|
HC UA DIPSTICK AUTO
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$17.87
|
| Rate for Payer: BCN Commercial |
$17.87
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.04
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
IP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.51
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
OP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: Aetna Medicare |
$3.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.98
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$3.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.47
|
| Rate for Payer: BCN Commercial |
$10.47
|
| Rate for Payer: BCN Medicare Advantage |
$3.18
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Mclaren Medicaid |
$2.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.02
|
| Rate for Payer: PACE SWMI |
$3.18
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: PHP Medicare Advantage |
$3.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Medicare |
$3.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: UHC Exchange |
$3.18
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHC Medicare Advantage |
$3.18
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$3.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.32
|
| Rate for Payer: BCBS Complete |
$7.30
|
| Rate for Payer: BCBS MAPPO |
$9.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.86
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.86
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$7.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Senior Care Partners |
$9.36
|
| Rate for Payer: PACE SWMI |
$9.86
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$9.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: UHC Exchange |
$9.86
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.86
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$9.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$32.57
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
OP
|
$85.96
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Aetna Medicare |
$22.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.86
|
| Rate for Payer: BCBS Complete |
$15.91
|
| Rate for Payer: BCBS MAPPO |
$21.49
|
| Rate for Payer: BCBS Trust/PPO |
$70.67
|
| Rate for Payer: BCN Commercial |
$70.67
|
| Rate for Payer: BCN Medicare Advantage |
$21.49
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.49
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Mclaren Medicaid |
$15.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.56
|
| Rate for Payer: Meridian Medicaid |
$15.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PACE Senior Care Partners |
$20.42
|
| Rate for Payer: PACE SWMI |
$21.49
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: PHP Medicare Advantage |
$21.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Medicare |
$21.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: Railroad Medicare Medicare |
$21.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: UHC Exchange |
$21.49
|
| Rate for Payer: UHC Medicaid |
$15.15
|
| Rate for Payer: UHC Medicare Advantage |
$21.49
|
| Rate for Payer: UHCCP Medicaid |
$15.15
|
| Rate for Payer: VA VA |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
IP
|
$85.96
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.83 |
| Max. Negotiated Rate |
$77.36 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: Cash Price |
$68.77
|
| Rate for Payer: Cofinity Commercial |
$73.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.77
|
| Rate for Payer: Healthscope Commercial |
$77.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.07
|
| Rate for Payer: Nomi Health Commercial |
$70.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.47
|
| Rate for Payer: PHP Commercial |
$73.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.64
|
| Rate for Payer: UHC Core |
$71.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.47
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
IP
|
$9,827.84
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,840.18 |
| Max. Negotiated Rate |
$8,845.06 |
| Rate for Payer: Aetna Commercial |
$8,353.66
|
| Rate for Payer: BCBS Trust/PPO |
$8,116.81
|
| Rate for Payer: BCN Commercial |
$8,116.81
|
| Rate for Payer: Cash Price |
$7,862.27
|
| Rate for Payer: Cofinity Commercial |
$8,451.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,862.27
|
| Rate for Payer: Healthscope Commercial |
$8,845.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,370.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,353.66
|
| Rate for Payer: Nomi Health Commercial |
$8,058.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,370.88
|
| Rate for Payer: PHP Commercial |
$8,353.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,550.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,840.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,648.50
|
| Rate for Payer: UHC Core |
$8,206.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,370.88
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
OP
|
$9,827.84
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,732.65 |
| Max. Negotiated Rate |
$8,845.06 |
| Rate for Payer: Aetna Commercial |
$8,353.66
|
| Rate for Payer: Aetna Medicare |
$2,555.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,071.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,071.20
|
| Rate for Payer: BCBS Complete |
$1,819.13
|
| Rate for Payer: BCBS MAPPO |
$2,456.96
|
| Rate for Payer: BCBS Trust/PPO |
$8,079.47
|
| Rate for Payer: BCN Commercial |
$8,079.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,456.96
|
| Rate for Payer: Cash Price |
$7,862.27
|
