|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
IP
|
$317.85
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$193.86 |
| Max. Negotiated Rate |
$286.06 |
| Rate for Payer: Aetna Commercial |
$270.17
|
| Rate for Payer: BCBS Trust/PPO |
$245.63
|
| Rate for Payer: BCN Commercial |
$245.63
|
| Rate for Payer: Cash Price |
$254.28
|
| Rate for Payer: Cofinity Commercial |
$273.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.28
|
| Rate for Payer: Healthscope Commercial |
$286.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$270.17
|
| Rate for Payer: PHP Commercial |
$270.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.71
|
| Rate for Payer: UHC Core |
$265.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.39
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
OP
|
$317.85
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$286.06 |
| Rate for Payer: Aetna Commercial |
$270.17
|
| Rate for Payer: Aetna Medicare |
$82.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.33
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$79.46
|
| Rate for Payer: BCBS Trust/PPO |
$247.13
|
| Rate for Payer: BCN Commercial |
$247.13
|
| Rate for Payer: BCN Medicare Advantage |
$79.46
|
| Rate for Payer: Cash Price |
$254.28
|
| Rate for Payer: Cash Price |
$254.28
|
| Rate for Payer: Cofinity Commercial |
$273.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.46
|
| Rate for Payer: Healthscope Commercial |
$286.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.39
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$270.17
|
| Rate for Payer: PACE Senior Care Partners |
$75.49
|
| Rate for Payer: PACE SWMI |
$79.46
|
| Rate for Payer: PHP Commercial |
$270.17
|
| Rate for Payer: PHP Medicare Advantage |
$79.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$276.53
|
| Rate for Payer: Priority Health Medicare |
$79.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.86
|
| Rate for Payer: Railroad Medicare Medicare |
$79.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.71
|
| Rate for Payer: UHC Core |
$265.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.46
|
| Rate for Payer: UHC Medicare Advantage |
$81.85
|
| Rate for Payer: VA VA |
$79.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.39
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
IP
|
$580.55
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$354.08 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Aetna Commercial |
$493.47
|
| Rate for Payer: BCBS Trust/PPO |
$448.65
|
| Rate for Payer: BCN Commercial |
$448.65
|
| Rate for Payer: Cash Price |
$464.44
|
| Rate for Payer: Cofinity Commercial |
$499.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.44
|
| Rate for Payer: Healthscope Commercial |
$522.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.47
|
| Rate for Payer: PHP Commercial |
$493.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.88
|
| Rate for Payer: UHC Core |
$484.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.41
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
OP
|
$580.55
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.88 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Aetna Commercial |
$493.47
|
| Rate for Payer: Aetna Medicare |
$150.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.42
|
| Rate for Payer: BCBS Complete |
$232.22
|
| Rate for Payer: BCBS MAPPO |
$145.14
|
| Rate for Payer: BCBS Trust/PPO |
$451.38
|
| Rate for Payer: BCN Commercial |
$451.38
|
| Rate for Payer: BCN Medicare Advantage |
$145.14
|
| Rate for Payer: Cash Price |
$464.44
|
| Rate for Payer: Cofinity Commercial |
$499.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.14
|
| Rate for Payer: Healthscope Commercial |
$522.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$152.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$493.47
|
| Rate for Payer: PACE Senior Care Partners |
$137.88
|
| Rate for Payer: PACE SWMI |
$145.14
|
| Rate for Payer: PHP Commercial |
$493.47
|
| Rate for Payer: PHP Medicare Advantage |
$145.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.08
|
| Rate for Payer: Priority Health Medicare |
$145.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.08
|
| Rate for Payer: Railroad Medicare Medicare |
$145.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.88
|
| Rate for Payer: UHC Core |
$484.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.14
|
| Rate for Payer: UHC Medicare Advantage |
$149.49
|
| Rate for Payer: VA VA |
$145.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.41
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$135.81 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$148.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.70
|
| Rate for Payer: BCBS Complete |
$228.74
|
| Rate for Payer: BCBS MAPPO |
$142.96
|
