|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,686.83
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,174.03 |
| Max. Negotiated Rate |
$1,518.15 |
| Rate for Payer: Aetna Commercial |
$1,433.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,393.15
|
| Rate for Payer: BCN Commercial |
$1,393.15
|
| Rate for Payer: Cash Price |
$1,349.46
|
| Rate for Payer: Cofinity Commercial |
$1,450.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.46
|
| Rate for Payer: Healthscope Commercial |
$1,518.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,265.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.81
|
| Rate for Payer: Nomi Health Commercial |
$1,383.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,265.12
|
| Rate for Payer: PHP Commercial |
$1,433.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,467.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,484.41
|
| Rate for Payer: UHC Core |
$1,408.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,265.12
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BILAT CONT
|
Facility
|
IP
|
$2,001.00
|
|
|
Service Code
|
CPT 64489
|
| Hospital Charge Code |
37000032
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,392.70 |
| Max. Negotiated Rate |
$1,800.90 |
| Rate for Payer: Aetna Commercial |
$1,700.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,652.63
|
| Rate for Payer: BCN Commercial |
$1,652.63
|
| Rate for Payer: Cash Price |
$1,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,720.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.80
|
| Rate for Payer: Healthscope Commercial |
$1,800.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.85
|
| Rate for Payer: Nomi Health Commercial |
$1,640.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.75
|
| Rate for Payer: PHP Commercial |
$1,700.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,740.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,392.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.88
|
| Rate for Payer: UHC Core |
$1,670.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.75
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BILAT CONT
|
Facility
|
OP
|
$2,001.00
|
|
|
Service Code
|
CPT 64489
|
| Hospital Charge Code |
37000032
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$352.78 |
| Max. Negotiated Rate |
$1,800.90 |
| Rate for Payer: Aetna Commercial |
$1,700.85
|
| Rate for Payer: Aetna Medicare |
$520.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.31
|
| Rate for Payer: BCBS Complete |
$370.39
|
| Rate for Payer: BCBS MAPPO |
$500.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,645.02
|
| Rate for Payer: BCN Commercial |
$1,645.02
|
| Rate for Payer: BCN Medicare Advantage |
$500.25
|
| Rate for Payer: Cash Price |
$1,600.80
|
| Rate for Payer: Cofinity Commercial |
$1,720.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.25
|
| Rate for Payer: Healthscope Commercial |
$1,800.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.75
|
| Rate for Payer: Mclaren Medicaid |
$352.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.26
|
| Rate for Payer: Meridian Medicaid |
$370.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.85
|
| Rate for Payer: Nomi Health Commercial |
$1,640.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.75
|
| Rate for Payer: PACE Senior Care Partners |
$475.24
|
| Rate for Payer: PACE SWMI |
$500.25
|
| Rate for Payer: PHP Commercial |
$1,700.85
|
| Rate for Payer: PHP Medicare Advantage |
$500.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,740.87
|
| Rate for Payer: Priority Health Medicare |
$505.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,392.70
|
| Rate for Payer: Railroad Medicare Medicare |
$500.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,760.88
|
| Rate for Payer: UHC Core |
$1,670.84
|
| Rate for Payer: UHC Exchange |
$500.25
|
| Rate for Payer: UHC Medicaid |
$352.78
|
| Rate for Payer: UHC Medicare Advantage |
$500.25
|
| Rate for Payer: UHCCP Medicaid |
$352.78
|
| Rate for Payer: VA VA |
$500.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.75
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,218.27
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$847.92 |
| Max. Negotiated Rate |
$1,096.44 |
| Rate for Payer: Aetna Commercial |
$1,035.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.17
|
| Rate for Payer: BCN Commercial |
$1,006.17
|
| Rate for Payer: Cash Price |
$974.62
|
| Rate for Payer: Cofinity Commercial |
$1,047.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.62
|
| Rate for Payer: Healthscope Commercial |
$1,096.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$913.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.53
|
| Rate for Payer: Nomi Health Commercial |
$998.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.70
|
| Rate for Payer: PHP Commercial |
$1,035.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,059.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,072.08
|
| Rate for Payer: UHC Core |
$1,017.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$913.70
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,218.27
