|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$991.53
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$235.49 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: Aetna Medicare |
$257.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.85
|
| Rate for Payer: BCBS Complete |
$396.61
|
| Rate for Payer: BCBS MAPPO |
$247.88
|
| Rate for Payer: BCBS Trust/PPO |
$770.91
|
| Rate for Payer: BCN Commercial |
$770.91
|
| Rate for Payer: BCN Medicare Advantage |
$247.88
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.88
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$260.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PACE Senior Care Partners |
$235.49
|
| Rate for Payer: PACE SWMI |
$247.88
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: PHP Medicare Advantage |
$247.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.63
|
| Rate for Payer: Priority Health Medicare |
$247.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.73
|
| Rate for Payer: Railroad Medicare Medicare |
$247.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.55
|
| Rate for Payer: UHC Core |
$827.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$247.88
|
| Rate for Payer: UHC Medicare Advantage |
$255.32
|
| Rate for Payer: VA VA |
$247.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$991.53
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$604.73 |
| Max. Negotiated Rate |
$892.38 |
| Rate for Payer: Aetna Commercial |
$842.80
|
| Rate for Payer: BCBS Trust/PPO |
$766.25
|
| Rate for Payer: BCN Commercial |
$766.25
|
| Rate for Payer: Cash Price |
$793.22
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.22
|
| Rate for Payer: Healthscope Commercial |
$892.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.80
|
| Rate for Payer: PHP Commercial |
$842.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$694.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$862.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.55
|
| Rate for Payer: UHC Core |
$827.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,829.05
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,646.14 |
| Rate for Payer: Aetna Commercial |
$1,554.69
|
| Rate for Payer: Aetna Medicare |
$475.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$571.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$571.58
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$457.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,422.09
|
| Rate for Payer: BCN Commercial |
$1,422.09
|
| Rate for Payer: BCN Medicare Advantage |
$457.26
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cofinity Commercial |
$1,572.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,463.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.26
|
| Rate for Payer: Healthscope Commercial |
$1,646.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.79
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$480.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$525.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,554.69
|
| Rate for Payer: PACE Senior Care Partners |
$434.40
|
| Rate for Payer: PACE SWMI |
$457.26
|
| Rate for Payer: PHP Commercial |
$1,554.69
|
| Rate for Payer: PHP Medicare Advantage |
$457.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,591.27
|
| Rate for Payer: Priority Health Medicare |
$457.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.54
|
| Rate for Payer: Railroad Medicare Medicare |
$457.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.56
|
| Rate for Payer: UHC Core |
$1,527.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$457.26
|
| Rate for Payer: UHC Medicare Advantage |
$470.98
|
| Rate for Payer: VA VA |
$457.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.79
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,829.05
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,115.54 |
| Max. Negotiated Rate |
$1,646.14 |
| Rate for Payer: Aetna Commercial |
$1,554.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,413.49
|
| Rate for Payer: BCN Commercial |
$1,413.49
|
| Rate for Payer: Cash Price |
$1,463.24
|
| Rate for Payer: Cofinity Commercial |
$1,572.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,463.24
|
| Rate for Payer: Healthscope Commercial |
$1,646.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,554.69
|
| Rate for Payer: PHP Commercial |
$1,554.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,280.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,591.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,115.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,609.56
|
| Rate for Payer: UHC Core |
$1,527.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.79
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna Medicare |
$27.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.12
|
| Rate for Payer: BCBS Complete |
$11.31
|
| Rate for Payer: BCBS MAPPO |
$26.50
|
| Rate for Payer: BCBS Trust/PPO |
$82.42
|
| Rate for Payer: BCN Commercial |
$82.42
|
| Rate for Payer: BCN Medicare Advantage |
$26.50
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.50
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Mclaren Medicaid |
$10.77
|
| Rate for Payer: Meridian Medicaid |
$11.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PACE Senior Care Partners |
$25.18
|
| Rate for Payer: PACE SWMI |
$26.50
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.22
|
| Rate for Payer: Priority Health Medicare |
$26.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.65
|
| Rate for Payer: Railroad Medicare Medicare |
$26.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.28
|
| Rate for Payer: UHC Core |
