|
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 |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.77
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| 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 |
$436.40
|
| 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 |
$436.40
|
|
|
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 |
$75.33 |
| 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 |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$145.46
|
| Rate for Payer: BCBS Trust/PPO |
$478.35
|
| Rate for Payer: BCN Commercial |
$452.40
|
| Rate for Payer: BCN Medicare Advantage |
$145.46
|
| 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 |
$145.46
|
| Rate for Payer: Healthscope Commercial |
$523.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$436.40
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.74
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$145.46
|
| Rate for Payer: PHP Commercial |
$494.58
|
| Rate for Payer: PHP Medicare Advantage |
$145.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| 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 |
$145.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$512.04
|
| Rate for Payer: UHC Core |
$485.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.46
|
| Rate for Payer: UHC Exchange |
$145.46
|
| Rate for Payer: UHC Medicare Advantage |
$145.46
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$145.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$436.40
|
|
|
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 LTD
|
Facility
|
OP
|
$486.11
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.60
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| Rate for Payer: VA VA |
$121.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.58
|
|
|
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 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 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 |
$75.33 |
| 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 |
$79.10
|
| 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 |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.33
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| 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 |
$75.33
|
| 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 |
$75.33
|
| Rate for Payer: VA VA |
$114.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.79
|
|
|
HC US OB TRANSVAG ONLY
|
Facility
|
OP
|
$398.27
|
|
|
Service Code
|
CPT 76817
|
| Hospital Charge Code |
40200025
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$358.44 |
| Rate for Payer: Aetna Commercial |
$338.53
|
| Rate for Payer: Aetna Medicare |
$103.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.46
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$99.57
|
| Rate for Payer: BCBS Trust/PPO |
$327.42
|
| Rate for Payer: BCN Commercial |
$309.65
|
| Rate for Payer: BCN Medicare Advantage |
$99.57
|
| Rate for Payer: Cash Price |
$318.62
|
| Rate for Payer: Cash Price |
$318.62
|
| Rate for Payer: Cofinity Commercial |
$342.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.57
|
| Rate for Payer: Healthscope Commercial |
$358.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.70
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.55
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.53
|
| Rate for Payer: Nomi Health Commercial |
$326.58
|
| Rate for Payer: PACE Senior Care Partners |
$94.59
|
| Rate for Payer: PACE SWMI |
$99.57
|
| Rate for Payer: PHP Commercial |
$338.53
|
| Rate for Payer: PHP Medicare Advantage |
$99.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.88
|
| Rate for Payer: Priority Health HMO/PPO |
$346.49
|
| Rate for Payer: Priority Health Medicare |
$100.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.84
|
| Rate for Payer: Railroad Medicare Medicare |
$99.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.48
|
| Rate for Payer: UHC Core |
$332.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.57
|
| Rate for Payer: UHC Exchange |
$99.57
|
| Rate for Payer: UHC Medicare Advantage |
$99.57
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$99.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.70
|
|
|
HC US OB TRANSVAG ONLY
|
Facility
|
IP
|
$398.27
|
|
|
Service Code
|
CPT 76817
|
| Hospital Charge Code |
40200025
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$258.88 |
| Max. Negotiated Rate |
$358.44 |
| Rate for Payer: Aetna Commercial |
$338.53
|
| Rate for Payer: BCBS Trust/PPO |
$325.11
|
| Rate for Payer: BCN Commercial |
$307.78
|
| Rate for Payer: Cash Price |
$318.62
|
| Rate for Payer: Cofinity Commercial |
$342.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.62
|
| Rate for Payer: Healthscope Commercial |
$358.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.53
|
| Rate for Payer: Nomi Health Commercial |
$326.58
|
| Rate for Payer: PHP Commercial |
$338.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.88
|
| Rate for Payer: Priority Health HMO/PPO |
$346.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.48
|
| Rate for Payer: UHC Core |
$332.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.70
|
|
|
HC US OB UNLISTED PROCEDURE
|
Facility
|
IP
|
$1,089.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$707.85 |
| Max. Negotiated Rate |
$980.10 |
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: BCBS Trust/PPO |
$888.95
|
| Rate for Payer: BCN Commercial |
$841.58
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: Nomi Health Commercial |
$892.98
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO |
$947.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$729.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.32