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.78 |
| Max. Negotiated Rate |
$1,096.44 |
| Rate for Payer: Aetna Commercial |
$1,035.53
|
| Rate for Payer: Aetna Medicare |
$316.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$380.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$380.71
|
| Rate for Payer: BCBS Complete |
$225.50
|
| Rate for Payer: BCBS MAPPO |
$304.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.54
|
| Rate for Payer: BCN Commercial |
$1,001.54
|
| Rate for Payer: BCN Medicare Advantage |
$304.57
|
| Rate for Payer: Cash Price |
$974.62
|
| Rate for Payer: Cofinity Commercial |
$1,047.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$974.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$304.57
|
| Rate for Payer: Healthscope Commercial |
$1,096.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$913.70
|
| Rate for Payer: Mclaren Medicaid |
$214.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$319.80
|
| Rate for Payer: Meridian Medicaid |
$225.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,035.53
|
| Rate for Payer: Nomi Health Commercial |
$998.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$913.70
|
| Rate for Payer: PACE Senior Care Partners |
$289.34
|
| Rate for Payer: PACE SWMI |
$304.57
|
| Rate for Payer: PHP Commercial |
$1,035.53
|
| Rate for Payer: PHP Medicare Advantage |
$304.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$214.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,059.89
|
| Rate for Payer: Priority Health Medicare |
$307.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.92
|
| Rate for Payer: Railroad Medicare Medicare |
$304.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,072.08
|
| Rate for Payer: UHC Core |
$1,017.26
|
| Rate for Payer: UHC Exchange |
$304.57
|
| Rate for Payer: UHC Medicaid |
$214.78
|
| Rate for Payer: UHC Medicare Advantage |
$304.57
|
| Rate for Payer: UHCCP Medicaid |
$214.78
|
| Rate for Payer: VA VA |
$304.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$913.70
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNILAT CONT
|
Facility
|
OP
|
$1,334.00
|
|
|
Service Code
|
CPT 64487
|
| Hospital Charge Code |
37000031
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$235.18 |
| Max. Negotiated Rate |
$1,200.60 |
| Rate for Payer: Aetna Commercial |
$1,133.90
|
| Rate for Payer: Aetna Medicare |
$346.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.88
|
| Rate for Payer: BCBS Complete |
$246.92
|
| Rate for Payer: BCBS MAPPO |
$333.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.68
|
| Rate for Payer: BCN Commercial |
$1,096.68
|
| Rate for Payer: BCN Medicare Advantage |
$333.50
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$1,147.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.50
|
| Rate for Payer: Healthscope Commercial |
$1,200.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.50
|
| Rate for Payer: Mclaren Medicaid |
$235.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.18
|
| Rate for Payer: Meridian Medicaid |
$246.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.90
|
| Rate for Payer: Nomi Health Commercial |
$1,093.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: PACE Senior Care Partners |
$316.82
|
| Rate for Payer: PACE SWMI |
$333.50
|
| Rate for Payer: PHP Commercial |
$1,133.90
|
| Rate for Payer: PHP Medicare Advantage |
$333.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,160.58
|
| Rate for Payer: Priority Health Medicare |
$336.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.46
|
| Rate for Payer: Railroad Medicare Medicare |
$333.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.92
|
| Rate for Payer: UHC Core |
$1,113.89
|
| Rate for Payer: UHC Exchange |
$333.50
|
| Rate for Payer: UHC Medicaid |
$235.18
|
| Rate for Payer: UHC Medicare Advantage |
$333.50
|
| Rate for Payer: UHCCP Medicaid |
$235.18
|
| Rate for Payer: VA VA |
$333.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.50
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNILAT CONT
|
Facility
|
IP
|
$1,334.00
|
|
|
Service Code
|
CPT 64487
|
| Hospital Charge Code |
37000031
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$928.46 |
| Max. Negotiated Rate |
$1,200.60 |
| Rate for Payer: Aetna Commercial |
$1,133.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.75
|
| Rate for Payer: BCN Commercial |
$1,101.75
|
| Rate for Payer: Cash Price |
$1,067.20
|
| Rate for Payer: Cofinity Commercial |
$1,147.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.20
|
| Rate for Payer: Healthscope Commercial |
$1,200.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.90
|
| Rate for Payer: Nomi Health Commercial |
$1,093.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.50
|
| Rate for Payer: PHP Commercial |
$1,133.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,160.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.92
|
| Rate for Payer: UHC Core |
$1,113.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.50
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$5,001.20
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$881.71 |
| Max. Negotiated Rate |
$4,501.08 |
