|
HC URINE PRESUMPTIVE ID
|
Facility
|
OP
|
$66.38
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.70 |
| Max. Negotiated Rate |
$59.74 |
| Rate for Payer: Aetna Commercial |
$56.42
|
| Rate for Payer: Aetna Medicare |
$17.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.74
|
| Rate for Payer: BCBS Complete |
$12.29
|
| Rate for Payer: BCBS MAPPO |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$54.57
|
| Rate for Payer: BCN Commercial |
$54.57
|
| Rate for Payer: BCN Medicare Advantage |
$16.59
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cofinity Commercial |
$57.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$59.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.78
|
| Rate for Payer: Mclaren Medicaid |
$11.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.42
|
| Rate for Payer: Meridian Medicaid |
$12.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Nomi Health Commercial |
$54.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.78
|
| Rate for Payer: PACE Senior Care Partners |
$15.77
|
| Rate for Payer: PACE SWMI |
$16.59
|
| Rate for Payer: PHP Commercial |
$56.42
|
| Rate for Payer: PHP Medicare Advantage |
$16.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.75
|
| Rate for Payer: Priority Health Medicare |
$16.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.20
|
| Rate for Payer: Railroad Medicare Medicare |
$16.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.41
|
| Rate for Payer: UHC Core |
$55.43
|
| Rate for Payer: UHC Exchange |
$16.59
|
| Rate for Payer: UHC Medicaid |
$11.70
|
| Rate for Payer: UHC Medicare Advantage |
$16.59
|
| Rate for Payer: UHCCP Medicaid |
$11.70
|
| Rate for Payer: VA VA |
$16.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.78
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
IP
|
$66.38
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.20 |
| Max. Negotiated Rate |
$59.74 |
| Rate for Payer: Aetna Commercial |
$56.42
|
| Rate for Payer: BCBS Trust/PPO |
$54.82
|
| Rate for Payer: BCN Commercial |
$54.82
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cofinity Commercial |
$57.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Healthscope Commercial |
$59.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Nomi Health Commercial |
$54.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.78
|
| Rate for Payer: PHP Commercial |
$56.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.41
|
| Rate for Payer: UHC Core |
$55.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.78
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
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 URINE REDUCING SUBSTANCES
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
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 URIN MDMA
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.13
|
| Rate for Payer: BCBS Complete |
$17.85
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.31
|
| Rate for Payer: Meridian Medicaid |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Medicare |
$24.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$17.00
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URIN MDMA
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.11 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: BCBS Trust/PPO |
$79.63
|
| Rate for Payer: BCN Commercial |
$79.63
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URN COTININE.
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC URN COTININE.
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC URN MDMA
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC URN MDMA
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC URN TRICYCLIC
|
Facility
|
IP
|
$48.72
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.91 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: BCBS Trust/PPO |
$40.24
|
| Rate for Payer: BCN Commercial |
$40.24
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$39.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.87
|
| Rate for Payer: UHC Core |
$40.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC URN TRICYCLIC
|
Facility
|
OP
|
$48.72
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: Aetna Medicare |
$12.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.22
|
| Rate for Payer: BCBS Complete |
$9.02
|
| Rate for Payer: BCBS MAPPO |
$12.18
|
| Rate for Payer: BCBS Trust/PPO |
$40.05
|
| Rate for Payer: BCN Commercial |
$40.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.18
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.18
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Mclaren Medicaid |
$8.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.79
|
| Rate for Payer: Meridian Medicaid |
$9.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$39.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PACE Senior Care Partners |
$11.57
|
| Rate for Payer: PACE SWMI |
$12.18
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: PHP Medicare Advantage |
$12.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.39
|
| Rate for Payer: Priority Health Medicare |
$12.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.87
|
| Rate for Payer: UHC Core |
$40.68
|
| Rate for Payer: UHC Exchange |
$12.18
|
| Rate for Payer: UHC Medicaid |
$8.59
|
| Rate for Payer: UHC Medicare Advantage |
$12.18
|
| Rate for Payer: UHCCP Medicaid |
$8.59
|
| Rate for Payer: VA VA |
$12.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
OP
|
$2,003.04
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.14 |
| Max. Negotiated Rate |
$1,802.74 |
| Rate for Payer: Aetna Commercial |
$1,702.58
|
| Rate for Payer: Aetna Medicare |