| Rate for Payer: Cofinity Commercial |
$8,451.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,862.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,456.96
|
| Rate for Payer: Healthscope Commercial |
$8,845.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,370.88
|
| Rate for Payer: Mclaren Medicaid |
$1,732.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,579.81
|
| Rate for Payer: Meridian Medicaid |
$1,819.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,825.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,702.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,353.66
|
| Rate for Payer: Nomi Health Commercial |
$8,058.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,370.88
|
| Rate for Payer: PACE Senior Care Partners |
$2,334.11
|
| Rate for Payer: PACE SWMI |
$2,456.96
|
| Rate for Payer: PHP Commercial |
$8,353.66
|
| Rate for Payer: PHP Medicare Advantage |
$2,456.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,732.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,550.22
|
| Rate for Payer: Priority Health Medicare |
$2,481.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,840.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,456.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,648.50
|
| Rate for Payer: UHC Core |
$8,206.25
|
| Rate for Payer: UHC Exchange |
$2,456.96
|
| Rate for Payer: UHC Medicaid |
$1,732.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,456.96
|
| Rate for Payer: UHCCP Medicaid |
$1,732.65
|
| Rate for Payer: VA VA |
$2,456.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,370.88
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
IP
|
$249.34
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$173.54 |
| Max. Negotiated Rate |
$224.41 |
| Rate for Payer: Aetna Commercial |
$211.94
|
| Rate for Payer: BCBS Trust/PPO |
$205.93
|
| Rate for Payer: BCN Commercial |
$205.93
|
| Rate for Payer: Cash Price |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$214.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.47
|
| Rate for Payer: Healthscope Commercial |
$224.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.94
|
| Rate for Payer: Nomi Health Commercial |
$204.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.00
|
| Rate for Payer: PHP Commercial |
$211.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$216.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.42
|
| Rate for Payer: UHC Core |
$208.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.00
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
OP
|
$249.34
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$224.41 |
| Rate for Payer: Aetna Commercial |
$211.94
|
| Rate for Payer: Aetna Medicare |
$64.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.92
|
| Rate for Payer: BCBS Complete |
$46.15
|
| Rate for Payer: BCBS MAPPO |
$62.34
|
| Rate for Payer: BCBS Trust/PPO |
$204.98
|
| Rate for Payer: BCN Commercial |
$204.98
|
| Rate for Payer: BCN Medicare Advantage |
$62.34
|
| Rate for Payer: Cash Price |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$214.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.34
|
| Rate for Payer: Healthscope Commercial |
$224.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.00
|
| Rate for Payer: Mclaren Medicaid |
$43.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.45
|
| Rate for Payer: Meridian Medicaid |
$46.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.94
|
| Rate for Payer: Nomi Health Commercial |
$204.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.00
|
| Rate for Payer: PACE Senior Care Partners |
$59.22
|
| Rate for Payer: PACE SWMI |
$62.34
|
| Rate for Payer: PHP Commercial |
$211.94
|
| Rate for Payer: PHP Medicare Advantage |
$62.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$216.93
|
| Rate for Payer: Priority Health Medicare |
$62.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.54
|
| Rate for Payer: Railroad Medicare Medicare |
$62.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.42
|
| Rate for Payer: UHC Core |
$208.20
|
| Rate for Payer: UHC Exchange |
$62.34
|
| Rate for Payer: UHC Medicaid |
$43.96
|
| Rate for Payer: UHC Medicare Advantage |
$62.34
|
| Rate for Payer: UHCCP Medicaid |
$43.96
|
| Rate for Payer: VA VA |
$62.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.00
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$217.91
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.42 |
| Max. Negotiated Rate |
$196.12 |
| Rate for Payer: Aetna Commercial |
$185.22
|
| Rate for Payer: Aetna Medicare |
$56.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.10
|
| Rate for Payer: BCBS Complete |
$40.34
|
| Rate for Payer: BCBS MAPPO |
$54.48
|
| Rate for Payer: BCBS Trust/PPO |
$179.14
|
| Rate for Payer: BCN Commercial |
$179.14
|
| Rate for Payer: BCN Medicare Advantage |
$54.48
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$187.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.48
|
| Rate for Payer: Healthscope Commercial |
$196.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.43
|
| Rate for Payer: Mclaren Medicaid |
$38.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.20
|
| Rate for Payer: Meridian Medicaid |
$40.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: PACE Senior Care Partners |
$51.75
|
| Rate for Payer: PACE SWMI |
$54.48
|
| Rate for Payer: PHP Commercial |
$185.22
|
| Rate for Payer: PHP Medicare Advantage |
$54.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.58
|
| Rate for Payer: Priority Health Medicare |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.67
|
| Rate for Payer: Railroad Medicare Medicare |
$54.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.76
