|
HC US ELASTOGRAPHY 1ST LESION
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$169.86
|
| Rate for Payer: BCN Commercial |
$160.80
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$201.50 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: BCBS Trust/PPO |
$253.05
|
| Rate for Payer: BCN Commercial |
$239.57
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: Nomi Health Commercial |
$254.20
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO |
$269.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.80
|
| Rate for Payer: UHC Core |
$258.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC US ELASTOGRAPHY 1ST TARGET LESION
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
CPT 76982
|
| Hospital Charge Code |
40200082
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$73.62 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna Medicare |
$80.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.88
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$77.50
|
| Rate for Payer: BCBS Trust/PPO |
$254.85
|
| Rate for Payer: BCCCP Commercial |
$86.41
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: BCN Medicare Advantage |
$77.50
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.50
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.38
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: Nomi Health Commercial |
$254.20
|
| Rate for Payer: PACE Senior Care Partners |
$73.62
|
| Rate for Payer: PACE SWMI |
$77.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: PHP Medicare Advantage |
$77.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO |
$269.70
|
| Rate for Payer: Priority Health Medicare |
$78.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.70
|
| Rate for Payer: Railroad Medicare Medicare |
$77.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.80
|
| Rate for Payer: UHC Core |
$258.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.50
|
| Rate for Payer: UHC Exchange |
$77.50
|
| Rate for Payer: UHC Medicare Advantage |
$77.50
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$77.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC US ELASTOGRAPHY EA ADDL LESION
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.88 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$178.50
|
| Rate for Payer: Aetna Medicare |
$54.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.62
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCBS MAPPO |
$52.50
|
| Rate for Payer: BCBS Trust/PPO |
$172.64
|
| Rate for Payer: BCN Commercial |
$163.28
|
| Rate for Payer: BCN Medicare Advantage |
$52.50
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$180.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.50
|
| Rate for Payer: Healthscope Commercial |
$189.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: PACE Senior Care Partners |
$49.88
|
| Rate for Payer: PACE SWMI |
$52.50
|
| Rate for Payer: PHP Commercial |
$178.50
|
| Rate for Payer: PHP Medicare Advantage |
$52.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$182.70
|
| Rate for Payer: Priority Health Medicare |
$53.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.70
|
| Rate for Payer: Railroad Medicare Medicare |
$52.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.80
|
| Rate for Payer: UHC Core |
$175.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.50
|
| Rate for Payer: UHC Exchange |
$52.50
|
| Rate for Payer: UHC Medicare Advantage |
$52.50
|
| Rate for Payer: VA VA |
$52.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.50
|
|
|
HC US ELASTOGRAPHY EA ADDL TARGET LESION
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 76983
|
| Hospital Charge Code |
40200083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$178.50
|
| Rate for Payer: BCBS Trust/PPO |
$171.42
|
| Rate for Payer: BCN Commercial |
$162.29
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$180.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.00
|
| Rate for Payer: Healthscope Commercial |
$189.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.50
|
| Rate for Payer: Nomi Health Commercial |
$172.20
|
| Rate for Payer: PHP Commercial |
$178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$182.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.80
|
| Rate for Payer: UHC Core |
$175.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.50
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$58.14 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$63.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.50
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$201.25
|
| Rate for Payer: BCN Commercial |
$190.33
|
| Rate for Payer: BCN Medicare Advantage |
$61.20
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.26
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Senior Care Partners |
$58.14
|
| Rate for Payer: PACE SWMI |
$61.20
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$61.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Medicare |
$61.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: Railroad Medicare Medicare |
$61.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.20
|
| Rate for Payer: UHC Exchange |
$61.20
|
| Rate for Payer: UHC Medicare Advantage |
$61.20
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$61.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC US ELASTOGRAPHY ORGAN
