|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,926.47
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$692.24 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: Aetna Medicare |
$1,020.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,227.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,227.02
|
| Rate for Payer: BCBS Complete |
$726.79
|
| Rate for Payer: BCBS MAPPO |
$981.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,227.95
|
| Rate for Payer: BCN Commercial |
$3,227.95
|
| Rate for Payer: BCN Medicare Advantage |
$981.62
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.62
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Mclaren Medicaid |
$692.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.70
|
| Rate for Payer: Meridian Medicaid |
$726.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,128.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,079.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PACE Senior Care Partners |
$932.54
|
| Rate for Payer: PACE SWMI |
$981.62
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: PHP Medicare Advantage |
$981.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Medicare |
$991.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: Railroad Medicare Medicare |
$981.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: UHC Exchange |
$981.62
|
| Rate for Payer: UHC Medicaid |
$692.24
|
| Rate for Payer: UHC Medicare Advantage |
$981.62
|
| Rate for Payer: UHCCP Medicaid |
$692.24
|
| Rate for Payer: VA VA |
$981.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,926.47
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,732.82 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.87
|
| Rate for Payer: BCN Commercial |
$3,242.87
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$4,061.71
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,826.95 |
| Max. Negotiated Rate |
$3,655.54 |
| Rate for Payer: Aetna Commercial |
$3,452.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,354.57
|
| Rate for Payer: BCN Commercial |
$3,354.57
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cofinity Commercial |
$3,493.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,249.37
|
| Rate for Payer: Healthscope Commercial |
$3,655.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,046.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,452.45
|
| Rate for Payer: Nomi Health Commercial |
$3,330.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,046.28
|
| Rate for Payer: PHP Commercial |
$3,452.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,533.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,826.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,574.30
|
| Rate for Payer: UHC Core |
$3,391.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,046.28
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$4,061.71
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$716.08 |
| Max. Negotiated Rate |
$3,655.54 |
| Rate for Payer: Aetna Commercial |
$3,452.45
|
| Rate for Payer: Aetna Medicare |
$1,056.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,269.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,269.28
|
| Rate for Payer: BCBS Complete |
$751.82
|
| Rate for Payer: BCBS MAPPO |
$1,015.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.13
|
| Rate for Payer: BCN Commercial |
$3,339.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,015.43
|
| Rate for Payer: Cash Price |
$3,249.37
|
| Rate for Payer: Cofinity Commercial |
$3,493.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,249.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,015.43
|
| Rate for Payer: Healthscope Commercial |
$3,655.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,046.28
|
| Rate for Payer: Mclaren Medicaid |
$716.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,066.20
|
| Rate for Payer: Meridian Medicaid |
$751.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,167.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,116.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,452.45
|
| Rate for Payer: Nomi Health Commercial |
$3,330.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,046.28
|
| Rate for Payer: PACE Senior Care Partners |
$964.66
|
| Rate for Payer: PACE SWMI |
$1,015.43
|
| Rate for Payer: PHP Commercial |
$3,452.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,015.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$716.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,533.69
|
| Rate for Payer: Priority Health Medicare |
$1,025.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,826.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,015.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,574.30
|
| Rate for Payer: UHC Core |
$3,391.53
|
| Rate for Payer: UHC Exchange |
$1,015.43
|
| Rate for Payer: UHC Medicaid |
$716.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.43
|
| Rate for Payer: UHCCP Medicaid |
$716.08
|
