|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$656.83
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$457.15 |
| Max. Negotiated Rate |
$591.15 |
| Rate for Payer: Aetna Commercial |
$558.31
|
| Rate for Payer: BCBS Trust/PPO |
$542.48
|
| Rate for Payer: BCN Commercial |
$542.48
|
| 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: Healthscope Commercial |
$591.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.62
|
| 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: PHP Commercial |
$558.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$571.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.01
|
| Rate for Payer: UHC Core |
$548.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.62
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$253.71 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: BCBS Trust/PPO |
$301.07
|
| Rate for Payer: BCN Commercial |
$301.07
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$94.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.92
|
| Rate for Payer: BCBS Complete |
$67.47
|
| Rate for Payer: BCBS MAPPO |
$91.13
|
| Rate for Payer: BCBS Trust/PPO |
$299.68
|
| Rate for Payer: BCN Commercial |
$299.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.13
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.13
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.69
|
| Rate for Payer: Meridian Medicaid |
$67.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$298.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Senior Care Partners |
$86.58
|
| Rate for Payer: PACE SWMI |
$91.13
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$91.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$317.14
|
| Rate for Payer: Priority Health Medicare |
$92.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.71
|
| Rate for Payer: Railroad Medicare Medicare |
$91.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.79
|
| Rate for Payer: UHC Core |
$304.38
|
| Rate for Payer: UHC Exchange |
$91.13
|
| Rate for Payer: UHC Medicaid |
$64.27
|
| Rate for Payer: UHC Medicare Advantage |
$91.13
|
| Rate for Payer: UHCCP Medicaid |
$64.27
|
| Rate for Payer: VA VA |
$91.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
OP
|
$330.69
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$58.30 |
| Max. Negotiated Rate |
$297.62 |
| Rate for Payer: Aetna Commercial |
$281.09
|
| Rate for Payer: Aetna Medicare |
$85.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.34
|
| Rate for Payer: BCBS Complete |
$61.21
|
| Rate for Payer: BCBS MAPPO |
$82.67
|
| Rate for Payer: BCBS Trust/PPO |
$271.86
|
| Rate for Payer: BCN Commercial |
$271.86
|
| Rate for Payer: BCN Medicare Advantage |
$82.67
|
| Rate for Payer: Cash Price |
$264.55
|
| Rate for Payer: Cofinity Commercial |
$284.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.67
|
| Rate for Payer: Healthscope Commercial |
$297.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.02
|
| Rate for Payer: Mclaren Medicaid |
$58.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.81
|
| Rate for Payer: Meridian Medicaid |
$61.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.09
|
| Rate for Payer: Nomi Health Commercial |
$271.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.02
|
| Rate for Payer: PACE Senior Care Partners |
$78.54
|
| Rate for Payer: PACE SWMI |
$82.67
|
| Rate for Payer: PHP Commercial |
$281.09
|
| Rate for Payer: PHP Medicare Advantage |
$82.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.70
|
| Rate for Payer: Priority Health Medicare |
$83.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.16
|
| Rate for Payer: Railroad Medicare Medicare |
$82.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.01
|
| Rate for Payer: UHC Core |
$276.13
|
| Rate for Payer: UHC Exchange |
$82.67
|
| Rate for Payer: UHC Medicaid |
$58.30
|
| Rate for Payer: UHC Medicare Advantage |
$82.67
|
| Rate for Payer: UHCCP Medicaid |
$58.30
|
| Rate for Payer: VA VA |
$82.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.02
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
IP
|
$330.69
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$230.16 |
| Max. Negotiated Rate |
$297.62 |
| Rate for Payer: Aetna Commercial |
$281.09
|
| Rate for Payer: BCBS Trust/PPO |
$273.12
|
| Rate for Payer: BCN Commercial |
$273.12
|
| Rate for Payer: Cash Price |
$264.55
|
| Rate for Payer: Cofinity Commercial |
$284.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.55
|
| Rate for Payer: Healthscope Commercial |
$297.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.09
|
| Rate for Payer: Nomi Health Commercial |
