|
HC URINE PREGNANCY TEST
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
IP
|
$63.80
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.91 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: BCBS Trust/PPO |
$49.30
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.23
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.14
|
| Rate for Payer: UHC Core |
$53.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
OP
|
$63.80
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$57.42 |
| Rate for Payer: Aetna Commercial |
$54.23
|
| Rate for Payer: Aetna Medicare |
$16.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.94
|
| Rate for Payer: BCBS Complete |
$6.27
|
| Rate for Payer: BCBS MAPPO |
$15.95
|
| Rate for Payer: BCBS Trust/PPO |
$49.60
|
| Rate for Payer: BCN Commercial |
$49.60
|
| Rate for Payer: BCN Medicare Advantage |
$15.95
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cash Price |
$51.04
|
| Rate for Payer: Cofinity Commercial |
$54.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.95
|
| Rate for Payer: Healthscope Commercial |
$57.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.85
|
| Rate for Payer: Mclaren Medicaid |
$5.97
|
| Rate for Payer: Meridian Medicaid |
$6.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.23
|
| Rate for Payer: PACE Senior Care Partners |
$15.15
|
| Rate for Payer: PACE SWMI |
$15.95
|
| Rate for Payer: PHP Commercial |
$54.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.51
|
| Rate for Payer: Priority Health Medicare |
$15.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.91
|
| Rate for Payer: Railroad Medicare Medicare |
$15.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.14
|
| Rate for Payer: UHC Core |
$53.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.95
|
| Rate for Payer: UHC Medicare Advantage |
$16.43
|
| Rate for Payer: VA VA |
$15.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.85
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC URIN MDMA
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC URIN MDMA
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC URN COTININE.
|
Facility
|
OP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.74 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.96
|
| Rate for Payer: Aetna Medicare |
$25.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.23
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$77.71
|
| Rate for Payer: BCN Medicare Advantage |
$24.99
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$85.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.96
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: PACE Senior Care Partners |
$23.74
|
| Rate for Payer: PACE SWMI |
$24.99
|
| Rate for Payer: PHP Commercial |
$84.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.96
|
| Rate for Payer: Priority Health Medicare |
$24.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.96
|
| Rate for Payer: Railroad Medicare Medicare |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.74
|
| Rate for Payer: VA VA |
$24.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.96
|
|
|
HC URN COTININE.
|
Facility
|
IP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.96
|
| Rate for Payer: BCBS Trust/PPO |
$77.24
|
| Rate for Payer: BCN Commercial |
$77.24
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$85.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: PHP Commercial |
$84.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.96
|
|
|
HC URN MDMA
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC URN MDMA
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC URN TRICYCLIC
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$11.70
|
| Rate for Payer: BCBS Trust/PPO |
$36.40
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.70
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.70
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.56
|
| Rate for Payer: Railroad Medicare Medicare |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.70
|
| Rate for Payer: UHC Medicare Advantage |
$12.06
|
| Rate for Payer: VA VA |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC URN TRICYCLIC
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$36.18
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
OP
|
$1,925.25
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$457.25 |
| Max. Negotiated Rate |
$1,732.72 |
| Rate for Payer: Aetna Commercial |
$1,636.46
|
| Rate for Payer: Aetna Medicare |
$500.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.64
|
| Rate for Payer: BCBS Complete |
$770.10
|
| Rate for Payer: BCBS MAPPO |
$481.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.88
|
| Rate for Payer: BCN Commercial |
$1,496.88
|
| Rate for Payer: BCN Medicare Advantage |
$481.31
|
| Rate for Payer: Cash Price |
$1,540.20
|
| Rate for Payer: Cofinity Commercial |
$1,655.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.31
|
| Rate for Payer: Healthscope Commercial |
$1,732.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$505.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.46
|
| Rate for Payer: PACE Senior Care Partners |
$457.25
|
| Rate for Payer: PACE SWMI |
$481.31
|
| Rate for Payer: PHP Commercial |
$1,636.46
|
| Rate for Payer: PHP Medicare Advantage |
$481.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.97
|
| Rate for Payer: Priority Health Medicare |
$481.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.21
|
| Rate for Payer: Railroad Medicare Medicare |
$481.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.22
|
| Rate for Payer: UHC Core |
$1,607.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.31
|
| Rate for Payer: UHC Medicare Advantage |
$495.75
|
| Rate for Payer: VA VA |
$481.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.94
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
IP
|
$1,925.25
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,174.21 |
| Max. Negotiated Rate |