| Rate for Payer: VA VA |
$1,015.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,046.28
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,331.45
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$587.33 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna Medicare |
$866.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,041.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,041.08
|
| Rate for Payer: BCBS Complete |
$616.65
|
| Rate for Payer: BCBS MAPPO |
$832.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,738.79
|
| Rate for Payer: BCN Commercial |
$2,738.79
|
| Rate for Payer: BCN Medicare Advantage |
$832.86
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.86
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Mclaren Medicaid |
$587.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$874.51
|
| Rate for Payer: Meridian Medicaid |
$616.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$957.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$916.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$2,731.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PACE Senior Care Partners |
$791.22
|
| Rate for Payer: PACE SWMI |
$832.86
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: PHP Medicare Advantage |
$832.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,898.36
|
| Rate for Payer: Priority Health Medicare |
$841.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,318.69
|
| Rate for Payer: Railroad Medicare Medicare |
$832.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,931.68
|
| Rate for Payer: UHC Core |
$2,781.76
|
| Rate for Payer: UHC Exchange |
$832.86
|
| Rate for Payer: UHC Medicaid |
$587.33
|
| Rate for Payer: UHC Medicare Advantage |
$832.86
|
| Rate for Payer: UHCCP Medicaid |
$587.33
|
| Rate for Payer: VA VA |
$832.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,331.45
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,318.69 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,751.44
|
| Rate for Payer: BCN Commercial |
$2,751.44
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$2,731.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,898.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,318.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,931.68
|
| Rate for Payer: UHC Core |
$2,781.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$157.06
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: Aetna Medicare |
$40.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$29.07
|
| Rate for Payer: BCBS MAPPO |
$39.27
|
| Rate for Payer: BCBS Trust/PPO |
$129.12
|
| Rate for Payer: BCN Commercial |
$129.12
|
| Rate for Payer: BCN Medicare Advantage |
$39.27
|
| Rate for Payer: Cash Price |
$125.65
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.27
|
| Rate for Payer: Healthscope Commercial |
$141.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.80
|
| Rate for Payer: Mclaren Medicaid |
$27.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.23
|
| Rate for Payer: Meridian Medicaid |
$29.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.50
|
| Rate for Payer: Nomi Health Commercial |
$128.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.80
|
| Rate for Payer: PACE Senior Care Partners |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.27
|
| Rate for Payer: PHP Commercial |
$133.50
|
| Rate for Payer: PHP Medicare Advantage |
$39.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.64
|
| Rate for Payer: Priority Health Medicare |
$39.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.31
|
| Rate for Payer: Railroad Medicare Medicare |
$39.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.21
|
| Rate for Payer: UHC Core |
$131.15
|
| Rate for Payer: UHC Exchange |
$39.27
|
| Rate for Payer: UHC Medicaid |
$27.69
|
| Rate for Payer: UHC Medicare Advantage |
$39.27
|
| Rate for Payer: UHCCP Medicaid |
$27.69
|
| Rate for Payer: VA VA |
$39.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.80
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$157.06
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$109.31 |
| Max. Negotiated Rate |
$141.35 |
| Rate for Payer: Aetna Commercial |
$133.50
|
| Rate for Payer: BCBS Trust/PPO |
$129.72
|
| Rate for Payer: BCN Commercial |
$129.72
|
| Rate for Payer: Cash Price |
$125.65
|
| Rate for Payer: Cofinity Commercial |
$135.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.65
|
| Rate for Payer: Healthscope Commercial |
$141.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.50
|
| Rate for Payer: Nomi Health Commercial |
$128.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.80
|
| Rate for Payer: PHP Commercial |
$133.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.21
|
| Rate for Payer: UHC Core |
$131.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.80
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$245.98
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$43.37 |
| Max. Negotiated Rate |
$221.38 |