$271.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.02
|
| Rate for Payer: PHP Commercial |
$281.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$287.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.01
|
| Rate for Payer: UHC Core |
$276.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.02
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
OP
|
$604.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$106.49 |
| Max. Negotiated Rate |
$543.60 |
| Rate for Payer: Aetna Commercial |
$513.40
|
| Rate for Payer: Aetna Medicare |
$157.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.75
|
| Rate for Payer: BCBS Complete |
$111.80
|
| Rate for Payer: BCBS MAPPO |
$151.00
|
| Rate for Payer: BCBS Trust/PPO |
$496.55
|
| Rate for Payer: BCN Commercial |
$496.55
|
| Rate for Payer: BCN Medicare Advantage |
$151.00
|
| Rate for Payer: Cash Price |
$483.20
|
| Rate for Payer: Cofinity Commercial |
$519.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.00
|
| Rate for Payer: Healthscope Commercial |
$543.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$453.00
|
| Rate for Payer: Mclaren Medicaid |
$106.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.55
|
| Rate for Payer: Meridian Medicaid |
$111.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$166.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.40
|
| Rate for Payer: Nomi Health Commercial |
$495.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$453.00
|
| Rate for Payer: PACE Senior Care Partners |
$143.45
|
| Rate for Payer: PACE SWMI |
$151.00
|
| Rate for Payer: PHP Commercial |
$513.40
|
| Rate for Payer: PHP Medicare Advantage |
$151.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$525.48
|
| Rate for Payer: Priority Health Medicare |
$152.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.38
|
| Rate for Payer: Railroad Medicare Medicare |
$151.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.52
|
| Rate for Payer: UHC Core |
$504.34
|
| Rate for Payer: UHC Exchange |
$151.00
|
| Rate for Payer: UHC Medicaid |
$106.49
|
| Rate for Payer: UHC Medicare Advantage |
$151.00
|
| Rate for Payer: UHCCP Medicaid |
$106.49
|
| Rate for Payer: VA VA |
$151.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$453.00
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
IP
|
$604.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$420.38 |
| Max. Negotiated Rate |
$543.60 |
| Rate for Payer: Aetna Commercial |
$513.40
|
| Rate for Payer: BCBS Trust/PPO |
$498.84
|
| Rate for Payer: BCN Commercial |
$498.84
|
| Rate for Payer: Cash Price |
$483.20
|
| Rate for Payer: Cofinity Commercial |
$519.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.20
|
| Rate for Payer: Healthscope Commercial |
$543.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$453.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$513.40
|
| Rate for Payer: Nomi Health Commercial |
$495.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$453.00
|
| Rate for Payer: PHP Commercial |
$513.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$525.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.52
|
| Rate for Payer: UHC Core |
$504.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$453.00
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$414.09 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: BCBS Trust/PPO |
$491.37
|
| Rate for Payer: BCN Commercial |
$491.37
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$104.89 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.92
|
| Rate for Payer: BCBS Complete |
$110.13
|
| Rate for Payer: BCBS MAPPO |
$148.74
|
| Rate for Payer: BCBS Trust/PPO |
$489.11
|
| Rate for Payer: BCN Commercial |
$489.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.74
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.74
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Mclaren Medicaid |
$104.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.17
|
| Rate for Payer: Meridian Medicaid |
$110.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Senior Care Partners |
$141.30
|
| Rate for Payer: PACE SWMI |
$148.74
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$148.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Medicare |
$150.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: Railroad Medicare Medicare |
$148.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: UHC Exchange |
$148.74
|
| Rate for Payer: UHC Medicaid |
$104.89
|
| Rate for Payer: UHC Medicare Advantage |
$148.74
|
| Rate for Payer: UHCCP Medicaid |
$104.89
|
| Rate for Payer: VA VA |
