|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$67.55
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.91 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Medicare |
$17.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.11
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS MAPPO |
$16.89
|
| Rate for Payer: BCBS Trust/PPO |
$55.53
|
| Rate for Payer: BCN Commercial |
$55.53
|
| Rate for Payer: BCN Medicare Advantage |
$16.89
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.89
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Mclaren Medicaid |
$11.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.73
|
| Rate for Payer: Meridian Medicaid |
$12.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PACE Senior Care Partners |
$16.04
|
| Rate for Payer: PACE SWMI |
$16.89
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: PHP Medicare Advantage |
$16.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: UHC Exchange |
$16.89
|
| Rate for Payer: UHC Medicaid |
$11.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.89
|
| Rate for Payer: UHCCP Medicaid |
$11.91
|
| Rate for Payer: VA VA |
$16.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$67.55
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.01 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: BCBS Trust/PPO |
$55.79
|
| Rate for Payer: BCN Commercial |
$55.79
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$84.11
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.54 |
| Max. Negotiated Rate |
$75.70 |
| Rate for Payer: Aetna Commercial |
$71.49
|
| Rate for Payer: BCBS Trust/PPO |
$69.47
|
| Rate for Payer: BCN Commercial |
$69.47
|
| Rate for Payer: Cash Price |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$72.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.29
|
| Rate for Payer: Healthscope Commercial |
$75.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.49
|
| Rate for Payer: Nomi Health Commercial |
$68.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.08
|
| Rate for Payer: PHP Commercial |
$71.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.02
|
| Rate for Payer: UHC Core |
$70.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.08
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$84.11
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.83 |
| Max. Negotiated Rate |
$75.70 |
| Rate for Payer: Aetna Commercial |
$71.49
|
| Rate for Payer: Aetna Medicare |
$21.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.28
|
| Rate for Payer: BCBS Complete |
$15.57
|
| Rate for Payer: BCBS MAPPO |
$21.03
|
| Rate for Payer: BCBS Trust/PPO |
$69.15
|
| Rate for Payer: BCN Commercial |
$69.15
|
| Rate for Payer: BCN Medicare Advantage |
$21.03
|
| Rate for Payer: Cash Price |
$67.29
|
| Rate for Payer: Cofinity Commercial |
$72.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.03
|
| Rate for Payer: Healthscope Commercial |
$75.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.08
|
| Rate for Payer: Mclaren Medicaid |
$14.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.08
|
| Rate for Payer: Meridian Medicaid |
$15.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.49
|
| Rate for Payer: Nomi Health Commercial |
$68.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.08
|
| Rate for Payer: PACE Senior Care Partners |
$19.98
|
| Rate for Payer: PACE SWMI |
$21.03
|
| Rate for Payer: PHP Commercial |
$71.49
|
| Rate for Payer: PHP Medicare Advantage |
$21.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.18
|
| Rate for Payer: Priority Health Medicare |
$21.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.54
|
| Rate for Payer: Railroad Medicare Medicare |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.02
|
| Rate for Payer: UHC Core |
$70.23
|
| Rate for Payer: UHC Exchange |
$21.03
|
| Rate for Payer: UHC Medicaid |
$14.83
|
| Rate for Payer: UHC Medicare Advantage |
$21.03
|
| Rate for Payer: UHCCP Medicaid |
$14.83
|
| Rate for Payer: VA VA |
$21.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.08
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$67.55
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.01 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: BCBS Trust/PPO |
$55.79
|
| Rate for Payer: BCN Commercial |
$55.79
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$67.55
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.91 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Medicare |
$17.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.11
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS MAPPO |
$16.89
|
| Rate for Payer: BCBS Trust/PPO |
$55.53
|
| Rate for Payer: BCN Commercial |
$55.53
|
| Rate for Payer: BCN Medicare Advantage |
$16.89
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.89
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Mclaren Medicaid |
$11.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.73
|
| Rate for Payer: Meridian Medicaid |
$12.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PACE Senior Care Partners |
$16.04
|
| Rate for Payer: PACE SWMI |
$16.89
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: PHP Medicare Advantage |
$16.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: UHC Exchange |
$16.89
|
| Rate for Payer: UHC Medicaid |
$11.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.89
|
| Rate for Payer: UHCCP Medicaid |
$11.91
|
| Rate for Payer: VA VA |
$16.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$67.55
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.01 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: BCBS Trust/PPO |
$55.79
|
| Rate for Payer: BCN Commercial |
$55.79
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$67.55
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.91 |
| Max. Negotiated Rate |
$60.80 |
| Rate for Payer: Aetna Commercial |
$57.42
|
| Rate for Payer: Aetna Medicare |
