|
HC URN COTININE.
|
Facility
|
IP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$91.75 |
| Rate for Payer: Aetna Commercial |
$86.66
|
| Rate for Payer: BCBS Trust/PPO |
$83.22
|
| Rate for Payer: BCN Commercial |
$78.79
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$87.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Healthscope Commercial |
$91.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.66
|
| Rate for Payer: Nomi Health Commercial |
$83.60
|
| Rate for Payer: PHP Commercial |
$86.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health HMO/PPO |
$88.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.46
|
|
|
HC URN COTININE.
|
Facility
|
OP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.21 |
| Max. Negotiated Rate |
$91.75 |
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.49
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.46
|
| Rate for Payer: Aetna Commercial |
$86.66
|
| Rate for Payer: Aetna Medicare |
$26.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.86
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$83.81
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$25.49
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$87.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.49
|
| Rate for Payer: Healthscope Commercial |
$91.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.46
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.76
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.66
|
| Rate for Payer: Nomi Health Commercial |
$83.60
|
| Rate for Payer: PACE Senior Care Partners |
$24.21
|
| Rate for Payer: PACE SWMI |
$25.49
|
| Rate for Payer: PHP Commercial |
$86.66
|
| Rate for Payer: PHP Medicare Advantage |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health HMO/PPO |
$88.70
|
| Rate for Payer: Priority Health Medicare |
$25.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: Railroad Medicare Medicare |
$25.49
|
|
|
HC URN MDMA
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC URN MDMA
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC URN TRICYCLIC
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.04 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$38.99
|
| Rate for Payer: BCN Commercial |
$36.91
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: Priority Health HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC URN TRICYCLIC
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$37.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.04
|
| Rate for Payer: Priority Health HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.00
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.94
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
IP
|
$1,963.76
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,276.44 |
| Max. Negotiated Rate |
$1,767.38 |
| Rate for Payer: Aetna Commercial |
$1,669.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.02
|
| Rate for Payer: BCN Commercial |
$1,517.59
|
| Rate for Payer: Cash Price |
$1,571.01
|
| Rate for Payer: Cofinity Commercial |
$1,688.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.01
|
| Rate for Payer: Healthscope Commercial |
$1,767.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.20
|
| Rate for Payer: Nomi Health Commercial |
$1,610.28
|
| Rate for Payer: PHP Commercial |
$1,669.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,708.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,315.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,728.11
|
| Rate for Payer: UHC Core |
$1,639.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.82
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
OP
|
$1,963.76
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.39 |
| Max. Negotiated Rate |
$1,767.38 |
| Rate for Payer: Aetna Commercial |
$1,669.20
|
| Rate for Payer: Aetna Medicare |
$510.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$613.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$613.67
|
| Rate for Payer: BCBS Complete |
$785.50
|
| Rate for Payer: BCBS MAPPO |
$490.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.41
|
| Rate for Payer: BCN Commercial |
$1,526.82
|
| Rate for Payer: BCN Medicare Advantage |
$490.94
|
| Rate for Payer: Cash Price |
$1,571.01
|
| Rate for Payer: Cofinity Commercial |
$1,688.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.94
|
| Rate for Payer: Healthscope Commercial |
$1,767.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$564.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,669.20
|
| Rate for Payer: Nomi Health Commercial |
$1,610.28
|
| Rate for Payer: PACE Senior Care Partners |
$466.39
|
| Rate for Payer: PACE SWMI |
$490.94
|
| Rate for Payer: PHP Commercial |
$1,669.20
|
| Rate for Payer: PHP Medicare Advantage |
$490.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.44
|
| Rate for Payer: Priority Health HMO/PPO |
$1,708.47
|
| Rate for Payer: Priority Health Medicare |
$495.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,315.72
|
| Rate for Payer: Railroad Medicare Medicare |
$490.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,728.11
|
| Rate for Payer: UHC Core |
$1,639.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.94
|
| Rate for Payer: UHC Exchange |
$490.94
|
| Rate for Payer: UHC Medicare Advantage |
$490.94
|
| Rate for Payer: VA VA |
$490.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.82
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
IP
|
$16.37
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Aetna Commercial |
$13.91
|
| Rate for Payer: BCBS Trust/PPO |
$13.36
|
| Rate for Payer: BCN Commercial |
$12.65
|
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$14.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.91
|
| Rate for Payer: Nomi Health Commercial |
