|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
OP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$98.17 |
| Max. Negotiated Rate |
$372.02 |
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: Aetna Medicare |
$107.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.18
|
| Rate for Payer: BCBS Complete |
$165.34
|
| Rate for Payer: BCBS MAPPO |
$103.34
|
| Rate for Payer: BCBS Trust/PPO |
$339.82
|
| Rate for Payer: BCN Commercial |
$321.39
|
| Rate for Payer: BCN Medicare Advantage |
$103.34
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$355.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.34
|
| Rate for Payer: Healthscope Commercial |
$372.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: Nomi Health Commercial |
$338.96
|
| Rate for Payer: PACE Senior Care Partners |
$98.17
|
| Rate for Payer: PACE SWMI |
$103.34
|
| Rate for Payer: PHP Commercial |
$351.36
|
| Rate for Payer: PHP Medicare Advantage |
$103.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: Priority Health HMO/PPO |
$359.62
|
| Rate for Payer: Priority Health Medicare |
$104.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.95
|
| Rate for Payer: Railroad Medicare Medicare |
$103.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.76
|
| Rate for Payer: UHC Core |
$345.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.34
|
| Rate for Payer: UHC Exchange |
$103.34
|
| Rate for Payer: UHC Medicare Advantage |
$103.34
|
| Rate for Payer: VA VA |
$103.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.02
|
|
|
HC US GUIDED INTERSTITIAL THERAPY
|
Facility
|
IP
|
$413.36
|
|
|
Service Code
|
CPT 76965
|
| Hospital Charge Code |
40200063
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$268.68 |
| Max. Negotiated Rate |
$372.02 |
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: BCBS Trust/PPO |
$337.43
|
| Rate for Payer: BCN Commercial |
$319.44
|
| Rate for Payer: Cash Price |
$330.69
|
| Rate for Payer: Cofinity Commercial |
$355.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.69
|
| Rate for Payer: Healthscope Commercial |
$372.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.36
|
| Rate for Payer: Nomi Health Commercial |
$338.96
|
| Rate for Payer: PHP Commercial |
$351.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.68
|
| Rate for Payer: Priority Health HMO/PPO |
$359.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.76
|
| Rate for Payer: UHC Core |
$345.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.02
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
IP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$418.57 |
| Max. Negotiated Rate |
$579.56 |
| Rate for Payer: Aetna Commercial |
$547.36
|
| Rate for Payer: BCBS Trust/PPO |
$525.66
|
| Rate for Payer: BCN Commercial |
$497.64
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$553.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Healthscope Commercial |
$579.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: Nomi Health Commercial |
$528.04
|
| Rate for Payer: PHP Commercial |
$547.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: Priority Health HMO/PPO |
$560.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.68
|
| Rate for Payer: UHC Core |
$537.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.96
|
|
|
HC US GUIDE FOR NEEDLE PLACEMENT
|
Facility
|
OP
|
$643.95
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
40200045
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$55.83 |
| Max. Negotiated Rate |
$579.56 |
| Rate for Payer: Aetna Commercial |
$547.36
|
| Rate for Payer: Aetna Medicare |
$167.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.23
|
| Rate for Payer: BCBS Complete |
$257.58
|
| Rate for Payer: BCBS MAPPO |
$160.99
|
| Rate for Payer: BCBS Trust/PPO |
$529.39
|
| Rate for Payer: BCCCP Commercial |
$55.83
|
| Rate for Payer: BCN Commercial |
$500.67
|
| Rate for Payer: BCN Medicare Advantage |
$160.99
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cash Price |
$515.16
|
| Rate for Payer: Cofinity Commercial |
$553.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$515.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.99
|
| Rate for Payer: Healthscope Commercial |
$579.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$547.36
|
| Rate for Payer: Nomi Health Commercial |
$528.04
|
| Rate for Payer: PACE Senior Care Partners |
$152.94
|
| Rate for Payer: PACE SWMI |
$160.99
|
| Rate for Payer: PHP Commercial |
$547.36
|
| Rate for Payer: PHP Medicare Advantage |
$160.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$418.57
|
| Rate for Payer: Priority Health HMO/PPO |
$560.24
|
| Rate for Payer: Priority Health Medicare |
$162.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.45
|
| Rate for Payer: Railroad Medicare Medicare |
$160.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.68
|
| Rate for Payer: UHC Core |
$537.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.99
|
| Rate for Payer: UHC Exchange |
$160.99
|
| Rate for Payer: UHC Medicare Advantage |
$160.99
|
| Rate for Payer: VA VA |
$160.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.96
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$84.88 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$92.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.68
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$89.34
|
| Rate for Payer: BCBS Trust/PPO |
$293.80
|
| Rate for Payer: BCN Commercial |
$277.86
|
| Rate for Payer: BCN Medicare Advantage |
$89.34
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.34
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.81
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PACE Senior Care Partners |