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 76981
|
| Hospital Charge Code |
40200074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: BCBS Trust/PPO |
$199.83
|
| Rate for Payer: BCN Commercial |
$189.18
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
IP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$307.55 |
| Max. Negotiated Rate |
$425.84 |
| Rate for Payer: Aetna Commercial |
$402.19
|
| Rate for Payer: BCBS Trust/PPO |
$386.24
|
| Rate for Payer: BCN Commercial |
$365.66
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$406.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Healthscope Commercial |
$425.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: Nomi Health Commercial |
$387.99
|
| Rate for Payer: PHP Commercial |
$402.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: Priority Health HMO/PPO |
$411.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.38
|
| Rate for Payer: UHC Core |
$395.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.87
|
|
|
HC USE OF SPEECH DEVICE SERVICE
|
Facility
|
OP
|
$473.16
|
|
|
Service Code
|
CPT 92609
|
| Hospital Charge Code |
44000003
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$112.38 |
| Max. Negotiated Rate |
$425.84 |
| Rate for Payer: Aetna Commercial |
$402.19
|
| Rate for Payer: Aetna Medicare |
$123.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.86
|
| Rate for Payer: BCBS Complete |
$189.26
|
| Rate for Payer: BCBS MAPPO |
$118.29
|
| Rate for Payer: BCBS Trust/PPO |
$388.98
|
| Rate for Payer: BCN Commercial |
$367.88
|
| Rate for Payer: BCN Medicare Advantage |
$118.29
|
| Rate for Payer: Cash Price |
$378.53
|
| Rate for Payer: Cofinity Commercial |
$406.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.29
|
| Rate for Payer: Healthscope Commercial |
$425.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.19
|
| Rate for Payer: Nomi Health Commercial |
$387.99
|
| Rate for Payer: PACE Senior Care Partners |
$112.38
|
| Rate for Payer: PACE SWMI |
$118.29
|
| Rate for Payer: PHP Commercial |
$402.19
|
| Rate for Payer: PHP Medicare Advantage |
$118.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.55
|
| Rate for Payer: Priority Health HMO/PPO |
$411.65
|
| Rate for Payer: Priority Health Medicare |
$119.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.02
|
| Rate for Payer: Railroad Medicare Medicare |
$118.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.38
|
| Rate for Payer: UHC Core |
$395.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.29
|
| Rate for Payer: UHC Exchange |
$118.29
|
| Rate for Payer: UHC Medicare Advantage |
$118.29
|
| Rate for Payer: VA VA |
$118.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.87
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$446.56 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: BCBS Trust/PPO |
$560.81
|
| Rate for Payer: BCN Commercial |
$530.92
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO |
$597.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$460.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.57
|
| Rate for Payer: UHC Core |
$573.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASC LTD
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
40200038
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna Medicare |
$178.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.69
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$171.75
|
| Rate for Payer: BCBS Trust/PPO |
$564.79
|
| Rate for Payer: BCCCP Commercial |
$60.92
|
| Rate for Payer: BCN Commercial |
$534.15
|
| Rate for Payer: BCN Medicare Advantage |
$171.75
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.75
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.34
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PACE Senior Care Partners |
$163.16
|
| Rate for Payer: PACE SWMI |
$171.75
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: PHP Medicare Advantage |
$171.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO |
$597.70
|
| Rate for Payer: Priority Health Medicare |
$173.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$460.30
|
| Rate for Payer: Railroad Medicare Medicare |
$171.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.57
|
| Rate for Payer: UHC Core |
$573.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.75
|
| Rate for Payer: UHC Exchange |
$171.75
|
| Rate for Payer: UHC Medicare Advantage |
$171.75
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$171.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
OP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: Aetna Medicare |
$178.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.69
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$171.75
|
| Rate for Payer: BCBS Trust/PPO |
$564.79
|
| Rate for Payer: BCN Commercial |
$534.15
|
| Rate for Payer: BCN Medicare Advantage |
$171.75
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.75
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.34
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PACE Senior Care Partners |
$163.16
|
| Rate for Payer: PACE SWMI |
$171.75
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: PHP Medicare Advantage |
$171.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO |
$597.70
|
| Rate for Payer: Priority Health Medicare |
$173.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$460.30
|
| Rate for Payer: Railroad Medicare Medicare |
$171.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.57
|
| Rate for Payer: UHC Core |
$573.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.75
|
| Rate for Payer: UHC Exchange |
$171.75
|
| Rate for Payer: UHC Medicare Advantage |
$171.75
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$171.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EXTREMITY NONVASCULAR COMP
|
Facility
|
IP
|
$687.01
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
40200037
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$446.56 |
| Max. Negotiated Rate |
$618.31 |
| Rate for Payer: Aetna Commercial |
$583.96
|
| Rate for Payer: BCBS Trust/PPO |
$560.81
|
| Rate for Payer: BCN Commercial |
$530.92
|
| Rate for Payer: Cash Price |
$549.61
|
| Rate for Payer: Cofinity Commercial |
$590.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.61
|
| Rate for Payer: Healthscope Commercial |
$618.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.96
|
| Rate for Payer: Nomi Health Commercial |
$563.35
|
| Rate for Payer: PHP Commercial |
$583.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.56
|
| Rate for Payer: Priority Health HMO/PPO |
$597.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$460.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.57
|
| Rate for Payer: UHC Core |
$573.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.26
|
|
|
HC US EYE B MODE
|
Facility
|
IP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$788.11 |
| Max. Negotiated Rate |
$1,091.23 |
| Rate for Payer: Aetna Commercial |
$1,030.61
|
| Rate for Payer: BCBS Trust/PPO |
$989.75
|
| Rate for Payer: BCN Commercial |
$937.00
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$1,042.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Healthscope Commercial |
$1,091.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$994.23
|
| Rate for Payer: PHP Commercial |
$1,030.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,066.98
|
| Rate for Payer: UHC Core |
$1,012.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.36
|
|
|
HC US EYE B MODE
|
Facility
|
OP
|
$1,212.48
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200004
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$1,091.23 |
| Rate for Payer: Aetna Commercial |
$1,030.61
|
| Rate for Payer: Aetna Medicare |
$315.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.90
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$303.12
|
| Rate for Payer: BCBS Trust/PPO |
$996.78
|
| Rate for Payer: BCN Commercial |
$942.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.12
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cash Price |
$969.98
|
| Rate for Payer: Cofinity Commercial |
$1,042.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.12
|
| Rate for Payer: Healthscope Commercial |
$1,091.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.36
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.28
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.61
|
| Rate for Payer: Nomi Health Commercial |
$994.23
|
| Rate for Payer: PACE Senior Care Partners |
$287.96
|
| Rate for Payer: PACE SWMI |
$303.12
|
| Rate for Payer: PHP Commercial |
$1,030.61
|
| Rate for Payer: PHP Medicare Advantage |
$303.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.86
|
| Rate for Payer: Priority Health Medicare |
$306.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.36
|
| Rate for Payer: Railroad Medicare Medicare |
$303.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,066.98
|
| Rate for Payer: UHC Core |
$1,012.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.12
|
| Rate for Payer: UHC Exchange |
$303.12
|
| Rate for Payer: UHC Medicare Advantage |
$303.12
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$303.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.36
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
OP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$2,182.58 |
| Rate for Payer: Aetna Commercial |
$2,061.33
|
| Rate for Payer: Aetna Medicare |
$630.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.84
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$606.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,993.67
|
| Rate for Payer: BCN Commercial |
$1,885.51
|
| Rate for Payer: BCN Medicare Advantage |
$606.27
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$2,085.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$606.27
|
| Rate for Payer: Healthscope Commercial |
$2,182.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,818.82
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.59
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$697.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: Nomi Health Commercial |
$1,988.57
|
| Rate for Payer: PACE Senior Care Partners |
$575.96
|
| Rate for Payer: PACE SWMI |
$606.27
|
| Rate for Payer: PHP Commercial |
$2,061.33
|
| Rate for Payer: PHP Medicare Advantage |
$606.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,109.83
|
| Rate for Payer: Priority Health Medicare |
$612.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,624.81
|
| Rate for Payer: Railroad Medicare Medicare |
