|
HC US BREAST BIL LIMITED
|
Facility
|
IP
|
$551.42
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$336.31 |
| Max. Negotiated Rate |
$496.28 |
| Rate for Payer: Aetna Commercial |
$468.71
|
| Rate for Payer: BCBS Trust/PPO |
$426.14
|
| Rate for Payer: BCN Commercial |
$426.14
|
| Rate for Payer: Cash Price |
$441.14
|
| Rate for Payer: Cofinity Commercial |
$474.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.14
|
| Rate for Payer: Healthscope Commercial |
$496.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$468.71
|
| Rate for Payer: PHP Commercial |
$468.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.25
|
| Rate for Payer: UHC Core |
$460.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.56
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
OP
|
$551.42
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$496.28 |
| Rate for Payer: Aetna Commercial |
$468.71
|
| Rate for Payer: Aetna Medicare |
$143.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.32
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$137.86
|
| Rate for Payer: BCBS Trust/PPO |
$428.73
|
| Rate for Payer: BCCCP Commercial |
$87.39
|
| Rate for Payer: BCN Commercial |
$428.73
|
| Rate for Payer: BCN Medicare Advantage |
$137.86
|
| Rate for Payer: Cash Price |
$441.14
|
| Rate for Payer: Cash Price |
$441.14
|
| Rate for Payer: Cofinity Commercial |
$474.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.86
|
| Rate for Payer: Healthscope Commercial |
$496.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$413.56
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$468.71
|
| Rate for Payer: PACE Senior Care Partners |
$130.96
|
| Rate for Payer: PACE SWMI |
$137.86
|
| Rate for Payer: PHP Commercial |
$468.71
|
| Rate for Payer: PHP Medicare Advantage |
$137.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.74
|
| Rate for Payer: Priority Health Medicare |
$137.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$336.31
|
| Rate for Payer: Railroad Medicare Medicare |
$137.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$485.25
|
| Rate for Payer: UHC Core |
$460.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.86
|
| Rate for Payer: UHC Medicare Advantage |
$141.99
|
| Rate for Payer: VA VA |
$137.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$413.56
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$550.58
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$335.80 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: BCBS Trust/PPO |
$425.49
|
| Rate for Payer: BCN Commercial |
$425.49
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$550.58
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: Aetna Medicare |
$143.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.06
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$137.64
|
| Rate for Payer: BCBS Trust/PPO |
$428.08
|
| Rate for Payer: BCCCP Commercial |
$105.89
|
| Rate for Payer: BCN Commercial |
$428.08
|
| Rate for Payer: BCN Medicare Advantage |
$137.64
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.64
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PACE Senior Care Partners |
$130.76
|
| Rate for Payer: PACE SWMI |
$137.64
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: PHP Medicare Advantage |
$137.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Medicare |
$137.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: Railroad Medicare Medicare |
$137.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.64
|
| Rate for Payer: UHC Medicare Advantage |
$141.77
|
| Rate for Payer: VA VA |
$137.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$550.58
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: Aetna Medicare |
$143.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.06
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$137.64
|
| Rate for Payer: BCBS Trust/PPO |
$428.08
|
| Rate for Payer: BCCCP Commercial |
$87.39
|
| Rate for Payer: BCN Commercial |
$428.08
|
| Rate for Payer: BCN Medicare Advantage |
$137.64
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.64
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PACE Senior Care Partners |
$130.76
|
| Rate for Payer: PACE SWMI |
$137.64
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: PHP Medicare Advantage |
$137.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Medicare |
$137.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: Railroad Medicare Medicare |
$137.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.64
|
| Rate for Payer: UHC Medicare Advantage |
$141.77
|
| Rate for Payer: VA VA |
$137.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$550.58
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$335.80 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: BCBS Trust/PPO |
$425.49
|
| Rate for Payer: BCN Commercial |
$425.49
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US CHEST
|
Facility
|
IP
|
$550.58
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$335.80 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: BCBS Trust/PPO |
$425.49
|
| Rate for Payer: BCN Commercial |
$425.49
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US CHEST
|
Facility
|
OP
|
$550.58
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$495.52 |
| Rate for Payer: Aetna Commercial |
$467.99
|
| Rate for Payer: Aetna Medicare |
$143.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.06
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$137.64
|
| Rate for Payer: BCBS Trust/PPO |
$428.08
|
| Rate for Payer: BCN Commercial |
$428.08
|
| Rate for Payer: BCN Medicare Advantage |
$137.64
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cash Price |
