|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$372.65 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: Aetna Medicare |
$407.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.33
|
| Rate for Payer: BCBS Complete |
$501.91
|
| Rate for Payer: BCBS MAPPO |
$392.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.92
|
| Rate for Payer: BCN Commercial |
$1,219.94
|
| Rate for Payer: BCN Medicare Advantage |
$392.26
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.26
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Mclaren Medicaid |
$477.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.88
|
| Rate for Payer: Meridian Medicaid |
$501.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$451.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: Nomi Health Commercial |
$1,286.63
|
| Rate for Payer: PACE Senior Care Partners |
$372.65
|
| Rate for Payer: PACE SWMI |
$392.26
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: PHP Medicare Advantage |
$392.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.08
|
| Rate for Payer: Priority Health Medicare |
$396.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.27
|
| Rate for Payer: Railroad Medicare Medicare |
$392.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.77
|
| Rate for Payer: UHC Core |
$1,310.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.26
|
| Rate for Payer: UHC Exchange |
$392.26
|
| Rate for Payer: UHC Medicare Advantage |
$392.26
|
| Rate for Payer: UHCCP Medicaid |
$477.98
|
| Rate for Payer: VA VA |
$392.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,019.89 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.82
|
| Rate for Payer: BCN Commercial |
$1,212.57
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: Nomi Health Commercial |
$1,286.63
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health HMO/PPO |
$1,365.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,051.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,380.77
|
| Rate for Payer: UHC Core |
$1,310.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$284.39 |
| Max. Negotiated Rate |
$1,077.70 |
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: Aetna Medicare |
$311.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.20
|
| Rate for Payer: BCBS Complete |
$501.91
|
| Rate for Payer: BCBS MAPPO |
$299.36
|
| Rate for Payer: BCBS Trust/PPO |
$984.42
|
| Rate for Payer: BCN Commercial |
$931.02
|
| Rate for Payer: BCN Medicare Advantage |
$299.36
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.36
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Mclaren Medicaid |
$477.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.33
|
| Rate for Payer: Meridian Medicaid |
$501.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: Nomi Health Commercial |
$981.91
|
| Rate for Payer: PACE Senior Care Partners |
$284.39
|
| Rate for Payer: PACE SWMI |
$299.36
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: PHP Medicare Advantage |
$299.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,041.78
|
| Rate for Payer: Priority Health Medicare |
$302.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.29
|
| Rate for Payer: Railroad Medicare Medicare |
$299.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.76
|
| Rate for Payer: UHC Core |
$999.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.36
|
| Rate for Payer: UHC Exchange |
$299.36
|
| Rate for Payer: UHC Medicare Advantage |
$299.36
|
| Rate for Payer: UHCCP Medicaid |
$477.98
|
| Rate for Payer: VA VA |
$299.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$778.34 |
| Max. Negotiated Rate |
$1,077.70 |
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: BCBS Trust/PPO |
$977.48
|
| Rate for Payer: BCN Commercial |
$925.39
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: Nomi Health Commercial |
$981.91
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,041.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,053.76
|
| Rate for Payer: UHC Core |
$999.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$886.52 |
| Max. Negotiated Rate |
$1,227.48 |
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.33
|
| Rate for Payer: BCN Commercial |
$1,054.00
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: Nomi Health Commercial |
$1,118.37
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,186.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.21
|
| Rate for Payer: UHC Core |
$1,138.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.92 |
| Max. Negotiated Rate |
$1,227.48 |
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: Aetna Medicare |
$354.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$426.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$426.21
|
| Rate for Payer: BCBS Complete |
$506.74
|
| Rate for Payer: BCBS MAPPO |
$340.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,121.24
|
| Rate for Payer: BCN Commercial |
$1,060.41
|
| Rate for Payer: BCN Medicare Advantage |
$340.97
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$340.97
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Mclaren Medicaid |
$482.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$358.02
