|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
OP
|
$214.20
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.76 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna Medicare |
$55.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.94
|
| Rate for Payer: BCBS Complete |
$39.65
|
| Rate for Payer: BCBS MAPPO |
$53.55
|
| Rate for Payer: BCBS Trust/PPO |
$176.09
|
| Rate for Payer: BCN Commercial |
$176.09
|
| Rate for Payer: BCN Medicare Advantage |
$53.55
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.55
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Mclaren Medicaid |
$37.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.23
|
| Rate for Payer: Meridian Medicaid |
$39.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: Nomi Health Commercial |
$175.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.65
|
| Rate for Payer: PACE Senior Care Partners |
$50.87
|
| Rate for Payer: PACE SWMI |
$53.55
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: PHP Medicare Advantage |
$53.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.35
|
| Rate for Payer: Priority Health Medicare |
$54.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.08
|
| Rate for Payer: Railroad Medicare Medicare |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: UHC Exchange |
$53.55
|
| Rate for Payer: UHC Medicaid |
$37.76
|
| Rate for Payer: UHC Medicare Advantage |
$53.55
|
| Rate for Payer: UHCCP Medicaid |
$37.76
|
| Rate for Payer: VA VA |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
IP
|
$214.20
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.08 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: BCBS Trust/PPO |
$176.91
|
| Rate for Payer: BCN Commercial |
$176.91
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: Nomi Health Commercial |
$175.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.65
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$293.76
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$51.79 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: Aetna Medicare |
$76.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.80
|
| Rate for Payer: BCBS Complete |
$54.37
|
| Rate for Payer: BCBS MAPPO |
$73.44
|
| Rate for Payer: BCBS Trust/PPO |
$241.50
|
| Rate for Payer: BCN Commercial |
$241.50
|
| Rate for Payer: BCN Medicare Advantage |
$73.44
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$51.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.11
|
| Rate for Payer: Meridian Medicaid |
$54.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Nomi Health Commercial |
$240.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PACE Senior Care Partners |
$69.77
|
| Rate for Payer: PACE SWMI |
$73.44
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: PHP Medicare Advantage |
$73.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.57
|
| Rate for Payer: Priority Health Medicare |
$74.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.46
|
| Rate for Payer: Railroad Medicare Medicare |
$73.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.51
|
| Rate for Payer: UHC Core |
$245.29
|
| Rate for Payer: UHC Exchange |
$73.44
|
| Rate for Payer: UHC Medicaid |
$51.79
|
| Rate for Payer: UHC Medicare Advantage |
$73.44
|
| Rate for Payer: UHCCP Medicaid |
$51.79
|
| Rate for Payer: VA VA |
$73.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$293.76
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$204.46 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: BCBS Trust/PPO |
$242.62
|
| Rate for Payer: BCN Commercial |
$242.62
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Nomi Health Commercial |
$240.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.51
|
| Rate for Payer: UHC Core |
$245.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$482.62
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$85.09 |
| Max. Negotiated Rate |
$434.36 |
| Rate for Payer: Aetna Commercial |
$410.23
|
| Rate for Payer: Aetna Medicare |
$125.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.82
|
| Rate for Payer: BCBS Complete |
$89.33
|
| Rate for Payer: BCBS MAPPO |
$120.66
|
| Rate for Payer: BCBS Trust/PPO |
$396.76
|
| Rate for Payer: BCN Commercial |
$396.76
|
| Rate for Payer: BCN Medicare Advantage |
$120.66
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cofinity Commercial |
$415.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.66
|
| Rate for Payer: Healthscope Commercial |
$434.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.96
|
| Rate for Payer: Mclaren Medicaid |
$85.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.69
|
| Rate for Payer: Meridian Medicaid |
$89.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.23
|
| Rate for Payer: Nomi Health Commercial |
$395.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.96
|
| Rate for Payer: PACE Senior Care Partners |
$114.62
|
| Rate for Payer: PACE SWMI |
$120.66
|
| Rate for Payer: PHP Commercial |
$410.23
|
| Rate for Payer: PHP Medicare Advantage |
$120.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$85.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$419.88
|
| Rate for Payer: Priority Health Medicare |
$121.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.90
|
| Rate for Payer: Railroad Medicare Medicare |
$120.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.71
|
| Rate for Payer: UHC Core |
$402.99
|
| Rate for Payer: UHC Exchange |
$120.66
|
