|
HC AMP FINGER/THUMB W FLAP
|
Facility
|
IP
|
$4,566.80
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
45000091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,785.29 |
| Max. Negotiated Rate |
$4,110.12 |
| Rate for Payer: Aetna Commercial |
$3,881.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,529.22
|
| Rate for Payer: BCN Commercial |
$3,529.22
|
| Rate for Payer: Cash Price |
$3,653.44
|
| Rate for Payer: Cofinity Commercial |
$3,927.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,653.44
|
| Rate for Payer: Healthscope Commercial |
$4,110.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,425.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,881.78
|
| Rate for Payer: PHP Commercial |
$3,881.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,196.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,973.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,785.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,018.78
|
| Rate for Payer: UHC Core |
$3,813.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,425.10
|
|
|
HC AMP FINGER/THUMB W FLAP
|
Facility
|
OP
|
$4,566.80
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
45000091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,084.62 |
| Max. Negotiated Rate |
$4,110.12 |
| Rate for Payer: Aetna Commercial |
$3,881.78
|
| Rate for Payer: Aetna Medicare |
$1,187.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,427.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,427.12
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$1,141.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,550.69
|
| Rate for Payer: BCN Commercial |
$3,550.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.70
|
| Rate for Payer: Cash Price |
$3,653.44
|
| Rate for Payer: Cash Price |
$3,653.44
|
| Rate for Payer: Cofinity Commercial |
$3,927.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,653.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.70
|
| Rate for Payer: Healthscope Commercial |
$4,110.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,425.10
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,198.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,312.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,881.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,084.62
|
| Rate for Payer: PACE SWMI |
$1,141.70
|
| Rate for Payer: PHP Commercial |
$3,881.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,196.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,973.12
|
| Rate for Payer: Priority Health Medicare |
$1,141.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,785.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,141.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,018.78
|
| Rate for Payer: UHC Core |
$3,813.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,175.95
|
| Rate for Payer: VA VA |
$1,141.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,425.10
|
|
|
HC AMPHETAMINES 3 OR 4
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: Aetna Medicare |
$9.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.56
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$9.25
|
| Rate for Payer: BCBS Trust/PPO |
$28.77
|
| Rate for Payer: BCN Commercial |
$28.77
|
| Rate for Payer: BCN Medicare Advantage |
$9.25
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.25
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.45
|
| Rate for Payer: PACE Senior Care Partners |
$8.79
|
| Rate for Payer: PACE SWMI |
$9.25
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: PHP Medicare Advantage |
$9.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Medicare |
$9.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: Railroad Medicare Medicare |
$9.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.56
|
| Rate for Payer: UHC Core |
$30.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.25
|
| Rate for Payer: UHC Medicare Advantage |
$9.53
|
| Rate for Payer: VA VA |
$9.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.75
|
|
|
HC AMPHETAMINES 3 OR 4
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: BCBS Trust/PPO |
$28.59
|
| Rate for Payer: BCN Commercial |
$28.59
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.45
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.56
|
| Rate for Payer: UHC Core |
$30.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.75
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: Aetna Medicare |
$8.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.69
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$7.75
|
| Rate for Payer: BCBS Trust/PPO |
$24.10
|
| Rate for Payer: BCN Commercial |
$24.10
|
| Rate for Payer: BCN Medicare Advantage |
$7.75
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.75
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PACE Senior Care Partners |
$7.36
|
| Rate for Payer: PACE SWMI |
$7.75
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Medicare |
$7.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.75
|
| Rate for Payer: UHC Medicare Advantage |
$7.98
|
| Rate for Payer: VA VA |
$7.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.91 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna Commercial |
$26.35
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$23.96
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$27.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.35
|
| Rate for Payer: PHP Commercial |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.28
|
| Rate for Payer: UHC Core |
$25.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.25
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$173.82 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$220.25
|
| Rate for Payer: BCN Commercial |
$220.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: Aetna Medicare |
$74.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.06
|
| Rate for Payer: BCBS Complete |
$22.63
|
| Rate for Payer: BCBS MAPPO |
$71.25
|
| Rate for Payer: BCBS Trust/PPO |
$221.59
|
| Rate for Payer: BCN Commercial |
$221.59
|
| Rate for Payer: BCN Medicare Advantage |
$71.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.25
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Mclaren Medicaid |
$21.56
|
| Rate for Payer: Meridian Medicaid |
$22.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$74.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.25
|
| Rate for Payer: PACE Senior Care Partners |
$67.69
|
| Rate for Payer: PACE SWMI |
$71.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: PHP Medicare Advantage |
$71.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$247.95
|
| Rate for Payer: Priority Health Medicare |
$71.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.82
|
| Rate for Payer: Railroad Medicare Medicare |
$71.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.25
|
| Rate for Payer: UHC Medicare Advantage |
$73.39
|
| Rate for Payer: VA VA |
$71.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC AMYLASE FLUID
|
Facility
|
OP
|
$60.40
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$54.36 |
| Rate for Payer: Aetna Commercial |
$51.34
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.88
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$15.10
|
| Rate for Payer: BCBS Trust/PPO |
$46.96
|
| Rate for Payer: BCN Commercial |
$46.96
|
| Rate for Payer: BCN Medicare Advantage |
$15.10
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.10
|
| Rate for Payer: Healthscope Commercial |
$54.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.30
|
| Rate for Payer: Mclaren Medicaid |
