|
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
|
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 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 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 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 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 BPP WO NON STRESS
|
Facility
|
OP
|
$642.88
|
|
|
Service Code
|
CPT 76819
|
| Hospital Charge Code |
40200027
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| 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 |
$80.73
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.76
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$160.72
|
| 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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.11
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| 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
|
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 |
$183.51
|
| 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 |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.63
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| 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 |
$174.76
|
| 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 |
$174.76
|
| Rate for Payer: VA VA |
$172.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.93
|
|
|
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 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 FU
|
Facility
|
OP
|
$486.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| 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 |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$121.50
|
| Rate for Payer: BCBS Trust/PPO |
$399.54
|
| Rate for Payer: BCN Commercial |
$377.87
|
| 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 |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.58
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| 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 |
$76.88
|
| 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 |
$76.88
|
| Rate for Payer: VA VA |
$121.50
|
| 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
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
OP
|
$581.99
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$523.79 |
| Rate for Payer: Aetna Commercial |
$494.69
|
| Rate for Payer: Aetna Medicare |
$151.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.87
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$145.50
|
| Rate for Payer: BCBS Trust/PPO |
$478.45
|
| Rate for Payer: BCN Commercial |
$452.50
|
| Rate for Payer: BCN Medicare Advantage |
$145.50
|
| Rate for Payer: Cash Price |
$465.59
|
| 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: Health Alliance Plan Medicare Advantage |
$145.50
|
| Rate for Payer: Healthscope Commercial |
$523.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.49
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.77
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.69
|
| Rate for Payer: Nomi Health Commercial |
$477.23
|
| Rate for Payer: PACE Senior Care Partners |
$138.22
|
| Rate for Payer: PACE SWMI |
$145.50
|
| Rate for Payer: PHP Commercial |
$494.69
|
| Rate for Payer: PHP Medicare Advantage |
$145.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.29
|
| Rate for Payer: Priority Health HMO/PPO |
$506.33
|
| Rate for Payer: Priority Health Medicare |
$146.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.93
|
| Rate for Payer: Railroad Medicare Medicare |
$145.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.15
|
| Rate for Payer: UHC Core |
$485.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.50
|
| Rate for Payer: UHC Exchange |
$145.50
|
| Rate for Payer: UHC Medicare Advantage |
$145.50
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$145.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.49
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
IP
|
$581.86
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$378.21 |
| Max. Negotiated Rate |
$523.67 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: BCBS Trust/PPO |
$474.97
|
| Rate for Payer: BCN Commercial |
$449.66
|
| Rate for Payer: Cash Price |
$465.49
|
| Rate for Payer: Cofinity Commercial |
$500.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.49
|
| Rate for Payer: Healthscope Commercial |
$523.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.58
|
| Rate for Payer: Nomi Health Commercial |
$477.13
|
| Rate for Payer: PHP Commercial |
$494.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.21
|
| Rate for Payer: Priority Health HMO/PPO |
$506.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.04
|
| Rate for Payer: UHC Core |
$485.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.39
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
OP
|
$581.86
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$523.67 |
