|
HC TUBING 1/2
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.98 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Aetna Commercial |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$13.91
|
| Rate for Payer: BCN Commercial |
$13.91
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$15.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.40
|
| Rate for Payer: Healthscope Commercial |
$16.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.30
|
| Rate for Payer: PHP Commercial |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.84
|
| Rate for Payer: UHC Core |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.50
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$18.55
|
| Rate for Payer: BCN Commercial |
$18.55
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
| Rate for Payer: UHC Core |
$20.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.50
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$18.66
|
| Rate for Payer: BCN Commercial |
$18.66
|
| Rate for Payer: BCN Medicare Advantage |
$6.00
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PACE Senior Care Partners |
$5.70
|
| Rate for Payer: PACE SWMI |
$6.00
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Medicare |
$6.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: Railroad Medicare Medicare |
$6.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
| Rate for Payer: UHC Core |
$20.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.00
|
| Rate for Payer: UHC Medicare Advantage |
$6.18
|
| Rate for Payer: VA VA |
$6.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$22.02
|
| Rate for Payer: BCN Commercial |
$22.02
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$24.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$25.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.08
|
| Rate for Payer: UHC Core |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$28.50
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Aetna Commercial |
$24.22
|
| Rate for Payer: Aetna Medicare |
$7.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.91
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$7.12
|
| Rate for Payer: BCBS Trust/PPO |
$22.16
|
| Rate for Payer: BCN Commercial |
$22.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.12
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cofinity Commercial |
$24.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.12
|
| Rate for Payer: Healthscope Commercial |
$25.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.22
|
| Rate for Payer: PACE Senior Care Partners |
$6.77
|
| Rate for Payer: PACE SWMI |
$7.12
|
| Rate for Payer: PHP Commercial |
$24.22
|
| Rate for Payer: PHP Medicare Advantage |
$7.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.80
|
| Rate for Payer: Priority Health Medicare |
$7.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: Railroad Medicare Medicare |
$7.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.08
|
| Rate for Payer: UHC Core |
$23.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.12
|
| Rate for Payer: UHC Medicare Advantage |
$7.34
|
| Rate for Payer: VA VA |
$7.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$178.55 |
| Rate for Payer: Aetna Commercial |
$168.63
|
| Rate for Payer: Aetna Medicare |
$51.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.00
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$49.60
|
| Rate for Payer: BCBS Trust/PPO |
$154.25
|
| Rate for Payer: BCCCP Commercial |
$119.02
|
| Rate for Payer: BCN Commercial |
$154.25
|
| Rate for Payer: BCN Medicare Advantage |
$49.60
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$170.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$178.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.79
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: PACE Senior Care Partners |
$47.12
|
| Rate for Payer: PACE SWMI |
$49.60
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: PHP Medicare Advantage |
$49.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.60
|
| Rate for Payer: Priority Health Medicare |
$49.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.00
|
| Rate for Payer: Railroad Medicare Medicare |
$49.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.58
|
| Rate for Payer: UHC Core |
$165.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.60
|
| Rate for Payer: UHC Medicare Advantage |
$51.09
|
| Rate for Payer: VA VA |
$49.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.79
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$198.39
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$121.00 |
| Max. Negotiated Rate |
$178.55 |
| Rate for Payer: Aetna Commercial |
$168.63
|
| Rate for Payer: BCBS Trust/PPO |
$153.32
|
| Rate for Payer: BCN Commercial |
$153.32
|
| Rate for Payer: Cash Price |
$158.71
|
| Rate for Payer: Cofinity Commercial |
$170.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.71
|
| Rate for Payer: Healthscope Commercial |
$178.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$168.63
|
| Rate for Payer: PHP Commercial |
$168.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.58
|
| Rate for Payer: UHC Core |
$165.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.79
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,492.34 |
| Max. Negotiated Rate |
$3,677.82 |
| Rate for Payer: Aetna Commercial |
$3,473.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,158.02
|
| Rate for Payer: BCN Commercial |
$3,158.02
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$3,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Healthscope Commercial |
$3,677.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,064.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: PHP Commercial |
$3,473.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,555.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,492.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,596.09
|
| Rate for Payer: UHC Core |
$3,412.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,064.85
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,086.47
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$970.54 |
| Max. Negotiated Rate |
$3,677.82 |
