|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,929.94
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,254.46 |
| Max. Negotiated Rate |
$1,736.95 |
| Rate for Payer: Aetna Commercial |
$1,640.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.41
|
| Rate for Payer: BCN Commercial |
$1,491.46
|
| 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: Healthscope Commercial |
$1,736.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,447.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,640.45
|
| Rate for Payer: Nomi Health Commercial |
$1,582.55
|
| Rate for Payer: PHP Commercial |
$1,640.45
|
| 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 Narrow/Tiered Network |
$1,293.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,698.35
|
| Rate for Payer: UHC Core |
$1,611.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,447.45
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.17
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.06
|
| Rate for Payer: BCN Commercial |
$53.07
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.69
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.56 |
| Max. Negotiated Rate |
$402.83 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$17.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$54.20
|
| Rate for Payer: BCN Medicare Advantage |
$17.43
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.43
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.30
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: PACE Senior Care Partners |
$16.56
|
| Rate for Payer: PACE SWMI |
$17.43
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$17.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: Priority Health HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Medicare |
$17.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.71
|
| Rate for Payer: Railroad Medicare Medicare |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.43
|
| Rate for Payer: UHC Exchange |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$17.43
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$17.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$45.31 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.90
|
| Rate for Payer: BCN Commercial |
$53.87
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: Priority Health HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$14.56
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$28.31
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.10
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.81
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$386.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.10
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Exchange |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$382.50
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$994.50 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.94
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,657.50 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,081.57
|
| Rate for Payer: BCN Commercial |
$1,970.64
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Nomi Health Commercial |
$2,091.00
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,218.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.00
|
| Rate for Payer: UHC Core |
$2,129.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$605.62 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: Aetna Medicare |
$663.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$796.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$796.88
|
| Rate for Payer: BCBS Complete |
$1,020.00
|
| Rate for Payer: BCBS MAPPO |
$637.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.36
|
| Rate for Payer: BCN Commercial |
$1,982.62
|
| Rate for Payer: BCN Medicare Advantage |
$637.50
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.50
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Nomi Health Commercial |
$2,091.00
|
| Rate for Payer: PACE Senior Care Partners |
$605.62
|
| Rate for Payer: PACE SWMI |
$637.50
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: PHP Medicare Advantage |
$637.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,218.50
|
| Rate for Payer: Priority Health Medicare |
$643.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,708.50
|
| Rate for Payer: Railroad Medicare Medicare |
$637.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.00
|
| Rate for Payer: UHC Core |
$2,129.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.50
|
| Rate for Payer: UHC Exchange |
$637.50
|
| Rate for Payer: UHC Medicare Advantage |
$637.50
|
| Rate for Payer: VA VA |
$637.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