$440.46
|
| Rate for Payer: Cofinity Commercial |
$473.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.64
|
| Rate for Payer: Healthscope Commercial |
$495.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.94
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$467.99
|
| Rate for Payer: PACE Senior Care Partners |
$130.76
|
| Rate for Payer: PACE SWMI |
$137.64
|
| Rate for Payer: PHP Commercial |
$467.99
|
| Rate for Payer: PHP Medicare Advantage |
$137.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.00
|
| Rate for Payer: Priority Health Medicare |
$137.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.80
|
| Rate for Payer: Railroad Medicare Medicare |
$137.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.51
|
| Rate for Payer: UHC Core |
$459.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.64
|
| Rate for Payer: UHC Medicare Advantage |
$141.77
|
| Rate for Payer: VA VA |
$137.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.94
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
OP
|
$562.35
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$133.56 |
| Max. Negotiated Rate |
$506.12 |
| Rate for Payer: Aetna Commercial |
$478.00
|
| Rate for Payer: Aetna Medicare |
$146.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.73
|
| Rate for Payer: BCBS Complete |
$224.94
|
| Rate for Payer: BCBS MAPPO |
$140.59
|
| Rate for Payer: BCBS Trust/PPO |
$437.23
|
| Rate for Payer: BCN Commercial |
$437.23
|
| Rate for Payer: BCN Medicare Advantage |
$140.59
|
| Rate for Payer: Cash Price |
$449.88
|
| Rate for Payer: Cofinity Commercial |
$483.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.59
|
| Rate for Payer: Healthscope Commercial |
$506.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$478.00
|
| Rate for Payer: PACE Senior Care Partners |
$133.56
|
| Rate for Payer: PACE SWMI |
$140.59
|
| Rate for Payer: PHP Commercial |
$478.00
|
| Rate for Payer: PHP Medicare Advantage |
$140.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.24
|
| Rate for Payer: Priority Health Medicare |
$140.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$140.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.87
|
| Rate for Payer: UHC Core |
$469.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.59
|
| Rate for Payer: UHC Medicare Advantage |
$144.81
|
| Rate for Payer: VA VA |
$140.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.76
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
IP
|
$562.35
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$342.98 |
| Max. Negotiated Rate |
$506.12 |
| Rate for Payer: Aetna Commercial |
$478.00
|
| Rate for Payer: BCBS Trust/PPO |
$434.58
|
| Rate for Payer: BCN Commercial |
$434.58
|
| Rate for Payer: Cash Price |
$449.88
|
| Rate for Payer: Cofinity Commercial |
$483.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.88
|
| Rate for Payer: Healthscope Commercial |
$506.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$478.00
|
| Rate for Payer: PHP Commercial |
$478.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$489.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.87
|
| Rate for Payer: UHC Core |
$469.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.76
|
|
|
HC US CRANIAL
|
Facility
|
IP
|
$810.15
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$494.11 |
| Max. Negotiated Rate |
$729.14 |
| Rate for Payer: Aetna Commercial |
$688.63
|
| Rate for Payer: BCBS Trust/PPO |
$626.08
|
| Rate for Payer: BCN Commercial |
$626.08
|
| Rate for Payer: Cash Price |
$648.12
|
| Rate for Payer: Cofinity Commercial |
$696.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.12
|
| Rate for Payer: Healthscope Commercial |
$729.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$688.63
|
| Rate for Payer: PHP Commercial |
$688.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.93
|
| Rate for Payer: UHC Core |
$676.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.61
|
|
|
HC US CRANIAL
|
Facility
|
OP
|
$810.15
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$729.14 |
| Rate for Payer: Aetna Commercial |
$688.63
|
| Rate for Payer: Aetna Medicare |
$210.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$253.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$253.17
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$202.54
|
| Rate for Payer: BCBS Trust/PPO |
$629.89
|
| Rate for Payer: BCN Commercial |
$629.89
|
| Rate for Payer: BCN Medicare Advantage |
$202.54
|
| Rate for Payer: Cash Price |
$648.12
|
| Rate for Payer: Cash Price |
$648.12
|
| Rate for Payer: Cofinity Commercial |
$696.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$648.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.54
|
| Rate for Payer: Healthscope Commercial |
$729.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.61
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$232.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$688.63
|
| Rate for Payer: PACE Senior Care Partners |
$192.41
|
| Rate for Payer: PACE SWMI |
$202.54
|
| Rate for Payer: PHP Commercial |
$688.63
|
| Rate for Payer: PHP Medicare Advantage |
$202.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$567.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$704.83
|
| Rate for Payer: Priority Health Medicare |
$202.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.11
|
| Rate for Payer: Railroad Medicare Medicare |
$202.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.93
|
| Rate for Payer: UHC Core |
$676.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.54
|
| Rate for Payer: UHC Medicare Advantage |
$208.61
|
| Rate for Payer: VA VA |
