|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.25 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$1,000.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,202.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,202.96
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$962.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.66
|
| Rate for Payer: BCN Commercial |
$2,992.97
|
| Rate for Payer: BCN Medicare Advantage |
$962.37
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.37
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,106.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Senior Care Partners |
$914.25
|
| Rate for Payer: PACE SWMI |
$962.37
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$962.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Medicare |
$971.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.37
|
| Rate for Payer: UHC Exchange |
$962.37
|
| Rate for Payer: UHC Medicare Advantage |
$962.37
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$962.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$945.74 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna Medicare |
$1,035.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,244.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,244.40
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$995.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,273.66
|
| Rate for Payer: BCN Commercial |
$3,096.06
|
| Rate for Payer: BCN Medicare Advantage |
$995.52
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.52
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.29
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,144.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: Nomi Health Commercial |
$3,265.30
|
| Rate for Payer: PACE Senior Care Partners |
$945.74
|
| Rate for Payer: PACE SWMI |
$995.52
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: PHP Medicare Advantage |
$995.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,464.40
|
| Rate for Payer: Priority Health Medicare |
$1,005.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.99
|
| Rate for Payer: Railroad Medicare Medicare |
$995.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,504.22
|
| Rate for Payer: UHC Core |
$3,325.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.52
|
| Rate for Payer: UHC Exchange |
$995.52
|
| Rate for Payer: UHC Medicare Advantage |
$995.52
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$995.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.35 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,250.56
|
| Rate for Payer: BCN Commercial |
$3,077.34
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: Nomi Health Commercial |
$3,265.30
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,464.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,504.22
|
| Rate for Payer: UHC Core |
$3,325.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,122.98 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,666.14
|
| Rate for Payer: BCN Commercial |
$2,524.07
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: Nomi Health Commercial |
$2,678.23
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health HMO/PPO |
$2,841.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,188.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,874.19
|
| Rate for Payer: UHC Core |
$2,727.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$775.71 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna Medicare |
$849.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,020.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,020.67
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$816.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,685.09
|
| Rate for Payer: BCN Commercial |
$2,539.42
|
| Rate for Payer: BCN Medicare Advantage |
$816.53
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.53
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.36
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$939.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: Nomi Health Commercial |
$2,678.23
|
| Rate for Payer: PACE Senior Care Partners |
$775.71
|
| Rate for Payer: PACE SWMI |
$816.53
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$816.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health HMO/PPO |
$2,841.53
|
| Rate for Payer: Priority Health Medicare |
$824.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,188.31
|
| Rate for Payer: Railroad Medicare Medicare |
$816.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,874.19
|
| Rate for Payer: UHC Core |
$2,727.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.53
|
| Rate for Payer: UHC Exchange |
$816.53
|
| Rate for Payer: UHC Medicare Advantage |
$816.53
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$816.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$40.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$98.76
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS Trust/PPO |
$126.59
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Mclaren Medicaid |