|
| Rate for Payer: Meridian Medicaid |
$506.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$392.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: Nomi Health Commercial |
$1,118.37
|
| Rate for Payer: PACE Senior Care Partners |
$323.92
|
| Rate for Payer: PACE SWMI |
$340.97
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: PHP Medicare Advantage |
$340.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,186.57
|
| Rate for Payer: Priority Health Medicare |
$344.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$913.79
|
| Rate for Payer: Railroad Medicare Medicare |
$340.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.21
|
| Rate for Payer: UHC Core |
$1,138.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$340.97
|
| Rate for Payer: UHC Exchange |
$340.97
|
| Rate for Payer: UHC Medicare Advantage |
$340.97
|
| Rate for Payer: UHCCP Medicaid |
$482.58
|
| Rate for Payer: VA VA |
$340.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$286.05 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: Aetna Medicare |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.38
|
| Rate for Payer: BCBS Complete |
$506.74
|
| Rate for Payer: BCBS MAPPO |
$301.10
|
| Rate for Payer: BCBS Trust/PPO |
$990.14
|
| Rate for Payer: BCN Commercial |
$936.42
|
| Rate for Payer: BCN Medicare Advantage |
$301.10
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.10
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Mclaren Medicaid |
$482.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.15
|
| Rate for Payer: Meridian Medicaid |
$506.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PACE Senior Care Partners |
$286.05
|
| Rate for Payer: PACE SWMI |
$301.10
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: PHP Medicare Advantage |
$301.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Medicare |
$304.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: Railroad Medicare Medicare |
$301.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.10
|
| Rate for Payer: UHC Exchange |
$301.10
|
| Rate for Payer: UHC Medicare Advantage |
$301.10
|
| Rate for Payer: UHCCP Medicaid |
$482.58
|
| Rate for Payer: VA VA |
$301.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.86 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: BCBS Trust/PPO |
$983.15
|
| Rate for Payer: BCN Commercial |
$930.76
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$969.42 |
| Max. Negotiated Rate |
$1,342.27 |
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.44
|
| Rate for Payer: BCN Commercial |
$1,152.56
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: Nomi Health Commercial |
$1,222.96
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,297.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$999.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.44
|
| Rate for Payer: UHC Core |
$1,245.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$354.21 |
| Max. Negotiated Rate |
$1,342.27 |
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: Aetna Medicare |
$387.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$466.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$466.07
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$372.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,226.09
|
| Rate for Payer: BCN Commercial |
$1,159.57
|
| Rate for Payer: BCN Medicare Advantage |
$372.85
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.85
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.50
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$428.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: Nomi Health Commercial |
$1,222.96
|
| Rate for Payer: PACE Senior Care Partners |
$354.21
|
| Rate for Payer: PACE SWMI |
$372.85
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: PHP Medicare Advantage |
$372.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,297.53
|
| Rate for Payer: Priority Health Medicare |
$376.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$999.24
|
| Rate for Payer: Railroad Medicare Medicare |
$372.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,312.44
|
| Rate for Payer: UHC Core |
$1,245.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$372.85
|
| Rate for Payer: UHC Exchange |
$372.85
|
| Rate for Payer: UHC Medicare Advantage |
$372.85
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$372.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.19 |
| Max. Negotiated Rate |
$682.83 |
| Rate for Payer: Aetna Commercial |
$644.89
|
| Rate for Payer: Aetna Medicare |
$197.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.09
|
| Rate for Payer: BCBS Complete |
$525.76
|
| Rate for Payer: BCBS MAPPO |
$189.68
|
| Rate for Payer: BCBS Trust/PPO |
$623.73
|
| Rate for Payer: BCN Commercial |
$589.89
|
| Rate for Payer: BCN Medicare Advantage |
$189.68
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.68
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.16
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.89
|
| Rate for Payer: Nomi Health Commercial |
$622.13
|
| Rate for Payer: PACE Senior Care Partners |
$180.19
|
| Rate for Payer: PACE SWMI |
$189.68
|
