|
HC US BREAST BIL LIMITED
|
Facility
|
IP
|
$573.70
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$516.33 |
| Rate for Payer: Aetna Commercial |
$487.64
|
| Rate for Payer: BCBS Trust/PPO |
$473.82
|
| Rate for Payer: BCN Commercial |
$473.82
|
| 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: Healthscope Commercial |
$516.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.27
|
| 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: PHP Commercial |
$487.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$499.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.86
|
| Rate for Payer: UHC Core |
$479.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.27
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$398.68 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: BCBS Trust/PPO |
$473.09
|
| Rate for Payer: BCN Commercial |
$473.09
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$95.65 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.01
|
| Rate for Payer: BCBS Complete |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$143.21
|
| Rate for Payer: BCBS Trust/PPO |
$470.92
|
| Rate for Payer: BCCCP Commercial |
$95.65
|
| Rate for Payer: BCN Commercial |
$470.92
|
| Rate for Payer: BCN Medicare Advantage |
$143.21
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.21
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Mclaren Medicaid |
$100.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.37
|
| Rate for Payer: Meridian Medicaid |
$106.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$136.04
|
| Rate for Payer: PACE SWMI |
$143.21
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Medicare |
$144.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: Railroad Medicare Medicare |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: UHC Exchange |
$143.21
|
| Rate for Payer: UHC Medicaid |
$100.99
|
| Rate for Payer: UHC Medicare Advantage |
$143.21
|
| Rate for Payer: UHCCP Medicaid |
$100.99
|
| Rate for Payer: VA VA |
$143.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.63 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.01
|
| Rate for Payer: BCBS Complete |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$143.21
|
| Rate for Payer: BCBS Trust/PPO |
$470.92
|
| Rate for Payer: BCCCP Commercial |
$79.63
|
| Rate for Payer: BCN Commercial |
$470.92
|
| Rate for Payer: BCN Medicare Advantage |
$143.21
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.21
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Mclaren Medicaid |
$100.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.37
|
| Rate for Payer: Meridian Medicaid |
$106.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$136.04
|
| Rate for Payer: PACE SWMI |
$143.21
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Medicare |
$144.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: Railroad Medicare Medicare |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: UHC Exchange |
$143.21
|
| Rate for Payer: UHC Medicaid |
$100.99
|
| Rate for Payer: UHC Medicare Advantage |
$143.21
|
| Rate for Payer: UHCCP Medicaid |
$100.99
|
| Rate for Payer: VA VA |
$143.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$398.68 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: BCBS Trust/PPO |
$473.09
|
| Rate for Payer: BCN Commercial |
$473.09
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US CHEST
|
Facility
|
OP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$100.99 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: Aetna Medicare |
$148.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.01
|
| Rate for Payer: BCBS Complete |
$106.03
|
| Rate for Payer: BCBS MAPPO |
$143.21
|
| Rate for Payer: BCBS Trust/PPO |
$470.92
|
| Rate for Payer: BCN Commercial |
$470.92
|
| Rate for Payer: BCN Medicare Advantage |
$143.21
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.21
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Mclaren Medicaid |
$100.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.37
|
| Rate for Payer: Meridian Medicaid |
$106.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$136.04
|
| Rate for Payer: PACE SWMI |
$143.21
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: PHP Medicare Advantage |
$143.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Medicare |
$144.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: Railroad Medicare Medicare |
$143.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: UHC Exchange |
$143.21
|
| Rate for Payer: UHC Medicaid |
$100.99
|
| Rate for Payer: UHC Medicare Advantage |
$143.21
|
| Rate for Payer: UHCCP Medicaid |
$100.99
|
| Rate for Payer: VA VA |
$143.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US CHEST
|
Facility
|
IP
|
$572.82
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$398.68 |
| Max. Negotiated Rate |
$515.54 |
| Rate for Payer: Aetna Commercial |
$486.90
|
| Rate for Payer: BCBS Trust/PPO |
$473.09
|
| Rate for Payer: BCN Commercial |
$473.09
|
| Rate for Payer: Cash Price |
$458.26
|
| Rate for Payer: Cofinity Commercial |
$492.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.26
|
| Rate for Payer: Healthscope Commercial |
$515.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$486.90
|
| Rate for Payer: Nomi Health Commercial |
$469.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$429.62
|
| Rate for Payer: PHP Commercial |
$486.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$498.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.08
|