|
| Rate for Payer: UHC Core |
$909.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.75
|
|
|
HC US OB UNLISTED PROCEDURE
|
Facility
|
OP
|
$1,089.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$980.10 |
| Rate for Payer: Aetna Commercial |
$925.65
|
| Rate for Payer: Aetna Medicare |
$283.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$340.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$340.31
|
| Rate for Payer: BCBS Complete |
$149.64
|
| Rate for Payer: BCBS MAPPO |
$272.25
|
| Rate for Payer: BCBS Trust/PPO |
$895.27
|
| Rate for Payer: BCN Commercial |
$846.70
|
| Rate for Payer: BCN Medicare Advantage |
$272.25
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cash Price |
$871.20
|
| Rate for Payer: Cofinity Commercial |
$936.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$871.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.25
|
| Rate for Payer: Healthscope Commercial |
$980.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.75
|
| Rate for Payer: Mclaren Medicaid |
$142.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.86
|
| Rate for Payer: Meridian Medicaid |
$149.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$313.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.65
|
| Rate for Payer: Nomi Health Commercial |
$892.98
|
| Rate for Payer: PACE Senior Care Partners |
$258.64
|
| Rate for Payer: PACE SWMI |
$272.25
|
| Rate for Payer: PHP Commercial |
$925.65
|
| Rate for Payer: PHP Medicare Advantage |
$272.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$707.85
|
| Rate for Payer: Priority Health HMO/PPO |
$947.43
|
| Rate for Payer: Priority Health Medicare |
$274.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$729.63
|
| Rate for Payer: Railroad Medicare Medicare |
$272.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$958.32
|
| Rate for Payer: UHC Core |
$909.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.25
|
| Rate for Payer: UHC Exchange |
$272.25
|
| Rate for Payer: UHC Medicare Advantage |
$272.25
|
| Rate for Payer: UHCCP Medicaid |
$142.50
|
| Rate for Payer: VA VA |
$272.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.75
|
|
|
HC US PARACENTESIS
|
Facility
|
IP
|
$1,369.02
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
36100346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$889.86 |
| Max. Negotiated Rate |
$1,232.12 |
| Rate for Payer: Aetna Commercial |
$1,163.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.53
|
| Rate for Payer: BCN Commercial |
$1,057.98
|
| Rate for Payer: Cash Price |
$1,095.22
|
| Rate for Payer: Cofinity Commercial |
$1,177.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.22
|
| Rate for Payer: Healthscope Commercial |
$1,232.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,026.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.67
|
| Rate for Payer: Nomi Health Commercial |
$1,122.60
|
| Rate for Payer: PHP Commercial |
$1,163.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.74
|
| Rate for Payer: UHC Core |
$1,143.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,026.76
|
|
|
HC US PARACENTESIS
|
Facility
|
OP
|
$1,369.02
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
36100346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$325.14 |
| Max. Negotiated Rate |
$1,232.12 |
| Rate for Payer: Aetna Commercial |
$1,163.67
|
| Rate for Payer: Aetna Medicare |
$355.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.82
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$342.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,125.47
|
| Rate for Payer: BCN Commercial |
$1,064.41
|
| Rate for Payer: BCN Medicare Advantage |
$342.26
|
| Rate for Payer: Cash Price |
$1,095.22
|
| Rate for Payer: Cash Price |
$1,095.22
|
| Rate for Payer: Cofinity Commercial |
$1,177.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$342.26
|
| Rate for Payer: Healthscope Commercial |
$1,232.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,026.76
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$359.37
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.67
|
| Rate for Payer: Nomi Health Commercial |
$1,122.60
|
| Rate for Payer: PACE Senior Care Partners |
$325.14
|
| Rate for Payer: PACE SWMI |
$342.26
|
| Rate for Payer: PHP Commercial |
$1,163.67
|
| Rate for Payer: PHP Medicare Advantage |
$342.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,191.05
|
| Rate for Payer: Priority Health Medicare |
$345.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$917.24
|
| Rate for Payer: Railroad Medicare Medicare |
$342.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.74
|
| Rate for Payer: UHC Core |
$1,143.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$342.26
|
| Rate for Payer: UHC Exchange |
$342.26
|
| Rate for Payer: UHC Medicare Advantage |
$342.26
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$342.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,026.76
|
|
|
HC US PELVIS LTD
|
Facility
|
IP
|
$510.39
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
40200034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$331.75 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: BCBS Trust/PPO |
$416.63
|
| Rate for Payer: BCN Commercial |
$394.43
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC US PELVIS LTD
|
Facility
|
OP
|
$510.39
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
40200034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$459.35 |
| Rate for Payer: Aetna Commercial |
$433.83
|
| Rate for Payer: Aetna Medicare |
$132.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.50
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$127.60
|
| Rate for Payer: BCBS Trust/PPO |
$419.59
|