|
| Rate for Payer: UHC Core |
$181.95
|
| Rate for Payer: UHC Exchange |
$54.48
|
| Rate for Payer: UHC Medicaid |
$38.42
|
| Rate for Payer: UHC Medicare Advantage |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$38.42
|
| Rate for Payer: VA VA |
$54.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.43
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
IP
|
$217.91
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$151.67 |
| Max. Negotiated Rate |
$196.12 |
| Rate for Payer: Aetna Commercial |
$185.22
|
| Rate for Payer: BCBS Trust/PPO |
$179.97
|
| Rate for Payer: BCN Commercial |
$179.97
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$187.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$196.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: PHP Commercial |
$185.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.76
|
| Rate for Payer: UHC Core |
$181.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.43
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
OP
|
$217.91
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.42 |
| Max. Negotiated Rate |
$196.12 |
| Rate for Payer: Aetna Commercial |
$185.22
|
| Rate for Payer: Aetna Medicare |
$56.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.10
|
| Rate for Payer: BCBS Complete |
$40.34
|
| Rate for Payer: BCBS MAPPO |
$54.48
|
| Rate for Payer: BCBS Trust/PPO |
$179.14
|
| Rate for Payer: BCN Commercial |
$179.14
|
| Rate for Payer: BCN Medicare Advantage |
$54.48
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$187.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.48
|
| Rate for Payer: Healthscope Commercial |
$196.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.43
|
| Rate for Payer: Mclaren Medicaid |
$38.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.20
|
| Rate for Payer: Meridian Medicaid |
$40.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: PACE Senior Care Partners |
$51.75
|
| Rate for Payer: PACE SWMI |
$54.48
|
| Rate for Payer: PHP Commercial |
$185.22
|
| Rate for Payer: PHP Medicare Advantage |
$54.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.58
|
| Rate for Payer: Priority Health Medicare |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.67
|
| Rate for Payer: Railroad Medicare Medicare |
$54.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.76
|
| Rate for Payer: UHC Core |
$181.95
|
| Rate for Payer: UHC Exchange |
$54.48
|
| Rate for Payer: UHC Medicaid |
$38.42
|
| Rate for Payer: UHC Medicare Advantage |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$38.42
|
| Rate for Payer: VA VA |
$54.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.43
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
IP
|
$217.91
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$151.67 |
| Max. Negotiated Rate |
$196.12 |
| Rate for Payer: Aetna Commercial |
$185.22
|
| Rate for Payer: BCBS Trust/PPO |
$179.97
|
| Rate for Payer: BCN Commercial |
$179.97
|
| Rate for Payer: Cash Price |
$174.33
|
| Rate for Payer: Cofinity Commercial |
$187.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.33
|
| Rate for Payer: Healthscope Commercial |
$196.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.22
|
| Rate for Payer: Nomi Health Commercial |
$178.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.43
|
| Rate for Payer: PHP Commercial |
$185.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.76
|
| Rate for Payer: UHC Core |
$181.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.43
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
IP
|
$352.12
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$245.08 |
| Max. Negotiated Rate |
$316.91 |
| Rate for Payer: Aetna Commercial |
$299.30
|
| Rate for Payer: BCBS Trust/PPO |
$290.82
|
| Rate for Payer: BCN Commercial |
$290.82
|
| Rate for Payer: Cash Price |
$281.70
|
| Rate for Payer: Cofinity Commercial |
$302.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.70
|
| Rate for Payer: Healthscope Commercial |
$316.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.30
|
| Rate for Payer: Nomi Health Commercial |
$288.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.09
|
| Rate for Payer: PHP Commercial |
$299.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$306.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.87
|
| Rate for Payer: UHC Core |
$294.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.09
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
OP
|
$352.12
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$62.08 |
| Max. Negotiated Rate |
$316.91 |
| Rate for Payer: Aetna Commercial |
$299.30
|
| Rate for Payer: Aetna Medicare |
$91.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.04
|
| Rate for Payer: BCBS Complete |
$65.18
|
| Rate for Payer: BCBS MAPPO |
$88.03
|
| Rate for Payer: BCBS Trust/PPO |
$289.48
|
| Rate for Payer: BCCCP Commercial |
$119.92
|
| Rate for Payer: BCN Commercial |
$289.48
|
| Rate for Payer: BCN Medicare Advantage |
$88.03
|
| Rate for Payer: Cash Price |
$281.70
|
| Rate for Payer: Cash Price |
$281.70
|
| Rate for Payer: Cofinity Commercial |
$302.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.03
|
| Rate for Payer: Healthscope Commercial |
$316.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.09
|
| Rate for Payer: Mclaren Medicaid |
$62.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.43
|
| Rate for Payer: Meridian Medicaid |
$65.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.30
|
| Rate for Payer: Nomi Health Commercial |
$288.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$264.09
|
| Rate for Payer: PACE Senior Care Partners |
$83.63
|
| Rate for Payer: PACE SWMI |