| Rate for Payer: UHC Core |
$478.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.62
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
OP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$103.15 |
| Max. Negotiated Rate |
$526.56 |
| Rate for Payer: Aetna Commercial |
$497.31
|
| Rate for Payer: Aetna Medicare |
$152.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.83
|
| Rate for Payer: BCBS Complete |
$108.30
|
| Rate for Payer: BCBS MAPPO |
$146.27
|
| Rate for Payer: BCBS Trust/PPO |
$480.99
|
| Rate for Payer: BCN Commercial |
$480.99
|
| Rate for Payer: BCN Medicare Advantage |
$146.27
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Commercial |
$503.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.27
|
| Rate for Payer: Healthscope Commercial |
$526.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.80
|
| Rate for Payer: Mclaren Medicaid |
$103.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.58
|
| Rate for Payer: Meridian Medicaid |
$108.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Nomi Health Commercial |
$479.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: PACE Senior Care Partners |
$138.95
|
| Rate for Payer: PACE SWMI |
$146.27
|
| Rate for Payer: PHP Commercial |
$497.31
|
| Rate for Payer: PHP Medicare Advantage |
$146.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$509.01
|
| Rate for Payer: Priority Health Medicare |
$147.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.21
|
| Rate for Payer: Railroad Medicare Medicare |
$146.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.86
|
| Rate for Payer: UHC Core |
$488.53
|
| Rate for Payer: UHC Exchange |
$146.27
|
| Rate for Payer: UHC Medicaid |
$103.15
|
| Rate for Payer: UHC Medicare Advantage |
$146.27
|
| Rate for Payer: UHCCP Medicaid |
$103.15
|
| Rate for Payer: VA VA |
$146.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.80
|
|
|
HC US CHORIONIC VILLIS SAMPLE
|
Facility
|
IP
|
$585.07
|
|
|
Service Code
|
CPT 76945
|
| Hospital Charge Code |
40200048
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$407.21 |
| Max. Negotiated Rate |
$526.56 |
| Rate for Payer: Aetna Commercial |
$497.31
|
| Rate for Payer: BCBS Trust/PPO |
$483.21
|
| Rate for Payer: BCN Commercial |
$483.21
|
| Rate for Payer: Cash Price |
$468.06
|
| Rate for Payer: Cofinity Commercial |
$503.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.06
|
| Rate for Payer: Healthscope Commercial |
$526.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.31
|
| Rate for Payer: Nomi Health Commercial |
$479.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.80
|
| Rate for Payer: PHP Commercial |
$497.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$509.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.86
|
| Rate for Payer: UHC Core |
$488.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.80
|
|
|
HC US CRANIAL
|
Facility
|
OP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$148.60 |
| Max. Negotiated Rate |
$758.59 |
| Rate for Payer: Aetna Commercial |
$716.45
|
| Rate for Payer: Aetna Medicare |
$219.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.40
|
| Rate for Payer: BCBS Complete |
$156.02
|
| Rate for Payer: BCBS MAPPO |
$210.72
|
| Rate for Payer: BCBS Trust/PPO |
$692.93
|
| Rate for Payer: BCN Commercial |
$692.93
|
| Rate for Payer: BCN Medicare Advantage |
$210.72
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Commercial |
$724.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.72
|
| Rate for Payer: Healthscope Commercial |
$758.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.16
|
| Rate for Payer: Mclaren Medicaid |
$148.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.26
|
| Rate for Payer: Meridian Medicaid |
$156.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.45
|
| Rate for Payer: Nomi Health Commercial |
$691.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| Rate for Payer: PACE Senior Care Partners |
$200.18
|
| Rate for Payer: PACE SWMI |
$210.72
|
| Rate for Payer: PHP Commercial |
$716.45
|
| Rate for Payer: PHP Medicare Advantage |
$210.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$733.31
|
| Rate for Payer: Priority Health Medicare |
$212.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.64
|
| Rate for Payer: Railroad Medicare Medicare |
$210.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$741.73
|
| Rate for Payer: UHC Core |
$703.80
|
| Rate for Payer: UHC Exchange |
$210.72
|
| Rate for Payer: UHC Medicaid |
$148.60
|
| Rate for Payer: UHC Medicare Advantage |
$210.72
|
| Rate for Payer: UHCCP Medicaid |
$148.60
|
| Rate for Payer: VA VA |
$210.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.16
|
|
|
HC US CRANIAL
|
Facility
|
IP
|
$842.88
|
|
|
Service Code
|
CPT 76506
|
| Hospital Charge Code |
40200053
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$586.64 |
| Max. Negotiated Rate |
$758.59 |
| Rate for Payer: Aetna Commercial |
$716.45
|
| Rate for Payer: BCBS Trust/PPO |
$696.13
|
| Rate for Payer: BCN Commercial |
$696.13
|
| Rate for Payer: Cash Price |
$674.30
|
| Rate for Payer: Cofinity Commercial |
$724.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.30
|
| Rate for Payer: Healthscope Commercial |
$758.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.45
|
| Rate for Payer: Nomi Health Commercial |
$691.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.16
|
| Rate for Payer: PHP Commercial |
$716.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$733.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$741.73