IP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.93 |
| Max. Negotiated Rate |
$142.52 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: BCBS Trust/PPO |
$129.27
|
| Rate for Payer: BCN Commercial |
$122.38
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health HMO/PPO |
$137.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.36
|
| Rate for Payer: UHC Core |
$132.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
OP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$273.10 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna Medicare |
$41.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.49
|
| Rate for Payer: BCBS Complete |
$273.10
|
| Rate for Payer: BCBS MAPPO |
$39.59
|
| Rate for Payer: BCBS Trust/PPO |
$130.19
|
| Rate for Payer: BCN Commercial |
$123.12
|
| Rate for Payer: BCN Medicare Advantage |
$39.59
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.59
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| Rate for Payer: Mclaren Medicaid |
$260.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.57
|
| Rate for Payer: Meridian Medicaid |
$273.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: PACE Senior Care Partners |
$37.61
|
| Rate for Payer: PACE SWMI |
$39.59
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health HMO/PPO |
$137.77
|
| Rate for Payer: Priority Health Medicare |
$39.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.10
|
| Rate for Payer: Railroad Medicare Medicare |
$39.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.36
|
| Rate for Payer: UHC Core |
$132.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.59
|
| Rate for Payer: UHC Exchange |
$39.59
|
| Rate for Payer: UHC Medicare Advantage |
$39.59
|
| Rate for Payer: UHCCP Medicaid |
$260.08
|
| Rate for Payer: VA VA |
$39.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
OP
|
$56.18
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.34 |
| Max. Negotiated Rate |
$50.56 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$14.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.56
|
| Rate for Payer: BCBS Complete |
$22.47
|
| Rate for Payer: BCBS MAPPO |
$14.04
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$43.68
|
| Rate for Payer: BCN Medicare Advantage |
$14.04
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.04
|
| Rate for Payer: Healthscope Commercial |
$50.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: PACE Senior Care Partners |
$13.34
|
| Rate for Payer: PACE SWMI |
$14.04
|
| Rate for Payer: PHP Commercial |
$47.75
|
| Rate for Payer: PHP Medicare Advantage |
$14.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: Priority Health HMO/PPO |
$48.88
|
| Rate for Payer: Priority Health Medicare |
$14.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.64
|
| Rate for Payer: Railroad Medicare Medicare |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.44
|
| Rate for Payer: UHC Core |
$46.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.04
|
| Rate for Payer: UHC Exchange |
$14.04
|
| Rate for Payer: UHC Medicare Advantage |
$14.04
|
| Rate for Payer: VA VA |
$14.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.13
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
IP
|
$56.18
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.52 |
| Max. Negotiated Rate |
$50.56 |
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: BCBS Trust/PPO |
$45.86
|
| Rate for Payer: BCN Commercial |
$43.42
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Healthscope Commercial |
$50.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: Nomi Health Commercial |
$46.07
|
| Rate for Payer: PHP Commercial |
$47.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: Priority Health HMO/PPO |
$48.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.44
|
| Rate for Payer: UHC Core |
$46.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.13
|
|
|
HC NEW PATIENT VISIT 99202
|
Facility
|
OP
|
$169.02
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.14 |
| Max. Negotiated Rate |
$152.12 |
| Rate for Payer: Aetna Commercial |
$143.67
|
| Rate for Payer: Aetna Medicare |
$43.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.82
|
| Rate for Payer: BCBS Complete |
$67.61
|
| Rate for Payer: BCBS MAPPO |
$42.26
|
| Rate for Payer: BCBS Trust/PPO |
$138.95
|
| Rate for Payer: BCN Commercial |
$131.41
|
| Rate for Payer: BCN Medicare Advantage |
$42.26
|
| Rate for Payer: Cash Price |
$135.22
|
| Rate for Payer: Cofinity Commercial |
$145.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.26
|
| Rate for Payer: Healthscope Commercial |
$152.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.67
|
