicare Advantage |
$392.34
|
| Rate for Payer: PHP Medicare Advantage |
$588.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health HMO/PPO |
$2,048.02
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.35
|
| Rate for Payer: Priority Health Medicare |
$396.27
|
| Rate for Payer: Priority Health Medicare |
$594.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,577.21
|
| Rate for Payer: Railroad Medicare Medicare |
$588.51
|
| Rate for Payer: Railroad Medicare Medicare |
$392.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.51
|
| Rate for Payer: UHC Exchange |
$588.51
|
| Rate for Payer: UHC Exchange |
$392.34
|
| Rate for Payer: UHC Medicare Advantage |
$588.51
|
| Rate for Payer: UHC Medicare Advantage |
$392.34
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$392.34
|
| Rate for Payer: VA VA |
$588.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST UNI WO W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS C8905
|
| Hospital Charge Code |
61000057
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,020.09 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,921.61
|
| Rate for Payer: BCN Commercial |
$1,212.81
|
| Rate for Payer: BCN Commercial |
$1,819.21
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Nomi Health Commercial |
$1,286.88
|
| Rate for Payer: Nomi Health Commercial |
$1,930.32
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,048.02
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,577.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
OP
|
$1,569.37
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$318.72 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: Aetna Medicare |
$612.05
|
| Rate for Payer: Aetna Medicare |
$408.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$735.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$735.64
|
| Rate for Payer: BCBS Complete |
$941.62
|
| Rate for Payer: BCBS Complete |
$627.75
|
| Rate for Payer: BCBS MAPPO |
$392.34
|
| Rate for Payer: BCBS MAPPO |
$588.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.26
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCCCP Commercial |
$318.72
|
| Rate for Payer: BCN Commercial |
$1,220.19
|
| Rate for Payer: BCN Commercial |
$1,830.27
|
| Rate for Payer: BCN Medicare Advantage |
$392.34
|
| Rate for Payer: BCN Medicare Advantage |
$588.51
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$588.51
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$617.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$676.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: Nomi Health Commercial |
$1,286.88
|
| Rate for Payer: Nomi Health Commercial |
$1,930.32
|
| Rate for Payer: PACE Senior Care Partners |
$559.09
|
| Rate for Payer: PACE Senior Care Partners |
$372.73
|
| Rate for Payer: PACE SWMI |
$392.34
|
| Rate for Payer: PACE SWMI |
$588.51
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Medicare Advantage |
$392.34
|
| Rate for Payer: PHP Medicare Advantage |
$588.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,048.02
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.35
|
| Rate for Payer: Priority Health Medicare |
$594.40
|
| Rate for Payer: Priority Health Medicare |
$396.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,577.21
|
| Rate for Payer: Railroad Medicare Medicare |
$392.34
|
| Rate for Payer: Railroad Medicare Medicare |
$588.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$588.51
|
| Rate for Payer: UHC Exchange |
$588.51
|
| Rate for Payer: UHC Exchange |
$392.34
|
| Rate for Payer: UHC Medicare Advantage |
$588.51
|
| Rate for Payer: UHC Medicare Advantage |
$392.34
|
| Rate for Payer: VA VA |
$392.34
|
| Rate for Payer: VA VA |
$588.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST W CON
|
Facility
|
IP
|
$1,569.37
|
|
|
Service Code
|
HCPCS 77048
|
| Hospital Charge Code |
61000055
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,020.09 |
| Max. Negotiated Rate |
$1,412.43 |
| Rate for Payer: Aetna Commercial |
$1,333.96
|
| Rate for Payer: Aetna Commercial |
$2,000.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,281.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,921.61
|
| Rate for Payer: BCN Commercial |
$1,212.81
|
| Rate for Payer: BCN Commercial |
$1,819.21
|
| Rate for Payer: Cash Price |
$1,255.50
|
| Rate for Payer: Cash Price |
$1,883.24
|
| Rate for Payer: Cofinity Commercial |
$2,024.48
|
| Rate for Payer: Cofinity Commercial |
$1,349.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,883.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.50
|
| Rate for Payer: Healthscope Commercial |
$1,412.43
|
| Rate for Payer: Healthscope Commercial |
$2,118.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,177.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,765.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,000.94
|
| Rate for Payer: Nomi Health Commercial |
$1,286.88
|
| Rate for Payer: Nomi Health Commercial |
$1,930.32
|
| Rate for Payer: PHP Commercial |
$1,333.96
|
| Rate for Payer: PHP Commercial |
$2,000.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,530.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,020.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,048.02
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,577.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,381.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,071.56