$94.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$98.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: PACE Senior Care Partners |
$36.57
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$38.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.17
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.50
|
| Rate for Payer: UHC Exchange |
$38.50
|
| Rate for Payer: UHC Medicare Advantage |
$38.50
|
| Rate for Payer: UHCCP Medicaid |
$94.06
|
| Rate for Payer: VA VA |
$38.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: BCBS Trust/PPO |
$125.69
|
| Rate for Payer: BCN Commercial |
$119.00
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$146.61 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: BCBS Trust/PPO |
$184.12
|
| Rate for Payer: BCN Commercial |
$174.31
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: Nomi Health Commercial |
$184.95
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health HMO/PPO |
$196.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.48
|
| Rate for Payer: UHC Core |
$188.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna Medicare |
$58.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.48
|
| Rate for Payer: BCBS Complete |
$39.74
|
| Rate for Payer: BCBS MAPPO |
$56.39
|
| Rate for Payer: BCBS Trust/PPO |
$185.42
|
| Rate for Payer: BCN Commercial |
$175.37
|
| Rate for Payer: BCN Medicare Advantage |
$56.39
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.39
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Mclaren Medicaid |
$37.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.21
|
| Rate for Payer: Meridian Medicaid |
$39.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: Nomi Health Commercial |
$184.95
|
| Rate for Payer: PACE Senior Care Partners |
$53.57
|
| Rate for Payer: PACE SWMI |
$56.39
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: PHP Medicare Advantage |
$56.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health HMO/PPO |
$196.23
|
| Rate for Payer: Priority Health Medicare |
$56.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: Railroad Medicare Medicare |
$56.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.48
|
| Rate for Payer: UHC Core |
$188.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.39
|
| Rate for Payer: UHC Exchange |
$56.39
|
| Rate for Payer: UHC Medicare Advantage |
$56.39
|
| Rate for Payer: UHCCP Medicaid |
$37.85
|
| Rate for Payer: VA VA |
$56.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.28 |
| Max. Negotiated Rate |
$167.80 |
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: Aetna Medicare |
$48.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.27
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$46.61
|
| Rate for Payer: BCBS Trust/PPO |
$153.28
|
| Rate for Payer: BCN Commercial |
$144.96
|
| Rate for Payer: BCN Medicare Advantage |
$46.61
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.61
|
| Rate for Payer: Healthscope Commercial |
$167.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.84
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.94
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.48
|
| Rate for Payer: Nomi Health Commercial |
$152.89
|
| Rate for Payer: PACE Senior Care Partners |
$44.28
|
| Rate for Payer: PACE SWMI |
$46.61
|
| Rate for Payer: PHP Commercial |
$158.48
|
| Rate for Payer: PHP Medicare Advantage |
$46.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.19
|
| Rate for Payer: Priority Health HMO/PPO |
$162.21
|
| Rate for Payer: Priority Health Medicare |
$47.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.92
|
| Rate for Payer: Railroad Medicare Medicare |
$46.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.08
|
| Rate for Payer: UHC Core |
$155.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.61
|
| Rate for Payer: UHC Exchange |
$46.61
|
| Rate for Payer: UHC Medicare Advantage |
$46.61
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$46.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.84
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$186.45
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$121.19 |
| Max. Negotiated Rate |
$167.80 |
| Rate for Payer: Aetna Commercial |
$158.48
|
| Rate for Payer: BCBS Trust/PPO |
$152.20
|
| Rate for Payer: BCN Commercial |
$144.09
|
| Rate for Payer: Cash Price |
$149.16
|
| Rate for Payer: Cofinity Commercial |
$160.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.16
|
| Rate for Payer: Healthscope Commercial |
$167.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.48
|
| Rate for Payer: Nomi Health Commercial |
$152.89
|
| Rate for Payer: PHP Commercial |
$158.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.19
|
| Rate for Payer: Priority Health HMO/PPO |
$162.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.08
|
| Rate for Payer: UHC Core |
$155.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.84
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: Aetna Medicare |
$3.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.86