| Rate for Payer: Aetna Commercial |
$3,473.50
|
| Rate for Payer: Aetna Medicare |
$1,062.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,277.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,277.02
|
| Rate for Payer: BCBS Complete |
$1,634.59
|
| Rate for Payer: BCBS MAPPO |
$1,021.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,177.23
|
| Rate for Payer: BCN Commercial |
$3,177.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,021.62
|
| Rate for Payer: Cash Price |
$3,269.18
|
| Rate for Payer: Cofinity Commercial |
$3,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,269.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,021.62
|
| Rate for Payer: Healthscope Commercial |
$3,677.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,064.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,072.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,174.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,473.50
|
| Rate for Payer: PACE Senior Care Partners |
$970.54
|
| Rate for Payer: PACE SWMI |
$1,021.62
|
| Rate for Payer: PHP Commercial |
$3,473.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,021.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,860.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,555.23
|
| Rate for Payer: Priority Health Medicare |
$1,021.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,492.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,021.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,596.09
|
| Rate for Payer: UHC Core |
$3,412.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,021.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,052.27
|
| Rate for Payer: VA VA |
$1,021.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,064.85
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$3,240.00 |
| Rate for Payer: Aetna Commercial |
$3,060.00
|
| Rate for Payer: Aetna Medicare |
$936.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,125.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,125.00
|
| Rate for Payer: BCBS Complete |
$1,440.00
|
| Rate for Payer: BCBS MAPPO |
$900.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,799.00
|
| Rate for Payer: BCN Commercial |
$2,799.00
|
| Rate for Payer: BCN Medicare Advantage |
$900.00
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$3,096.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$3,240.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,700.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$945.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,035.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: PACE Senior Care Partners |
$855.00
|
| Rate for Payer: PACE SWMI |
$900.00
|
| Rate for Payer: PHP Commercial |
$3,060.00
|
| Rate for Payer: PHP Medicare Advantage |
$900.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.00
|
| Rate for Payer: Priority Health Medicare |
$900.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,195.64
|
| Rate for Payer: Railroad Medicare Medicare |
$900.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,168.00
|
| Rate for Payer: UHC Core |
$3,006.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$900.00
|
| Rate for Payer: UHC Medicare Advantage |
$927.00
|
| Rate for Payer: VA VA |
$900.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,700.00
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,195.64 |
| Max. Negotiated Rate |
$3,240.00 |
| Rate for Payer: Aetna Commercial |
$3,060.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,782.08
|
| Rate for Payer: BCN Commercial |
$2,782.08
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$3,096.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Healthscope Commercial |
$3,240.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,700.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: PHP Commercial |
$3,060.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,195.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,168.00
|
| Rate for Payer: UHC Core |
$3,006.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,700.00
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,850.06 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,025.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,434.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,434.29
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,947.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,056.52
|
| Rate for Payer: BCN Commercial |
$6,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.44
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.44
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,044.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,239.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,850.06
|
| Rate for Payer: PACE SWMI |
$1,947.44
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Medicare |
$1,947.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,947.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,005.86
|
| Rate for Payer: VA VA |
$1,947.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,750.96 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,019.91
|
| Rate for Payer: BCN Commercial |
$6,019.91
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,750.96 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,019.91
|
| Rate for Payer: BCN Commercial |
$6,019.91
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,850.06 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,025.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,434.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,434.29
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,947.44
|
| Rate for Payer: BCBS Trust/PPO |
$6,056.52
|
| Rate for Payer: BCN Commercial |
$6,056.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,947.44
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,947.44
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,044.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,239.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Senior Care Partners |
$1,850.06
|
| Rate for Payer: PACE SWMI |
$1,947.44
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,947.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,777.07