| Rate for Payer: BCN Commercial |
$396.83
|
| Rate for Payer: BCN Medicare Advantage |
$127.60
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cash Price |
$408.31
|
| Rate for Payer: Cofinity Commercial |
$438.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.60
|
| Rate for Payer: Healthscope Commercial |
$459.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.79
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.98
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.83
|
| Rate for Payer: Nomi Health Commercial |
$418.52
|
| Rate for Payer: PACE Senior Care Partners |
$121.22
|
| Rate for Payer: PACE SWMI |
$127.60
|
| Rate for Payer: PHP Commercial |
$433.83
|
| Rate for Payer: PHP Medicare Advantage |
$127.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.75
|
| Rate for Payer: Priority Health HMO/PPO |
$444.04
|
| Rate for Payer: Priority Health Medicare |
$128.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.96
|
| Rate for Payer: Railroad Medicare Medicare |
$127.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.14
|
| Rate for Payer: UHC Core |
$426.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.60
|
| Rate for Payer: UHC Exchange |
$127.60
|
| Rate for Payer: UHC Medicare Advantage |
$127.60
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$127.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.79
|
|
|
HC US PELVIS TRANSABDOMINAL ONLY
|
Facility
|
IP
|
$918.71
|
|
|
Service Code
|
CPT 76856
|
| Hospital Charge Code |
40200033
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$597.16 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: BCBS Trust/PPO |
$749.94
|
| Rate for Payer: BCN Commercial |
$709.98
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO |
$799.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.46
|
| Rate for Payer: UHC Core |
$767.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC US PELVIS TRANSABDOMINAL ONLY
|
Facility
|
OP
|
$918.71
|
|
|
Service Code
|
CPT 76856
|
| Hospital Charge Code |
40200033
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$826.84 |
| Rate for Payer: Aetna Commercial |
$780.90
|
| Rate for Payer: Aetna Medicare |
$238.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.10
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$229.68
|
| Rate for Payer: BCBS Trust/PPO |
$755.27
|
| Rate for Payer: BCN Commercial |
$714.30
|
| Rate for Payer: BCN Medicare Advantage |
$229.68
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cash Price |
$734.97
|
| Rate for Payer: Cofinity Commercial |
$790.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.68
|
| Rate for Payer: Healthscope Commercial |
$826.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.03
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.16
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$780.90
|
| Rate for Payer: Nomi Health Commercial |
$753.34
|
| Rate for Payer: PACE Senior Care Partners |
$218.19
|
| Rate for Payer: PACE SWMI |
$229.68
|
| Rate for Payer: PHP Commercial |
$780.90
|
| Rate for Payer: PHP Medicare Advantage |
$229.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.16
|
| Rate for Payer: Priority Health HMO/PPO |
$799.28
|
| Rate for Payer: Priority Health Medicare |
$231.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.54
|
| Rate for Payer: Railroad Medicare Medicare |
$229.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$808.46
|
| Rate for Payer: UHC Core |
$767.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.68
|
| Rate for Payer: UHC Exchange |
$229.68
|
| Rate for Payer: UHC Medicare Advantage |
$229.68
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$229.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.03
|
|
|
HC US PELVIS TRANSVAG ONLY
|
Facility
|
IP
|
$377.89
|
|
|
Service Code
|
CPT 76830
|
| Hospital Charge Code |
40200031
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$245.63 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: BCBS Trust/PPO |
$308.47
|
| Rate for Payer: BCN Commercial |
$292.03
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC US PELVIS TRANSVAG ONLY
|
Facility
|
OP
|
$377.89
|
|
|
Service Code
|
CPT 76830
|
| Hospital Charge Code |
40200031
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Aetna Commercial |
$321.21
|
| Rate for Payer: Aetna Medicare |
$98.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.09
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$94.47
|
| Rate for Payer: BCBS Trust/PPO |
$310.66
|
| Rate for Payer: BCN Commercial |
$293.81
|
| Rate for Payer: BCN Medicare Advantage |
$94.47
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cash Price |
$302.31
|
| Rate for Payer: Cofinity Commercial |
$324.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.47
|
| Rate for Payer: Healthscope Commercial |
$340.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.42
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.20
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.21
|
| Rate for Payer: Nomi Health Commercial |
$309.87
|
| Rate for Payer: PACE Senior Care Partners |
$89.75
|
| Rate for Payer: PACE SWMI |
$94.47
|
| Rate for Payer: PHP Commercial |
$321.21
|
| Rate for Payer: PHP Medicare Advantage |
$94.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.63
|
| Rate for Payer: Priority Health HMO/PPO |
$328.76
|
| Rate for Payer: Priority Health Medicare |
$95.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.19
|
| Rate for Payer: Railroad Medicare Medicare |
$94.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.54
|
| Rate for Payer: UHC Core |
$315.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.47
|
| Rate for Payer: UHC Exchange |
$94.47
|
| Rate for Payer: UHC Medicare Advantage |
$94.47