| Rate for Payer: Aetna Commercial |
$209.08
|
| Rate for Payer: Aetna Medicare |
$63.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.87
|
| Rate for Payer: BCBS Complete |
$45.53
|
| Rate for Payer: BCBS MAPPO |
$61.49
|
| Rate for Payer: BCBS Trust/PPO |
$202.22
|
| Rate for Payer: BCN Commercial |
$202.22
|
| Rate for Payer: BCN Medicare Advantage |
$61.49
|
| Rate for Payer: Cash Price |
$196.78
|
| Rate for Payer: Cofinity Commercial |
$211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.49
|
| Rate for Payer: Healthscope Commercial |
$221.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.49
|
| Rate for Payer: Mclaren Medicaid |
$43.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.57
|
| Rate for Payer: Meridian Medicaid |
$45.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.08
|
| Rate for Payer: Nomi Health Commercial |
$201.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.49
|
| Rate for Payer: PACE Senior Care Partners |
$58.42
|
| Rate for Payer: PACE SWMI |
$61.49
|
| Rate for Payer: PHP Commercial |
$209.08
|
| Rate for Payer: PHP Medicare Advantage |
$61.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.00
|
| Rate for Payer: Priority Health Medicare |
$62.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.20
|
| Rate for Payer: Railroad Medicare Medicare |
$61.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.46
|
| Rate for Payer: UHC Core |
$205.39
|
| Rate for Payer: UHC Exchange |
$61.49
|
| Rate for Payer: UHC Medicaid |
$43.37
|
| Rate for Payer: UHC Medicare Advantage |
$61.49
|
| Rate for Payer: UHCCP Medicaid |
$43.37
|
| Rate for Payer: VA VA |
$61.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.49
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$245.98
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$221.38 |
| Rate for Payer: Aetna Commercial |
$209.08
|
| Rate for Payer: BCBS Trust/PPO |
$203.15
|
| Rate for Payer: BCN Commercial |
$203.15
|
| Rate for Payer: Cash Price |
$196.78
|
| Rate for Payer: Cofinity Commercial |
$211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.78
|
| Rate for Payer: Healthscope Commercial |
$221.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.08
|
| Rate for Payer: Nomi Health Commercial |
$201.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.49
|
| Rate for Payer: PHP Commercial |
$209.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$214.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.46
|
| Rate for Payer: UHC Core |
$205.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.49
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$201.18
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.47 |
| Max. Negotiated Rate |
$181.06 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: Aetna Medicare |
$52.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.87
|
| Rate for Payer: BCBS Complete |
$37.24
|
| Rate for Payer: BCBS MAPPO |
$50.30
|
| Rate for Payer: BCBS Trust/PPO |
$165.39
|
| Rate for Payer: BCN Commercial |
$165.39
|
| Rate for Payer: BCN Medicare Advantage |
$50.30
|
| Rate for Payer: Cash Price |
$160.94
|
| Rate for Payer: Cofinity Commercial |
$173.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.30
|
| Rate for Payer: Healthscope Commercial |
$181.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.88
|
| Rate for Payer: Mclaren Medicaid |
$35.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.81
|
| Rate for Payer: Meridian Medicaid |
$37.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.00
|
| Rate for Payer: Nomi Health Commercial |
$164.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.88
|
| Rate for Payer: PACE Senior Care Partners |
$47.78
|
| Rate for Payer: PACE SWMI |
$50.30
|
| Rate for Payer: PHP Commercial |
$171.00
|
| Rate for Payer: PHP Medicare Advantage |
$50.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.03
|
| Rate for Payer: Priority Health Medicare |
$50.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.02
|
| Rate for Payer: Railroad Medicare Medicare |
$50.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.04
|
| Rate for Payer: UHC Core |
$167.99
|
| Rate for Payer: UHC Exchange |
$50.30
|
| Rate for Payer: UHC Medicaid |
$35.47
|
| Rate for Payer: UHC Medicare Advantage |
$50.30
|
| Rate for Payer: UHCCP Medicaid |
$35.47
|
| Rate for Payer: VA VA |
$50.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.88
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$201.18
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$140.02 |
| Max. Negotiated Rate |
$181.06 |
| Rate for Payer: Aetna Commercial |
$171.00
|
| Rate for Payer: BCBS Trust/PPO |
$166.15
|
| Rate for Payer: BCN Commercial |
$166.15
|
| Rate for Payer: Cash Price |
$160.94
|
| Rate for Payer: Cofinity Commercial |
$173.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.94
|
| Rate for Payer: Healthscope Commercial |
$181.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.00
|
| Rate for Payer: Nomi Health Commercial |