$4.78
|
| Rate for Payer: Meridian Medicaid |
$5.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.34
|
| Rate for Payer: PACE Senior Care Partners |
$14.34
|
| Rate for Payer: PACE SWMI |
$15.10
|
| Rate for Payer: PHP Commercial |
$51.34
|
| Rate for Payer: PHP Medicare Advantage |
$15.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.55
|
| Rate for Payer: Priority Health Medicare |
$15.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.84
|
| Rate for Payer: Railroad Medicare Medicare |
$15.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.15
|
| Rate for Payer: UHC Core |
$50.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.10
|
| Rate for Payer: UHC Medicare Advantage |
$15.55
|
| Rate for Payer: VA VA |
$15.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.30
|
|
|
HC AMYLASE FLUID
|
Facility
|
IP
|
$60.40
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.84 |
| Max. Negotiated Rate |
$54.36 |
| Rate for Payer: Aetna Commercial |
$51.34
|
| Rate for Payer: BCBS Trust/PPO |
$46.68
|
| Rate for Payer: BCN Commercial |
$46.68
|
| Rate for Payer: Cash Price |
$48.32
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.32
|
| Rate for Payer: Healthscope Commercial |
$54.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.34
|
| Rate for Payer: PHP Commercial |
$51.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.15
|
| Rate for Payer: UHC Core |
$50.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.30
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
OP
|
$209.30
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna Commercial |
$177.90
|
| Rate for Payer: Aetna Medicare |
$54.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.41
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$52.32
|
| Rate for Payer: BCBS Trust/PPO |
$162.73
|
| Rate for Payer: BCN Commercial |
$162.73
|
| Rate for Payer: BCN Medicare Advantage |
$52.32
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$180.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.32
|
| Rate for Payer: Healthscope Commercial |
$188.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.98
|
| Rate for Payer: Mclaren Medicaid |
$4.78
|
| Rate for Payer: Meridian Medicaid |
$5.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.90
|
| Rate for Payer: PACE Senior Care Partners |
$49.71
|
| Rate for Payer: PACE SWMI |
$52.32
|
| Rate for Payer: PHP Commercial |
$177.90
|
| Rate for Payer: PHP Medicare Advantage |
$52.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.09
|
| Rate for Payer: Priority Health Medicare |
$52.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.65
|
| Rate for Payer: Railroad Medicare Medicare |
$52.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.18
|
| Rate for Payer: UHC Core |
$174.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.32
|
| Rate for Payer: UHC Medicare Advantage |
$53.89
|
| Rate for Payer: VA VA |
$52.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.98
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
IP
|
$209.30
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$127.65 |
| Max. Negotiated Rate |
$188.37 |
| Rate for Payer: Aetna Commercial |
$177.90
|
| Rate for Payer: BCBS Trust/PPO |
$161.75
|
| Rate for Payer: BCN Commercial |
$161.75
|
| Rate for Payer: Cash Price |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$180.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.44
|
| Rate for Payer: Healthscope Commercial |
$188.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.90
|
| Rate for Payer: PHP Commercial |
$177.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.18
|
| Rate for Payer: UHC Core |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.98
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$4.78
|
| Rate for Payer: Meridian Medicaid |
$5.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$122.10
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$109.89 |
| Rate for Payer: Aetna Commercial |
$103.78
|
| Rate for Payer: Aetna Medicare |
$31.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.16
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$30.52
|
| Rate for Payer: BCBS Trust/PPO |
$94.93
|
| Rate for Payer: BCN Commercial |
$94.93
|
| Rate for Payer: BCN Medicare Advantage |
$30.52
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cofinity Commercial |
$105.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.52
|
| Rate for Payer: Healthscope Commercial |
$109.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.58
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.78
|
| Rate for Payer: PACE Senior Care Partners |
$29.00
|
| Rate for Payer: PACE SWMI |
$30.52
|
| Rate for Payer: PHP Commercial |
$103.78
|
| Rate for Payer: PHP Medicare Advantage |
$30.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.23
|
| Rate for Payer: Priority Health Medicare |
$30.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.47
|
| Rate for Payer: Railroad Medicare Medicare |
$30.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.45
|
| Rate for Payer: UHC Core |
$101.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.52
|
| Rate for Payer: UHC Medicare Advantage |
$31.44
|
| Rate for Payer: VA VA |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.58
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$122.10
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.47 |
| Max. Negotiated Rate |
$109.89 |
| Rate for Payer: Aetna Commercial |
$103.78
|
| Rate for Payer: BCBS Trust/PPO |
$94.36
|
| Rate for Payer: BCN Commercial |
$94.36
|
| Rate for Payer: Cash Price |
$97.68
|
| Rate for Payer: Cofinity Commercial |
$105.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.68
|
| Rate for Payer: Healthscope Commercial |
$109.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.78
|
| Rate for Payer: PHP Commercial |
$103.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.45
|
| Rate for Payer: UHC Core |
$101.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.58
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$13.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.03
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$12.83
|
| Rate for Payer: BCBS Trust/PPO |
$39.89
|
| Rate for Payer: BCN Commercial |
$39.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.83
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.83
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.61
|
| Rate for Payer: PACE Senior Care Partners |
$12.19
|
| Rate for Payer: PACE SWMI |
$12.83
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.64
|
| Rate for Payer: Priority Health Medicare |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.29
|
| Rate for Payer: Railroad Medicare Medicare |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.83
|
| Rate for Payer: UHC Medicare Advantage |
$13.21
|
| Rate for Payer: VA VA |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.97 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$231.84
|
| Rate for Payer: BCN Commercial |
$231.84
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.50 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$66.67
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$233.25
|
| Rate for Payer: BCN Commercial |
$233.25
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Mclaren Medicaid |
$63.50
|
| Rate for Payer: Meridian Medicaid |
$66.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$77.25
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.01
|
| Rate for Payer: BCN Commercial |
$85.01
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