$17.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.11
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS MAPPO |
$16.89
|
| Rate for Payer: BCBS Trust/PPO |
$55.53
|
| Rate for Payer: BCN Commercial |
$55.53
|
| Rate for Payer: BCN Medicare Advantage |
$16.89
|
| Rate for Payer: Cash Price |
$54.04
|
| Rate for Payer: Cofinity Commercial |
$58.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.89
|
| Rate for Payer: Healthscope Commercial |
$60.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.66
|
| Rate for Payer: Mclaren Medicaid |
$11.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.73
|
| Rate for Payer: Meridian Medicaid |
$12.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.42
|
| Rate for Payer: Nomi Health Commercial |
$55.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.66
|
| Rate for Payer: PACE Senior Care Partners |
$16.04
|
| Rate for Payer: PACE SWMI |
$16.89
|
| Rate for Payer: PHP Commercial |
$57.42
|
| Rate for Payer: PHP Medicare Advantage |
$16.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.77
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.44
|
| Rate for Payer: UHC Core |
$56.40
|
| Rate for Payer: UHC Exchange |
$16.89
|
| Rate for Payer: UHC Medicaid |
$11.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.89
|
| Rate for Payer: UHCCP Medicaid |
$11.91
|
| Rate for Payer: VA VA |
$16.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.66
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$25.27
|
| Rate for Payer: BCN Commercial |
$25.27
|
| 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 Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.95
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.30
|
| 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
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$5.66
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$25.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| 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: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$5.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Meridian Medicaid |
$5.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.95
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicaid |
$5.39
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: UHCCP Medicaid |
$5.39
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$85.22
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$76.70 |
| Rate for Payer: Aetna Commercial |
$72.44
|
| Rate for Payer: Aetna Medicare |
$22.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.63
|
| Rate for Payer: BCBS Complete |
$15.77
|
| Rate for Payer: BCBS MAPPO |
$21.30
|
| Rate for Payer: BCBS Trust/PPO |
$70.06
|
| Rate for Payer: BCN Commercial |
$70.06
|
| Rate for Payer: BCN Medicare Advantage |
$21.30
|
| Rate for Payer: Cash Price |
$68.18
|
| Rate for Payer: Cofinity Commercial |
$73.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.30
|
| Rate for Payer: Healthscope Commercial |
$76.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.91
|
| Rate for Payer: Mclaren Medicaid |
$15.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.37
|
| Rate for Payer: Meridian Medicaid |
$15.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.44
|
| Rate for Payer: Nomi Health Commercial |
$69.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.91
|
| Rate for Payer: PACE Senior Care Partners |
$20.24
|
| Rate for Payer: PACE SWMI |
$21.30
|
| Rate for Payer: PHP Commercial |
$72.44
|
| Rate for Payer: PHP Medicare Advantage |
$21.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.14
|
| Rate for Payer: Priority Health Medicare |
$21.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.31
|
| Rate for Payer: Railroad Medicare Medicare |
$21.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.99
|
| Rate for Payer: UHC Core |
$71.16
|
| Rate for Payer: UHC Exchange |
$21.30
|
| Rate for Payer: UHC Medicaid |
$15.02
|
| Rate for Payer: UHC Medicare Advantage |
$21.30
|
| Rate for Payer: UHCCP Medicaid |
$15.02
|
| Rate for Payer: VA VA |
$21.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.91
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$85.22
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.31 |
| Max. Negotiated Rate |
$76.70 |
| Rate for Payer: Aetna Commercial |
$72.44
|
| Rate for Payer: BCBS Trust/PPO |
$70.38
|
| Rate for Payer: BCN Commercial |
$70.38
|
| Rate for Payer: Cash Price |
$68.18
|
| Rate for Payer: Cofinity Commercial |
$73.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.18
|
| Rate for Payer: Healthscope Commercial |
$76.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.44
|
| Rate for Payer: Nomi Health Commercial |
$69.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.91
|
| Rate for Payer: PHP Commercial |
$72.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.99
|
| Rate for Payer: UHC Core |
$71.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.91
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$281.22
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.73 |
| Max. Negotiated Rate |
$253.10 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: BCBS Trust/PPO |
$232.26
|
| Rate for Payer: BCN Commercial |
$232.26
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.47
|
| Rate for Payer: UHC Core |
$234.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.91
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$281.22
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.58 |
| Max. Negotiated Rate |
$253.10 |
| Rate for Payer: Aetna Commercial |
$239.04
|
| Rate for Payer: Aetna Medicare |
$73.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.88
|
| Rate for Payer: BCBS Complete |
$52.05
|
| Rate for Payer: BCBS MAPPO |
$70.31
|
| Rate for Payer: BCBS Trust/PPO |
$231.19
|
| Rate for Payer: BCN Commercial |
$231.19
|
| Rate for Payer: BCN Medicare Advantage |