| Rate for Payer: UHC Medicaid |
$85.09
|
| Rate for Payer: UHC Medicare Advantage |
$120.66
|
| Rate for Payer: UHCCP Medicaid |
$85.09
|
| Rate for Payer: VA VA |
$120.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.96
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$482.62
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$335.90 |
| Max. Negotiated Rate |
$434.36 |
| Rate for Payer: Aetna Commercial |
$410.23
|
| Rate for Payer: BCBS Trust/PPO |
$398.60
|
| Rate for Payer: BCN Commercial |
$398.60
|
| Rate for Payer: Cash Price |
$386.10
|
| Rate for Payer: Cofinity Commercial |
$415.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.10
|
| Rate for Payer: Healthscope Commercial |
$434.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.23
|
| Rate for Payer: Nomi Health Commercial |
$395.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$361.96
|
| Rate for Payer: PHP Commercial |
$410.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$419.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.71
|
| Rate for Payer: UHC Core |
$402.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.96
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$700.75
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$487.72 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: BCBS Trust/PPO |
$578.75
|
| Rate for Payer: BCN Commercial |
$578.75
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$574.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$609.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.66
|
| Rate for Payer: UHC Core |
$585.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$700.75
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna Medicare |
$182.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.98
|
| Rate for Payer: BCBS Complete |
$129.71
|
| Rate for Payer: BCBS MAPPO |
$175.19
|
| Rate for Payer: BCBS Trust/PPO |
$576.09
|
| Rate for Payer: BCCCP Commercial |
$60.92
|
| Rate for Payer: BCN Commercial |
$576.09
|
| Rate for Payer: BCN Medicare Advantage |
$175.19
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.19
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.95
|
| Rate for Payer: Meridian Medicaid |
$129.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$574.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PACE Senior Care Partners |
$166.43
|
| Rate for Payer: PACE SWMI |
$175.19
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: PHP Medicare Advantage |
$175.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$609.65
|
| Rate for Payer: Priority Health Medicare |
$176.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.72
|
| Rate for Payer: Railroad Medicare Medicare |
$175.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.66
|
| Rate for Payer: UHC Core |
$585.13
|
| Rate for Payer: UHC Exchange |
$175.19
|
| Rate for Payer: UHC Medicaid |
$123.54
|
| Rate for Payer: UHC Medicare Advantage |
$175.19
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
| Rate for Payer: VA VA |
$175.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$700.75
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$487.72 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: BCBS Trust/PPO |
$578.75
|
| Rate for Payer: BCN Commercial |
$578.75
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$574.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$609.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.66
|
| Rate for Payer: UHC Core |
$585.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$700.75
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$123.54 |
| Max. Negotiated Rate |
$630.67 |
| Rate for Payer: Aetna Commercial |
$595.64
|
| Rate for Payer: Aetna Medicare |
$182.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.98
|
| Rate for Payer: BCBS Complete |
$129.71
|
| Rate for Payer: BCBS MAPPO |
$175.19
|
| Rate for Payer: BCBS Trust/PPO |
$576.09
|
| Rate for Payer: BCN Commercial |
$576.09
|
| Rate for Payer: BCN Medicare Advantage |
$175.19
|
| Rate for Payer: Cash Price |
$560.60
|
| Rate for Payer: Cofinity Commercial |
$602.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.19
|
| Rate for Payer: Healthscope Commercial |
$630.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.56
|
| Rate for Payer: Mclaren Medicaid |
$123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.95
|
| Rate for Payer: Meridian Medicaid |
$129.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.64
|
| Rate for Payer: Nomi Health Commercial |
$574.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.56
|
| Rate for Payer: PACE Senior Care Partners |
$166.43
|
| Rate for Payer: PACE SWMI |
$175.19
|
| Rate for Payer: PHP Commercial |
$595.64
|
| Rate for Payer: PHP Medicare Advantage |
$175.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$609.65
|
| Rate for Payer: Priority Health Medicare |
$176.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$487.72
|
| Rate for Payer: Railroad Medicare Medicare |
$175.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.66
|
| Rate for Payer: UHC Core |
$585.13
|
| Rate for Payer: UHC Exchange |
$175.19
|
| Rate for Payer: UHC Medicaid |
$123.54
|
| Rate for Payer: UHC Medicare Advantage |
$175.19
|
| Rate for Payer: UHCCP Medicaid |
$123.54
|
| Rate for Payer: VA VA |
$175.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.56
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,236.73
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$218.04 |