|
| Rate for Payer: BCBS Complete |
$2.49
|
| Rate for Payer: BCBS MAPPO |
$3.08
|
| Rate for Payer: BCBS Trust/PPO |
$10.14
|
| Rate for Payer: BCN Commercial |
$9.59
|
| Rate for Payer: BCN Medicare Advantage |
$3.08
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.08
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.26
|
| Rate for Payer: Mclaren Medicaid |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.24
|
| Rate for Payer: Meridian Medicaid |
$2.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: Nomi Health Commercial |
$10.12
|
| Rate for Payer: PACE Senior Care Partners |
$2.93
|
| Rate for Payer: PACE SWMI |
$3.08
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: PHP Medicare Advantage |
$3.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health HMO/PPO |
$10.74
|
| Rate for Payer: Priority Health Medicare |
$3.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.86
|
| Rate for Payer: UHC Core |
$10.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.08
|
| Rate for Payer: UHC Exchange |
$3.08
|
| Rate for Payer: UHC Medicare Advantage |
$3.08
|
| Rate for Payer: UHCCP Medicaid |
$2.37
|
| Rate for Payer: VA VA |
$3.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.26
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.34
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$11.11 |
| Rate for Payer: Aetna Commercial |
$10.49
|
| Rate for Payer: BCBS Trust/PPO |
$10.07
|
| Rate for Payer: BCN Commercial |
$9.54
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cofinity Commercial |
$10.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$11.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.49
|
| Rate for Payer: Nomi Health Commercial |
$10.12
|
| Rate for Payer: PHP Commercial |
$10.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.02
|
| Rate for Payer: Priority Health HMO/PPO |
$10.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.86
|
| Rate for Payer: UHC Core |
$10.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.26
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare |
$11.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.77
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS MAPPO |
$11.02
|
| Rate for Payer: BCBS Trust/PPO |
$36.22
|
| Rate for Payer: BCN Commercial |
$34.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.02
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.57
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: PACE Senior Care Partners |
$10.46
|
| Rate for Payer: PACE SWMI |
$11.02
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health HMO/PPO |
$38.33
|
| Rate for Payer: Priority Health Medicare |
$11.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.52
|
| Rate for Payer: Railroad Medicare Medicare |
$11.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.77
|
| Rate for Payer: UHC Core |
$36.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.02
|
| Rate for Payer: UHC Exchange |
$11.02
|
| Rate for Payer: UHC Medicare Advantage |
$11.02
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: VA VA |
$11.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
|
HC SPECIMEN CONCENTRATION FOR INFECTIOUS AGENTS
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600068
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.64 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: BCBS Trust/PPO |
$35.97
|
| Rate for Payer: BCN Commercial |
$34.05
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.45
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.64
|
| Rate for Payer: Priority Health HMO/PPO |
$38.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.77
|
| Rate for Payer: UHC Core |
$36.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
IP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$361.80 |
| Max. Negotiated Rate |
$500.95 |
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: BCBS Trust/PPO |
$454.36
|
| Rate for Payer: BCN Commercial |
$430.15
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$417.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.12
|
| Rate for Payer: Nomi Health Commercial |
$456.42
|
| Rate for Payer: PHP Commercial |
$473.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.80
|
| Rate for Payer: Priority Health HMO/PPO |
$484.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$489.82
|
| Rate for Payer: UHC Core |
$464.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$417.46
|
|
|
HC SPEC PHYSICS CONSULT
|
Facility
|
OP
|
$556.61
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
33300017
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$94.06 |
| Max. Negotiated Rate |
$500.95 |
| Rate for Payer: Aetna Commercial |
$473.12
|
| Rate for Payer: Aetna Medicare |
$144.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.94
|
| Rate for Payer: BCBS Complete |
$98.76
|
| Rate for Payer: BCBS MAPPO |
$139.15
|
| Rate for Payer: BCBS Trust/PPO |
$457.59
|
| Rate for Payer: BCN Commercial |
$432.76
|
| Rate for Payer: BCN Medicare Advantage |
$139.15