| Rate for Payer: Aetna Commercial |
$4,251.02
|
| Rate for Payer: Aetna Medicare |
$1,300.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,562.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,562.88
|
| Rate for Payer: BCBS Complete |
$925.72
|
| Rate for Payer: BCBS MAPPO |
$1,250.30
|
| Rate for Payer: BCBS Trust/PPO |
$4,111.49
|
| Rate for Payer: BCN Commercial |
$4,111.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,250.30
|
| Rate for Payer: Cash Price |
$4,000.96
|
| Rate for Payer: Cofinity Commercial |
$4,301.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,250.30
|
| Rate for Payer: Healthscope Commercial |
$4,501.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.90
|
| Rate for Payer: Mclaren Medicaid |
$881.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,312.82
|
| Rate for Payer: Meridian Medicaid |
$925.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,437.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,375.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,251.02
|
| Rate for Payer: Nomi Health Commercial |
$4,100.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,750.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,187.79
|
| Rate for Payer: PACE SWMI |
$1,250.30
|
| Rate for Payer: PHP Commercial |
$4,251.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,250.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$881.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,351.04
|
| Rate for Payer: Priority Health Medicare |
$1,262.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,480.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,250.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,401.06
|
| Rate for Payer: UHC Core |
$4,176.00
|
| Rate for Payer: UHC Exchange |
$1,250.30
|
| Rate for Payer: UHC Medicaid |
$881.71
|
| Rate for Payer: UHC Medicare Advantage |
$1,250.30
|
| Rate for Payer: UHCCP Medicaid |
$881.71
|
| Rate for Payer: VA VA |
$1,250.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.90
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$5,001.20
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,480.84 |
| Max. Negotiated Rate |
$4,501.08 |
| Rate for Payer: Aetna Commercial |
$4,251.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,130.49
|
| Rate for Payer: BCN Commercial |
$4,130.49
|
| Rate for Payer: Cash Price |
$4,000.96
|
| Rate for Payer: Cofinity Commercial |
$4,301.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.96
|
| Rate for Payer: Healthscope Commercial |
$4,501.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,251.02
|
| Rate for Payer: Nomi Health Commercial |
$4,100.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,750.90
|
| Rate for Payer: PHP Commercial |
$4,251.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,351.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,480.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,401.06
|
| Rate for Payer: UHC Core |
$4,176.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.90
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,328.18
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$763.06 |
| Max. Negotiated Rate |
$3,895.36 |
| Rate for Payer: Aetna Commercial |
$3,678.95
|
| Rate for Payer: Aetna Medicare |
$1,125.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,352.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,352.56
|
| Rate for Payer: BCBS Complete |
$801.15
|
| Rate for Payer: BCBS MAPPO |
$1,082.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,558.20
|
| Rate for Payer: BCN Commercial |
$3,558.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,082.05
|
| Rate for Payer: Cash Price |
$3,462.54
|
| Rate for Payer: Cofinity Commercial |
$3,722.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,462.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,082.05
|
| Rate for Payer: Healthscope Commercial |
$3,895.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,246.14
|
| Rate for Payer: Mclaren Medicaid |
$763.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,136.15
|
| Rate for Payer: Meridian Medicaid |
$801.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,244.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,190.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,678.95
|
| Rate for Payer: Nomi Health Commercial |
$3,549.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,246.14
|
| Rate for Payer: PACE Senior Care Partners |
$1,027.94
|
| Rate for Payer: PACE SWMI |
$1,082.05
|
| Rate for Payer: PHP Commercial |
$3,678.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,082.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$763.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,765.52
|
| Rate for Payer: Priority Health Medicare |
$1,092.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,012.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,082.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,808.80
|
| Rate for Payer: UHC Core |
$3,614.03
|
| Rate for Payer: UHC Exchange |
$1,082.05
|
| Rate for Payer: UHC Medicaid |
$763.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,082.05
|
| Rate for Payer: UHCCP Medicaid |