$164.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.88
|
| Rate for Payer: PHP Commercial |
$171.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.04
|
| Rate for Payer: UHC Core |
$167.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.88
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.59
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$11.33 |
| Rate for Payer: Aetna Commercial |
$10.70
|
| Rate for Payer: Aetna Medicare |
$3.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.93
|
| Rate for Payer: BCBS Complete |
$2.33
|
| Rate for Payer: BCBS MAPPO |
$3.15
|
| Rate for Payer: BCBS Trust/PPO |
$10.35
|
| Rate for Payer: BCN Commercial |
$10.35
|
| Rate for Payer: BCN Medicare Advantage |
$3.15
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cofinity Commercial |
$10.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.15
|
| Rate for Payer: Healthscope Commercial |
$11.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.44
|
| Rate for Payer: Mclaren Medicaid |
$2.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.30
|
| Rate for Payer: Meridian Medicaid |
$2.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.70
|
| Rate for Payer: Nomi Health Commercial |
$10.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.44
|
| Rate for Payer: PACE Senior Care Partners |
$2.99
|
| Rate for Payer: PACE SWMI |
$3.15
|
| Rate for Payer: PHP Commercial |
$10.70
|
| Rate for Payer: PHP Medicare Advantage |
$3.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.95
|
| Rate for Payer: Priority Health Medicare |
$3.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.76
|
| Rate for Payer: Railroad Medicare Medicare |
$3.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.08
|
| Rate for Payer: UHC Core |
$10.51
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UHC Medicaid |
$2.22
|
| Rate for Payer: UHC Medicare Advantage |
$3.15
|
| Rate for Payer: UHCCP Medicaid |
$2.22
|
| Rate for Payer: VA VA |
$3.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.44
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.59
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$11.33 |
| Rate for Payer: Aetna Commercial |
$10.70
|
| Rate for Payer: BCBS Trust/PPO |
$10.40
|
| Rate for Payer: BCN Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cofinity Commercial |
$10.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.07
|
| Rate for Payer: Healthscope Commercial |
$11.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.70
|
| Rate for Payer: Nomi Health Commercial |
$10.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.44
|
| Rate for Payer: PHP Commercial |
$10.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.08
|
| Rate for Payer: UHC Core |
$10.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.44
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.28 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: BCBS Trust/PPO |
$37.12
|
| Rate for Payer: BCN Commercial |
$37.12
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.55
|
| Rate for Payer: UHC Core |
$37.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.70
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$11.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.04
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$11.23
|
| Rate for Payer: BCBS Trust/PPO |
$36.95
|
| Rate for Payer: BCN Commercial |
$36.95
|
| Rate for Payer: BCN Medicare Advantage |
$11.23
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.23
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.70
|
| Rate for Payer: Mclaren Medicaid |
$7.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.80
|
| Rate for Payer: Meridian Medicaid |
$8.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PACE Senior Care Partners |
$10.67
|
| Rate for Payer: PACE SWMI |
$11.23
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: PHP Medicare Advantage |
$11.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.10
|
| Rate for Payer: Priority Health Medicare |
$11.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.55
|
| Rate for Payer: UHC Core |
$37.52
|
| Rate for Payer: UHC Exchange |
$11.23
|
| Rate for Payer: UHC Medicaid |
$7.92
|
| Rate for Payer: UHC Medicare Advantage |
$11.23
|
| Rate for Payer: UHCCP Medicaid |
$7.92
|
| Rate for Payer: VA VA |
$11.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.70
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$567.74
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$395.15 |
| Max. Negotiated Rate |
$510.97 |
| Rate for Payer: Aetna Commercial |
$482.58
|
| Rate for Payer: BCBS Trust/PPO |
$468.90
|
| Rate for Payer: BCN Commercial |
$468.90
|
| Rate for Payer: Cash Price |
$454.19
|
| Rate for Payer: Cofinity Commercial |
$488.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.19
|
| Rate for Payer: Healthscope Commercial |
$510.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$482.58
|
| Rate for Payer: Nomi Health Commercial |
$465.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.81