| Rate for Payer: PHP Commercial |
$644.89
|
| Rate for Payer: PHP Medicare Advantage |
$189.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.15
|
| Rate for Payer: Priority Health HMO/PPO |
$660.07
|
| Rate for Payer: Priority Health Medicare |
$191.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.33
|
| Rate for Payer: Railroad Medicare Medicare |
$189.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.66
|
| Rate for Payer: UHC Core |
$633.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.68
|
| Rate for Payer: UHC Exchange |
$189.68
|
| Rate for Payer: UHC Medicare Advantage |
$189.68
|
| Rate for Payer: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$189.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.15 |
| Max. Negotiated Rate |
$682.83 |
| Rate for Payer: Aetna Commercial |
$644.89
|
| Rate for Payer: BCBS Trust/PPO |
$619.33
|
| Rate for Payer: BCN Commercial |
$586.32
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.89
|
| Rate for Payer: Nomi Health Commercial |
$622.13
|
| Rate for Payer: PHP Commercial |
$644.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.15
|
| Rate for Payer: Priority Health HMO/PPO |
$660.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$508.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.66
|
| Rate for Payer: UHC Core |
$633.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$87.91 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: BCBS Trust/PPO |
$110.40
|
| Rate for Payer: BCN Commercial |
$104.52
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health HMO/PPO |
$117.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.02
|
| Rate for Payer: UHC Core |
$112.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna Medicare |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.27
|
| Rate for Payer: BCBS Complete |
$54.10
|
| Rate for Payer: BCBS MAPPO |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$111.19
|
| Rate for Payer: BCN Commercial |
$105.16
|
| Rate for Payer: BCN Medicare Advantage |
$33.81
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.81
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: PACE Senior Care Partners |
$32.12
|
| Rate for Payer: PACE SWMI |
$33.81
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: PHP Medicare Advantage |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health HMO/PPO |
$117.67
|
| Rate for Payer: Priority Health Medicare |
$34.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.62
|
| Rate for Payer: Railroad Medicare Medicare |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.02
|
| Rate for Payer: UHC Core |
$112.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.81
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UHC Medicare Advantage |
$33.81
|
| Rate for Payer: VA VA |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
OP
|
$275.10
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$65.34 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$71.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.97
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$68.78
|
| Rate for Payer: BCBS Trust/PPO |
$226.16
|
| Rate for Payer: BCN Commercial |
$213.89
|
| Rate for Payer: BCN Medicare Advantage |
$68.78
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cofinity Commercial |
$236.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.78
|
| Rate for Payer: Healthscope Commercial |
$247.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.32
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.21
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.84
|
| Rate for Payer: Nomi Health Commercial |
$225.58
|
| Rate for Payer: PACE Senior Care Partners |
$65.34
|
| Rate for Payer: PACE SWMI |
$68.78
|
| Rate for Payer: PHP Commercial |
$233.84
|
| Rate for Payer: PHP Medicare Advantage |
$68.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.81
|
| Rate for Payer: Priority Health HMO/PPO |
$239.34
|
| Rate for Payer: Priority Health Medicare |
$69.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.32
|
| Rate for Payer: Railroad Medicare Medicare |
$68.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.09
|
| Rate for Payer: UHC Core |
$229.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.78
|
| Rate for Payer: UHC Exchange |
$68.78
|
| Rate for Payer: UHC Medicare Advantage |
$68.78
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$68.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.32
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$275.10
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$178.81 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: BCBS Trust/PPO |
$224.56
|
| Rate for Payer: BCN Commercial |
$212.60
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cofinity Commercial |
$236.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.08
|
| Rate for Payer: Healthscope Commercial |
$247.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.84
|
| Rate for Payer: Nomi Health Commercial |
$225.58
|
| Rate for Payer: PHP Commercial |
$233.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.81
|
| Rate for Payer: Priority Health HMO/PPO |
$239.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.09