$520.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.95
|
| Rate for Payer: BCBS Complete |
$370.76
|
| Rate for Payer: BCBS MAPPO |
$500.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.70
|
| Rate for Payer: BCN Commercial |
$1,646.70
|
| Rate for Payer: BCN Medicare Advantage |
$500.76
|
| Rate for Payer: Cash Price |
$1,602.43
|
| Rate for Payer: Cofinity Commercial |
$1,722.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.76
|
| Rate for Payer: Healthscope Commercial |
$1,802.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.28
|
| Rate for Payer: Mclaren Medicaid |
$353.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.80
|
| Rate for Payer: Meridian Medicaid |
$370.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.58
|
| Rate for Payer: Nomi Health Commercial |
$1,642.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.28
|
| Rate for Payer: PACE Senior Care Partners |
$475.72
|
| Rate for Payer: PACE SWMI |
$500.76
|
| Rate for Payer: PHP Commercial |
$1,702.58
|
| Rate for Payer: PHP Medicare Advantage |
$500.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,742.64
|
| Rate for Payer: Priority Health Medicare |
$505.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.12
|
| Rate for Payer: Railroad Medicare Medicare |
$500.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,762.68
|
| Rate for Payer: UHC Core |
$1,672.54
|
| Rate for Payer: UHC Exchange |
$500.76
|
| Rate for Payer: UHC Medicaid |
$353.14
|
| Rate for Payer: UHC Medicare Advantage |
$500.76
|
| Rate for Payer: UHCCP Medicaid |
$353.14
|
| Rate for Payer: VA VA |
$500.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.28
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
IP
|
$2,003.04
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,394.12 |
| Max. Negotiated Rate |
$1,802.74 |
| Rate for Payer: Aetna Commercial |
$1,702.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.31
|
| Rate for Payer: BCN Commercial |
$1,654.31
|
| Rate for Payer: Cash Price |
$1,602.43
|
| Rate for Payer: Cofinity Commercial |
$1,722.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.43
|
| Rate for Payer: Healthscope Commercial |
$1,802.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.58
|
| Rate for Payer: Nomi Health Commercial |
$1,642.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.28
|
| Rate for Payer: PHP Commercial |
$1,702.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,742.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,762.68
|
| Rate for Payer: UHC Core |
$1,672.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.28
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
OP
|
$16.70
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$4.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.22
|
| Rate for Payer: BCBS Complete |
$3.09
|
| Rate for Payer: BCBS MAPPO |
$4.17
|
| Rate for Payer: BCBS Trust/PPO |
$13.73
|
| Rate for Payer: BCN Commercial |
$13.73
|
| Rate for Payer: BCN Medicare Advantage |
$4.17
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.17
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Mclaren Medicaid |
$2.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.38
|
| Rate for Payer: Meridian Medicaid |
$3.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$13.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PACE Senior Care Partners |
$3.97
|
| Rate for Payer: PACE SWMI |
$4.17
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.53
|
| Rate for Payer: Priority Health Medicare |
$4.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$13.94
|
| Rate for Payer: UHC Exchange |
$4.17
|
| Rate for Payer: UHC Medicaid |
$2.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.17
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$4.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
IP
|
$16.70
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.62 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: BCBS Trust/PPO |
$13.79
|
| Rate for Payer: BCN Commercial |
$13.79
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$13.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Core |
$13.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
HC US AAA SCREENING
|
Facility
|
IP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$260.55 |
| Max. Negotiated Rate |
$336.92 |
| Rate for Payer: Aetna Commercial |
$318.21
|
| Rate for Payer: BCBS Trust/PPO |
$309.18
|
| Rate for Payer: BCN Commercial |
$309.18
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Commercial |
$321.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Healthscope Commercial |
$336.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.21
|
| Rate for Payer: Nomi Health Commercial |
$306.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| Rate for Payer: PHP Commercial |
$318.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.44
|
| Rate for Payer: UHC Core |
$312.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.77
|
|
|
HC US AAA SCREENING
|
Facility
|
OP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$336.92 |
| Rate for Payer: Aetna Commercial |
$318.21
|
| Rate for Payer: Aetna Medicare |
$97.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.99
|
| Rate for Payer: BCBS Complete |
$69.29
|
| Rate for Payer: BCBS MAPPO |
$93.59
|
| Rate for Payer: BCBS Trust/PPO |
$307.76
|
| Rate for Payer: BCN Commercial |
$307.76
|
| Rate for Payer: BCN Medicare Advantage |
$93.59
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Commercial |
$321.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.59
|
| Rate for Payer: Healthscope Commercial |
$336.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.77
|