$70.31
|
| Rate for Payer: Cash Price |
$224.98
|
| Rate for Payer: Cofinity Commercial |
$241.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.31
|
| Rate for Payer: Healthscope Commercial |
$253.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.91
|
| Rate for Payer: Mclaren Medicaid |
$49.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.82
|
| Rate for Payer: Meridian Medicaid |
$52.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.04
|
| Rate for Payer: Nomi Health Commercial |
$230.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.91
|
| Rate for Payer: PACE Senior Care Partners |
$66.79
|
| Rate for Payer: PACE SWMI |
$70.31
|
| Rate for Payer: PHP Commercial |
$239.04
|
| Rate for Payer: PHP Medicare Advantage |
$70.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.66
|
| Rate for Payer: Priority Health Medicare |
$71.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.73
|
| Rate for Payer: Railroad Medicare Medicare |
$70.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.47
|
| Rate for Payer: UHC Core |
$234.82
|
| Rate for Payer: UHC Exchange |
$70.31
|
| Rate for Payer: UHC Medicaid |
$49.58
|
| Rate for Payer: UHC Medicare Advantage |
$70.31
|
| Rate for Payer: UHCCP Medicaid |
$49.58
|
| Rate for Payer: VA VA |
$70.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.91
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
IP
|
$6,656.19
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,632.71 |
| Max. Negotiated Rate |
$5,990.57 |
| Rate for Payer: Aetna Commercial |
$5,657.76
|
| Rate for Payer: BCBS Trust/PPO |
$5,497.35
|
| Rate for Payer: BCN Commercial |
$5,497.35
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$5,724.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Healthscope Commercial |
$5,990.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: PHP Commercial |
$5,657.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,790.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,632.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,857.45
|
| Rate for Payer: UHC Core |
$5,557.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.14
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
OP
|
$6,656.19
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,173.49 |
| Max. Negotiated Rate |
$5,990.57 |
| Rate for Payer: Aetna Commercial |
$5,657.76
|
| Rate for Payer: Aetna Medicare |
$1,730.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,080.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,080.06
|
| Rate for Payer: BCBS Complete |
$1,232.06
|
| Rate for Payer: BCBS MAPPO |
$1,664.05
|
| Rate for Payer: BCBS Trust/PPO |
$5,472.05
|
| Rate for Payer: BCN Commercial |
$5,472.05
|
| Rate for Payer: BCN Medicare Advantage |
$1,664.05
|
| Rate for Payer: Cash Price |
$5,324.95
|
| Rate for Payer: Cofinity Commercial |
$5,724.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,324.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,664.05
|
| Rate for Payer: Healthscope Commercial |
$5,990.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.14
|
| Rate for Payer: Mclaren Medicaid |
$1,173.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,747.25
|
| Rate for Payer: Meridian Medicaid |
$1,232.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,913.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,830.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,657.76
|
| Rate for Payer: Nomi Health Commercial |
$5,458.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,992.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,580.85
|
| Rate for Payer: PACE SWMI |
$1,664.05
|
| Rate for Payer: PHP Commercial |
$5,657.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,664.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,173.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,790.89
|
| Rate for Payer: Priority Health Medicare |
$1,680.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,632.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,664.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,857.45
|
| Rate for Payer: UHC Core |
$5,557.92
|
| Rate for Payer: UHC Exchange |
$1,664.05
|
| Rate for Payer: UHC Medicaid |
$1,173.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,664.05
|
| Rate for Payer: UHCCP Medicaid |
$1,173.49
|
| Rate for Payer: VA VA |
$1,664.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.14
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
OP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,611.25 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: Aetna Medicare |
$9,750.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,718.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,718.75
|
| Rate for Payer: BCBS Complete |
$6,941.25
|
| Rate for Payer: BCBS MAPPO |
$9,375.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,828.75
|
| Rate for Payer: BCN Commercial |
$30,828.75
|
| Rate for Payer: BCN Medicare Advantage |
$9,375.00
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,375.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Mclaren Medicaid |
$6,611.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,843.75
|
| Rate for Payer: Meridian Medicaid |
$6,941.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,781.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$10,312.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28,125.00
|
| Rate for Payer: PACE Senior Care Partners |
$8,906.25
|
| Rate for Payer: PACE SWMI |
$9,375.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: PHP Medicare Advantage |
$9,375.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,611.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32,625.00
|
| Rate for Payer: Priority Health Medicare |
$9,468.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26,100.00
|
| Rate for Payer: Railroad Medicare Medicare |