| Max. Negotiated Rate |
$1,113.06 |
| Rate for Payer: Aetna Commercial |
$1,051.22
|
| Rate for Payer: Aetna Medicare |
$321.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$386.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$386.48
|
| Rate for Payer: BCBS Complete |
$228.92
|
| Rate for Payer: BCBS MAPPO |
$309.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,016.72
|
| Rate for Payer: BCN Commercial |
$1,016.72
|
| Rate for Payer: BCN Medicare Advantage |
$309.18
|
| Rate for Payer: Cash Price |
$989.38
|
| Rate for Payer: Cofinity Commercial |
$1,063.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.18
|
| Rate for Payer: Healthscope Commercial |
$1,113.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.55
|
| Rate for Payer: Mclaren Medicaid |
$218.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.64
|
| Rate for Payer: Meridian Medicaid |
$228.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.22
|
| Rate for Payer: Nomi Health Commercial |
$1,014.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.55
|
| Rate for Payer: PACE Senior Care Partners |
$293.72
|
| Rate for Payer: PACE SWMI |
$309.18
|
| Rate for Payer: PHP Commercial |
$1,051.22
|
| Rate for Payer: PHP Medicare Advantage |
$309.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,075.96
|
| Rate for Payer: Priority Health Medicare |
$312.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$860.76
|
| Rate for Payer: Railroad Medicare Medicare |
$309.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.32
|
| Rate for Payer: UHC Core |
$1,032.67
|
| Rate for Payer: UHC Exchange |
$309.18
|
| Rate for Payer: UHC Medicaid |
$218.04
|
| Rate for Payer: UHC Medicare Advantage |
$309.18
|
| Rate for Payer: UHCCP Medicaid |
$218.04
|
| Rate for Payer: VA VA |
$309.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.55
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,236.73
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$860.76 |
| Max. Negotiated Rate |
$1,113.06 |
| Rate for Payer: Aetna Commercial |
$1,051.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,021.42
|
| Rate for Payer: BCN Commercial |
$1,021.42
|
| Rate for Payer: Cash Price |
$989.38
|
| Rate for Payer: Cofinity Commercial |
$1,063.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.38
|
| Rate for Payer: Healthscope Commercial |
$1,113.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.22
|
| Rate for Payer: Nomi Health Commercial |
$1,014.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.55
|
| Rate for Payer: PHP Commercial |
$1,051.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,075.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$860.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.32
|
| Rate for Payer: UHC Core |
$1,032.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.55
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
IP
|
$2,473.59
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,721.62 |
| Max. Negotiated Rate |
$2,226.23 |
| Rate for Payer: Aetna Commercial |
$2,102.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,042.94
|
| Rate for Payer: BCN Commercial |
$2,042.94
|
| Rate for Payer: Cash Price |
$1,978.87
|
| Rate for Payer: Cofinity Commercial |
$2,127.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,978.87
|
| Rate for Payer: Healthscope Commercial |
$2,226.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,855.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,102.55
|
| Rate for Payer: Nomi Health Commercial |
$2,028.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,855.19
|
| Rate for Payer: PHP Commercial |
$2,102.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,152.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,721.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,176.76
|
| Rate for Payer: UHC Core |
$2,065.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,855.19
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
OP
|
$2,473.59
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$436.09 |
| Max. Negotiated Rate |
$2,226.23 |
| Rate for Payer: Aetna Commercial |
$2,102.55
|
| Rate for Payer: Aetna Medicare |
$643.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$773.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$773.00
|
| Rate for Payer: BCBS Complete |
$457.86
|
| Rate for Payer: BCBS MAPPO |
$618.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,033.54
|
| Rate for Payer: BCN Commercial |
$2,033.54
|
| Rate for Payer: BCN Medicare Advantage |
$618.40
|
| Rate for Payer: Cash Price |
$1,978.87
|
| Rate for Payer: Cofinity Commercial |
$2,127.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,978.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$618.40
|
| Rate for Payer: Healthscope Commercial |
$2,226.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,855.19
|
| Rate for Payer: Mclaren Medicaid |
$436.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$649.32
|
| Rate for Payer: Meridian Medicaid |
$457.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$711.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$680.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,102.55
|
| Rate for Payer: Nomi Health Commercial |
$2,028.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,855.19
|
| Rate for Payer: PACE Senior Care Partners |
$587.48
|
| Rate for Payer: PACE SWMI |
$618.40
|
| Rate for Payer: PHP Commercial |
$2,102.55
|