$148.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
IP
|
$655.74
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$456.40 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: BCBS Trust/PPO |
$541.58
|
| Rate for Payer: BCN Commercial |
$541.58
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
OP
|
$655.74
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$115.61 |
| Max. Negotiated Rate |
$590.17 |
| Rate for Payer: Aetna Commercial |
$557.38
|
| Rate for Payer: Aetna Medicare |
$170.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.92
|
| Rate for Payer: BCBS Complete |
$121.38
|
| Rate for Payer: BCBS MAPPO |
$163.94
|
| Rate for Payer: BCBS Trust/PPO |
$539.08
|
| Rate for Payer: BCN Commercial |
$539.08
|
| Rate for Payer: BCN Medicare Advantage |
$163.94
|
| Rate for Payer: Cash Price |
$524.59
|
| Rate for Payer: Cofinity Commercial |
$563.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.94
|
| Rate for Payer: Healthscope Commercial |
$590.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.81
|
| Rate for Payer: Mclaren Medicaid |
$115.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.13
|
| Rate for Payer: Meridian Medicaid |
$121.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.38
|
| Rate for Payer: Nomi Health Commercial |
$537.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$491.81
|
| Rate for Payer: PACE Senior Care Partners |
$155.74
|
| Rate for Payer: PACE SWMI |
$163.94
|
| Rate for Payer: PHP Commercial |
$557.38
|
| Rate for Payer: PHP Medicare Advantage |
$163.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$570.49
|
| Rate for Payer: Priority Health Medicare |
$165.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.40
|
| Rate for Payer: Railroad Medicare Medicare |
$163.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$577.05
|
| Rate for Payer: UHC Core |
$547.54
|
| Rate for Payer: UHC Exchange |
$163.94
|
| Rate for Payer: UHC Medicaid |
$115.61
|
| Rate for Payer: UHC Medicare Advantage |
$163.94
|
| Rate for Payer: UHCCP Medicaid |
$115.61
|
| Rate for Payer: VA VA |
$163.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.81
|
|
|
HC US OB DETAILED
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$104.89 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.92
|
| Rate for Payer: BCBS Complete |
$110.13
|
| Rate for Payer: BCBS MAPPO |
$148.74
|
| Rate for Payer: BCBS Trust/PPO |
$489.11
|
| Rate for Payer: BCN Commercial |
$489.11
|
| Rate for Payer: BCN Medicare Advantage |
$148.74
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.74
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Mclaren Medicaid |
$104.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.17
|
| Rate for Payer: Meridian Medicaid |
$110.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Senior Care Partners |
$141.30
|
| Rate for Payer: PACE SWMI |
$148.74
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$148.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Medicare |
$150.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: Railroad Medicare Medicare |
$148.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: UHC Exchange |
$148.74
|
| Rate for Payer: UHC Medicaid |
$104.89
|
| Rate for Payer: UHC Medicare Advantage |
$148.74
|
| Rate for Payer: UHCCP Medicaid |
$104.89
|
| Rate for Payer: VA VA |
$148.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC US OB DETAILED
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$414.09 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: BCBS Trust/PPO |
$491.37
|
| Rate for Payer: BCN Commercial |
$491.37
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$487.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$517.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$414.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$523.56
|
| Rate for Payer: UHC Core |
$496.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$275.95 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: BCBS Trust/PPO |
$327.45
|
| Rate for Payer: BCN Commercial |
$327.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.90 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$103.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.90
|
| Rate for Payer: BCBS Complete |
$73.39
|
| Rate for Payer: BCBS MAPPO |
$99.12
|
| Rate for Payer: BCBS Trust/PPO |
$325.95
|
| Rate for Payer: BCN Commercial |
$325.95
|
| Rate for Payer: BCN Medicare Advantage |
$99.12
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.12
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$69.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.08
|