| Rate for Payer: Mclaren Medicaid |
$66.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.27
|
| Rate for Payer: Meridian Medicaid |
$69.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.21
|
| Rate for Payer: Nomi Health Commercial |
$306.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| Rate for Payer: PACE Senior Care Partners |
$88.91
|
| Rate for Payer: PACE SWMI |
$93.59
|
| Rate for Payer: PHP Commercial |
$318.21
|
| Rate for Payer: PHP Medicare Advantage |
$93.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.69
|
| Rate for Payer: Priority Health Medicare |
$94.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.55
|
| Rate for Payer: Railroad Medicare Medicare |
$93.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.44
|
| Rate for Payer: UHC Core |
$312.59
|
| Rate for Payer: UHC Exchange |
$93.59
|
| Rate for Payer: UHC Medicaid |
$66.00
|
| Rate for Payer: UHC Medicare Advantage |
$93.59
|
| Rate for Payer: UHCCP Medicaid |
$66.00
|
| Rate for Payer: VA VA |
$93.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.77
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
OP
|
$969.94
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$171.00 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna Commercial |
$824.45
|
| Rate for Payer: Aetna Medicare |
$252.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.11
|
| Rate for Payer: BCBS Complete |
$179.54
|
| Rate for Payer: BCBS MAPPO |
$242.49
|
| Rate for Payer: BCBS Trust/PPO |
$797.39
|
| Rate for Payer: BCN Commercial |
$797.39
|
| Rate for Payer: BCN Medicare Advantage |
$242.49
|
| Rate for Payer: Cash Price |
$775.95
|
| Rate for Payer: Cofinity Commercial |
$834.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.49
|
| Rate for Payer: Healthscope Commercial |
$872.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$727.46
|
| Rate for Payer: Mclaren Medicaid |
$171.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$254.61
|
| Rate for Payer: Meridian Medicaid |
$179.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$266.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.45
|
| Rate for Payer: Nomi Health Commercial |
$795.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.46
|
| Rate for Payer: PACE Senior Care Partners |
$230.36
|
| Rate for Payer: PACE SWMI |
$242.49
|
| Rate for Payer: PHP Commercial |
$824.45
|
| Rate for Payer: PHP Medicare Advantage |
$242.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$843.85
|
| Rate for Payer: Priority Health Medicare |
$244.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$675.08
|
| Rate for Payer: Railroad Medicare Medicare |
$242.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.55
|
| Rate for Payer: UHC Core |
$809.90
|
| Rate for Payer: UHC Exchange |
$242.49
|
| Rate for Payer: UHC Medicaid |
$171.00
|
| Rate for Payer: UHC Medicare Advantage |
$242.49
|
| Rate for Payer: UHCCP Medicaid |
$171.00
|
| Rate for Payer: VA VA |
$242.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$727.46
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
IP
|
$969.94
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$675.08 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna Commercial |
$824.45
|
| Rate for Payer: BCBS Trust/PPO |
$801.07
|
| Rate for Payer: BCN Commercial |
$801.07
|
| Rate for Payer: Cash Price |
$775.95
|
| Rate for Payer: Cofinity Commercial |
$834.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.95
|
| Rate for Payer: Healthscope Commercial |
$872.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$727.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$824.45
|
| Rate for Payer: Nomi Health Commercial |
$795.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$727.46
|
| Rate for Payer: PHP Commercial |
$824.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$843.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$675.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$853.55
|
| Rate for Payer: UHC Core |
$809.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$727.46
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
IP
|
$832.99
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$579.76 |
| Max. Negotiated Rate |
$749.69 |
| Rate for Payer: Aetna Commercial |
$708.04
|
| Rate for Payer: BCBS Trust/PPO |
$687.97
|
| Rate for Payer: BCN Commercial |
$687.97
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$716.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Healthscope Commercial |
$749.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: PHP Commercial |
$708.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.03
|
| Rate for Payer: UHC Core |
$695.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.74
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
OP
|
$832.99
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$146.86 |
| Max. Negotiated Rate |
$749.69 |
| Rate for Payer: Aetna Commercial |
$708.04
|
| Rate for Payer: Aetna Medicare |
$216.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.31
|
| Rate for Payer: BCBS Complete |
$154.19
|
| Rate for Payer: BCBS MAPPO |
$208.25
|
| Rate for Payer: BCBS Trust/PPO |
$684.80
|
| Rate for Payer: BCN Commercial |
$684.80
|
| Rate for Payer: BCN Medicare Advantage |
$208.25
|
| Rate for Payer: Cash Price |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$716.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.25
|
| Rate for Payer: Healthscope Commercial |
$749.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.74
|
| Rate for Payer: Mclaren Medicaid |
$146.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.66
|
| Rate for Payer: Meridian Medicaid |