$88.03
|
| Rate for Payer: PHP Commercial |
$299.30
|
| Rate for Payer: PHP Medicare Advantage |
$88.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$306.34
|
| Rate for Payer: Priority Health Medicare |
$88.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.08
|
| Rate for Payer: Railroad Medicare Medicare |
$88.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.87
|
| Rate for Payer: UHC Core |
$294.02
|
| Rate for Payer: UHC Exchange |
$88.03
|
| Rate for Payer: UHC Medicaid |
$62.08
|
| Rate for Payer: UHC Medicare Advantage |
$88.03
|
| Rate for Payer: UHCCP Medicaid |
$62.08
|
| Rate for Payer: VA VA |
$88.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.09
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$105.27
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.27 |
| Max. Negotiated Rate |
$94.74 |
| Rate for Payer: Aetna Commercial |
$89.48
|
| Rate for Payer: BCBS Trust/PPO |
$86.94
|
| Rate for Payer: BCN Commercial |
$86.94
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$90.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Healthscope Commercial |
$94.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.48
|
| Rate for Payer: Nomi Health Commercial |
$86.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.95
|
| Rate for Payer: PHP Commercial |
$89.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.64
|
| Rate for Payer: UHC Core |
$87.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.95
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$105.27
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$18.56 |
| Max. Negotiated Rate |
$94.74 |
| Rate for Payer: Aetna Commercial |
$89.48
|
| Rate for Payer: Aetna Medicare |
$27.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.90
|
| Rate for Payer: BCBS Complete |
$19.49
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCBS Trust/PPO |
$86.54
|
| Rate for Payer: BCN Commercial |
$86.54
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: Cash Price |
$84.22
|
| Rate for Payer: Cofinity Commercial |
$90.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$94.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.95
|
| Rate for Payer: Mclaren Medicaid |
$18.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.63
|
| Rate for Payer: Meridian Medicaid |
$19.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.48
|
| Rate for Payer: Nomi Health Commercial |
$86.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.95
|
| Rate for Payer: PACE Senior Care Partners |
$25.00
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PHP Commercial |
$89.48
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.58
|
| Rate for Payer: Priority Health Medicare |
$26.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.27
|
| Rate for Payer: Railroad Medicare Medicare |
$26.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.64
|
| Rate for Payer: UHC Core |
$87.90
|
| Rate for Payer: UHC Exchange |
$26.32
|
| Rate for Payer: UHC Medicaid |
$18.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UHCCP Medicaid |
$18.56
|
| Rate for Payer: VA VA |
$26.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.95
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$9,848.75
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,854.73 |
| Max. Negotiated Rate |
$8,863.88 |
| Rate for Payer: Aetna Commercial |
$8,371.44
|
| Rate for Payer: BCBS Trust/PPO |
$8,134.08
|
| Rate for Payer: BCN Commercial |
$8,134.08
|
| Rate for Payer: Cash Price |
$7,879.00
|
| Rate for Payer: Cofinity Commercial |
$8,469.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,879.00
|
| Rate for Payer: Healthscope Commercial |
$8,863.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,386.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,371.44
|
| Rate for Payer: Nomi Health Commercial |
$8,075.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,386.56
|
| Rate for Payer: PHP Commercial |
$8,371.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,568.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,854.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,666.90
|
| Rate for Payer: UHC Core |
$8,223.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,386.56
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$9,848.75
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,736.33 |
| Max. Negotiated Rate |
$8,863.88 |
| Rate for Payer: Aetna Commercial |
$8,371.44
|
| Rate for Payer: Aetna Medicare |
$2,560.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,077.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,077.73
|
| Rate for Payer: BCBS Complete |
$1,823.00
|
| Rate for Payer: BCBS MAPPO |
$2,462.19
|
| Rate for Payer: BCBS Trust/PPO |
$8,096.66
|
| Rate for Payer: BCN Commercial |
$8,096.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,462.19
|
| Rate for Payer: Cash Price |
$7,879.00
|
| Rate for Payer: Cofinity Commercial |
$8,469.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,879.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,462.19
|
| Rate for Payer: Healthscope Commercial |
$8,863.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,386.56
|
| Rate for Payer: Mclaren Medicaid |
$1,736.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,585.30
|
| Rate for Payer: Meridian Medicaid |
$1,823.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,831.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,708.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,371.44
|
| Rate for Payer: Nomi Health Commercial |
$8,075.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,386.56
|
| Rate for Payer: PACE Senior Care Partners |
$2,339.08
|
| Rate for Payer: PACE SWMI |