| Rate for Payer: Meridian Medicaid |
$73.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$325.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Senior Care Partners |
$94.16
|
| Rate for Payer: PACE SWMI |
$99.12
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$99.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.94
|
| Rate for Payer: Priority Health Medicare |
$100.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.90
|
| Rate for Payer: UHC Core |
$331.06
|
| Rate for Payer: UHC Exchange |
$99.12
|
| Rate for Payer: UHC Medicaid |
$69.90
|
| Rate for Payer: UHC Medicare Advantage |
$99.12
|
| Rate for Payer: UHCCP Medicaid |
$69.90
|
| Rate for Payer: VA VA |
$99.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
IP
|
$705.75
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$491.20 |
| Max. Negotiated Rate |
$635.17 |
| Rate for Payer: Aetna Commercial |
$599.89
|
| Rate for Payer: BCBS Trust/PPO |
$582.88
|
| Rate for Payer: BCN Commercial |
$582.88
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cofinity Commercial |
$606.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.60
|
| Rate for Payer: Healthscope Commercial |
$635.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.89
|
| Rate for Payer: Nomi Health Commercial |
$578.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.31
|
| Rate for Payer: PHP Commercial |
$599.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$614.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.06
|
| Rate for Payer: UHC Core |
$589.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.31
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
OP
|
$705.75
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$124.42 |
| Max. Negotiated Rate |
$635.17 |
| Rate for Payer: Aetna Commercial |
$599.89
|
| Rate for Payer: Aetna Medicare |
$183.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.55
|
| Rate for Payer: BCBS Complete |
$130.63
|
| Rate for Payer: BCBS MAPPO |
$176.44
|
| Rate for Payer: BCBS Trust/PPO |
$580.20
|
| Rate for Payer: BCN Commercial |
$580.20
|
| Rate for Payer: BCN Medicare Advantage |
$176.44
|
| Rate for Payer: Cash Price |
$564.60
|
| Rate for Payer: Cofinity Commercial |
$606.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.44
|
| Rate for Payer: Healthscope Commercial |
$635.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.31
|
| Rate for Payer: Mclaren Medicaid |
$124.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.26
|
| Rate for Payer: Meridian Medicaid |
$130.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.89
|
| Rate for Payer: Nomi Health Commercial |
$578.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.31
|
| Rate for Payer: PACE Senior Care Partners |
$167.62
|
| Rate for Payer: PACE SWMI |
$176.44
|
| Rate for Payer: PHP Commercial |
$599.89
|
| Rate for Payer: PHP Medicare Advantage |
$176.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$614.00
|
| Rate for Payer: Priority Health Medicare |
$178.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.20
|
| Rate for Payer: Railroad Medicare Medicare |
$176.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.06
|
| Rate for Payer: UHC Core |
$589.30
|
| Rate for Payer: UHC Exchange |
$176.44
|
| Rate for Payer: UHC Medicaid |
$124.42
|
| Rate for Payer: UHC Medicare Advantage |
$176.44
|
| Rate for Payer: UHCCP Medicaid |
$124.42
|
| Rate for Payer: VA VA |
$176.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.31
|
|
|
HC US OB FU
|
Facility
|
OP
|
$495.72
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB FU
|
Facility
|
IP
|
$495.72
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
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 OB GREATER THAN 14 WEEKS
|
Facility
|
IP
|
$593.63
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$413.17 |
| Max. Negotiated Rate |
$534.27 |
| Rate for Payer: Aetna Commercial |
$504.59
|
| Rate for Payer: BCBS Trust/PPO |
$490.28
|
| Rate for Payer: BCN Commercial |
$490.28
|
| Rate for Payer: Cash Price |
$474.90
|
| Rate for Payer: Cofinity Commercial |
$510.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.90
|
| Rate for Payer: Healthscope Commercial |
$534.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.59
|
| Rate for Payer: Nomi Health Commercial |
$486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.22
|
| Rate for Payer: PHP Commercial |
$504.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.39
|
| Rate for Payer: UHC Core |
$495.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.22
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
OP
|
$593.63