| Rate for Payer: BCBS Trust/PPO |
$444.61
|
| Rate for Payer: BCN Commercial |
$444.61
|
| Rate for Payer: BCN Medicare Advantage |
$142.96
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.96
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Senior Care Partners |
$135.81
|
| Rate for Payer: PACE SWMI |
$142.96
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$142.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Medicare |
$142.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: Railroad Medicare Medicare |
$142.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.96
|
| Rate for Payer: UHC Medicare Advantage |
$147.25
|
| Rate for Payer: VA VA |
$142.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: BCBS Trust/PPO |
$441.92
|
| Rate for Payer: BCN Commercial |
$441.92
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
IP
|
$630.27
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$384.40 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: BCBS Trust/PPO |
$487.07
|
| Rate for Payer: BCN Commercial |
$487.07
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
OP
|
$630.27
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$567.24 |
| Rate for Payer: Aetna Commercial |
$535.73
|
| Rate for Payer: Aetna Medicare |
$163.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.96
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$157.57
|
| Rate for Payer: BCBS Trust/PPO |
$490.03
|
| Rate for Payer: BCN Commercial |
$490.03
|
| Rate for Payer: BCN Medicare Advantage |
$157.57
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cash Price |
$504.22
|
| Rate for Payer: Cofinity Commercial |
$542.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.57
|
| Rate for Payer: Healthscope Commercial |
$567.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$472.70
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$165.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$535.73
|
| Rate for Payer: PACE Senior Care Partners |
$149.69
|
| Rate for Payer: PACE SWMI |
$157.57
|
| Rate for Payer: PHP Commercial |
$535.73
|
| Rate for Payer: PHP Medicare Advantage |
$157.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.33
|
| Rate for Payer: Priority Health Medicare |
$157.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.40
|
| Rate for Payer: Railroad Medicare Medicare |
$157.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.64
|
| Rate for Payer: UHC Core |
$526.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.57
|
| Rate for Payer: UHC Medicare Advantage |
$162.29
|
| Rate for Payer: VA VA |
$157.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$472.70
|
|
|
HC US OB DETAILED
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$135.81 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$148.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.70
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$142.96
|
| Rate for Payer: BCBS Trust/PPO |
$444.61
|
| Rate for Payer: BCN Commercial |
$444.61
|
| Rate for Payer: BCN Medicare Advantage |
$142.96
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.96
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Senior Care Partners |
$135.81
|
| Rate for Payer: PACE SWMI |
$142.96
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$142.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Medicare |
$142.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: Railroad Medicare Medicare |
$142.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.96
|
| Rate for Payer: UHC Medicare Advantage |
$147.25
|
| Rate for Payer: VA VA |
$142.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC US OB DETAILED
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$348.77 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: BCBS Trust/PPO |
$441.92
|
| Rate for Payer: BCN Commercial |
$441.92
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.22
|
| Rate for Payer: UHC Core |
$477.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$152.44
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
OP
|
$678.34
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$610.51 |
| Rate for Payer: Aetna Commercial |
$576.59
|
| Rate for Payer: Aetna Medicare |
$176.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.98
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$169.58
|
| Rate for Payer: BCBS Trust/PPO |
$527.41
|
| Rate for Payer: BCN Commercial |
$527.41
|
| Rate for Payer: BCN Medicare Advantage |
$169.58
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cofinity Commercial |
$583.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.58
|
| Rate for Payer: Healthscope Commercial |
$610.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.76
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.59
|
| Rate for Payer: PACE Senior Care Partners |
$161.11
|