$763.06
|
| Rate for Payer: VA VA |
$1,082.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,246.14
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,328.18
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,012.41 |
| Max. Negotiated Rate |
$3,895.36 |
| Rate for Payer: Aetna Commercial |
$3,678.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,574.64
|
| Rate for Payer: BCN Commercial |
$3,574.64
|
| Rate for Payer: Cash Price |
$3,462.54
|
| Rate for Payer: Cofinity Commercial |
$3,722.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,462.54
|
| Rate for Payer: Healthscope Commercial |
$3,895.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,246.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,678.95
|
| Rate for Payer: Nomi Health Commercial |
$3,549.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,246.14
|
| Rate for Payer: PHP Commercial |
$3,678.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,765.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,012.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,808.80
|
| Rate for Payer: UHC Core |
$3,614.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,246.14
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$4.81
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$21.38
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$4.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$4.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicaid |
$4.59
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$4.59
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.48
|
| Rate for Payer: BCN Commercial |
$21.48
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.51
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.62
|
| Rate for Payer: BCN Commercial |
$20.62
|
| 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: Healthscope Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| 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: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$20.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| 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
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.97 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.29
|
| Rate for Payer: BCN Commercial |
$59.29
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.66 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$18.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.43
|
| Rate for Payer: BCBS Complete |
$13.29
|
| Rate for Payer: BCBS MAPPO |
$17.95
|
| Rate for Payer: BCBS Trust/PPO |
$59.02
|
| Rate for Payer: BCN Commercial |
$59.02
|
| Rate for Payer: BCN Medicare Advantage |
$17.95
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$12.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.84
|
| Rate for Payer: Meridian Medicaid |
$13.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$58.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PACE Senior Care Partners |
$17.05
|
| Rate for Payer: PACE SWMI |
$17.95
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$17.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.46
|
| Rate for Payer: Priority Health Medicare |
$18.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.97
|
| Rate for Payer: Railroad Medicare Medicare |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.18
|
| Rate for Payer: UHC Core |
$59.94
|
| Rate for Payer: UHC Exchange |
$17.95
|
| Rate for Payer: UHC Medicaid |
$12.66
|
| Rate for Payer: UHC Medicare Advantage |
$17.95
|
| Rate for Payer: UHCCP Medicaid |
$12.66
|
| Rate for Payer: VA VA |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$28.25
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$25.43 |
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: Aetna Medicare |
$7.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.83
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$7.06
|
| Rate for Payer: BCBS Trust/PPO |
$23.22
|
| Rate for Payer: BCN Commercial |
$23.22
|
| Rate for Payer: BCN Medicare Advantage |
$7.06
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.06
|
| Rate for Payer: Healthscope Commercial |
$25.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.42
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.01
|
| Rate for Payer: Nomi Health Commercial |
$23.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.19
|
| Rate for Payer: PACE Senior Care Partners |
$6.71
|
| Rate for Payer: PACE SWMI |
$7.06
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.58
|
| Rate for Payer: Priority Health Medicare |
$7.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.86
|
| Rate for Payer: UHC Core |
$23.59
|
| Rate for Payer: UHC Exchange |
$7.06
|
| Rate for Payer: UHC Medicaid |
$4.98
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: VA VA |
$7.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$28.25
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$25.43 |
| Rate for Payer: Aetna Commercial |
$24.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.33
|
| Rate for Payer: BCN Commercial |
$23.33
|
| Rate for Payer: Cash Price |
$22.60
|
| Rate for Payer: Cofinity Commercial |