$606.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,134.08
|
| Rate for Payer: UHC Core |
$2,024.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$606.27
|
| Rate for Payer: UHC Exchange |
$606.27
|
| Rate for Payer: UHC Medicare Advantage |
$606.27
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$606.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,818.82
|
|
|
HC US EYE B MODE BILAT
|
Facility
|
IP
|
$2,425.09
|
|
|
Service Code
|
CPT 76512
|
| Hospital Charge Code |
40200005
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,576.31 |
| Max. Negotiated Rate |
$2,182.58 |
| Rate for Payer: Aetna Commercial |
$2,061.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.60
|
| Rate for Payer: BCN Commercial |
$1,874.11
|
| Rate for Payer: Cash Price |
$1,940.07
|
| Rate for Payer: Cofinity Commercial |
$2,085.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,940.07
|
| Rate for Payer: Healthscope Commercial |
$2,182.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,818.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,061.33
|
| Rate for Payer: Nomi Health Commercial |
$1,988.57
|
| Rate for Payer: PHP Commercial |
$2,061.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,109.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,624.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,134.08
|
| Rate for Payer: UHC Core |
$2,024.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,818.82
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
IP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$560.61 |
| Max. Negotiated Rate |
$776.23 |
| Rate for Payer: Aetna Commercial |
$733.11
|
| Rate for Payer: BCBS Trust/PPO |
$704.04
|
| Rate for Payer: BCN Commercial |
$666.52
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$741.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Healthscope Commercial |
$776.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: Nomi Health Commercial |
$707.23
|
| Rate for Payer: PHP Commercial |
$733.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: Priority Health HMO/PPO |
$750.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.98
|
| Rate for Payer: UHC Core |
$720.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.86
|
|
|
HC US FETAL FLUID DRAIN INCL GUID
|
Facility
|
OP
|
$862.48
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
36100088
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.84 |
| Max. Negotiated Rate |
$776.23 |
| Rate for Payer: Aetna Commercial |
$733.11
|
| Rate for Payer: Aetna Medicare |
$224.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$269.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$269.52
|
| Rate for Payer: BCBS Complete |
$226.27
|
| Rate for Payer: BCBS MAPPO |
$215.62
|
| Rate for Payer: BCBS Trust/PPO |
$709.04
|
| Rate for Payer: BCN Commercial |
$670.58
|
| Rate for Payer: BCN Medicare Advantage |
$215.62
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cash Price |
$689.98
|
| Rate for Payer: Cofinity Commercial |
$741.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.62
|
| Rate for Payer: Healthscope Commercial |
$776.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.86
|
| Rate for Payer: Mclaren Medicaid |
$215.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.40
|
| Rate for Payer: Meridian Medicaid |
$226.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.11
|
| Rate for Payer: Nomi Health Commercial |
$707.23
|
| Rate for Payer: PACE Senior Care Partners |
$204.84
|
| Rate for Payer: PACE SWMI |
$215.62
|
| Rate for Payer: PHP Commercial |
$733.11
|
| Rate for Payer: PHP Medicare Advantage |
$215.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.61
|
| Rate for Payer: Priority Health HMO/PPO |
$750.36
|
| Rate for Payer: Priority Health Medicare |
$217.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$577.86
|
| Rate for Payer: Railroad Medicare Medicare |
$215.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$758.98
|
| Rate for Payer: UHC Core |
$720.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.62
|
| Rate for Payer: UHC Exchange |
$215.62
|
| Rate for Payer: UHC Medicare Advantage |
$215.62
|
| Rate for Payer: UHCCP Medicaid |
$215.48
|
| Rate for Payer: VA VA |
$215.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.86
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$238.23
|
| Rate for Payer: BCN Commercial |
$225.53
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL MCA DOPPLER VELOCIMETREY
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76821
|
| Hospital Charge Code |
40200029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.31 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.92
|
| Rate for Payer: BCN Commercial |
$226.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.96
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.31 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.92
|
| Rate for Payer: BCN Commercial |
$226.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.96
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC US FETAL UMBILICAL ART DOPPLER
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
40200028
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$238.23
|
| Rate for Payer: BCN Commercial |
$225.53
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