|
| Rate for Payer: Priority Health Medicare |
$1,947.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,750.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,947.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,854.97
|
| Rate for Payer: UHC Core |
$6,504.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,947.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,005.86
|
| Rate for Payer: VA VA |
$1,947.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$463.79 |
| Max. Negotiated Rate |
$684.40 |
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: BCBS Trust/PPO |
$587.67
|
| Rate for Payer: BCN Commercial |
$587.67
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$653.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Healthscope Commercial |
$684.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.19
|
| Rate for Payer: UHC Core |
$634.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.33
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.60 |
| Max. Negotiated Rate |
$684.40 |
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: Aetna Medicare |
$197.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.64
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$190.11
|
| Rate for Payer: BCBS Trust/PPO |
$591.24
|
| Rate for Payer: BCN Commercial |
$591.24
|
| Rate for Payer: BCN Medicare Advantage |
$190.11
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$653.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.11
|
| Rate for Payer: Healthscope Commercial |
$684.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.33
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: PACE Senior Care Partners |
$180.60
|
| Rate for Payer: PACE SWMI |
$190.11
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: PHP Medicare Advantage |
$190.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.58
|
| Rate for Payer: Priority Health Medicare |
$190.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.79
|
| Rate for Payer: Railroad Medicare Medicare |
$190.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.19
|
| Rate for Payer: UHC Core |
$634.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.11
|
| Rate for Payer: UHC Medicare Advantage |
$195.81
|
| Rate for Payer: VA VA |
$190.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.33
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
OP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$296.51 |
| Rate for Payer: Aetna Commercial |
$280.04
|
| Rate for Payer: Aetna Medicare |
$85.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.96
|
| Rate for Payer: BCBS Complete |
$162.43
|
| Rate for Payer: BCBS MAPPO |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$256.16
|
| Rate for Payer: BCN Commercial |
$256.16
|
| Rate for Payer: BCN Medicare Advantage |
$82.36
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$283.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.36
|
| Rate for Payer: Healthscope Commercial |
$296.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.10
|
| Rate for Payer: Mclaren Medicaid |
$154.70
|
| Rate for Payer: Meridian Medicaid |
$162.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: PACE Senior Care Partners |
$78.25
|
| Rate for Payer: PACE SWMI |
$82.36
|
| Rate for Payer: PHP Commercial |
$280.04
|
| Rate for Payer: PHP Medicare Advantage |
$82.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.63
|
| Rate for Payer: Priority Health Medicare |
$82.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.94
|
| Rate for Payer: Railroad Medicare Medicare |
$82.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.92
|
| Rate for Payer: UHC Core |
$275.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.36
|
| Rate for Payer: UHC Medicare Advantage |
$84.84
|
| Rate for Payer: VA VA |
$82.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.10
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
IP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.94 |
| Max. Negotiated Rate |
$296.51 |
| Rate for Payer: Aetna Commercial |
$280.04
|
| Rate for Payer: BCBS Trust/PPO |
$254.61
|
| Rate for Payer: BCN Commercial |
$254.61
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$283.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Healthscope Commercial |
$296.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: PHP Commercial |
$280.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.92
|
| Rate for Payer: UHC Core |
$275.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.10
|
|
|
HC TYMPANOMETRY
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$22.07
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC TYMPANOMETRY
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$6.78 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.92
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.21
|
| Rate for Payer: BCN Commercial |
$22.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Senior Care Partners |
$6.78
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Medicare |
$7.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$7.35
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna Medicare |
$37.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.62
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$36.50
|
| Rate for Payer: BCBS Trust/PPO |
$113.52
|
| Rate for Payer: BCN Commercial |
$113.52
|
| Rate for Payer: BCN Medicare Advantage |
$36.50
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PACE Senior Care Partners |
$34.68
|
| Rate for Payer: PACE SWMI |
$36.50
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: PHP Medicare Advantage |
$36.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Medicare |
$36.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: Railroad Medicare Medicare |
$36.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.50
|
| Rate for Payer: UHC Medicare Advantage |
$37.60
|
| Rate for Payer: VA VA |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$89.05 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: BCBS Trust/PPO |
$112.83
|
| Rate for Payer: BCN Commercial |
$112.83
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