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cash Price |
$445.29
|
| Rate for Payer: Cofinity Commercial |
$478.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$445.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.15
|
| Rate for Payer: Healthscope Commercial |
$500.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$417.46
|
| Rate for Payer: Mclaren Medicaid |
$94.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.11
|
| Rate for Payer: Meridian Medicaid |
$98.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$160.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$473.12
|
| Rate for Payer: Nomi Health Commercial |
$456.42
|
| Rate for Payer: PACE Senior Care Partners |
$132.19
|
| Rate for Payer: PACE SWMI |
$139.15
|
| Rate for Payer: PHP Commercial |
$473.12
|
| Rate for Payer: PHP Medicare Advantage |
$139.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.80
|
| Rate for Payer: Priority Health HMO/PPO |
$484.25
|
| Rate for Payer: Priority Health Medicare |
$140.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.93
|
| Rate for Payer: Railroad Medicare Medicare |
$139.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$489.82
|
| Rate for Payer: UHC Core |
$464.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.15
|
| Rate for Payer: UHC Exchange |
$139.15
|
| Rate for Payer: UHC Medicare Advantage |
$139.15
|
| Rate for Payer: UHCCP Medicaid |
$94.06
|
| Rate for Payer: VA VA |
$139.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$417.46
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
IP
|
$493.59
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$320.83 |
| Max. Negotiated Rate |
$444.23 |
| Rate for Payer: Aetna Commercial |
$419.55
|
| Rate for Payer: BCBS Trust/PPO |
$402.92
|
| Rate for Payer: BCN Commercial |
$381.45
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cofinity Commercial |
$424.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.87
|
| Rate for Payer: Healthscope Commercial |
$444.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.55
|
| Rate for Payer: Nomi Health Commercial |
$404.74
|
| Rate for Payer: PHP Commercial |
$419.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.83
|
| Rate for Payer: Priority Health HMO/PPO |
$429.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.36
|
| Rate for Payer: UHC Core |
$412.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.19
|
|
|
HC SPECTRAL DOPPLER
|
Facility
|
OP
|
$493.59
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
48000006
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$117.23 |
| Max. Negotiated Rate |
$444.23 |
| Rate for Payer: Aetna Commercial |
$419.55
|
| Rate for Payer: Aetna Medicare |
$128.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.25
|
| Rate for Payer: BCBS Complete |
$197.44
|
| Rate for Payer: BCBS MAPPO |
$123.40
|
| Rate for Payer: BCBS Trust/PPO |
$405.78
|
| Rate for Payer: BCN Commercial |
$383.77
|
| Rate for Payer: BCN Medicare Advantage |
$123.40
|
| Rate for Payer: Cash Price |
$394.87
|
| Rate for Payer: Cofinity Commercial |
$424.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.40
|
| Rate for Payer: Healthscope Commercial |
$444.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.55
|
| Rate for Payer: Nomi Health Commercial |
$404.74
|
| Rate for Payer: PACE Senior Care Partners |
$117.23
|
| Rate for Payer: PACE SWMI |
$123.40
|
| Rate for Payer: PHP Commercial |
$419.55
|
| Rate for Payer: PHP Medicare Advantage |
$123.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.83
|
| Rate for Payer: Priority Health HMO/PPO |
$429.42
|
| Rate for Payer: Priority Health Medicare |
$124.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.71
|
| Rate for Payer: Railroad Medicare Medicare |
$123.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$434.36
|
| Rate for Payer: UHC Core |
$412.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.40
|
| Rate for Payer: UHC Exchange |
$123.40
|
| Rate for Payer: UHC Medicare Advantage |
$123.40
|
| Rate for Payer: VA VA |
$123.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.19
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
OP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$377.07 |
| Max. Negotiated Rate |
$1,428.88 |
| Rate for Payer: Aetna Commercial |
$1,349.50
|
| Rate for Payer: Aetna Medicare |
$412.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$496.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$496.14
|
| Rate for Payer: BCBS Complete |
$430.29
|
| Rate for Payer: BCBS MAPPO |
$396.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.21
|
| Rate for Payer: BCN Commercial |
$1,234.40
|
| Rate for Payer: BCN Medicare Advantage |
$396.91
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,365.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.91
|
| Rate for Payer: Healthscope Commercial |
$1,428.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.74
|
| Rate for Payer: Mclaren Medicaid |
$409.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.76
|
| Rate for Payer: Meridian Medicaid |