|
| Rate for Payer: UHC Core |
$703.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.16
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
OP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$181.88 |
| Max. Negotiated Rate |
$928.49 |
| Rate for Payer: Aetna Commercial |
$876.91
|
| Rate for Payer: Aetna Medicare |
$268.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.39
|
| Rate for Payer: BCBS Complete |
$190.96
|
| Rate for Payer: BCBS MAPPO |
$257.92
|
| Rate for Payer: BCBS Trust/PPO |
$848.13
|
| Rate for Payer: BCN Commercial |
$848.13
|
| Rate for Payer: BCN Medicare Advantage |
$257.92
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Commercial |
$887.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.92
|
| Rate for Payer: Healthscope Commercial |
$928.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.75
|
| Rate for Payer: Mclaren Medicaid |
$181.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.81
|
| Rate for Payer: Meridian Medicaid |
$190.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.91
|
| Rate for Payer: Nomi Health Commercial |
$845.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| Rate for Payer: PACE Senior Care Partners |
$245.02
|
| Rate for Payer: PACE SWMI |
$257.92
|
| Rate for Payer: PHP Commercial |
$876.91
|
| Rate for Payer: PHP Medicare Advantage |
$257.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.54
|
| Rate for Payer: Priority Health Medicare |
$260.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.04
|
| Rate for Payer: Railroad Medicare Medicare |
$257.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.86
|
| Rate for Payer: UHC Core |
$861.44
|
| Rate for Payer: UHC Exchange |
$257.92
|
| Rate for Payer: UHC Medicaid |
$181.88
|
| Rate for Payer: UHC Medicare Advantage |
$257.92
|
| Rate for Payer: UHCCP Medicaid |
$181.88
|
| Rate for Payer: VA VA |
$257.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.75
|
|
|
HC US DUPLX DOP ABD PEL SCROT LTD
|
Facility
|
IP
|
$1,031.66
|
|
|
Service Code
|
CPT 93976
|
| Hospital Charge Code |
92100014
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$718.04 |
| Max. Negotiated Rate |
$928.49 |
| Rate for Payer: Aetna Commercial |
$876.91
|
| Rate for Payer: BCBS Trust/PPO |
$852.05
|
| Rate for Payer: BCN Commercial |
$852.05
|
| Rate for Payer: Cash Price |
$825.33
|
| Rate for Payer: Cofinity Commercial |
$887.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.33
|
| Rate for Payer: Healthscope Commercial |
$928.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.91
|
| Rate for Payer: Nomi Health Commercial |
$845.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.75
|
| Rate for Payer: PHP Commercial |
$876.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.86
|
| Rate for Payer: UHC Core |
$861.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.75
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
IP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,237.01 |
| Max. Negotiated Rate |
$1,599.58 |
| Rate for Payer: Aetna Commercial |
$1,510.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,467.88
|
| Rate for Payer: BCN Commercial |
$1,467.88
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Commercial |
$1,528.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Healthscope Commercial |
$1,599.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,332.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,510.71
|
| Rate for Payer: Nomi Health Commercial |
$1,457.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| Rate for Payer: PHP Commercial |
$1,510.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,546.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,237.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.03
|
| Rate for Payer: UHC Core |
$1,484.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,332.98
|
|
|
HC US DUPLX DOP ABD PELV SCROTUM
|
Facility
|
OP
|
$1,777.31
|
|
|
Service Code
|
CPT 93975
|
| Hospital Charge Code |
92100013
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$313.34 |
| Max. Negotiated Rate |
$1,599.58 |
| Rate for Payer: Aetna Commercial |
$1,510.71
|
| Rate for Payer: Aetna Medicare |
$462.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$555.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$555.41
|
| Rate for Payer: BCBS Complete |
$328.98
|
| Rate for Payer: BCBS MAPPO |
$444.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.13
|
| Rate for Payer: BCN Commercial |
$1,461.13
|
| Rate for Payer: BCN Medicare Advantage |
$444.33
|
| Rate for Payer: Cash Price |
$1,421.85
|
| Rate for Payer: Cofinity Commercial |
$1,528.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,421.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.33
|
| Rate for Payer: Healthscope Commercial |
$1,599.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,332.98
|
| Rate for Payer: Mclaren Medicaid |
$313.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.54
|
| Rate for Payer: Meridian Medicaid |
$328.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$510.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$488.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,510.71
|
| Rate for Payer: Nomi Health Commercial |
$1,457.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,332.98
|
| Rate for Payer: PACE Senior Care Partners |
$422.11
|
| Rate for Payer: PACE SWMI |
$444.33
|
| Rate for Payer: PHP Commercial |
$1,510.71
|
| Rate for Payer: PHP Medicare Advantage |