| Rate for Payer: PACE SWMI |
$169.58
|
| Rate for Payer: PHP Commercial |
$576.59
|
| Rate for Payer: PHP Medicare Advantage |
$169.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.16
|
| Rate for Payer: Priority Health Medicare |
$169.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.72
|
| Rate for Payer: Railroad Medicare Medicare |
$169.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.94
|
| Rate for Payer: UHC Core |
$566.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.58
|
| Rate for Payer: UHC Medicare Advantage |
$174.67
|
| Rate for Payer: VA VA |
$169.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.76
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
IP
|
$678.34
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$413.72 |
| Max. Negotiated Rate |
$610.51 |
| Rate for Payer: Aetna Commercial |
$576.59
|
| Rate for Payer: BCBS Trust/PPO |
$524.22
|
| Rate for Payer: BCN Commercial |
$524.22
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cofinity Commercial |
$583.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.67
|
| Rate for Payer: Healthscope Commercial |
$610.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.59
|
| Rate for Payer: PHP Commercial |
$576.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$590.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.94
|
| Rate for Payer: UHC Core |
$566.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.76
|
|
|
HC US OB FU
|
Facility
|
IP
|
$476.47
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB FU
|
Facility
|
OP
|
$476.47
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB GREATER THAN 14 WEEKS
|
Facility
|
OP
|
$570.58
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$513.52 |
| Rate for Payer: Aetna Commercial |
$484.99
|
| Rate for Payer: Aetna Medicare |
$148.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.31
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$142.64
|
| Rate for Payer: BCBS Trust/PPO |
$443.63
|
| Rate for Payer: BCN Commercial |
$443.63
|
| Rate for Payer: BCN Medicare Advantage |
$142.64
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cofinity Commercial |
$490.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.64
|
| Rate for Payer: Healthscope Commercial |
$513.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.94
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.99
|
| Rate for Payer: PACE Senior Care Partners |
$135.51
|
| Rate for Payer: PACE SWMI |
$142.64
|
| Rate for Payer: PHP Commercial |
$484.99
|
| Rate for Payer: PHP Medicare Advantage |
$142.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.40
|
| Rate for Payer: Priority Health Medicare |
$142.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.00
|
| Rate for Payer: Railroad Medicare Medicare |
$142.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.11
|
| Rate for Payer: UHC Core |
$476.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.64
|
| Rate for Payer: UHC Medicare Advantage |
$146.92
|
| Rate for Payer: VA VA |
$142.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.94
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
IP
|
$570.58
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$513.52 |
| Rate for Payer: Aetna Commercial |
$484.99
|
| Rate for Payer: BCBS Trust/PPO |
$440.94
|
| Rate for Payer: BCN Commercial |
$440.94
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cofinity Commercial |
$490.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.46
|
| Rate for Payer: Healthscope Commercial |
$513.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.99
|
| Rate for Payer: PHP Commercial |
$484.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.11
|
| Rate for Payer: UHC Core |
$476.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.94
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
OP
|
$570.45
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$513.40 |
| Rate for Payer: Aetna Commercial |
$484.88
|
| Rate for Payer: Aetna Medicare |
$148.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.27
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$142.61
|
| Rate for Payer: BCBS Trust/PPO |
$443.52
|
| Rate for Payer: BCN Commercial |
$443.52
|
| Rate for Payer: BCN Medicare Advantage |
$142.61
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cofinity Commercial |
$490.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.61
|
| Rate for Payer: Healthscope Commercial |
$513.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.84
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.88
|
| Rate for Payer: PACE Senior Care Partners |
$135.48
|
| Rate for Payer: PACE SWMI |
$142.61
|
| Rate for Payer: PHP Commercial |
$484.88
|
| Rate for Payer: PHP Medicare Advantage |
$142.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.29
|