| Rate for Payer: PHP Medicare Advantage |
$618.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$436.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,152.02
|
| Rate for Payer: Priority Health Medicare |
$624.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,721.62
|
| Rate for Payer: Railroad Medicare Medicare |
$618.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,176.76
|
| Rate for Payer: UHC Core |
$2,065.45
|
| Rate for Payer: UHC Exchange |
$618.40
|
| Rate for Payer: UHC Medicaid |
$436.09
|
| Rate for Payer: UHC Medicare Advantage |
$618.40
|
| Rate for Payer: UHCCP Medicaid |
$436.09
|
| Rate for Payer: VA VA |
$618.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,855.19
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
IP
|
$879.73
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$612.29 |
| Max. Negotiated Rate |
$791.76 |
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: BCBS Trust/PPO |
$726.57
|
| Rate for Payer: BCN Commercial |
$726.57
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cofinity Commercial |
$756.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$703.78
|
| Rate for Payer: Healthscope Commercial |
$791.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$659.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$747.77
|
| Rate for Payer: Nomi Health Commercial |
$721.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$659.80
|
| Rate for Payer: PHP Commercial |
$747.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$765.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$612.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$774.16
|
| Rate for Payer: UHC Core |
$734.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$659.80
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
OP
|
$879.73
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.10 |
| Max. Negotiated Rate |
$791.76 |
| Rate for Payer: Aetna Commercial |
$747.77
|
| Rate for Payer: Aetna Medicare |
$228.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.92
|
| Rate for Payer: BCBS Complete |
$162.84
|
| Rate for Payer: BCBS MAPPO |
$219.93
|
| Rate for Payer: BCBS Trust/PPO |
$723.23
|
| Rate for Payer: BCN Commercial |
$723.23
|
| Rate for Payer: BCN Medicare Advantage |
$219.93
|
| Rate for Payer: Cash Price |
$703.78
|
| Rate for Payer: Cofinity Commercial |
$756.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$703.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.93
|
| Rate for Payer: Healthscope Commercial |
$791.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$659.80
|
| Rate for Payer: Mclaren Medicaid |
$155.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.93
|
| Rate for Payer: Meridian Medicaid |
$162.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$747.77
|
| Rate for Payer: Nomi Health Commercial |
$721.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$659.80
|
| Rate for Payer: PACE Senior Care Partners |
$208.94
|
| Rate for Payer: PACE SWMI |
$219.93
|
| Rate for Payer: PHP Commercial |
$747.77
|
| Rate for Payer: PHP Medicare Advantage |
$219.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$765.37
|
| Rate for Payer: Priority Health Medicare |
$222.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$612.29
|
| Rate for Payer: Railroad Medicare Medicare |
$219.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$774.16
|
| Rate for Payer: UHC Core |
$734.57
|
| Rate for Payer: UHC Exchange |
$219.93
|
| Rate for Payer: UHC Medicaid |
$155.10
|
| Rate for Payer: UHC Medicare Advantage |
$219.93
|
| Rate for Payer: UHCCP Medicaid |
$155.10
|
| Rate for Payer: VA VA |
$219.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$659.80
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.85
|
| Rate for Payer: BCN Commercial |
$245.85
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$52.48 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$77.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.03
|
| Rate for Payer: BCBS Complete |
$55.10
|
| Rate for Payer: BCBS MAPPO |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.72
|
| Rate for Payer: BCN Commercial |
$244.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.42
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.42
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$52.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Medicaid |
$55.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Senior Care Partners |
$70.70
|
| Rate for Payer: PACE SWMI |
$74.42
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Medicare |
$75.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: Railroad Medicare Medicare |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: UHC Exchange |
$74.42
|
| Rate for Payer: UHC Medicaid |
$52.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.42
|
| Rate for Payer: UHCCP Medicaid |
$52.48
|
| Rate for Payer: VA VA |
$74.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.85
|
| Rate for Payer: BCN Commercial |
$245.85
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$52.48 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$77.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.03
|
| Rate for Payer: BCBS Complete |
$55.10
|
| Rate for Payer: BCBS MAPPO |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.72
|
| Rate for Payer: BCN Commercial |
$244.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.42
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.42