$154.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$708.04
|
| Rate for Payer: Nomi Health Commercial |
$683.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.74
|
| Rate for Payer: PACE Senior Care Partners |
$197.84
|
| Rate for Payer: PACE SWMI |
$208.25
|
| Rate for Payer: PHP Commercial |
$708.04
|
| Rate for Payer: PHP Medicare Advantage |
$208.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.70
|
| Rate for Payer: Priority Health Medicare |
$210.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.76
|
| Rate for Payer: Railroad Medicare Medicare |
$208.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.03
|
| Rate for Payer: UHC Core |
$695.55
|
| Rate for Payer: UHC Exchange |
$208.25
|
| Rate for Payer: UHC Medicaid |
$146.86
|
| Rate for Payer: UHC Medicare Advantage |
$208.25
|
| Rate for Payer: UHCCP Medicaid |
$146.86
|
| Rate for Payer: VA VA |
$208.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.74
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
IP
|
$614.24
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$427.51 |
| Max. Negotiated Rate |
$552.82 |
| Rate for Payer: Aetna Commercial |
$522.10
|
| Rate for Payer: BCBS Trust/PPO |
$507.30
|
| Rate for Payer: BCN Commercial |
$507.30
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$528.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Healthscope Commercial |
$552.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: PHP Commercial |
$522.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.53
|
| Rate for Payer: UHC Core |
$512.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.68
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
OP
|
$614.24
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$95.65 |
| Max. Negotiated Rate |
$552.82 |
| Rate for Payer: Aetna Commercial |
$522.10
|
| Rate for Payer: Aetna Medicare |
$159.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.95
|
| Rate for Payer: BCBS Complete |
$113.70
|
| Rate for Payer: BCBS MAPPO |
$153.56
|
| Rate for Payer: BCBS Trust/PPO |
$504.97
|
| Rate for Payer: BCCCP Commercial |
$95.65
|
| Rate for Payer: BCN Commercial |
$504.97
|
| Rate for Payer: BCN Medicare Advantage |
$153.56
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cash Price |
$491.39
|
| Rate for Payer: Cofinity Commercial |
$528.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$491.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.56
|
| Rate for Payer: Healthscope Commercial |
$552.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$460.68
|
| Rate for Payer: Mclaren Medicaid |
$108.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.24
|
| Rate for Payer: Meridian Medicaid |
$113.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$168.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.10
|
| Rate for Payer: Nomi Health Commercial |
$503.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.68
|
| Rate for Payer: PACE Senior Care Partners |
$145.88
|
| Rate for Payer: PACE SWMI |
$153.56
|
| Rate for Payer: PHP Commercial |
$522.10
|
| Rate for Payer: PHP Medicare Advantage |
$153.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$534.39
|
| Rate for Payer: Priority Health Medicare |
$155.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$427.51
|
| Rate for Payer: Railroad Medicare Medicare |
$153.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.53
|
| Rate for Payer: UHC Core |
$512.89
|
| Rate for Payer: UHC Exchange |
$153.56
|
| Rate for Payer: UHC Medicaid |
$108.29
|
| Rate for Payer: UHC Medicare Advantage |
$153.56
|
| Rate for Payer: UHCCP Medicaid |
$108.29
|
| Rate for Payer: VA VA |
$153.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$460.68
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
OP
|
$573.70
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.63 |
| Max. Negotiated Rate |
$516.33 |
| Rate for Payer: Aetna Commercial |
$487.64
|
| Rate for Payer: Aetna Medicare |
$149.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.28
|
| Rate for Payer: BCBS Complete |
$106.19
|
| Rate for Payer: BCBS MAPPO |
$143.43
|
| Rate for Payer: BCBS Trust/PPO |
$471.64
|
| Rate for Payer: BCCCP Commercial |
$79.63
|
| Rate for Payer: BCN Commercial |
$471.64
|
| Rate for Payer: BCN Medicare Advantage |
$143.43
|
| Rate for Payer: Cash Price |
$458.96
|
| Rate for Payer: Cash Price |
$458.96
|
| Rate for Payer: Cofinity Commercial |
$493.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.43
|
| Rate for Payer: Healthscope Commercial |
$516.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.27
|
| Rate for Payer: Mclaren Medicaid |
$101.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.60
|
| Rate for Payer: Meridian Medicaid |
$106.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.64
|
| Rate for Payer: Nomi Health Commercial |
$470.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.27
|
| Rate for Payer: PACE Senior Care Partners |
$136.25
|
| Rate for Payer: PACE SWMI |
$143.43
|
| Rate for Payer: PHP Commercial |
$487.64
|
| Rate for Payer: PHP Medicare Advantage |
$143.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$499.12
|
| Rate for Payer: Priority Health Medicare |
$144.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.30
|
| Rate for Payer: Railroad Medicare Medicare |
$143.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.86
|
| Rate for Payer: UHC Core |
$479.04
|
| Rate for Payer: UHC Exchange |
$143.43
|
| Rate for Payer: UHC Medicaid |
$101.14
|
| Rate for Payer: UHC Medicare Advantage |
$143.43
|
| Rate for Payer: UHCCP Medicaid |
$101.14
|
| Rate for Payer: VA VA |
$143.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.27
|
|