$2,462.19
|
| Rate for Payer: PHP Commercial |
$8,371.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,462.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,736.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,568.41
|
| Rate for Payer: Priority Health Medicare |
$2,486.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,854.73
|
| Rate for Payer: Railroad Medicare Medicare |
$2,462.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,666.90
|
| Rate for Payer: UHC Core |
$8,223.71
|
| Rate for Payer: UHC Exchange |
$2,462.19
|
| Rate for Payer: UHC Medicaid |
$1,736.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,462.19
|
| Rate for Payer: UHCCP Medicaid |
$1,736.33
|
| Rate for Payer: VA VA |
$2,462.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,386.56
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,147.85
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.37 |
| Max. Negotiated Rate |
$1,033.07 |
| Rate for Payer: Aetna Commercial |
$975.67
|
| Rate for Payer: Aetna Medicare |
$298.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$358.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$358.70
|
| Rate for Payer: BCBS Complete |
$212.47
|
| Rate for Payer: BCBS MAPPO |
$286.96
|
| Rate for Payer: BCBS Trust/PPO |
$943.65
|
| Rate for Payer: BCN Commercial |
$943.65
|
| Rate for Payer: BCN Medicare Advantage |
$286.96
|
| Rate for Payer: Cash Price |
$918.28
|
| Rate for Payer: Cofinity Commercial |
$987.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.96
|
| Rate for Payer: Healthscope Commercial |
$1,033.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.89
|
| Rate for Payer: Mclaren Medicaid |
$202.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.31
|
| Rate for Payer: Meridian Medicaid |
$212.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$330.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$315.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.67
|
| Rate for Payer: Nomi Health Commercial |
$941.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.89
|
| Rate for Payer: PACE Senior Care Partners |
$272.61
|
| Rate for Payer: PACE SWMI |
$286.96
|
| Rate for Payer: PHP Commercial |
$975.67
|
| Rate for Payer: PHP Medicare Advantage |
$286.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$998.63
|
| Rate for Payer: Priority Health Medicare |
$289.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.90
|
| Rate for Payer: Railroad Medicare Medicare |
$286.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.11
|
| Rate for Payer: UHC Core |
$958.45
|
| Rate for Payer: UHC Exchange |
$286.96
|
| Rate for Payer: UHC Medicaid |
$202.37
|
| Rate for Payer: UHC Medicare Advantage |
$286.96
|
| Rate for Payer: UHCCP Medicaid |
$202.37
|
| Rate for Payer: VA VA |
$286.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.89
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
IP
|
$1,147.85
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$798.90 |
| Max. Negotiated Rate |
$1,033.07 |
| Rate for Payer: Aetna Commercial |
$975.67
|
| Rate for Payer: BCBS Trust/PPO |
$948.01
|
| Rate for Payer: BCN Commercial |
$948.01
|
| Rate for Payer: Cash Price |
$918.28
|
| Rate for Payer: Cofinity Commercial |
$987.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.28
|
| Rate for Payer: Healthscope Commercial |
$1,033.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.67
|
| Rate for Payer: Nomi Health Commercial |
$941.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.89
|
| Rate for Payer: PHP Commercial |
$975.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$998.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$798.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.11
|
| Rate for Payer: UHC Core |
$958.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.89
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
IP
|
$686.66
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$477.92 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: BCBS Trust/PPO |
$567.11
|
| Rate for Payer: BCN Commercial |
$567.11
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.26
|
| Rate for Payer: UHC Core |
$573.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
OP
|
$686.66
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.06 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: Aetna Medicare |
$178.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.58
|
| Rate for Payer: BCBS Complete |
$127.10
|
| Rate for Payer: BCBS MAPPO |
$171.66
|
| Rate for Payer: BCBS Trust/PPO |
$564.50
|
| Rate for Payer: BCN Commercial |
$564.50
|
| Rate for Payer: BCN Medicare Advantage |
$171.66
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.66
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: Mclaren Medicaid |
$121.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.25
|
| Rate for Payer: Meridian Medicaid |
$127.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PACE Senior Care Partners |
$163.08
|
| Rate for Payer: PACE SWMI |
$171.66
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: PHP Medicare Advantage |
$171.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.39
|
| Rate for Payer: Priority Health Medicare |
$173.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.92
|
| Rate for Payer: Railroad Medicare Medicare |
$171.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.26
|
| Rate for Payer: UHC Core |
$573.36
|
| Rate for Payer: UHC Exchange |
$171.66
|
| Rate for Payer: UHC Medicaid |
$121.06
|
| Rate for Payer: UHC Medicare Advantage |
$171.66
|
| Rate for Payer: UHCCP Medicaid |
$121.06
|
| Rate for Payer: VA VA |
$171.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