|
| Rate for Payer: UHC Core |
$1,310.42
|
| Rate for Payer: UHC Core |
$1,965.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,177.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,765.54
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
IP
|
$2,132.92
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,386.40 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,741.10
|
| Rate for Payer: BCN Commercial |
$1,648.32
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,855.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST WO CON BIL
|
Facility
|
OP
|
$2,132.92
|
|
|
Service Code
|
CPT 77047
|
| Hospital Charge Code |
61000091
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,919.63 |
| Rate for Payer: Aetna Commercial |
$1,812.98
|
| Rate for Payer: Aetna Medicare |
$554.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$666.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$666.54
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$533.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,753.47
|
| Rate for Payer: BCCCP Commercial |
$207.57
|
| Rate for Payer: BCN Commercial |
$1,658.35
|
| Rate for Payer: BCN Medicare Advantage |
$533.23
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cash Price |
$1,706.34
|
| Rate for Payer: Cofinity Commercial |
$1,834.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,706.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$533.23
|
| Rate for Payer: Healthscope Commercial |
$1,919.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,599.69
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$559.89
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$613.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,812.98
|
| Rate for Payer: Nomi Health Commercial |
$1,748.99
|
| Rate for Payer: PACE Senior Care Partners |
$506.57
|
| Rate for Payer: PACE SWMI |
$533.23
|
| Rate for Payer: PHP Commercial |
$1,812.98
|
| Rate for Payer: PHP Medicare Advantage |
$533.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,386.40
|
| Rate for Payer: Priority Health HMO/PPO |
$1,855.64
|
| Rate for Payer: Priority Health Medicare |
$538.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,429.06
|
| Rate for Payer: Railroad Medicare Medicare |
$533.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,876.97
|
| Rate for Payer: UHC Core |
$1,780.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$533.23
|
| Rate for Payer: UHC Exchange |
$533.23
|
| Rate for Payer: UHC Medicare Advantage |
$533.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$533.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,599.69
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
OP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,411.88 |
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: Aetna Medicare |
$407.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.24
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$392.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.68
|
| Rate for Payer: BCCCP Commercial |
$201.08
|
| Rate for Payer: BCN Commercial |
$1,219.71
|
| Rate for Payer: BCN Medicare Advantage |
$392.19
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.19
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.45
|
| Rate for Payer: Nomi Health Commercial |
$1,286.38
|
| Rate for Payer: PACE Senior Care Partners |
$372.58
|
| Rate for Payer: PACE SWMI |
$392.19
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| Rate for Payer: PHP Medicare Advantage |
$392.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.82
|
| Rate for Payer: Priority Health Medicare |
$396.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.07
|
| Rate for Payer: Railroad Medicare Medicare |
$392.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.51
|
| Rate for Payer: UHC Core |
$1,309.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.19
|
| Rate for Payer: UHC Exchange |
$392.19
|
| Rate for Payer: UHC Medicare Advantage |
$392.19
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$392.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR BREAST WO CON UNI
|
Facility
|
IP
|
$1,568.76
|
|
|
Service Code
|
CPT 77046
|
| Hospital Charge Code |
61000090
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,019.69 |
| Max. Negotiated Rate |
$1,411.88 |
| Rate for Payer: Aetna Commercial |
$1,333.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.58
|
| Rate for Payer: BCN Commercial |
$1,212.34
|
| Rate for Payer: Cash Price |
$1,255.01
|
| Rate for Payer: Cofinity Commercial |
$1,349.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.01
|
| Rate for Payer: Healthscope Commercial |
$1,411.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.45
|
| Rate for Payer: Nomi Health Commercial |
$1,286.38
|
| Rate for Payer: PHP Commercial |
$1,333.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.69
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.51
|
| Rate for Payer: UHC Core |
$1,309.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.57
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
OP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: Aetna Medicare |
$559.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$673.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$673.01