| Rate for Payer: Aetna Commercial |
$494.58
|
| Rate for Payer: Aetna Medicare |
$151.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.83
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$145.47
|
| Rate for Payer: BCBS Trust/PPO |
$478.35
|
| Rate for Payer: BCN Commercial |
$452.40
|
| Rate for Payer: BCN Medicare Advantage |
$145.47
|
| Rate for Payer: Cash Price |
$465.49
|
| Rate for Payer: Cash Price |
$465.49
|
| Rate for Payer: Cofinity Commercial |
$500.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$465.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.47
|
| Rate for Payer: Healthscope Commercial |
$523.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.39
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.74
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$167.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$494.58
|
| Rate for Payer: Nomi Health Commercial |
$477.13
|
| Rate for Payer: PACE Senior Care Partners |
$138.19
|
| Rate for Payer: PACE SWMI |
$145.47
|
| Rate for Payer: PHP Commercial |
$494.58
|
| Rate for Payer: PHP Medicare Advantage |
$145.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$378.21
|
| Rate for Payer: Priority Health HMO/PPO |
$506.22
|
| Rate for Payer: Priority Health Medicare |
$146.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$389.85
|
| Rate for Payer: Railroad Medicare Medicare |
$145.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.04
|
| Rate for Payer: UHC Core |
$485.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.47
|
| Rate for Payer: UHC Exchange |
$145.47
|
| Rate for Payer: UHC Medicare Advantage |
$145.47
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$145.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.39
|
|
|
HC US OB LTD
|
Facility
|
OP
|
$486.11
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$413.19
|
| Rate for Payer: Aetna Medicare |
$126.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.91
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$121.53
|
| Rate for Payer: BCBS Trust/PPO |
$399.63
|
| Rate for Payer: BCN Commercial |
$377.95
|
| Rate for Payer: BCN Medicare Advantage |
$121.53
|
| Rate for Payer: Cash Price |
$388.89
|
| Rate for Payer: Cash Price |
$388.89
|
| Rate for Payer: Cofinity Commercial |
$418.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.53
|
| Rate for Payer: Healthscope Commercial |
$437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.58
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.60
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.19
|
| Rate for Payer: Nomi Health Commercial |
$398.61
|
| Rate for Payer: PACE Senior Care Partners |
$115.45
|
| Rate for Payer: PACE SWMI |
$121.53
|
| Rate for Payer: PHP Commercial |
$413.19
|
| Rate for Payer: PHP Medicare Advantage |
$121.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.97
|
| Rate for Payer: Priority Health HMO/PPO |
$422.92
|
| Rate for Payer: Priority Health Medicare |
$122.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.69
|
| Rate for Payer: Railroad Medicare Medicare |
$121.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.78
|
| Rate for Payer: UHC Core |
$405.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.53
|
| Rate for Payer: UHC Exchange |
$121.53
|
| Rate for Payer: UHC Medicare Advantage |
$121.53
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$121.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.58
|
|
|
HC US OB LTD
|
Facility
|
IP
|
$486.11
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$315.97 |
| Max. Negotiated Rate |
$437.50 |
| Rate for Payer: Aetna Commercial |
$413.19
|
| Rate for Payer: BCBS Trust/PPO |
$396.81
|
| Rate for Payer: BCN Commercial |
$375.67
|
| Rate for Payer: Cash Price |
$388.89
|
| Rate for Payer: Cofinity Commercial |
$418.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$388.89
|
| Rate for Payer: Healthscope Commercial |
$437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.19
|
| Rate for Payer: Nomi Health Commercial |
$398.61
|
| Rate for Payer: PHP Commercial |
$413.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.97
|
| Rate for Payer: Priority Health HMO/PPO |
$422.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.78
|
| Rate for Payer: UHC Core |
$405.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.58
|
|
|
HC US OB NT EACH ADDL FETUS
|
Facility
|
OP
|
$176.49
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
40200022
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$41.92 |
| Max. Negotiated Rate |
$158.84 |
| Rate for Payer: Aetna Commercial |
$150.02
|
| Rate for Payer: Aetna Medicare |
$45.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.15
|
| Rate for Payer: BCBS Complete |
$70.60
|
| Rate for Payer: BCBS MAPPO |
$44.12
|
| Rate for Payer: BCBS Trust/PPO |
$145.09
|
| Rate for Payer: BCN Commercial |
$137.22
|
| Rate for Payer: BCN Medicare Advantage |
$44.12