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$94.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.42
|
|
|
HC US PROSTATE TRANSRECTAL
|
Facility
|
OP
|
$1,086.05
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
40200036
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$977.44 |
| Rate for Payer: Aetna Commercial |
$923.14
|
| Rate for Payer: Aetna Medicare |
$282.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$339.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$339.39
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$271.51
|
| Rate for Payer: BCBS Trust/PPO |
$892.84
|
| Rate for Payer: BCN Commercial |
$844.40
|
| Rate for Payer: BCN Medicare Advantage |
$271.51
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cofinity Commercial |
$934.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.51
|
| Rate for Payer: Healthscope Commercial |
$977.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.54
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$285.09
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.14
|
| Rate for Payer: Nomi Health Commercial |
$890.56
|
| Rate for Payer: PACE Senior Care Partners |
$257.94
|
| Rate for Payer: PACE SWMI |
$271.51
|
| Rate for Payer: PHP Commercial |
$923.14
|
| Rate for Payer: PHP Medicare Advantage |
$271.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.93
|
| Rate for Payer: Priority Health HMO/PPO |
$944.86
|
| Rate for Payer: Priority Health Medicare |
$274.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.65
|
| Rate for Payer: Railroad Medicare Medicare |
$271.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.72
|
| Rate for Payer: UHC Core |
$906.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.51
|
| Rate for Payer: UHC Exchange |
$271.51
|
| Rate for Payer: UHC Medicare Advantage |
$271.51
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$271.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.54
|
|
|
HC US PROSTATE TRANSRECTAL
|
Facility
|
IP
|
$1,086.05
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
40200036
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$705.93 |
| Max. Negotiated Rate |
$977.44 |
| Rate for Payer: Aetna Commercial |
$923.14
|
| Rate for Payer: BCBS Trust/PPO |
$886.54
|
| Rate for Payer: BCN Commercial |
$839.30
|
| Rate for Payer: Cash Price |
$868.84
|
| Rate for Payer: Cofinity Commercial |
$934.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$868.84
|
| Rate for Payer: Healthscope Commercial |
$977.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.14
|
| Rate for Payer: Nomi Health Commercial |
$890.56
|
| Rate for Payer: PHP Commercial |
$923.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$705.93
|
| Rate for Payer: Priority Health HMO/PPO |
$944.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.72
|
| Rate for Payer: UHC Core |
$906.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.54
|
|
|
HC US PROSTATE TRANSRECT TX PLAN SEP PROC
|
Facility
|
IP
|
$291.31
|
|
|
Service Code
|
CPT 76873
|
| Hospital Charge Code |
40200081
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$189.35 |
| Max. Negotiated Rate |
$262.18 |
| Rate for Payer: Aetna Commercial |
$247.61
|
| Rate for Payer: BCBS Trust/PPO |
$237.80
|
| Rate for Payer: BCN Commercial |
$225.12
|
| Rate for Payer: Cash Price |
$233.05
|
| Rate for Payer: Cofinity Commercial |
$250.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.05
|
| Rate for Payer: Healthscope Commercial |
$262.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.61
|
| Rate for Payer: Nomi Health Commercial |
$238.87
|
| Rate for Payer: PHP Commercial |
$247.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.35
|
| Rate for Payer: Priority Health HMO/PPO |
$253.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.35
|
| Rate for Payer: UHC Core |
$243.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.48
|
|
|
HC US PROSTATE TRANSRECT TX PLAN SEP PROC
|
Facility
|
OP
|
$291.31
|
|
|
Service Code
|
CPT 76873
|
| Hospital Charge Code |
40200081
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$262.18 |
| Rate for Payer: Aetna Commercial |
$247.61
|
| Rate for Payer: Aetna Medicare |
$75.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.03
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$72.83
|
| Rate for Payer: BCBS Trust/PPO |
$239.49
|
| Rate for Payer: BCN Commercial |
$226.49
|
| Rate for Payer: BCN Medicare Advantage |
$72.83
|
| Rate for Payer: Cash Price |
$233.05
|
| Rate for Payer: Cash Price |
$233.05
|
| Rate for Payer: Cofinity Commercial |
$250.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.83
|
| Rate for Payer: Healthscope Commercial |
$262.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.48
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.47
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$247.61
|
| Rate for Payer: Nomi Health Commercial |
$238.87
|
| Rate for Payer: PACE Senior Care Partners |
$69.19
|
| Rate for Payer: PACE SWMI |
$72.83
|
| Rate for Payer: PHP Commercial |
$247.61
|
| Rate for Payer: PHP Medicare Advantage |
$72.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.35
|
| Rate for Payer: Priority Health HMO/PPO |
$253.44
|
| Rate for Payer: Priority Health Medicare |
$73.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.18
|
| Rate for Payer: Railroad Medicare Medicare |
$72.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.35
|
| Rate for Payer: UHC Core |
$243.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.83
|
| Rate for Payer: UHC Exchange |
$72.83
|
| Rate for Payer: UHC Medicare Advantage |
$72.83
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$72.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.48
|
|