$9,375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,000.00
|
| Rate for Payer: UHC Core |
$31,312.50
|
| Rate for Payer: UHC Exchange |
$9,375.00
|
| Rate for Payer: UHC Medicaid |
$6,611.25
|
| Rate for Payer: UHC Medicare Advantage |
$9,375.00
|
| Rate for Payer: UHCCP Medicaid |
$6,611.25
|
| Rate for Payer: VA VA |
$9,375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
IP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26,100.00 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,971.25
|
| Rate for Payer: BCN Commercial |
$30,971.25
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28,125.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32,625.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26,100.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,000.00
|
| Rate for Payer: UHC Core |
$31,312.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
IP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28,275.00 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: BCBS Trust/PPO |
$33,552.19
|
| Rate for Payer: BCN Commercial |
$33,552.19
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30,468.75
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35,343.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28,275.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,750.00
|
| Rate for Payer: UHC Core |
$33,921.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
OP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,162.19 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna Medicare |
$10,562.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,695.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,695.31
|
| Rate for Payer: BCBS Complete |
$7,519.69
|
| Rate for Payer: BCBS MAPPO |
$10,156.25
|
| Rate for Payer: BCBS Trust/PPO |
$33,397.81
|
| Rate for Payer: BCN Commercial |
$33,397.81
|
| Rate for Payer: BCN Medicare Advantage |
$10,156.25
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,156.25
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Mclaren Medicaid |
$7,162.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,664.06
|
| Rate for Payer: Meridian Medicaid |
$7,519.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,679.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,171.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30,468.75
|
| Rate for Payer: PACE Senior Care Partners |
$9,648.44
|
| Rate for Payer: PACE SWMI |
$10,156.25
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: PHP Medicare Advantage |
$10,156.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,162.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35,343.75
|
| Rate for Payer: Priority Health Medicare |
$10,257.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28,275.00
|
| Rate for Payer: Railroad Medicare Medicare |
$10,156.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,750.00
|
| Rate for Payer: UHC Core |
$33,921.88
|
| Rate for Payer: UHC Exchange |
$10,156.25
|
| Rate for Payer: UHC Medicaid |
$7,162.19
|
| Rate for Payer: UHC Medicare Advantage |
$10,156.25
|
| Rate for Payer: UHCCP Medicaid |
$7,162.19
|
| Rate for Payer: VA VA |
$10,156.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.66
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS MAPPO |
$10.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.93
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$8.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PACE Senior Care Partners |
$10.38
|
| Rate for Payer: PACE SWMI |
$10.93
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$10.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: Railroad Medicare Medicare |
$10.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: UHC Exchange |
$10.93
|
| Rate for Payer: UHC Medicaid |
$7.70
|
| Rate for Payer: UHC Medicare Advantage |
$10.93
|
| Rate for Payer: UHCCP Medicaid |
$7.70
|
| Rate for Payer: VA VA |
$10.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.66
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.55
|
| Rate for Payer: BCN Commercial |
$209.55
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.91
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Senior Care Partners |
$60.54
|
| Rate for Payer: PACE SWMI |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Medicare |
$64.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: Railroad Medicare Medicare |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: VA VA |
$63.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$177.41 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: BCBS Trust/PPO |
$210.52
|
| Rate for Payer: BCN Commercial |
$210.52
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC TB TEST
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$6.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.80
|
| Rate for Payer: BCBS Complete |
$4.62
|
| Rate for Payer: BCBS MAPPO |
$6.24
|
| Rate for Payer: BCBS Trust/PPO |
$20.53
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: BCN Medicare Advantage |
$6.24
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$4.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.55
|
| Rate for Payer: Meridian Medicaid |
$4.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PACE Senior Care Partners |
$5.93
|
| Rate for Payer: PACE SWMI |
$6.24
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: PHP Medicare Advantage |
$6.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.72
|
| Rate for Payer: Priority Health Medicare |
$6.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: Railroad Medicare Medicare |
$6.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$20.85
|
| Rate for Payer: UHC Exchange |
$6.24
|
| Rate for Payer: UHC Medicaid |
$4.40
|
| Rate for Payer: UHC Medicare Advantage |
$6.24
|
| Rate for Payer: UHCCP Medicaid |
$4.40
|
| Rate for Payer: VA VA |
$6.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