$202.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.61
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$991.60
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$892.44 |
| Rate for Payer: Aetna Commercial |
$842.86
|
| Rate for Payer: Aetna Medicare |
$257.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.88
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$247.90
|
| Rate for Payer: BCBS Trust/PPO |
$770.97
|
| Rate for Payer: BCN Commercial |
$770.97
|
| Rate for Payer: BCN Medicare Advantage |
$247.90
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cofinity Commercial |
$852.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.90
|
| Rate for Payer: Healthscope Commercial |
$892.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.70
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.86
|
| Rate for Payer: PACE Senior Care Partners |
$235.50
|
| Rate for Payer: PACE SWMI |
$247.90
|
| Rate for Payer: PHP Commercial |
$842.86
|
| Rate for Payer: PHP Medicare Advantage |
$247.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.69
|
| Rate for Payer: Priority Health Medicare |
$247.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.78
|
| Rate for Payer: Railroad Medicare Medicare |
$247.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.61
|
| Rate for Payer: UHC Core |
$827.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.90
|
| Rate for Payer: UHC Medicare Advantage |
$255.34
|
| Rate for Payer: VA VA |
$247.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.70
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$991.60
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$604.78 |
| Max. Negotiated Rate |
$892.44 |
| Rate for Payer: Aetna Commercial |
$842.86
|
| Rate for Payer: BCBS Trust/PPO |
$766.31
|
| Rate for Payer: BCN Commercial |
$766.31
|
| Rate for Payer: Cash Price |
$793.28
|
| Rate for Payer: Cofinity Commercial |
$852.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.28
|
| Rate for Payer: Healthscope Commercial |
$892.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.86
|
| Rate for Payer: PHP Commercial |
$842.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.61
|
| Rate for Payer: UHC Core |
$827.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.70
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,708.29
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,041.89 |
| Max. Negotiated Rate |
$1,537.46 |
| Rate for Payer: Aetna Commercial |
$1,452.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.17
|
| Rate for Payer: BCN Commercial |
$1,320.17
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cofinity Commercial |
$1,469.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,366.63
|
| Rate for Payer: Healthscope Commercial |
$1,537.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,281.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,452.05
|
| Rate for Payer: PHP Commercial |
$1,452.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,041.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,503.30
|
| Rate for Payer: UHC Core |
$1,426.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,281.22
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,708.29
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,537.46 |
| Rate for Payer: Aetna Commercial |
$1,452.05
|
| Rate for Payer: Aetna Medicare |
$444.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$533.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$533.84
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$427.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,328.20
|
| Rate for Payer: BCN Commercial |
$1,328.20
|
| Rate for Payer: BCN Medicare Advantage |
$427.07
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cash Price |
$1,366.63
|
| Rate for Payer: Cofinity Commercial |
$1,469.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,366.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.07
|
| Rate for Payer: Healthscope Commercial |
$1,537.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,281.22
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$448.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$491.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,452.05
|
| Rate for Payer: PACE Senior Care Partners |
$405.72
|
| Rate for Payer: PACE SWMI |
$427.07
|
| Rate for Payer: PHP Commercial |
$1,452.05
|
| Rate for Payer: PHP Medicare Advantage |
$427.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,486.21
|
| Rate for Payer: Priority Health Medicare |
$427.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,041.89
|
| Rate for Payer: Railroad Medicare Medicare |
$427.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,503.30
|
| Rate for Payer: UHC Core |
$1,426.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.07
|
| Rate for Payer: UHC Medicare Advantage |
$439.88
|
| Rate for Payer: VA VA |
$427.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,281.22
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
OP
|
$476.47
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$123.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.90
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$119.12
|
| Rate for Payer: BCBS Trust/PPO |
$370.46
|
| Rate for Payer: BCN Commercial |
$370.46
|
| Rate for Payer: BCN Medicare Advantage |
$119.12
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.12
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PACE Senior Care Partners |
$113.16
|
| Rate for Payer: PACE SWMI |
$119.12
|
| Rate for Payer: PHP Commercial |
$405.00
|
| Rate for Payer: PHP Medicare Advantage |
$119.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.53