| Rate for Payer: Priority Health Medicare |
$142.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.92
|
| Rate for Payer: Railroad Medicare Medicare |
$142.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.00
|
| Rate for Payer: UHC Core |
$476.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.61
|
| Rate for Payer: UHC Medicare Advantage |
$146.89
|
| Rate for Payer: VA VA |
$142.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.84
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
IP
|
$570.45
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$347.92 |
| Max. Negotiated Rate |
$513.40 |
| Rate for Payer: Aetna Commercial |
$484.88
|
| Rate for Payer: BCBS Trust/PPO |
$440.84
|
| Rate for Payer: BCN Commercial |
$440.84
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cofinity Commercial |
$490.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.36
|
| Rate for Payer: Healthscope Commercial |
$513.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.88
|
| Rate for Payer: PHP Commercial |
$484.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$502.00
|
| Rate for Payer: UHC Core |
$476.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.84
|
|
|
HC US OB LTD
|
Facility
|
OP
|
$476.58
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$428.92 |
| Rate for Payer: Aetna Commercial |
$405.09
|
| Rate for Payer: Aetna Medicare |
$123.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.93
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$119.14
|
| Rate for Payer: BCBS Trust/PPO |
$370.54
|
| Rate for Payer: BCN Commercial |
$370.54
|
| Rate for Payer: BCN Medicare Advantage |
$119.14
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cofinity Commercial |
$409.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$428.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.44
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.09
|
| Rate for Payer: PACE Senior Care Partners |
$113.19
|
| Rate for Payer: PACE SWMI |
$119.14
|
| Rate for Payer: PHP Commercial |
$405.09
|
| Rate for Payer: PHP Medicare Advantage |
$119.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.62
|
| Rate for Payer: Priority Health Medicare |
$119.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.67
|
| Rate for Payer: Railroad Medicare Medicare |
$119.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.39
|
| Rate for Payer: UHC Core |
$397.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.14
|
| Rate for Payer: UHC Medicare Advantage |
$122.72
|
| Rate for Payer: VA VA |
$119.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.44
|
|
|
HC US OB LTD
|
Facility
|
IP
|
$476.58
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$290.67 |
| Max. Negotiated Rate |
$428.92 |
| Rate for Payer: Aetna Commercial |
$405.09
|
| Rate for Payer: BCBS Trust/PPO |
$368.30
|
| Rate for Payer: BCN Commercial |
$368.30
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cofinity Commercial |
$409.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.26
|
| Rate for Payer: Healthscope Commercial |
$428.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.09
|
| Rate for Payer: PHP Commercial |
$405.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.39
|
| Rate for Payer: UHC Core |
$397.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.44
|
|
|
HC US OB NT EACH ADDL FETUS
|
Facility
|
OP
|
$173.03
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
40200022
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$41.09 |
| Max. Negotiated Rate |
$155.73 |
| Rate for Payer: Aetna Commercial |
$147.08
|
| Rate for Payer: Aetna Medicare |
$44.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.07
|
| Rate for Payer: BCBS Complete |
$69.21
|
| Rate for Payer: BCBS MAPPO |
$43.26
|
| Rate for Payer: BCBS Trust/PPO |
$134.53
|
| Rate for Payer: BCN Commercial |
$134.53
|
| Rate for Payer: BCN Medicare Advantage |
$43.26
|
| Rate for Payer: Cash Price |
$138.42
|
| Rate for Payer: Cofinity Commercial |
$148.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.26
|
| Rate for Payer: Healthscope Commercial |
$155.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.08
|
| Rate for Payer: PACE Senior Care Partners |
$41.09
|
| Rate for Payer: PACE SWMI |
$43.26
|
| Rate for Payer: PHP Commercial |
$147.08
|
| Rate for Payer: PHP Medicare Advantage |
$43.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.54
|
| Rate for Payer: Priority Health Medicare |
$43.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.53
|
| Rate for Payer: Railroad Medicare Medicare |
$43.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.27
|
| Rate for Payer: UHC Core |
$144.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.26
|
| Rate for Payer: UHC Medicare Advantage |
$44.56
|
| Rate for Payer: VA VA |
$43.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.77
|
|