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$538.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.50
|
| Rate for Payer: BCN Commercial |
$1,674.45
|
| Rate for Payer: BCN Medicare Advantage |
$538.41
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$538.41
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$565.33
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$619.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Nomi Health Commercial |
$1,765.98
|
| Rate for Payer: PACE Senior Care Partners |
$511.49
|
| Rate for Payer: PACE SWMI |
$538.41
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: PHP Medicare Advantage |
$538.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,873.66
|
| Rate for Payer: Priority Health Medicare |
$543.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.93
|
| Rate for Payer: Railroad Medicare Medicare |
$538.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.19
|
| Rate for Payer: UHC Core |
$1,798.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$538.41
|
| Rate for Payer: UHC Exchange |
$538.41
|
| Rate for Payer: UHC Medicare Advantage |
$538.41
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$538.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC FOR MORPHOLOGY WO CON
|
Facility
|
IP
|
$2,153.63
|
|
|
Service Code
|
CPT 75557
|
| Hospital Charge Code |
61000046
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,399.86 |
| Max. Negotiated Rate |
$1,938.27 |
| Rate for Payer: Aetna Commercial |
$1,830.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,758.01
|
| Rate for Payer: BCN Commercial |
$1,664.33
|
| Rate for Payer: Cash Price |
$1,722.90
|
| Rate for Payer: Cofinity Commercial |
$1,852.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,722.90
|
| Rate for Payer: Healthscope Commercial |
$1,938.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,615.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,830.59
|
| Rate for Payer: Nomi Health Commercial |
$1,765.98
|
| Rate for Payer: PHP Commercial |
$1,830.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,873.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,442.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,895.19
|
| Rate for Payer: UHC Core |
$1,798.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,615.22
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
IP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$644.14 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: BCBS Trust/PPO |
$808.94
|
| Rate for Payer: BCN Commercial |
$765.83
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.33
|
| Rate for Payer: Nomi Health Commercial |
$812.60
|
| Rate for Payer: PHP Commercial |
$842.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.14
|
| Rate for Payer: Priority Health HMO/PPO |
$862.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.06
|
| Rate for Payer: UHC Core |
$827.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC MORP AND FUNC WO W CON
|
Facility
|
OP
|
$990.98
|
|
|
Service Code
|
CPT 75561
|
| Hospital Charge Code |
61000047
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$235.36 |
| Max. Negotiated Rate |
$891.88 |
| Rate for Payer: Aetna Commercial |
$842.33
|
| Rate for Payer: Aetna Medicare |
$257.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.68
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$247.74
|
| Rate for Payer: BCBS Trust/PPO |
$814.68
|
| Rate for Payer: BCN Commercial |
$770.49
|
| Rate for Payer: BCN Medicare Advantage |
$247.74
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cash Price |
$792.78
|
| Rate for Payer: Cofinity Commercial |
$852.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.74
|
| Rate for Payer: Healthscope Commercial |
$891.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.24
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.13
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.33
|
| Rate for Payer: Nomi Health Commercial |
$812.60
|
| Rate for Payer: PACE Senior Care Partners |
$235.36
|
| Rate for Payer: PACE SWMI |
$247.74
|
| Rate for Payer: PHP Commercial |
$842.33
|
| Rate for Payer: PHP Medicare Advantage |
$247.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.14
|
| Rate for Payer: Priority Health HMO/PPO |
$862.15
|
| Rate for Payer: Priority Health Medicare |
$250.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.96
|
| Rate for Payer: Railroad Medicare Medicare |
$247.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.06
|
| Rate for Payer: UHC Core |
$827.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.74
|
| Rate for Payer: UHC Exchange |
$247.74
|
| Rate for Payer: UHC Medicare Advantage |
$247.74
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$247.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.24
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
IP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$805.54 |
| Max. Negotiated Rate |
$1,115.37 |
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,011.64
|
| Rate for Payer: BCN Commercial |
$957.73
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: Nomi Health Commercial |
$1,016.23
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,078.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.58
|
| Rate for Payer: UHC Core |
$1,034.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CARDIAC VELOCITY MAPPING