$13.42
|
| Rate for Payer: PHP Commercial |
$13.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.64
|
| Rate for Payer: Priority Health HMO/PPO |
$14.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.41
|
| Rate for Payer: UHC Core |
$13.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.28
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
OP
|
$16.37
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Aetna Commercial |
$13.91
|
| Rate for Payer: Aetna Medicare |
$4.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.12
|
| Rate for Payer: BCBS Complete |
$6.55
|
| Rate for Payer: BCBS MAPPO |
$4.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCN Commercial |
$12.73
|
| Rate for Payer: BCN Medicare Advantage |
$4.09
|
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Cofinity Commercial |
$14.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.09
|
| Rate for Payer: Healthscope Commercial |
$14.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.91
|
| Rate for Payer: Nomi Health Commercial |
$13.42
|
| Rate for Payer: PACE Senior Care Partners |
$3.89
|
| Rate for Payer: PACE SWMI |
$4.09
|
| Rate for Payer: PHP Commercial |
$13.91
|
| Rate for Payer: PHP Medicare Advantage |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.64
|
| Rate for Payer: Priority Health HMO/PPO |
$14.24
|
| Rate for Payer: Priority Health Medicare |
$4.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.97
|
| Rate for Payer: Railroad Medicare Medicare |
$4.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.41
|
| Rate for Payer: UHC Core |
$13.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.09
|
| Rate for Payer: UHC Exchange |
$4.09
|
| Rate for Payer: UHC Medicare Advantage |
$4.09
|
| Rate for Payer: VA VA |
$4.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.28
|
|
|
HC US AAA SCREENING
|
Facility
|
OP
|
$367.02
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$330.32 |
| Rate for Payer: Aetna Commercial |
$311.97
|
| Rate for Payer: Aetna Medicare |
$95.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.69
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$91.75
|
| Rate for Payer: BCBS Trust/PPO |
$301.73
|
| Rate for Payer: BCN Commercial |
$285.36
|
| Rate for Payer: BCN Medicare Advantage |
$91.75
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Cofinity Commercial |
$315.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$330.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.26
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.34
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.97
|
| Rate for Payer: Nomi Health Commercial |
$300.96
|
| Rate for Payer: PACE Senior Care Partners |
$87.17
|
| Rate for Payer: PACE SWMI |
$91.75
|
| Rate for Payer: PHP Commercial |
$311.97
|
| Rate for Payer: PHP Medicare Advantage |
$91.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.56
|
| Rate for Payer: Priority Health HMO/PPO |
$319.31
|
| Rate for Payer: Priority Health Medicare |
$92.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.90
|
| Rate for Payer: Railroad Medicare Medicare |
$91.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.98
|
| Rate for Payer: UHC Core |
$306.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.75
|
| Rate for Payer: UHC Exchange |
$91.75
|
| Rate for Payer: UHC Medicare Advantage |
$91.75
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$91.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.26
|
|
|
HC US AAA SCREENING
|
Facility
|
IP
|
$367.02
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$238.56 |
| Max. Negotiated Rate |
$330.32 |
| Rate for Payer: Aetna Commercial |
$311.97
|
| Rate for Payer: BCBS Trust/PPO |
$299.60
|
| Rate for Payer: BCN Commercial |
$283.63
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Cofinity Commercial |
$315.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.62
|
| Rate for Payer: Healthscope Commercial |
$330.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.97
|
| Rate for Payer: Nomi Health Commercial |
$300.96
|
| Rate for Payer: PHP Commercial |
$311.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.56
|
| Rate for Payer: Priority Health HMO/PPO |
$319.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.98
|
| Rate for Payer: UHC Core |
$306.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.26
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
OP
|
$950.92
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$855.83 |
| Rate for Payer: Aetna Commercial |
$808.28
|
| Rate for Payer: Aetna Medicare |
$247.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.16
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$237.73
|
| Rate for Payer: BCBS Trust/PPO |
$781.75
|
| Rate for Payer: BCN Commercial |
$739.34
|
| Rate for Payer: BCN Medicare Advantage |
$237.73
|
| Rate for Payer: Cash Price |
$760.74
|
| Rate for Payer: Cash Price |
$760.74
|
| Rate for Payer: Cofinity Commercial |
$817.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.73
|
| Rate for Payer: Healthscope Commercial |
$855.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.19
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.62
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$808.28
|
| Rate for Payer: Nomi Health Commercial |
$779.75
|
| Rate for Payer: PACE Senior Care Partners |
$225.84
|
| Rate for Payer: PACE SWMI |
$237.73
|
| Rate for Payer: PHP Commercial |
$808.28
|
| Rate for Payer: PHP Medicare Advantage |
$237.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: Priority Health HMO/PPO |
$827.30
|
| Rate for Payer: Priority Health Medicare |
$240.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.12
|
| Rate for Payer: Railroad Medicare Medicare |
$237.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.81