|
| Rate for Payer: UHC Core |
$229.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.32
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$11,880.07
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,821.52 |
| Max. Negotiated Rate |
$10,692.06 |
| Rate for Payer: Aetna Commercial |
$10,098.06
|
| Rate for Payer: Aetna Medicare |
$3,088.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,712.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,712.52
|
| Rate for Payer: BCBS Complete |
$4,752.03
|
| Rate for Payer: BCBS MAPPO |
$2,970.02
|
| Rate for Payer: BCBS Trust/PPO |
$9,766.61
|
| Rate for Payer: BCN Commercial |
$9,236.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,970.02
|
| Rate for Payer: Cash Price |
$9,504.06
|
| Rate for Payer: Cofinity Commercial |
$10,216.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,504.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,970.02
|
| Rate for Payer: Healthscope Commercial |
$10,692.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,910.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,118.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,415.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,098.06
|
| Rate for Payer: Nomi Health Commercial |
$9,741.66
|
| Rate for Payer: PACE Senior Care Partners |
$2,821.52
|
| Rate for Payer: PACE SWMI |
$2,970.02
|
| Rate for Payer: PHP Commercial |
$10,098.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,970.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,722.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,335.66
|
| Rate for Payer: Priority Health Medicare |
$2,999.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,959.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,970.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,454.46
|
| Rate for Payer: UHC Core |
$9,919.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,970.02
|
| Rate for Payer: UHC Exchange |
$2,970.02
|
| Rate for Payer: UHC Medicare Advantage |
$2,970.02
|
| Rate for Payer: VA VA |
$2,970.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,910.05
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$11,880.07
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,722.05 |
| Max. Negotiated Rate |
$10,692.06 |
| Rate for Payer: Aetna Commercial |
$10,098.06
|
| Rate for Payer: BCBS Trust/PPO |
$9,697.70
|
| Rate for Payer: BCN Commercial |
$9,180.92
|
| Rate for Payer: Cash Price |
$9,504.06
|
| Rate for Payer: Cofinity Commercial |
$10,216.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,504.06
|
| Rate for Payer: Healthscope Commercial |
$10,692.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,910.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,098.06
|
| Rate for Payer: Nomi Health Commercial |
$9,741.66
|
| Rate for Payer: PHP Commercial |
$10,098.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,722.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,335.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,959.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,454.46
|
| Rate for Payer: UHC Core |
$9,919.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,910.05
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,929.94
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$458.36 |
| Max. Negotiated Rate |
$1,736.95 |
| Rate for Payer: Aetna Commercial |
$1,640.45
|
| Rate for Payer: Aetna Medicare |
$501.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$603.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$603.11
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$482.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.60
|
| Rate for Payer: BCN Commercial |
$1,500.53
|
| Rate for Payer: BCN Medicare Advantage |
$482.49
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cofinity Commercial |
$1,659.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,543.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$482.49
|
| Rate for Payer: Healthscope Commercial |
$1,736.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,447.45
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$506.61
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$554.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,640.45
|
| Rate for Payer: Nomi Health Commercial |
$1,582.55
|
| Rate for Payer: PACE Senior Care Partners |
$458.36
|
| Rate for Payer: PACE SWMI |
$482.49
|
| Rate for Payer: PHP Commercial |
$1,640.45
|
| Rate for Payer: PHP Medicare Advantage |
$482.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.46
|
| Rate for Payer: Priority Health HMO/PPO |
$1,679.05
|
| Rate for Payer: Priority Health Medicare |
$487.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,293.06
|
| Rate for Payer: Railroad Medicare Medicare |
$482.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.35
|
| Rate for Payer: UHC Core |
$1,611.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$482.49
|
| Rate for Payer: UHC Exchange |
$482.49
|
| Rate for Payer: UHC Medicare Advantage |
$482.49
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$482.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,447.45
|
|