|
| Rate for Payer: PHP Commercial |
$482.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.61
|
| Rate for Payer: UHC Core |
$474.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.81
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$567.74
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$510.97 |
| Rate for Payer: Aetna Commercial |
$482.58
|
| Rate for Payer: Aetna Medicare |
$147.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.42
|
| Rate for Payer: BCBS Complete |
$105.09
|
| Rate for Payer: BCBS MAPPO |
$141.94
|
| Rate for Payer: BCBS Trust/PPO |
$466.74
|
| Rate for Payer: BCN Commercial |
$466.74
|
| Rate for Payer: BCN Medicare Advantage |
$141.94
|
| Rate for Payer: Cash Price |
$454.19
|
| Rate for Payer: Cofinity Commercial |
$488.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.94
|
| Rate for Payer: Healthscope Commercial |
$510.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$425.81
|
| Rate for Payer: Mclaren Medicaid |
$100.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.03
|
| Rate for Payer: Meridian Medicaid |
$105.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$163.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$482.58
|
| Rate for Payer: Nomi Health Commercial |
$465.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$425.81
|
| Rate for Payer: PACE Senior Care Partners |
$134.84
|
| Rate for Payer: PACE SWMI |
$141.94
|
| Rate for Payer: PHP Commercial |
$482.58
|
| Rate for Payer: PHP Medicare Advantage |
$141.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$493.93
|
| Rate for Payer: Priority Health Medicare |
$143.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.15
|
| Rate for Payer: Railroad Medicare Medicare |
$141.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.61
|
| Rate for Payer: UHC Core |
$474.06
|
| Rate for Payer: UHC Exchange |
$141.94
|
| Rate for Payer: UHC Medicaid |
$100.09
|
| Rate for Payer: UHC Medicare Advantage |
$141.94
|
| Rate for Payer: UHCCP Medicaid |
$100.09
|
| Rate for Payer: VA VA |
$141.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$425.81
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
OP
|
$503.46
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$88.76 |
| Max. Negotiated Rate |
$453.11 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: Aetna Medicare |
$130.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.33
|
| Rate for Payer: BCBS Complete |
$93.19
|
| Rate for Payer: BCBS MAPPO |
$125.86
|
| Rate for Payer: BCBS Trust/PPO |
$413.89
|
| Rate for Payer: BCN Commercial |
$413.89
|
| Rate for Payer: BCN Medicare Advantage |
$125.86
|
| Rate for Payer: Cash Price |
$402.77
|
| Rate for Payer: Cofinity Commercial |
$432.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.86
|
| Rate for Payer: Healthscope Commercial |
$453.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$377.60
|
| Rate for Payer: Mclaren Medicaid |
$88.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.16
|
| Rate for Payer: Meridian Medicaid |
$93.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.94
|
| Rate for Payer: Nomi Health Commercial |
$412.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$377.60
|
| Rate for Payer: PACE Senior Care Partners |
$119.57
|
| Rate for Payer: PACE SWMI |
$125.86
|
| Rate for Payer: PHP Commercial |
$427.94
|
| Rate for Payer: PHP Medicare Advantage |
$125.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.01
|
| Rate for Payer: Priority Health Medicare |
$127.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.41
|
| Rate for Payer: Railroad Medicare Medicare |
$125.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.04
|
| Rate for Payer: UHC Core |
$420.39
|
| Rate for Payer: UHC Exchange |
$125.86
|
| Rate for Payer: UHC Medicaid |
$88.76
|
| Rate for Payer: UHC Medicare Advantage |
$125.86
|
| Rate for Payer: UHCCP Medicaid |
$88.76
|
| Rate for Payer: VA VA |
$125.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$377.60
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$503.46
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$350.41 |
| Max. Negotiated Rate |
$453.11 |
| Rate for Payer: Aetna Commercial |
$427.94
|
| Rate for Payer: BCBS Trust/PPO |
$415.81
|
| Rate for Payer: BCN Commercial |
$415.81
|
| Rate for Payer: Cash Price |
$402.77
|
| Rate for Payer: Cofinity Commercial |
$432.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.77
|
| Rate for Payer: Healthscope Commercial |
$453.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$377.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.94
|
| Rate for Payer: Nomi Health Commercial |
$412.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$377.60
|
| Rate for Payer: PHP Commercial |
$427.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.04
|
| Rate for Payer: UHC Core |
$420.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$377.60
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$1,619.40