$430.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$456.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.50
|
| Rate for Payer: Nomi Health Commercial |
$1,301.87
|
| Rate for Payer: PACE Senior Care Partners |
$377.07
|
| Rate for Payer: PACE SWMI |
$396.91
|
| Rate for Payer: PHP Commercial |
$1,349.50
|
| Rate for Payer: PHP Medicare Advantage |
$396.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.97
|
| Rate for Payer: Priority Health HMO/PPO |
$1,381.26
|
| Rate for Payer: Priority Health Medicare |
$400.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.73
|
| Rate for Payer: Railroad Medicare Medicare |
$396.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.13
|
| Rate for Payer: UHC Core |
$1,325.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.91
|
| Rate for Payer: UHC Exchange |
$396.91
|
| Rate for Payer: UHC Medicare Advantage |
$396.91
|
| Rate for Payer: UHCCP Medicaid |
$409.77
|
| Rate for Payer: VA VA |
$396.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.74
|
|
|
HC SPEC TX PROCEDURE
|
Facility
|
IP
|
$1,587.65
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
33300026
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,031.97 |
| Max. Negotiated Rate |
$1,428.88 |
| Rate for Payer: Aetna Commercial |
$1,349.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.00
|
| Rate for Payer: BCN Commercial |
$1,226.94
|
| Rate for Payer: Cash Price |
$1,270.12
|
| Rate for Payer: Cofinity Commercial |
$1,365.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.12
|
| Rate for Payer: Healthscope Commercial |
$1,428.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,190.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.50
|
| Rate for Payer: Nomi Health Commercial |
$1,301.87
|
| Rate for Payer: PHP Commercial |
$1,349.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,031.97
|
| Rate for Payer: Priority Health HMO/PPO |
$1,381.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,063.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.13
|
| Rate for Payer: UHC Core |
$1,325.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,190.74
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Exchange |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$16.58
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC SPEECH AUDIOMETRY COMPLETE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 92556
|
| Hospital Charge Code |
76100502
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC SPEECH EVAL
|
Facility
|
IP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$389.79 |
| Max. Negotiated Rate |
$539.70 |
| Rate for Payer: Aetna Commercial |
$509.72
|
| Rate for Payer: BCBS Trust/PPO |
$489.51
|
| Rate for Payer: BCN Commercial |
$463.42
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$515.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Healthscope Commercial |
$539.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: Nomi Health Commercial |
$491.73
|
| Rate for Payer: PHP Commercial |
$509.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: Priority Health HMO/PPO |
$521.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.71
|
| Rate for Payer: UHC Core |
$500.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.75
|
|
|
HC SPEECH EVAL
|
Facility
|
OP
|
$599.67
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
44400009
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$142.42 |
| Max. Negotiated Rate |
$539.70 |
| Rate for Payer: Aetna Commercial |
$509.72
|
| Rate for Payer: Aetna Medicare |
$155.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.40
|
| Rate for Payer: BCBS Complete |
$239.87
|
| Rate for Payer: BCBS MAPPO |
$149.92
|
| Rate for Payer: BCBS Trust/PPO |
$492.99
|
| Rate for Payer: BCN Commercial |
$466.24
|
| Rate for Payer: BCN Medicare Advantage |
$149.92
|
| Rate for Payer: Cash Price |
$479.74
|
| Rate for Payer: Cofinity Commercial |
$515.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$479.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.92
|
| Rate for Payer: Healthscope Commercial |
$539.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$449.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$509.72
|
| Rate for Payer: Nomi Health Commercial |
$491.73
|
| Rate for Payer: PACE Senior Care Partners |
$142.42
|
| Rate for Payer: PACE SWMI |
$149.92
|
| Rate for Payer: PHP Commercial |
$509.72
|
| Rate for Payer: PHP Medicare Advantage |
$149.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$389.79
|
| Rate for Payer: Priority Health HMO/PPO |
$521.71
|
| Rate for Payer: Priority Health Medicare |
$151.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.78
|
| Rate for Payer: Railroad Medicare Medicare |
$149.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.71
|
| Rate for Payer: UHC Core |
$500.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$149.92
|
| Rate for Payer: UHC Exchange |
$149.92
|
| Rate for Payer: UHC Medicare Advantage |
$149.92
|
| Rate for Payer: VA VA |
$149.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$449.75
|
|