|
| Rate for Payer: UHC Core |
$794.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.73
|
| Rate for Payer: UHC Exchange |
$237.73
|
| Rate for Payer: UHC Medicare Advantage |
$237.73
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$237.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.19
|
|
|
HC US ABDOMEN COMPLETE
|
Facility
|
IP
|
$950.92
|
|
|
Service Code
|
CPT 76700
|
| Hospital Charge Code |
40200009
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$618.10 |
| Max. Negotiated Rate |
$855.83 |
| Rate for Payer: Aetna Commercial |
$808.28
|
| Rate for Payer: BCBS Trust/PPO |
$776.24
|
| Rate for Payer: BCN Commercial |
$734.87
|
| Rate for Payer: Cash Price |
$760.74
|
| Rate for Payer: Cofinity Commercial |
$817.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.74
|
| Rate for Payer: Healthscope Commercial |
$855.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$808.28
|
| Rate for Payer: Nomi Health Commercial |
$779.75
|
| Rate for Payer: PHP Commercial |
$808.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.10
|
| Rate for Payer: Priority Health HMO/PPO |
$827.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$637.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.81
|
| Rate for Payer: UHC Core |
$794.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.19
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
IP
|
$816.66
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$530.83 |
| Max. Negotiated Rate |
$734.99 |
| Rate for Payer: Aetna Commercial |
$694.16
|
| Rate for Payer: BCBS Trust/PPO |
$666.64
|
| Rate for Payer: BCN Commercial |
$631.11
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$702.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Healthscope Commercial |
$734.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: PHP Commercial |
$694.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: Priority Health HMO/PPO |
$710.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.66
|
| Rate for Payer: UHC Core |
$681.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.50
|
|
|
HC US ABDOMEN LIMITED
|
Facility
|
OP
|
$816.66
|
|
|
Service Code
|
CPT 76705
|
| Hospital Charge Code |
40200010
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$734.99 |
| Rate for Payer: Aetna Commercial |
$694.16
|
| Rate for Payer: Aetna Medicare |
$212.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.21
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$204.16
|
| Rate for Payer: BCBS Trust/PPO |
$671.38
|
| Rate for Payer: BCN Commercial |
$634.95
|
| Rate for Payer: BCN Medicare Advantage |
$204.16
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cash Price |
$653.33
|
| Rate for Payer: Cofinity Commercial |
$702.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$653.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.16
|
| Rate for Payer: Healthscope Commercial |
$734.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.50
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.37
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$694.16
|
| Rate for Payer: Nomi Health Commercial |
$669.66
|
| Rate for Payer: PACE Senior Care Partners |
$193.96
|
| Rate for Payer: PACE SWMI |
$204.16
|
| Rate for Payer: PHP Commercial |
$694.16
|
| Rate for Payer: PHP Medicare Advantage |
$204.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.83
|
| Rate for Payer: Priority Health HMO/PPO |
$710.49
|
| Rate for Payer: Priority Health Medicare |
$206.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.16
|
| Rate for Payer: Railroad Medicare Medicare |
$204.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$718.66
|
| Rate for Payer: UHC Core |
$681.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.16
|
| Rate for Payer: UHC Exchange |
$204.16
|
| Rate for Payer: UHC Medicare Advantage |
$204.16
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$204.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.50
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
OP
|
$602.20
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: Aetna Medicare |
$156.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$188.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$188.19
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$150.55
|
| Rate for Payer: BCBS Trust/PPO |
$495.07
|
| Rate for Payer: BCN Commercial |
$468.21
|
| Rate for Payer: BCN Medicare Advantage |
$150.55
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.55
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.08
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: PACE Senior Care Partners |
$143.02
|
| Rate for Payer: PACE SWMI |
$150.55
|
| Rate for Payer: PHP Commercial |
$511.87
|
| Rate for Payer: PHP Medicare Advantage |
$150.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health HMO/PPO |
$523.91
|
| Rate for Payer: Priority Health Medicare |
$152.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.47
|
| Rate for Payer: Railroad Medicare Medicare |
$150.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.94
|
| Rate for Payer: UHC Core |
$502.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.55
|
| Rate for Payer: UHC Exchange |
$150.55
|
| Rate for Payer: UHC Medicare Advantage |
$150.55
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$150.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC US BREAST BIL COMPLETE
|
Facility
|
IP
|
$602.20
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$391.43 |
| Max. Negotiated Rate |
$541.98 |
| Rate for Payer: Aetna Commercial |
$511.87
|
| Rate for Payer: BCBS Trust/PPO |
$491.58
|
| Rate for Payer: BCN Commercial |
$465.38
|
| Rate for Payer: Cash Price |
$481.76
|
| Rate for Payer: Cofinity Commercial |