|
Facility
|
OP
|
$1,239.30
|
|
|
Service Code
|
CPT 75565
|
| Hospital Charge Code |
61000048
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$294.33 |
| Max. Negotiated Rate |
$1,115.37 |
| Rate for Payer: Aetna Commercial |
$1,053.40
|
| Rate for Payer: Aetna Medicare |
$322.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$387.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$387.28
|
| Rate for Payer: BCBS Complete |
$495.72
|
| Rate for Payer: BCBS MAPPO |
$309.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.83
|
| Rate for Payer: BCN Commercial |
$963.56
|
| Rate for Payer: BCN Medicare Advantage |
$309.82
|
| Rate for Payer: Cash Price |
$991.44
|
| Rate for Payer: Cofinity Commercial |
$1,065.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.82
|
| Rate for Payer: Healthscope Commercial |
$1,115.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.40
|
| Rate for Payer: Nomi Health Commercial |
$1,016.23
|
| Rate for Payer: PACE Senior Care Partners |
$294.33
|
| Rate for Payer: PACE SWMI |
$309.82
|
| Rate for Payer: PHP Commercial |
$1,053.40
|
| Rate for Payer: PHP Medicare Advantage |
$309.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$805.54
|
| Rate for Payer: Priority Health HMO/PPO |
$1,078.19
|
| Rate for Payer: Priority Health Medicare |
$312.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.33
|
| Rate for Payer: Railroad Medicare Medicare |
$309.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,090.58
|
| Rate for Payer: UHC Core |
$1,034.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.82
|
| Rate for Payer: UHC Exchange |
$309.82
|
| Rate for Payer: UHC Medicare Advantage |
$309.82
|
| Rate for Payer: VA VA |
$309.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.48
|
|
|
HC MR CHEST W CON
|
Facility
|
IP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,516.45 |
| Max. Negotiated Rate |
$2,099.70 |
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,904.43
|
| Rate for Payer: BCN Commercial |
$1,802.94
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: Nomi Health Commercial |
$1,913.06
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.04
|
| Rate for Payer: UHC Core |
$1,948.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST W CON
|
Facility
|
OP
|
$2,333.00
|
|
|
Service Code
|
CPT 71551
|
| Hospital Charge Code |
61000011
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$554.09 |
| Max. Negotiated Rate |
$2,099.70 |
| Rate for Payer: Aetna Commercial |
$1,983.05
|
| Rate for Payer: Aetna Medicare |
$606.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$729.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$729.06
|
| Rate for Payer: BCBS Complete |
$587.68
|
| Rate for Payer: BCBS MAPPO |
$583.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,917.96
|
| Rate for Payer: BCN Commercial |
$1,813.91
|
| Rate for Payer: BCN Medicare Advantage |
$583.25
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cash Price |
$1,866.40
|
| Rate for Payer: Cofinity Commercial |
$2,006.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,866.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$583.25
|
| Rate for Payer: Healthscope Commercial |
$2,099.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,749.75
|
| Rate for Payer: Mclaren Medicaid |
$559.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$612.41
|
| Rate for Payer: Meridian Medicaid |
$587.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,983.05
|
| Rate for Payer: Nomi Health Commercial |
$1,913.06
|
| Rate for Payer: PACE Senior Care Partners |
$554.09
|
| Rate for Payer: PACE SWMI |
$583.25
|
| Rate for Payer: PHP Commercial |
$1,983.05
|
| Rate for Payer: PHP Medicare Advantage |
$583.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,516.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,029.71
|
| Rate for Payer: Priority Health Medicare |
$589.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,563.11
|
| Rate for Payer: Railroad Medicare Medicare |
$583.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,053.04
|
| Rate for Payer: UHC Core |
$1,948.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$583.25
|
| Rate for Payer: UHC Exchange |
$583.25
|
| Rate for Payer: UHC Medicare Advantage |
$583.25
|
| Rate for Payer: UHCCP Medicaid |
$559.66
|
| Rate for Payer: VA VA |
$583.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,749.75
|
|
|
HC MR CHEST WO CON
|
Facility
|
OP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: Aetna Medicare |
$528.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.08
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$508.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,670.71
|
| Rate for Payer: BCN Commercial |
$1,580.07
|
| Rate for Payer: BCN Medicare Advantage |
$508.06
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.06
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$533.47
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$584.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.41
|
| Rate for Payer: Nomi Health Commercial |
$1,666.44
|
| Rate for Payer: PACE Senior Care Partners |
$482.66
|
| Rate for Payer: PACE SWMI |
$508.06
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: PHP Medicare Advantage |
$508.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,768.06