|
| Rate for Payer: Priority Health Medicare |
$119.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.60
|
| Rate for Payer: Railroad Medicare Medicare |
$119.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.29
|
| Rate for Payer: UHC Core |
$397.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.12
|
| Rate for Payer: UHC Medicare Advantage |
$122.69
|
| Rate for Payer: VA VA |
$119.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
IP
|
$476.47
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$290.60 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: BCBS Trust/PPO |
$368.22
|
| Rate for Payer: BCN Commercial |
$368.22
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PHP Commercial |
$405.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.29
|
| Rate for Payer: UHC Core |
$397.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$423.30
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$258.17 |
| Max. Negotiated Rate |
$380.97 |
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: BCBS Trust/PPO |
$327.13
|
| Rate for Payer: BCN Commercial |
$327.13
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.50
|
| Rate for Payer: UHC Core |
$353.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
OP
|
$423.30
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$380.97 |
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: Aetna Medicare |
$110.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.28
|
| Rate for Payer: BCBS Complete |
$169.32
|
| Rate for Payer: BCBS MAPPO |
$105.82
|
| Rate for Payer: BCBS Trust/PPO |
$329.12
|
| Rate for Payer: BCN Commercial |
$329.12
|
| Rate for Payer: BCN Medicare Advantage |
$105.82
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.82
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: PACE Senior Care Partners |
$100.53
|
| Rate for Payer: PACE SWMI |
$105.82
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: PHP Medicare Advantage |
$105.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.27
|
| Rate for Payer: Priority Health Medicare |
$105.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.17
|
| Rate for Payer: Railroad Medicare Medicare |
$105.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.50
|
| Rate for Payer: UHC Core |
$353.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.82
|
| Rate for Payer: UHC Medicare Advantage |
$109.00
|
| Rate for Payer: VA VA |
$105.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$348.47
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$82.76 |
| Max. Negotiated Rate |
$313.62 |
| Rate for Payer: Aetna Commercial |
$296.20
|
| Rate for Payer: Aetna Medicare |
$90.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.90
|
| Rate for Payer: BCBS Complete |
$139.39
|
| Rate for Payer: BCBS MAPPO |
$87.12
|
| Rate for Payer: BCBS Trust/PPO |
$270.94
|
| Rate for Payer: BCN Commercial |
$270.94
|
| Rate for Payer: BCN Medicare Advantage |
$87.12
|
| Rate for Payer: Cash Price |
$278.78
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.12
|
| Rate for Payer: Healthscope Commercial |
$313.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.20
|
| Rate for Payer: PACE Senior Care Partners |
$82.76
|
| Rate for Payer: PACE SWMI |
$87.12
|
| Rate for Payer: PHP Commercial |
$296.20
|
| Rate for Payer: PHP Medicare Advantage |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.17
|
| Rate for Payer: Priority Health Medicare |
$87.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.53
|
| Rate for Payer: Railroad Medicare Medicare |
$87.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.65
|
| Rate for Payer: UHC Core |
$290.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.12
|
| Rate for Payer: UHC Medicare Advantage |
$89.73
|
| Rate for Payer: VA VA |
$87.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.35
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$348.47
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$212.53 |
| Max. Negotiated Rate |
$313.62 |
| Rate for Payer: Aetna Commercial |
$296.20
|
| Rate for Payer: BCBS Trust/PPO |
$269.30
|
| Rate for Payer: BCN Commercial |
$269.30
|
| Rate for Payer: Cash Price |
$278.78
|
| Rate for Payer: Cofinity Commercial |
$299.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.78
|
| Rate for Payer: Healthscope Commercial |
$313.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.20
|
| Rate for Payer: PHP Commercial |
$296.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.65
|
| Rate for Payer: UHC Core |
$290.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.35
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.75
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$158.61
|
| Rate for Payer: BCCCP Commercial |
$95.77
|
| Rate for Payer: BCN Commercial |
$158.61
|
| Rate for Payer: BCN Medicare Advantage |
$51.00
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.00
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PACE Senior Care Partners |
$48.45
|
| Rate for Payer: PACE SWMI |
$51.00
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$51.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.48
|
| Rate for Payer: Priority Health Medicare |
$51.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.42
|
| Rate for Payer: Railroad Medicare Medicare |
$51.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.00
|
| Rate for Payer: UHC Medicare Advantage |
$52.53
|
| Rate for Payer: VA VA |
$51.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$124.42 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$157.65
|
| Rate for Payer: BCN Commercial |
$157.65
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