|
| Rate for Payer: Cash Price |
$141.19
|
| Rate for Payer: Cofinity Commercial |
$151.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.12
|
| Rate for Payer: Healthscope Commercial |
$158.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.02
|
| Rate for Payer: Nomi Health Commercial |
$144.72
|
| Rate for Payer: PACE Senior Care Partners |
$41.92
|
| Rate for Payer: PACE SWMI |
$44.12
|
| Rate for Payer: PHP Commercial |
$150.02
|
| Rate for Payer: PHP Medicare Advantage |
$44.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.72
|
| Rate for Payer: Priority Health HMO/PPO |
$153.55
|
| Rate for Payer: Priority Health Medicare |
$44.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.25
|
| Rate for Payer: Railroad Medicare Medicare |
$44.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.31
|
| Rate for Payer: UHC Core |
$147.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.12
|
| Rate for Payer: UHC Exchange |
$44.12
|
| Rate for Payer: UHC Medicare Advantage |
$44.12
|
| Rate for Payer: VA VA |
$44.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.37
|
|
|
HC US OB NT EACH ADDL FETUS
|
Facility
|
IP
|
$176.49
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
40200022
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$114.72 |
| Max. Negotiated Rate |
$158.84 |
| Rate for Payer: Aetna Commercial |
$150.02
|
| Rate for Payer: BCBS Trust/PPO |
$144.07
|
| Rate for Payer: BCN Commercial |
$136.39
|
| Rate for Payer: Cash Price |
$141.19
|
| Rate for Payer: Cofinity Commercial |
$151.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.19
|
| Rate for Payer: Healthscope Commercial |
$158.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.02
|
| Rate for Payer: Nomi Health Commercial |
$144.72
|
| Rate for Payer: PHP Commercial |
$150.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.72
|
| Rate for Payer: Priority Health HMO/PPO |
$153.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.31
|
| Rate for Payer: UHC Core |
$147.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.37
|
|
|
HC US OB NUCHAL TRANSLUCENCY
|
Facility
|
IP
|
$458.39
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
40200021
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$297.95 |
| Max. Negotiated Rate |
$412.55 |
| Rate for Payer: Aetna Commercial |
$389.63
|
| Rate for Payer: BCBS Trust/PPO |
$374.18
|
| Rate for Payer: BCN Commercial |
$354.24
|
| Rate for Payer: Cash Price |
$366.71
|
| Rate for Payer: Cofinity Commercial |
$394.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.71
|
| Rate for Payer: Healthscope Commercial |
$412.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$389.63
|
| Rate for Payer: Nomi Health Commercial |
$375.88
|
| Rate for Payer: PHP Commercial |
$389.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.95
|
| Rate for Payer: Priority Health HMO/PPO |
$398.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.38
|
| Rate for Payer: UHC Core |
$382.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.79
|
|
|
HC US OB NUCHAL TRANSLUCENCY
|
Facility
|
OP
|
$458.39
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
40200021
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$412.55 |
| Rate for Payer: Aetna Commercial |
$389.63
|
| Rate for Payer: Aetna Medicare |
$119.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.25
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$114.60
|
| Rate for Payer: BCBS Trust/PPO |
$376.84
|
| Rate for Payer: BCN Commercial |
$356.40
|
| Rate for Payer: BCN Medicare Advantage |
$114.60
|
| Rate for Payer: Cash Price |
$366.71
|
| Rate for Payer: Cash Price |
$366.71
|
| Rate for Payer: Cofinity Commercial |
$394.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$366.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.60
|
| Rate for Payer: Healthscope Commercial |
$412.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.79
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.33
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$389.63
|
| Rate for Payer: Nomi Health Commercial |
$375.88
|
| Rate for Payer: PACE Senior Care Partners |
$108.87
|
| Rate for Payer: PACE SWMI |
$114.60
|
| Rate for Payer: PHP Commercial |
$389.63
|
| Rate for Payer: PHP Medicare Advantage |
$114.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.95
|
| Rate for Payer: Priority Health HMO/PPO |
$398.80
|
| Rate for Payer: Priority Health Medicare |
$115.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.12
|
| Rate for Payer: Railroad Medicare Medicare |
$114.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.38
|
| Rate for Payer: UHC Core |
$382.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.60
|
| Rate for Payer: UHC Exchange |
$114.60
|
| Rate for Payer: UHC Medicare Advantage |
$114.60
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$114.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.79
|
|