$1,732.72 |
| Rate for Payer: Aetna Commercial |
$1,636.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.83
|
| Rate for Payer: BCN Commercial |
$1,487.83
|
| Rate for Payer: Cash Price |
$1,540.20
|
| Rate for Payer: Cofinity Commercial |
$1,655.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.20
|
| Rate for Payer: Healthscope Commercial |
$1,732.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.46
|
| Rate for Payer: PHP Commercial |
$1,636.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.22
|
| Rate for Payer: UHC Core |
$1,607.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.94
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
IP
|
$16.05
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$14.44 |
| Rate for Payer: Aetna Commercial |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Healthscope Commercial |
$14.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.64
|
| Rate for Payer: PHP Commercial |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.12
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.04
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
OP
|
$16.05
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$14.44 |
| Rate for Payer: Aetna Commercial |
$13.64
|
| Rate for Payer: Aetna Medicare |
$4.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.02
|
| Rate for Payer: BCBS Complete |
$6.42
|
| Rate for Payer: BCBS MAPPO |
$4.01
|
| Rate for Payer: BCBS Trust/PPO |
$12.48
|
| Rate for Payer: BCN Commercial |
$12.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.01
|
| Rate for Payer: Cash Price |
$12.84
|
| Rate for Payer: Cofinity Commercial |
$13.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.01
|
| Rate for Payer: Healthscope Commercial |
$14.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.64
|
| Rate for Payer: PACE Senior Care Partners |
$3.81
|
| Rate for Payer: PACE SWMI |
$4.01
|
| Rate for Payer: PHP Commercial |
$13.64
|
| Rate for Payer: PHP Medicare Advantage |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.96
|
| Rate for Payer: Priority Health Medicare |
$4.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.79
|
| Rate for Payer: Railroad Medicare Medicare |
$4.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.12
|
| Rate for Payer: UHC Core |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.01
|
| Rate for Payer: UHC Medicare Advantage |
$4.13
|
| Rate for Payer: VA VA |
$4.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.04
|
|
|
HC US AAA SCREENING
|
Facility
|
IP
|
$359.82
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$219.45 |
| Max. Negotiated Rate |
$323.84 |
| Rate for Payer: Aetna Commercial |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$278.07
|
| Rate for Payer: BCN Commercial |
$278.07
|
| Rate for Payer: Cash Price |
$287.86
|
| Rate for Payer: Cofinity Commercial |
$309.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.86
|
| Rate for Payer: Healthscope Commercial |
$323.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.85
|
| Rate for Payer: PHP Commercial |
$305.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.64
|
| Rate for Payer: UHC Core |
$300.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.86
|
|
|
HC US AAA SCREENING
|
Facility
|
OP
|
$359.82
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$323.84 |
| Rate for Payer: Aetna Commercial |
$305.85
|
| Rate for Payer: Aetna Medicare |
$93.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.44
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$89.96
|
| Rate for Payer: BCBS Trust/PPO |
$279.76
|
| Rate for Payer: BCN Commercial |
$279.76
|
| Rate for Payer: BCN Medicare Advantage |
$89.96
|
| Rate for Payer: Cash Price |
$287.86
|
| Rate for Payer: Cash Price |
$287.86
|
| Rate for Payer: Cofinity Commercial |
$309.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.96
|
| Rate for Payer: Healthscope Commercial |
$323.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.86
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.85
|
| Rate for Payer: PACE Senior Care Partners |
$85.46
|
| Rate for Payer: PACE SWMI |
$89.96
|
| Rate for Payer: PHP Commercial |
$305.85
|
| Rate for Payer: PHP Medicare Advantage |
$89.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.04
|
| Rate for Payer: Priority Health Medicare |
$89.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.45
|
| Rate for Payer: Railroad Medicare Medicare |
$89.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.64
|
| Rate for Payer: UHC Core |
$300.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.96
|
| Rate for Payer: UHC Medicare Advantage |
$92.65
|
| Rate for Payer: VA VA |
$89.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.86
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
IP
|
$932.27
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$568.59 |
| Max. Negotiated Rate |
$839.04 |
| Rate for Payer: Aetna Commercial |
$792.43
|
| Rate for Payer: BCBS Trust/PPO |
$720.46
|
| Rate for Payer: BCN Commercial |
$720.46
|
| Rate for Payer: Cash Price |
$745.82
|
| Rate for Payer: Cofinity Commercial |
$801.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.82
|
| Rate for Payer: Healthscope Commercial |
$839.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$792.43
|
| Rate for Payer: PHP Commercial |
$792.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$652.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$568.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.40
|
| Rate for Payer: UHC Core |
$778.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.20
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
OP
|
$932.27
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$839.04 |
| Rate for Payer: Aetna Commercial |
$792.43
|
| Rate for Payer: Aetna Medicare |
$242.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.33
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$233.07
|
| Rate for Payer: BCBS Trust/PPO |