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$52.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.14
|
| Rate for Payer: Meridian Medicaid |
$55.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Senior Care Partners |
$70.70
|
| Rate for Payer: PACE SWMI |
$74.42
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Medicare |
$75.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: Railroad Medicare Medicare |
$74.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: UHC Exchange |
$74.42
|
| Rate for Payer: UHC Medicaid |
$52.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.42
|
| Rate for Payer: UHCCP Medicaid |
$52.48
|
| Rate for Payer: VA VA |
$74.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
OP
|
$421.63
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$74.33 |
| Max. Negotiated Rate |
$379.47 |
| Rate for Payer: Aetna Commercial |
$358.39
|
| Rate for Payer: Aetna Medicare |
$109.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.76
|
| Rate for Payer: BCBS Complete |
$78.04
|
| Rate for Payer: BCBS MAPPO |
$105.41
|
| Rate for Payer: BCBS Trust/PPO |
$346.62
|
| Rate for Payer: BCN Commercial |
$346.62
|
| Rate for Payer: BCN Medicare Advantage |
$105.41
|
| Rate for Payer: Cash Price |
$337.30
|
| Rate for Payer: Cofinity Commercial |
$362.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.41
|
| Rate for Payer: Healthscope Commercial |
$379.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.22
|
| Rate for Payer: Mclaren Medicaid |
$74.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.68
|
| Rate for Payer: Meridian Medicaid |
$78.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.39
|
| Rate for Payer: Nomi Health Commercial |
$345.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.22
|
| Rate for Payer: PACE Senior Care Partners |
$100.14
|
| Rate for Payer: PACE SWMI |
$105.41
|
| Rate for Payer: PHP Commercial |
$358.39
|
| Rate for Payer: PHP Medicare Advantage |
$105.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$366.82
|
| Rate for Payer: Priority Health Medicare |
$106.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.45
|
| Rate for Payer: Railroad Medicare Medicare |
$105.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.03
|
| Rate for Payer: UHC Core |
$352.06
|
| Rate for Payer: UHC Exchange |
$105.41
|
| Rate for Payer: UHC Medicaid |
$74.33
|
| Rate for Payer: UHC Medicare Advantage |
$105.41
|
| Rate for Payer: UHCCP Medicaid |
$74.33
|
| Rate for Payer: VA VA |
$105.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.22
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
IP
|
$421.63
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$293.45 |
| Max. Negotiated Rate |
$379.47 |
| Rate for Payer: Aetna Commercial |
$358.39
|
| Rate for Payer: BCBS Trust/PPO |
$348.22
|
| Rate for Payer: BCN Commercial |
$348.22
|
| Rate for Payer: Cash Price |
$337.30
|
| Rate for Payer: Cofinity Commercial |
$362.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.30
|
| Rate for Payer: Healthscope Commercial |
$379.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.39
|
| Rate for Payer: Nomi Health Commercial |
$345.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$316.22
|
| Rate for Payer: PHP Commercial |
$358.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$366.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.03
|
| Rate for Payer: UHC Core |
$352.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.22
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$656.83
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.83 |
| Max. Negotiated Rate |
$591.15 |
| Rate for Payer: Aetna Commercial |
$558.31
|
| Rate for Payer: Aetna Medicare |
$170.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.26
|
| Rate for Payer: BCBS Complete |
$121.58
|
| Rate for Payer: BCBS MAPPO |
$164.21
|
| Rate for Payer: BCBS Trust/PPO |
$539.98
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$539.98
|
| Rate for Payer: BCN Medicare Advantage |
$164.21
|
| Rate for Payer: Cash Price |
$525.46
|
| Rate for Payer: Cash Price |
$525.46
|
| Rate for Payer: Cofinity Commercial |
$564.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$525.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.21
|
| Rate for Payer: Healthscope Commercial |
$591.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.62
|
| Rate for Payer: Mclaren Medicaid |
$115.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.42
|
| Rate for Payer: Meridian Medicaid |
$121.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.31
|
| Rate for Payer: Nomi Health Commercial |
$538.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.62
|
| Rate for Payer: PACE Senior Care Partners |
$156.00
|
| Rate for Payer: PACE SWMI |
$164.21
|
| Rate for Payer: PHP Commercial |
$558.31
|
| Rate for Payer: PHP Medicare Advantage |
$164.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$571.44
|
| Rate for Payer: Priority Health Medicare |
$165.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.15
|
| Rate for Payer: Railroad Medicare Medicare |
$164.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.01
|
| Rate for Payer: UHC Core |
$548.45
|
| Rate for Payer: UHC Exchange |
$164.21
|
| Rate for Payer: UHC Medicaid |
$115.80
|
| Rate for Payer: UHC Medicare Advantage |
$164.21
|
| Rate for Payer: UHCCP Medicaid |
$115.80
|
| Rate for Payer: VA VA |
$164.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.62
|
|