| Rate for Payer: Nomi Health Commercial |
$138.60
|
| Rate for Payer: PACE Senior Care Partners |
$40.14
|
| Rate for Payer: PACE SWMI |
$42.26
|
| Rate for Payer: PHP Commercial |
$143.67
|
| Rate for Payer: PHP Medicare Advantage |
$42.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.86
|
| Rate for Payer: Priority Health HMO/PPO |
$147.05
|
| Rate for Payer: Priority Health Medicare |
$42.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.24
|
| Rate for Payer: Railroad Medicare Medicare |
$42.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.74
|
| Rate for Payer: UHC Core |
$141.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.26
|
| Rate for Payer: UHC Exchange |
$42.26
|
| Rate for Payer: UHC Medicare Advantage |
$42.26
|
| Rate for Payer: VA VA |
$42.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.77
|
|
|
HC NEW PATIENT VISIT 99202
|
Facility
|
IP
|
$169.02
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.86 |
| Max. Negotiated Rate |
$152.12 |
| Rate for Payer: Aetna Commercial |
$143.67
|
| Rate for Payer: BCBS Trust/PPO |
$137.97
|
| Rate for Payer: BCN Commercial |
$130.62
|
| Rate for Payer: Cash Price |
$135.22
|
| Rate for Payer: Cofinity Commercial |
$145.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.22
|
| Rate for Payer: Healthscope Commercial |
$152.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.67
|
| Rate for Payer: Nomi Health Commercial |
$138.60
|
| Rate for Payer: PHP Commercial |
$143.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.86
|
| Rate for Payer: Priority Health HMO/PPO |
$147.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.74
|
| Rate for Payer: UHC Core |
$141.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.77
|
|
|
HC NEW PATIENT VISIT 99203
|
Facility
|
IP
|
$205.10
|
|
|
Service Code
|
CPT 99203
|
| Hospital Charge Code |
51000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$133.31 |
| Max. Negotiated Rate |
$184.59 |
| Rate for Payer: Aetna Commercial |
$174.34
|
| Rate for Payer: BCBS Trust/PPO |
$167.42
|
| Rate for Payer: BCN Commercial |
$158.50
|
| Rate for Payer: Cash Price |
$164.08
|
| Rate for Payer: Cofinity Commercial |
$176.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.08
|
| Rate for Payer: Healthscope Commercial |
$184.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.34
|
| Rate for Payer: Nomi Health Commercial |
$168.18
|
| Rate for Payer: PHP Commercial |
$174.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.31
|
| Rate for Payer: Priority Health HMO/PPO |
$178.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.49
|
| Rate for Payer: UHC Core |
$171.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.82
|
|
|
HC NEW PATIENT VISIT 99203
|
Facility
|
OP
|
$205.10
|
|
|
Service Code
|
CPT 99203
|
| Hospital Charge Code |
51000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.71 |
| Max. Negotiated Rate |
$184.59 |
| Rate for Payer: Aetna Commercial |
$174.34
|
| Rate for Payer: Aetna Medicare |
$53.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.09
|
| Rate for Payer: BCBS Complete |
$82.04
|
| Rate for Payer: BCBS MAPPO |
$51.27
|
| Rate for Payer: BCBS Trust/PPO |
$168.61
|
| Rate for Payer: BCN Commercial |
$159.47
|
| Rate for Payer: BCN Medicare Advantage |
$51.27
|
| Rate for Payer: Cash Price |
$164.08
|
| Rate for Payer: Cofinity Commercial |
$176.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.27
|
| Rate for Payer: Healthscope Commercial |
$184.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.34
|
| Rate for Payer: Nomi Health Commercial |
$168.18
|
| Rate for Payer: PACE Senior Care Partners |
$48.71
|
| Rate for Payer: PACE SWMI |
$51.27
|
| Rate for Payer: PHP Commercial |
$174.34
|
| Rate for Payer: PHP Medicare Advantage |
$51.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.31
|
| Rate for Payer: Priority Health HMO/PPO |
$178.44
|
| Rate for Payer: Priority Health Medicare |
$51.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.42
|
| Rate for Payer: Railroad Medicare Medicare |
$51.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.49
|
| Rate for Payer: UHC Core |
$171.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.27
|
| Rate for Payer: UHC Exchange |
$51.27
|
| Rate for Payer: UHC Medicare Advantage |
$51.27
|
| Rate for Payer: VA VA |
$51.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.82
|
|
|
HC NEW PATIENT VISIT 99204
|
Facility
|
OP
|
$294.53
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.95 |
| Max. Negotiated Rate |
$265.08 |
| Rate for Payer: Aetna Commercial |
$250.35
|
| Rate for Payer: Aetna Medicare |
$76.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.04
|
| Rate for Payer: BCBS Complete |
$117.81