$444.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,546.26
|
| Rate for Payer: Priority Health Medicare |
$448.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,237.01
|
| Rate for Payer: Railroad Medicare Medicare |
$444.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.03
|
| Rate for Payer: UHC Core |
$1,484.05
|
| Rate for Payer: UHC Exchange |
$444.33
|
| Rate for Payer: UHC Medicaid |
$313.34
|
| Rate for Payer: UHC Medicare Advantage |
$444.33
|
| Rate for Payer: UHCCP Medicaid |
$313.34
|
| Rate for Payer: VA VA |
$444.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,332.98
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
OP
|
$495.72
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.40 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna Medicare |
$128.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.91
|
| Rate for Payer: BCBS Complete |
$91.76
|
| Rate for Payer: BCBS MAPPO |
$123.93
|
| Rate for Payer: BCBS Trust/PPO |
$407.53
|
| Rate for Payer: BCN Commercial |
$407.53
|
| Rate for Payer: BCN Medicare Advantage |
$123.93
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.93
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Mclaren Medicaid |
$87.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.13
|
| Rate for Payer: Meridian Medicaid |
$91.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$406.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PACE Senior Care Partners |
$117.73
|
| Rate for Payer: PACE SWMI |
$123.93
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: PHP Medicare Advantage |
$123.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$431.28
|
| Rate for Payer: Priority Health Medicare |
$125.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.02
|
| Rate for Payer: Railroad Medicare Medicare |
$123.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.23
|
| Rate for Payer: UHC Core |
$413.93
|
| Rate for Payer: UHC Exchange |
$123.93
|
| Rate for Payer: UHC Medicaid |
$87.40
|
| Rate for Payer: UHC Medicare Advantage |
$123.93
|
| Rate for Payer: UHCCP Medicaid |
$87.40
|
| Rate for Payer: VA VA |
$123.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC US EACH ADDL FETUS BPP
|
Facility
|
IP
|
$495.72
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200026
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$345.02 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: BCBS Trust/PPO |
$409.42
|
| Rate for Payer: BCN Commercial |
$409.42
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$406.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$431.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.23
|
| Rate for Payer: UHC Core |
$413.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
IP
|
$440.41
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$306.53 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: BCBS Trust/PPO |
$363.73
|
| Rate for Payer: BCN Commercial |
$363.73
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Nomi Health Commercial |
$361.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$383.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.56
|
| Rate for Payer: UHC Core |
$367.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.31
|
|
|
HC US EACH ADDL FETUS GT 14 WKS
|
Facility
|
OP
|
$440.41
|
|
|
Service Code
|
CPT 76810
|
| Hospital Charge Code |
40200018
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$77.64 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna Medicare |
$114.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.63
|
| Rate for Payer: BCBS Complete |
$81.52
|
| Rate for Payer: BCBS MAPPO |
$110.10
|
| Rate for Payer: BCBS Trust/PPO |
$362.06
|
| Rate for Payer: BCN Commercial |
$362.06
|
| Rate for Payer: BCN Medicare Advantage |
$110.10
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.10
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.31
|
| Rate for Payer: Mclaren Medicaid |
$77.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.61
|
| Rate for Payer: Meridian Medicaid |
$81.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Nomi Health Commercial |
$361.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PACE Senior Care Partners |
$104.60
|
| Rate for Payer: PACE SWMI |
$110.10
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: PHP Medicare Advantage |
$110.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$383.16
|
| Rate for Payer: Priority Health Medicare |
$111.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.53
|
| Rate for Payer: Railroad Medicare Medicare |
$110.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.56
|
| Rate for Payer: UHC Core |
$367.74
|
| Rate for Payer: UHC Exchange |
$110.10
|
| Rate for Payer: UHC Medicaid |
$77.64
|
| Rate for Payer: UHC Medicare Advantage |
$110.10
|
| Rate for Payer: UHCCP Medicaid |
$77.64
|
| Rate for Payer: VA VA |
$110.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.31
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
IP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$252.33 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: BCBS Trust/PPO |
$299.43
|
| Rate for Payer: BCN Commercial |
$299.43
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Nomi Health Commercial |
$297.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$315.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.04
|
| Rate for Payer: UHC Core |
$302.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.91
|
|
|
HC US EACH ADDL FETUS LESS THAN 14 WKS
|
Facility
|
OP
|
$362.55
|
|
|
Service Code
|