$24.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$25.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.01
|
| Rate for Payer: Nomi Health Commercial |
$23.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.19
|
| Rate for Payer: PHP Commercial |
$24.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.86
|
| Rate for Payer: UHC Core |
$23.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.19
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.56
|
| Rate for Payer: BCBS Complete |
$12.77
|
| Rate for Payer: BCBS MAPPO |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.71
|
| Rate for Payer: BCN Commercial |
$56.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.25
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$12.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$12.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Senior Care Partners |
$16.38
|
| Rate for Payer: PACE SWMI |
$17.25
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Medicare |
$17.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: UHC Exchange |
$17.25
|
| Rate for Payer: UHC Medicaid |
$12.16
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$12.16
|
| Rate for Payer: VA VA |
$17.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.01 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: BCBS Trust/PPO |
$56.97
|
| Rate for Payer: BCN Commercial |
$56.97
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.56
|
| Rate for Payer: BCBS Complete |
$12.77
|
| Rate for Payer: BCBS MAPPO |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.71
|
| Rate for Payer: BCN Commercial |
$56.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.25
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$12.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$12.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Senior Care Partners |
$16.38
|
| Rate for Payer: PACE SWMI |
$17.25
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Medicare |
$17.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: UHC Exchange |
$17.25
|
| Rate for Payer: UHC Medicaid |
$12.16
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$12.16
|
| Rate for Payer: VA VA |
$17.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.01 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: BCBS Trust/PPO |
$56.97
|
| Rate for Payer: BCN Commercial |
$56.97
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
OP
|
$456.30
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$80.45 |
| Max. Negotiated Rate |
$410.67 |
| Rate for Payer: Aetna Commercial |
$387.86
|
| Rate for Payer: Aetna Medicare |
$118.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.59
|
| Rate for Payer: BCBS Complete |
$84.46
|
| Rate for Payer: BCBS MAPPO |
$114.08
|
| Rate for Payer: BCBS Trust/PPO |
$375.12
|
| Rate for Payer: BCN Commercial |
$375.12
|
| Rate for Payer: BCN Medicare Advantage |
$114.08
|
| Rate for Payer: Cash Price |
$365.04
|
| Rate for Payer: Cash Price |
$365.04
|
| Rate for Payer: Cofinity Commercial |
$392.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.08
|
| Rate for Payer: Healthscope Commercial |
$410.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.23
|
| Rate for Payer: Mclaren Medicaid |
$80.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.78
|
| Rate for Payer: Meridian Medicaid |
$84.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$387.86
|
| Rate for Payer: Nomi Health Commercial |
$374.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.23
|
| Rate for Payer: PACE Senior Care Partners |
$108.37
|
| Rate for Payer: PACE SWMI |
$114.08
|
| Rate for Payer: PHP Commercial |
$387.86
|
| Rate for Payer: PHP Medicare Advantage |
$114.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$396.98
|
| Rate for Payer: Priority Health Medicare |
$115.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.58
|
| Rate for Payer: Railroad Medicare Medicare |
$114.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.54
|
| Rate for Payer: UHC Core |
$381.01
|
| Rate for Payer: UHC Exchange |
$114.08
|
| Rate for Payer: UHC Medicaid |
$80.45
|
| Rate for Payer: UHC Medicare Advantage |
$114.08
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$114.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.23
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
IP
|
$456.30
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$410.67 |
| Rate for Payer: Aetna Commercial |
$387.86
|
| Rate for Payer: BCBS Trust/PPO |
$376.86
|
| Rate for Payer: BCN Commercial |
$376.86
|
| Rate for Payer: Cash Price |
$365.04
|
| Rate for Payer: Cofinity Commercial |
$392.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.04
|
| Rate for Payer: Healthscope Commercial |
$410.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$387.86
|
| Rate for Payer: Nomi Health Commercial |
$374.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$342.23
|
| Rate for Payer: PHP Commercial |
$387.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$396.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.54
|
| Rate for Payer: UHC Core |
$381.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.23
|
|