|
| Rate for Payer: BCBS MAPPO |
$73.63
|
| Rate for Payer: BCBS Trust/PPO |
$242.13
|
| Rate for Payer: BCN Commercial |
$229.00
|
| Rate for Payer: BCN Medicare Advantage |
$73.63
|
| Rate for Payer: Cash Price |
$235.62
|
| Rate for Payer: Cofinity Commercial |
$253.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.63
|
| Rate for Payer: Healthscope Commercial |
$265.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.35
|
| Rate for Payer: Nomi Health Commercial |
$241.51
|
| Rate for Payer: PACE Senior Care Partners |
$69.95
|
| Rate for Payer: PACE SWMI |
$73.63
|
| Rate for Payer: PHP Commercial |
$250.35
|
| Rate for Payer: PHP Medicare Advantage |
$73.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.44
|
| Rate for Payer: Priority Health HMO/PPO |
$256.24
|
| Rate for Payer: Priority Health Medicare |
$74.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.34
|
| Rate for Payer: Railroad Medicare Medicare |
$73.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.19
|
| Rate for Payer: UHC Core |
$245.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.63
|
| Rate for Payer: UHC Exchange |
$73.63
|
| Rate for Payer: UHC Medicare Advantage |
$73.63
|
| Rate for Payer: VA VA |
$73.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.90
|
|
|
HC NEW PATIENT VISIT 99204
|
Facility
|
IP
|
$294.53
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.44 |
| Max. Negotiated Rate |
$265.08 |
| Rate for Payer: Aetna Commercial |
$250.35
|
| Rate for Payer: BCBS Trust/PPO |
$240.42
|
| Rate for Payer: BCN Commercial |
$227.61
|
| Rate for Payer: Cash Price |
$235.62
|
| Rate for Payer: Cofinity Commercial |
$253.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.62
|
| Rate for Payer: Healthscope Commercial |
$265.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$250.35
|
| Rate for Payer: Nomi Health Commercial |
$241.51
|
| Rate for Payer: PHP Commercial |
$250.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.44
|
| Rate for Payer: Priority Health HMO/PPO |
$256.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.19
|
| Rate for Payer: UHC Core |
$245.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.90
|
|
|
HC NEW PATIENT VISIT 99205
|
Facility
|
IP
|
$490.43
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.78 |
| Max. Negotiated Rate |
$441.39 |
| Rate for Payer: Aetna Commercial |
$416.87
|
| Rate for Payer: BCBS Trust/PPO |
$400.34
|
| Rate for Payer: BCN Commercial |
$379.00
|
| Rate for Payer: Cash Price |
$392.34
|
| Rate for Payer: Cofinity Commercial |
$421.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.34
|
| Rate for Payer: Healthscope Commercial |
$441.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.87
|
| Rate for Payer: Nomi Health Commercial |
$402.15
|
| Rate for Payer: PHP Commercial |
$416.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.78
|
| Rate for Payer: Priority Health HMO/PPO |
$426.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.58
|
| Rate for Payer: UHC Core |
$409.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.82
|
|
|
HC NEW PATIENT VISIT 99205
|
Facility
|
OP
|
$490.43
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.48 |
| Max. Negotiated Rate |
$441.39 |
| Rate for Payer: Aetna Commercial |
$416.87
|
| Rate for Payer: Aetna Medicare |
$127.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.26
|
| Rate for Payer: BCBS Complete |
$196.17
|
| Rate for Payer: BCBS MAPPO |
$122.61
|
| Rate for Payer: BCBS Trust/PPO |
$403.18
|
| Rate for Payer: BCN Commercial |
$381.31
|
| Rate for Payer: BCN Medicare Advantage |
$122.61
|
| Rate for Payer: Cash Price |
$392.34
|
| Rate for Payer: Cofinity Commercial |
$421.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.61
|
| Rate for Payer: Healthscope Commercial |
$441.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.87
|
| Rate for Payer: Nomi Health Commercial |
$402.15
|
| Rate for Payer: PACE Senior Care Partners |
$116.48
|
| Rate for Payer: PACE SWMI |
$122.61
|
| Rate for Payer: PHP Commercial |
$416.87
|
| Rate for Payer: PHP Medicare Advantage |
$122.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.78
|
| Rate for Payer: Priority Health HMO/PPO |
$426.67
|
| Rate for Payer: Priority Health Medicare |
$123.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.59
|
| Rate for Payer: Railroad Medicare Medicare |
$122.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.58
|
| Rate for Payer: UHC Core |
$409.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.61
|
| Rate for Payer: UHC Exchange |
$122.61
|
| Rate for Payer: UHC Medicare Advantage |
$122.61
|
| Rate for Payer: VA VA |
$122.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.82
|
|