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$104.66 |
| Max. Negotiated Rate |
$534.27 |
| Rate for Payer: Aetna Commercial |
$504.59
|
| Rate for Payer: Aetna Medicare |
$154.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.51
|
| Rate for Payer: BCBS Complete |
$109.88
|
| Rate for Payer: BCBS MAPPO |
$148.41
|
| Rate for Payer: BCBS Trust/PPO |
$488.02
|
| Rate for Payer: BCN Commercial |
$488.02
|
| Rate for Payer: BCN Medicare Advantage |
$148.41
|
| Rate for Payer: Cash Price |
$474.90
|
| Rate for Payer: Cofinity Commercial |
$510.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.41
|
| Rate for Payer: Healthscope Commercial |
$534.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.22
|
| Rate for Payer: Mclaren Medicaid |
$104.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.83
|
| Rate for Payer: Meridian Medicaid |
$109.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.59
|
| Rate for Payer: Nomi Health Commercial |
$486.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.22
|
| Rate for Payer: PACE Senior Care Partners |
$140.99
|
| Rate for Payer: PACE SWMI |
$148.41
|
| Rate for Payer: PHP Commercial |
$504.59
|
| Rate for Payer: PHP Medicare Advantage |
$148.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.46
|
| Rate for Payer: Priority Health Medicare |
$149.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.17
|
| Rate for Payer: Railroad Medicare Medicare |
$148.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.39
|
| Rate for Payer: UHC Core |
$495.68
|
| Rate for Payer: UHC Exchange |
$148.41
|
| Rate for Payer: UHC Medicaid |
$104.66
|
| Rate for Payer: UHC Medicare Advantage |
$148.41
|
| Rate for Payer: UHCCP Medicaid |
$104.66
|
| Rate for Payer: VA VA |
$148.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.22
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
IP
|
$593.50
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$413.08 |
| Max. Negotiated Rate |
$534.15 |
| Rate for Payer: Aetna Commercial |
$504.48
|
| Rate for Payer: BCBS Trust/PPO |
$490.17
|
| Rate for Payer: BCN Commercial |
$490.17
|
| Rate for Payer: Cash Price |
$474.80
|
| Rate for Payer: Cofinity Commercial |
$510.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.80
|
| Rate for Payer: Healthscope Commercial |
$534.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.48
|
| Rate for Payer: Nomi Health Commercial |
$486.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.12
|
| Rate for Payer: PHP Commercial |
$504.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.28
|
| Rate for Payer: UHC Core |
$495.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.12
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
OP
|
$593.50
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$104.63 |
| Max. Negotiated Rate |
$534.15 |
| Rate for Payer: Aetna Commercial |
$504.48
|
| Rate for Payer: Aetna Medicare |
$154.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.47
|
| Rate for Payer: BCBS Complete |
$109.86
|
| Rate for Payer: BCBS MAPPO |
$148.38
|
| Rate for Payer: BCBS Trust/PPO |
$487.92
|
| Rate for Payer: BCN Commercial |
$487.92
|
| Rate for Payer: BCN Medicare Advantage |
$148.38
|
| Rate for Payer: Cash Price |
$474.80
|
| Rate for Payer: Cofinity Commercial |
$510.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$474.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.38
|
| Rate for Payer: Healthscope Commercial |
$534.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$445.12
|
| Rate for Payer: Mclaren Medicaid |
$104.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.79
|
| Rate for Payer: Meridian Medicaid |
$109.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$504.48
|
| Rate for Payer: Nomi Health Commercial |
$486.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$445.12
|
| Rate for Payer: PACE Senior Care Partners |
$140.96
|
| Rate for Payer: PACE SWMI |
$148.38
|
| Rate for Payer: PHP Commercial |
$504.48
|
| Rate for Payer: PHP Medicare Advantage |
$148.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$516.35
|
| Rate for Payer: Priority Health Medicare |
$149.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.08
|
| Rate for Payer: Railroad Medicare Medicare |
$148.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.28
|
| Rate for Payer: UHC Core |
$495.57
|
| Rate for Payer: UHC Exchange |
$148.38
|
| Rate for Payer: UHC Medicaid |
$104.63
|
| Rate for Payer: UHC Medicare Advantage |
$148.38
|
| Rate for Payer: UHCCP Medicaid |
$104.63
|
| Rate for Payer: VA VA |
$148.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$445.12
|
|