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$285.50 |
| Max. Negotiated Rate |
$1,457.46 |
| Rate for Payer: Aetna Commercial |
$1,376.49
|
| Rate for Payer: Aetna Medicare |
$421.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.06
|
| Rate for Payer: BCBS Complete |
$299.75
|
| Rate for Payer: BCBS MAPPO |
$404.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.31
|
| Rate for Payer: BCN Commercial |
$1,331.31
|
| Rate for Payer: BCN Medicare Advantage |
$404.85
|
| Rate for Payer: Cash Price |
$1,295.52
|
| Rate for Payer: Cofinity Commercial |
$1,392.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.85
|
| Rate for Payer: Healthscope Commercial |
$1,457.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,214.55
|
| Rate for Payer: Mclaren Medicaid |
$285.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.09
|
| Rate for Payer: Meridian Medicaid |
$299.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.49
|
| Rate for Payer: Nomi Health Commercial |
$1,327.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.55
|
| Rate for Payer: PACE Senior Care Partners |
$384.61
|
| Rate for Payer: PACE SWMI |
$404.85
|
| Rate for Payer: PHP Commercial |
$1,376.49
|
| Rate for Payer: PHP Medicare Advantage |
$404.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,408.88
|
| Rate for Payer: Priority Health Medicare |
$408.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.10
|
| Rate for Payer: Railroad Medicare Medicare |
$404.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.07
|
| Rate for Payer: UHC Core |
$1,352.20
|
| Rate for Payer: UHC Exchange |
$404.85
|
| Rate for Payer: UHC Medicaid |
$285.50
|
| Rate for Payer: UHC Medicare Advantage |
$404.85
|
| Rate for Payer: UHCCP Medicaid |
$285.50
|
| Rate for Payer: VA VA |
$404.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,214.55
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,619.40
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,127.10 |
| Max. Negotiated Rate |
$1,457.46 |
| Rate for Payer: Aetna Commercial |
$1,376.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.46
|
| Rate for Payer: BCN Commercial |
$1,337.46
|
| Rate for Payer: Cash Price |
$1,295.52
|
| Rate for Payer: Cofinity Commercial |
$1,392.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.52
|
| Rate for Payer: Healthscope Commercial |
$1,457.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,214.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.49
|
| Rate for Payer: Nomi Health Commercial |
$1,327.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.55
|
| Rate for Payer: PHP Commercial |
$1,376.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,408.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.07
|
| Rate for Payer: UHC Core |
$1,352.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,214.55
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$11.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$12.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicaid |
$11.92
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$11.92
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.86
|
| Rate for Payer: BCN Commercial |
$55.86
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$667.13
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$117.62 |
| Max. Negotiated Rate |
$600.42 |
| Rate for Payer: Aetna Commercial |
$567.06
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.48
|
| Rate for Payer: BCBS Complete |
$123.49
|
| Rate for Payer: BCBS MAPPO |
$166.78
|
| Rate for Payer: BCBS Trust/PPO |
$548.45
|
| Rate for Payer: BCN Commercial |
$548.45
|
| Rate for Payer: BCN Medicare Advantage |
$166.78
|
| Rate for Payer: Cash Price |
$533.70
|
| Rate for Payer: Cofinity Commercial |
$573.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.78
|
| Rate for Payer: Healthscope Commercial |
$600.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.35
|
| Rate for Payer: Mclaren Medicaid |
$117.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.12
|
| Rate for Payer: Meridian Medicaid |
$123.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.06
|
| Rate for Payer: Nomi Health Commercial |
$547.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.35
|
| Rate for Payer: PACE Senior Care Partners |
$158.44
|
| Rate for Payer: PACE SWMI |
$166.78
|
| Rate for Payer: PHP Commercial |
$567.06
|
| Rate for Payer: PHP Medicare Advantage |
$166.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$580.40
|
| Rate for Payer: Priority Health Medicare |
$168.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.32
|
| Rate for Payer: Railroad Medicare Medicare |
$166.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.07
|
| Rate for Payer: UHC Core |
$557.05
|
| Rate for Payer: UHC Exchange |
$166.78
|
| Rate for Payer: UHC Medicaid |
$117.62
|
| Rate for Payer: UHC Medicare Advantage |
$166.78
|
| Rate for Payer: UHCCP Medicaid |
$117.62
|
| Rate for Payer: VA VA |
$166.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.35
|
|