$84.88
|
| Rate for Payer: PACE SWMI |
$89.34
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$89.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Medicare |
$90.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: Railroad Medicare Medicare |
$89.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.34
|
| Rate for Payer: UHC Exchange |
$89.34
|
| Rate for Payer: UHC Medicare Advantage |
$89.34
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$89.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC US HYSTEROSONOGRAM
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 76831
|
| Hospital Charge Code |
40200032
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$232.30 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: BCBS Trust/PPO |
$291.73
|
| Rate for Payer: BCN Commercial |
$276.18
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$293.05
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO |
$310.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.49
|
| Rate for Payer: UHC Core |
$298.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US INFANT HIPS W MANIPULATION
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76885
|
| Hospital Charge Code |
40200040
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
OP
|
$324.21
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$291.79 |
| Rate for Payer: Aetna Commercial |
$275.58
|
| Rate for Payer: Aetna Medicare |
$84.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.32
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$81.05
|
| Rate for Payer: BCBS Trust/PPO |
$266.53
|
| Rate for Payer: BCN Commercial |
$252.07
|
| Rate for Payer: BCN Medicare Advantage |
$81.05
|
| Rate for Payer: Cash Price |
$259.37
|
| Rate for Payer: Cash Price |
$259.37
|
| Rate for Payer: Cofinity Commercial |
$278.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.05
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.16
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.11
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.58
|
| Rate for Payer: Nomi Health Commercial |
$265.85
|
| Rate for Payer: PACE Senior Care Partners |
$77.00
|
| Rate for Payer: PACE SWMI |
$81.05
|
| Rate for Payer: PHP Commercial |
$275.58
|
| Rate for Payer: PHP Medicare Advantage |
$81.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.74
|
| Rate for Payer: Priority Health HMO/PPO |
$282.06
|
| Rate for Payer: Priority Health Medicare |
$81.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.22
|
| Rate for Payer: Railroad Medicare Medicare |
$81.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.30
|
| Rate for Payer: UHC Core |
$270.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.05
|
| Rate for Payer: UHC Exchange |
$81.05
|
| Rate for Payer: UHC Medicare Advantage |
$81.05
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$81.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.16
|
|
|
HC US INFANT HIPS WO MANIPULATION
|
Facility
|
IP
|
$324.21
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
40200041
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$210.74 |
| Max. Negotiated Rate |
$291.79 |
| Rate for Payer: Aetna Commercial |
$275.58
|
| Rate for Payer: BCBS Trust/PPO |
$264.65
|
| Rate for Payer: BCN Commercial |
$250.55
|
| Rate for Payer: Cash Price |
$259.37
|
| Rate for Payer: Cofinity Commercial |
$278.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.37
|
| Rate for Payer: Healthscope Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$275.58
|
| Rate for Payer: Nomi Health Commercial |
$265.85
|
| Rate for Payer: PHP Commercial |
$275.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.74
|
| Rate for Payer: Priority Health HMO/PPO |
$282.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.30
|
| Rate for Payer: UHC Core |
$270.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.16
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
OP
|
$592.16
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$140.64 |
| Max. Negotiated Rate |
$532.94 |
| Rate for Payer: Aetna Commercial |
$503.34
|
| Rate for Payer: Aetna Medicare |
$153.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$185.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$185.05
|
| Rate for Payer: BCBS Complete |
$236.86
|
| Rate for Payer: BCBS MAPPO |
$148.04
|
| Rate for Payer: BCBS Trust/PPO |
$486.81
|
| Rate for Payer: BCN Commercial |
$460.40
|
| Rate for Payer: BCN Medicare Advantage |
$148.04
|
| Rate for Payer: Cash Price |
$473.73
|
| Rate for Payer: Cofinity Commercial |
$509.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.04
|
| Rate for Payer: Healthscope Commercial |
$532.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$170.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.34
|
| Rate for Payer: Nomi Health Commercial |
$485.57
|
| Rate for Payer: PACE Senior Care Partners |
$140.64
|
| Rate for Payer: PACE SWMI |
$148.04
|
| Rate for Payer: PHP Commercial |
$503.34
|
| Rate for Payer: PHP Medicare Advantage |
$148.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.90
|
| Rate for Payer: Priority Health HMO/PPO |
$515.18
|
| Rate for Payer: Priority Health Medicare |
$149.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.75
|
| Rate for Payer: Railroad Medicare Medicare |
$148.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.10
|
| Rate for Payer: UHC Core |
$494.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.04
|
| Rate for Payer: UHC Exchange |
$148.04
|
| Rate for Payer: UHC Medicare Advantage |
$148.04
|
| Rate for Payer: VA VA |
$148.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.12
|
|
|
HC US MFM AMNIOCENTESIS W GUIDANCE