CPT 76802
|
| Hospital Charge Code |
40200016
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$326.30 |
| Rate for Payer: Aetna Commercial |
$308.17
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.30
|
| Rate for Payer: BCBS Complete |
$67.11
|
| Rate for Payer: BCBS MAPPO |
$90.64
|
| Rate for Payer: BCBS Trust/PPO |
$298.05
|
| Rate for Payer: BCN Commercial |
$298.05
|
| Rate for Payer: BCN Medicare Advantage |
$90.64
|
| Rate for Payer: Cash Price |
$290.04
|
| Rate for Payer: Cofinity Commercial |
$311.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$326.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$271.91
|
| Rate for Payer: Mclaren Medicaid |
$63.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.17
|
| Rate for Payer: Meridian Medicaid |
$67.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.17
|
| Rate for Payer: Nomi Health Commercial |
$297.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$271.91
|
| Rate for Payer: PACE Senior Care Partners |
$86.11
|
| Rate for Payer: PACE SWMI |
$90.64
|
| Rate for Payer: PHP Commercial |
$308.17
|
| Rate for Payer: PHP Medicare Advantage |
$90.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$315.42
|
| Rate for Payer: Priority Health Medicare |
$91.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.33
|
| Rate for Payer: Railroad Medicare Medicare |
$90.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.04
|
| Rate for Payer: UHC Core |
$302.73
|
| Rate for Payer: UHC Exchange |
$90.64
|
| Rate for Payer: UHC Medicaid |
$63.92
|
| Rate for Payer: UHC Medicare Advantage |
$90.64
|
| Rate for Payer: UHCCP Medicaid |
$63.92
|
| Rate for Payer: VA VA |
$90.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$271.91
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$37.42 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$55.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.33
|
| Rate for Payer: BCBS Complete |
$39.29
|
| Rate for Payer: BCBS MAPPO |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$174.48
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$174.48
|
| Rate for Payer: BCN Medicare Advantage |
$53.06
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.06
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Mclaren Medicaid |
$37.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.71
|
| Rate for Payer: Meridian Medicaid |
$39.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Senior Care Partners |
$50.41
|
| Rate for Payer: PACE SWMI |
$53.06
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$53.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Medicare |
$53.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: Railroad Medicare Medicare |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: UHC Exchange |
$53.06
|
| Rate for Payer: UHC Medicaid |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$53.06
|
| Rate for Payer: UHCCP Medicaid |
$37.42
|
| Rate for Payer: VA VA |
$53.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$147.72 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.29
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
IP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$220.08 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: BCBS Trust/PPO |
$261.15
|
| Rate for Payer: BCN Commercial |
$261.15
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Nomi Health Commercial |
$259.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$275.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.26
|
| Rate for Payer: UHC Core |
$264.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.15
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
OP
|
$316.20
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.75 |
| Max. Negotiated Rate |
$284.58 |
| Rate for Payer: Aetna Commercial |
$268.77
|
| Rate for Payer: Aetna Medicare |
$82.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.81
|
| Rate for Payer: BCBS Complete |
$58.53
|
| Rate for Payer: BCBS MAPPO |
$79.05
|
| Rate for Payer: BCBS Trust/PPO |
$259.95
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$259.95
|
| Rate for Payer: BCN Medicare Advantage |
$79.05
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cash Price |
$252.96
|
| Rate for Payer: Cofinity Commercial |
$271.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.05
|
| Rate for Payer: Healthscope Commercial |
$284.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.15
|
| Rate for Payer: Mclaren Medicaid |
$55.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.00
|
| Rate for Payer: Meridian Medicaid |
$58.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.77
|
| Rate for Payer: Nomi Health Commercial |
$259.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.15
|
| Rate for Payer: PACE Senior Care Partners |
$75.10
|
| Rate for Payer: PACE SWMI |
$79.05
|
| Rate for Payer: PHP Commercial |
$268.77
|
| Rate for Payer: PHP Medicare Advantage |
$79.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$275.09
|
| Rate for Payer: Priority Health Medicare |
$79.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.08
|
| Rate for Payer: Railroad Medicare Medicare |
$79.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.26
|
| Rate for Payer: UHC Core |
$264.03
|
| Rate for Payer: UHC Exchange |
$79.05
|
| Rate for Payer: UHC Medicaid |
$55.75
|
| Rate for Payer: UHC Medicare Advantage |
$79.05
|
| Rate for Payer: UHCCP Medicaid |
$55.75
|
| Rate for Payer: VA VA |
$79.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.15
|
|