$517.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$481.76
|
| Rate for Payer: Healthscope Commercial |
$541.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$451.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$511.87
|
| Rate for Payer: Nomi Health Commercial |
$493.80
|
| Rate for Payer: PHP Commercial |
$511.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.43
|
| Rate for Payer: Priority Health HMO/PPO |
$523.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.94
|
| Rate for Payer: UHC Core |
$502.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$451.65
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
OP
|
$562.45
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$506.20 |
| Rate for Payer: Aetna Commercial |
$478.08
|
| Rate for Payer: Aetna Medicare |
$146.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.77
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$140.61
|
| Rate for Payer: BCBS Trust/PPO |
$462.39
|
| Rate for Payer: BCN Commercial |
$437.30
|
| Rate for Payer: BCN Medicare Advantage |
$140.61
|
| Rate for Payer: Cash Price |
$449.96
|
| Rate for Payer: Cash Price |
$449.96
|
| Rate for Payer: Cofinity Commercial |
$483.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.61
|
| Rate for Payer: Healthscope Commercial |
$506.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.84
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.64
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.08
|
| Rate for Payer: Nomi Health Commercial |
$461.21
|
| Rate for Payer: PACE Senior Care Partners |
$133.58
|
| Rate for Payer: PACE SWMI |
$140.61
|
| Rate for Payer: PHP Commercial |
$478.08
|
| Rate for Payer: PHP Medicare Advantage |
$140.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.59
|
| Rate for Payer: Priority Health HMO/PPO |
$489.33
|
| Rate for Payer: Priority Health Medicare |
$142.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.84
|
| Rate for Payer: Railroad Medicare Medicare |
$140.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.96
|
| Rate for Payer: UHC Core |
$469.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.61
|
| Rate for Payer: UHC Exchange |
$140.61
|
| Rate for Payer: UHC Medicare Advantage |
$140.61
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$140.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.84
|
|
|
HC US BREAST BIL LIMITED
|
Facility
|
IP
|
$562.45
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$365.59 |
| Max. Negotiated Rate |
$506.20 |
| Rate for Payer: Aetna Commercial |
$478.08
|
| Rate for Payer: BCBS Trust/PPO |
$459.13
|
| Rate for Payer: BCN Commercial |
$434.66
|
| Rate for Payer: Cash Price |
$449.96
|
| Rate for Payer: Cofinity Commercial |
$483.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.96
|
| Rate for Payer: Healthscope Commercial |
$506.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.08
|
| Rate for Payer: Nomi Health Commercial |
$461.21
|
| Rate for Payer: PHP Commercial |
$478.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.59
|
| Rate for Payer: Priority Health HMO/PPO |
$489.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.96
|
| Rate for Payer: UHC Core |
$469.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.84
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCBS Trust/PPO |
$461.68
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Medicare |
$141.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Exchange |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$140.40
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, COMPLETE
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76641
|
| Hospital Charge Code |
40200068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$365.03 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: BCBS Trust/PPO |
$458.43
|
| Rate for Payer: BCN Commercial |
$434.00
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCBS Trust/PPO |
$461.68
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Medicare |
$141.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Exchange |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$140.40
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US BREAST UNI, LIMITED
|
Facility
|
IP
|
$561.59
|
|
|
Service Code
|
CPT 76642
|
| Hospital Charge Code |
40200069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$365.03 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: BCBS Trust/PPO |
$458.43
|
| Rate for Payer: BCN Commercial |
$434.00
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
|
HC US CHEST
|
Facility
|
OP
|
$561.59
|
|
|
Service Code
|
CPT 76604
|
| Hospital Charge Code |
40200007
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$505.43 |
| Rate for Payer: Aetna Commercial |
$477.35
|
| Rate for Payer: Aetna Medicare |
$146.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCBS Trust/PPO |
$461.68
|
| Rate for Payer: BCN Commercial |
$436.64
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cash Price |
$449.27
|
| Rate for Payer: Cofinity Commercial |
$482.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$505.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.19
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.35
|
| Rate for Payer: Nomi Health Commercial |
$460.50
|
| Rate for Payer: PACE Senior Care Partners |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$477.35
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.03
|
| Rate for Payer: Priority Health HMO/PPO |
$488.58
|
| Rate for Payer: Priority Health Medicare |
$141.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.20
|
| Rate for Payer: UHC Core |
$468.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Exchange |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$140.40
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.19
|
|