$724.84
|
| Rate for Payer: BCN Commercial |
$724.84
|
| Rate for Payer: BCN Medicare Advantage |
$233.07
|
| Rate for Payer: Cash Price |
$745.82
|
| Rate for Payer: Cash Price |
$745.82
|
| Rate for Payer: Cofinity Commercial |
$801.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.07
|
| Rate for Payer: Healthscope Commercial |
$839.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.20
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$792.43
|
| Rate for Payer: PACE Senior Care Partners |
$221.41
|
| Rate for Payer: PACE SWMI |
$233.07
|
| Rate for Payer: PHP Commercial |
$792.43
|
| Rate for Payer: PHP Medicare Advantage |
$233.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$652.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$811.07
|
| Rate for Payer: Priority Health Medicare |
$233.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$568.59
|
| Rate for Payer: Railroad Medicare Medicare |
$233.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.40
|
| Rate for Payer: UHC Core |
$778.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.07
|
| Rate for Payer: UHC Medicare Advantage |
$240.06
|
| Rate for Payer: VA VA |
$233.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.20
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
IP
|
$800.65
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$488.32 |
| Max. Negotiated Rate |
$720.58 |
| Rate for Payer: Aetna Commercial |
$680.55
|
| Rate for Payer: BCBS Trust/PPO |
$618.74
|
| Rate for Payer: BCN Commercial |
$618.74
|
| Rate for Payer: Cash Price |
$640.52
|
| Rate for Payer: Cofinity Commercial |
$688.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.52
|
| Rate for Payer: Healthscope Commercial |
$720.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.55
|
| Rate for Payer: PHP Commercial |
$680.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.57
|
| Rate for Payer: UHC Core |
$668.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.49
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
OP
|
$800.65
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$720.58 |
| Rate for Payer: Aetna Commercial |
$680.55
|
| Rate for Payer: Aetna Medicare |
$208.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.20
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$200.16
|
| Rate for Payer: BCBS Trust/PPO |
$622.51
|
| Rate for Payer: BCN Commercial |
$622.51
|
| Rate for Payer: BCN Medicare Advantage |
$200.16
|
| Rate for Payer: Cash Price |
$640.52
|
| Rate for Payer: Cash Price |
$640.52
|
| Rate for Payer: Cofinity Commercial |
$688.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.16
|
| Rate for Payer: Healthscope Commercial |
$720.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.49
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.55
|
| Rate for Payer: PACE Senior Care Partners |
$190.15
|
| Rate for Payer: PACE SWMI |
$200.16
|
| Rate for Payer: PHP Commercial |
$680.55
|
| Rate for Payer: PHP Medicare Advantage |
$200.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.57
|
| Rate for Payer: Priority Health Medicare |
$200.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.32
|
| Rate for Payer: Railroad Medicare Medicare |
$200.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.57
|
| Rate for Payer: UHC Core |
$668.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.16
|
| Rate for Payer: UHC Medicare Advantage |
$206.17
|
| Rate for Payer: VA VA |
$200.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.49
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
OP
|
$590.39
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$531.35 |
| Rate for Payer: Aetna Commercial |
$501.83
|
| Rate for Payer: Aetna Medicare |
$153.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.50
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$147.60
|
| Rate for Payer: BCBS Trust/PPO |
$459.03
|
| Rate for Payer: BCCCP Commercial |
$105.89
|
| Rate for Payer: BCN Commercial |
$459.03
|
| Rate for Payer: BCN Medicare Advantage |
$147.60
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cofinity Commercial |
$507.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.60
|
| Rate for Payer: Healthscope Commercial |
$531.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.79
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$154.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.83
|
| Rate for Payer: PACE Senior Care Partners |
$140.22
|
| Rate for Payer: PACE SWMI |
$147.60
|
| Rate for Payer: PHP Commercial |
$501.83
|
| Rate for Payer: PHP Medicare Advantage |
$147.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.64
|
| Rate for Payer: Priority Health Medicare |
$147.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.08
|
| Rate for Payer: Railroad Medicare Medicare |
$147.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.54
|
| Rate for Payer: UHC Core |
$492.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.60
|
| Rate for Payer: UHC Medicare Advantage |
$152.03
|
| Rate for Payer: VA VA |
$147.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.79
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
IP
|
$590.39
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$360.08 |
| Max. Negotiated Rate |
$531.35 |
| Rate for Payer: Aetna Commercial |
$501.83
|
| Rate for Payer: BCBS Trust/PPO |
$456.25
|
| Rate for Payer: BCN Commercial |
$456.25
|
| Rate for Payer: Cash Price |
$472.31
|
| Rate for Payer: Cofinity Commercial |
$507.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$472.31
|
| Rate for Payer: Healthscope Commercial |
$531.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.83
|
| Rate for Payer: PHP Commercial |
$501.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$413.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$513.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.54
|
| Rate for Payer: UHC Core |
$492.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.79
|
|