|
Facility
|
IP
|
$592.16
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
40200049
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$384.90 |
| Max. Negotiated Rate |
$532.94 |
| Rate for Payer: Aetna Commercial |
$503.34
|
| Rate for Payer: BCBS Trust/PPO |
$483.38
|
| Rate for Payer: BCN Commercial |
$457.62
|
| Rate for Payer: Cash Price |
$473.73
|
| Rate for Payer: Cofinity Commercial |
$509.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.73
|
| Rate for Payer: Healthscope Commercial |
$532.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$444.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$503.34
|
| Rate for Payer: Nomi Health Commercial |
$485.57
|
| Rate for Payer: PHP Commercial |
$503.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.90
|
| Rate for Payer: Priority Health HMO/PPO |
$515.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.10
|
| Rate for Payer: UHC Core |
$494.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$444.12
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$450.76
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US MFM CORDOCENTESIS GUIDE
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
40200044
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$151.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.28
|
| Rate for Payer: BCBS Complete |
$233.31
|
| Rate for Payer: BCBS MAPPO |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$479.51
|
| Rate for Payer: BCN Commercial |
$453.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.82
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.82
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Senior Care Partners |
$138.53
|
| Rate for Payer: PACE SWMI |
$145.82
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$145.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Medicare |
$147.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: Railroad Medicare Medicare |
$145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.82
|
| Rate for Payer: UHC Exchange |
$145.82
|
| Rate for Payer: UHC Medicare Advantage |
$145.82
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: Aetna Medicare |
$167.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.90
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$160.72
|
| Rate for Payer: BCBS Trust/PPO |
$528.51
|
| Rate for Payer: BCN Commercial |
$499.84
|
| Rate for Payer: BCN Medicare Advantage |
$160.72
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.72
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.76
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PACE Senior Care Partners |
$152.68
|
| Rate for Payer: PACE SWMI |
$160.72
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: PHP Medicare Advantage |
$160.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Medicare |
$162.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: Railroad Medicare Medicare |
$160.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.72
|
| Rate for Payer: UHC Exchange |
$160.72
|
| Rate for Payer: UHC Medicare Advantage |
$160.72
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$160.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC US OB BPP WO NON STRESS
|
Facility
|
IP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$417.87 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Aetna Commercial |
$546.45
|
| Rate for Payer: BCBS Trust/PPO |
$524.78
|
| Rate for Payer: BCN Commercial |
$496.82
|
| Rate for Payer: Cash Price |
$514.30
|
| Rate for Payer: Cofinity Commercial |
$552.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.30
|
| Rate for Payer: Healthscope Commercial |
$578.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$546.45
|
| Rate for Payer: Nomi Health Commercial |
$527.16
|
| Rate for Payer: PHP Commercial |
$546.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.87
|
| Rate for Payer: Priority Health HMO/PPO |
$559.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$430.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.73
|
| Rate for Payer: UHC Core |
$536.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.16
|
|
|
HC US OB DETAILED
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$138.53 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$151.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.28
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$145.82
|
| Rate for Payer: BCBS Trust/PPO |
$479.51
|
| Rate for Payer: BCN Commercial |
$453.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.82
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.82
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PACE Senior Care Partners |
$138.53
|
| Rate for Payer: PACE SWMI |
$145.82
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$145.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Medicare |
$147.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: Railroad Medicare Medicare |
$145.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.82
|
| Rate for Payer: UHC Exchange |
$145.82
|
| Rate for Payer: UHC Medicare Advantage |
$145.82
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$145.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB DETAILED
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$379.13 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: BCBS Trust/PPO |
$476.13
|
| Rate for Payer: BCN Commercial |
$450.76
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: Nomi Health Commercial |
$478.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health HMO/PPO |
$507.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.29
|
| Rate for Payer: UHC Core |
$487.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