|
| Rate for Payer: Priority Health Medicare |
$513.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.61
|
| Rate for Payer: Railroad Medicare Medicare |
$508.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.06
|
| Rate for Payer: UHC Exchange |
$508.06
|
| Rate for Payer: UHC Medicare Advantage |
$508.06
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$508.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO CON
|
Facility
|
IP
|
$2,032.25
|
|
|
Service Code
|
CPT 71550
|
| Hospital Charge Code |
61000010
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,320.96 |
| Max. Negotiated Rate |
$1,829.02 |
| Rate for Payer: Aetna Commercial |
$1,727.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.93
|
| Rate for Payer: BCN Commercial |
$1,570.52
|
| Rate for Payer: Cash Price |
$1,625.80
|
| Rate for Payer: Cofinity Commercial |
$1,747.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.80
|
| Rate for Payer: Healthscope Commercial |
$1,829.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,524.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.41
|
| Rate for Payer: Nomi Health Commercial |
$1,666.44
|
| Rate for Payer: PHP Commercial |
$1,727.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.96
|
| Rate for Payer: Priority Health HMO/PPO |
$1,768.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,361.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,788.38
|
| Rate for Payer: UHC Core |
$1,696.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,524.19
|
|
|
HC MR CHEST WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,984.32 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,492.00
|
| Rate for Payer: BCN Commercial |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR CHEST WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 71552
|
| Hospital Charge Code |
61000012
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna Medicare |
$793.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$954.00
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$763.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.71
|
| Rate for Payer: BCN Commercial |
$2,373.55
|
| Rate for Payer: BCN Medicare Advantage |
$763.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.20
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.36
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PACE Senior Care Partners |
$725.04
|
| Rate for Payer: PACE SWMI |
$763.20
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: PHP Medicare Advantage |
$763.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Medicare |
$770.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: Railroad Medicare Medicare |
$763.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.20
|
| Rate for Payer: UHC Exchange |
$763.20
|
| Rate for Payer: UHC Medicare Advantage |
$763.20
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$763.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
OP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: Aetna Medicare |
$93.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.49
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$90.00
|
| Rate for Payer: BCBS Trust/PPO |
$295.94
|
| Rate for Payer: BCN Commercial |
$279.88
|
| Rate for Payer: BCN Medicare Advantage |
$90.00
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.00
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.98
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.49
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.98
|
| Rate for Payer: Nomi Health Commercial |
$295.18
|
| Rate for Payer: PACE Senior Care Partners |
$85.50
|
| Rate for Payer: PACE SWMI |
$90.00
|
| Rate for Payer: PHP Commercial |
$305.98
|
| Rate for Payer: PHP Medicare Advantage |
$90.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.99
|
| Rate for Payer: Priority Health HMO/PPO |
$313.18
|
| Rate for Payer: Priority Health Medicare |
$90.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.19
|
| Rate for Payer: Railroad Medicare Medicare |
$90.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.78
|
| Rate for Payer: UHC Core |
$300.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.00
|
| Rate for Payer: UHC Exchange |
$90.00
|
| Rate for Payer: UHC Medicare Advantage |
$90.00
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$90.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.98
|
|
|
HC MR ELASTOGRAPHY
|
Facility
|
IP
|
$359.98
|
|
|
Service Code
|
CPT 76391
|
| Hospital Charge Code |
61000089
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$233.99 |
| Max. Negotiated Rate |
$323.98 |
| Rate for Payer: Aetna Commercial |
$305.98
|
| Rate for Payer: BCBS Trust/PPO |
$293.85
|
| Rate for Payer: BCN Commercial |
$278.19
|
| Rate for Payer: Cash Price |
$287.98
|
| Rate for Payer: Cofinity Commercial |
$309.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.98
|
| Rate for Payer: Healthscope Commercial |
$323.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.98
|
| Rate for Payer: Nomi Health Commercial |
$295.18
|
| Rate for Payer: PHP Commercial |
$305.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.99
|
| Rate for Payer: Priority Health HMO/PPO |
$313.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.78
|
| Rate for Payer: UHC Core |
$300.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.98
|
|