IP
|
$691.91
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$449.74 |
| Max. Negotiated Rate |
$622.72 |
| Rate for Payer: Aetna Commercial |
$588.12
|
| Rate for Payer: BCBS Trust/PPO |
$564.81
|
| Rate for Payer: BCN Commercial |
$534.71
|
| Rate for Payer: Cash Price |
$553.53
|
| Rate for Payer: Cofinity Commercial |
$595.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.53
|
| Rate for Payer: Healthscope Commercial |
$622.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.12
|
| Rate for Payer: Nomi Health Commercial |
$567.37
|
| Rate for Payer: PHP Commercial |
$588.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.74
|
| Rate for Payer: Priority Health HMO/PPO |
$601.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.88
|
| Rate for Payer: UHC Core |
$577.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
OP
|
$691.91
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.33 |
| Max. Negotiated Rate |
$622.72 |
| Rate for Payer: Aetna Commercial |
$588.12
|
| Rate for Payer: Aetna Medicare |
$179.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$216.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$216.22
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$172.98
|
| Rate for Payer: BCBS Trust/PPO |
$568.82
|
| Rate for Payer: BCN Commercial |
$537.96
|
| Rate for Payer: BCN Medicare Advantage |
$172.98
|
| Rate for Payer: Cash Price |
$553.53
|
| Rate for Payer: Cash Price |
$553.53
|
| Rate for Payer: Cofinity Commercial |
$595.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.98
|
| Rate for Payer: Healthscope Commercial |
$622.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.93
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.63
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.12
|
| Rate for Payer: Nomi Health Commercial |
$567.37
|
| Rate for Payer: PACE Senior Care Partners |
$164.33
|
| Rate for Payer: PACE SWMI |
$172.98
|
| Rate for Payer: PHP Commercial |
$588.12
|
| Rate for Payer: PHP Medicare Advantage |
$172.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.74
|
| Rate for Payer: Priority Health HMO/PPO |
$601.96
|
| Rate for Payer: Priority Health Medicare |
$174.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$463.58
|
| Rate for Payer: Railroad Medicare Medicare |
$172.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.88
|
| Rate for Payer: UHC Core |
$577.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.98
|
| Rate for Payer: UHC Exchange |
$172.98
|
| Rate for Payer: UHC Medicare Advantage |
$172.98
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$172.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
HC US OB FU
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: Aetna Medicare |
$126.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.88
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$121.50
|
| Rate for Payer: BCBS Trust/PPO |
$399.54
|
| Rate for Payer: BCN Commercial |
$377.86
|
| Rate for Payer: BCN Medicare Advantage |
$121.50
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.50
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.58
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: PACE Senior Care Partners |
$115.42
|
| Rate for Payer: PACE SWMI |
$121.50
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: PHP Medicare Advantage |
$121.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO |
$422.82
|
| Rate for Payer: Priority Health Medicare |
$122.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.62
|
| Rate for Payer: Railroad Medicare Medicare |
$121.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.68
|
| Rate for Payer: UHC Core |
$405.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.50
|
| Rate for Payer: UHC Exchange |
$121.50
|
| Rate for Payer: UHC Medicare Advantage |
$121.50
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$121.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC US OB FU
|
Facility
|
IP
|
$486.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$315.90 |
| Max. Negotiated Rate |
$437.40 |
| Rate for Payer: Aetna Commercial |
$413.10
|
| Rate for Payer: BCBS Trust/PPO |
$396.72
|
| Rate for Payer: BCN Commercial |
$375.58
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cofinity Commercial |
$417.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.80
|
| Rate for Payer: Healthscope Commercial |
$437.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.10
|
| Rate for Payer: Nomi Health Commercial |
$398.52
|
| Rate for Payer: PHP Commercial |
$413.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.90
|
| Rate for Payer: Priority Health HMO/PPO |
$422.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.68
|
| Rate for Payer: UHC Core |
$405.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.50
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
IP
|
$581.99
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$378.29 |
| Max. Negotiated Rate |
$523.79 |
| Rate for Payer: Aetna Commercial |
$494.69
|
| Rate for Payer: BCBS Trust/PPO |
$475.08
|
| Rate for Payer: BCN Commercial |
$449.76
|
| Rate for Payer: Cash Price |
$465.59
|
| Rate for Payer: Cofinity Commercial |
$500.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.59
|
| Rate for Payer: Healthscope Commercial |
$523.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.69
|
| Rate for Payer: Nomi Health Commercial |
$477.23
|
| Rate for Payer: PHP Commercial |
$494.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.29
|
| Rate for Payer: Priority Health HMO/PPO |
$506.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.15
|
| Rate for Payer: UHC Core |
$485.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.49
|
|