$88.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.50
|
| Rate for Payer: UHC Medicare Advantage |
$27.30
|
| Rate for Payer: VA VA |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC ANGIOTENSIN-1 CONVERTING ENZYME
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100105
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.65 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: BCBS Trust/PPO |
$81.92
|
| Rate for Payer: BCN Commercial |
$81.92
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.28
|
| Rate for Payer: UHC Core |
$88.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.77 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$27.59
|
| Rate for Payer: BCN Commercial |
$27.59
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC ANGIOTENSIN CONVERTING ENZYME LEVEL
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 82164
|
| Hospital Charge Code |
30100104
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$11.31
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$10.77
|
| Rate for Payer: Meridian Medicaid |
$11.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Senior Care Partners |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC ANGIOTENSIN II
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.14 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna Medicare |
$84.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.56
|
| Rate for Payer: BCBS Complete |
$15.90
|
| Rate for Payer: BCBS MAPPO |
$81.25
|
| Rate for Payer: BCBS Trust/PPO |
$252.69
|
| Rate for Payer: BCN Commercial |
$252.69
|
| Rate for Payer: BCN Medicare Advantage |
$81.25
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.25
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Mclaren Medicaid |
$15.14
|
| Rate for Payer: Meridian Medicaid |
$15.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.25
|
| Rate for Payer: PACE Senior Care Partners |
$77.19
|
| Rate for Payer: PACE SWMI |
$81.25
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: PHP Medicare Advantage |
$81.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.75
|
| Rate for Payer: Priority Health Medicare |
$81.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.22
|
| Rate for Payer: Railroad Medicare Medicare |
$81.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.00
|
| Rate for Payer: UHC Core |
$271.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.25
|
| Rate for Payer: UHC Medicare Advantage |
$83.69
|
| Rate for Payer: VA VA |
$81.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC ANGIOTENSIN II
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 82163
|
| Hospital Charge Code |
30100103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$198.22 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: BCBS Trust/PPO |
$251.16
|
| Rate for Payer: BCN Commercial |
$251.16
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.25
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.00
|
| Rate for Payer: UHC Core |
$271.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
OP
|
$65.48
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: Aetna Medicare |
$17.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.46
|
| Rate for Payer: BCBS Complete |
$27.63
|
| Rate for Payer: BCBS MAPPO |
$16.37
|
| Rate for Payer: BCBS Trust/PPO |
$50.91
|
| Rate for Payer: BCN Commercial |
$50.91
|
| Rate for Payer: BCN Medicare Advantage |
$16.37
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.37
|
| Rate for Payer: Healthscope Commercial |
$58.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.11
|
| Rate for Payer: Mclaren Medicaid |
$26.31
|
| Rate for Payer: Meridian Medicaid |
$27.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.66
|
| Rate for Payer: PACE Senior Care Partners |
$15.55
|
| Rate for Payer: PACE SWMI |
$16.37
|
| Rate for Payer: PHP Commercial |
$55.66
|
| Rate for Payer: PHP Medicare Advantage |
$16.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.97
|
| Rate for Payer: Priority Health Medicare |
$16.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.94
|
| Rate for Payer: Railroad Medicare Medicare |
$16.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.62
|
| Rate for Payer: UHC Core |
$54.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.86
|
| Rate for Payer: VA VA |
$16.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.11
|
|
|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
IP
|
$65.48
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$39.94 |
| Max. Negotiated Rate |
$58.93 |
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: BCBS Trust/PPO |
$50.60
|
| Rate for Payer: BCN Commercial |
$50.60
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.38
|
| Rate for Payer: Healthscope Commercial |
$58.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.66
|
| Rate for Payer: PHP Commercial |
$55.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.62
|
| Rate for Payer: UHC Core |
$54.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.11
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
OP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$29.48 |
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: Aetna Medicare |
$8.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.23
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCBS Trust/PPO |
$25.46
|
| Rate for Payer: BCN Commercial |
$25.46
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PACE Senior Care Partners |
$7.78
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.49
|
| Rate for Payer: Priority Health Medicare |
$8.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.82
|
| Rate for Payer: UHC Core |
$27.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.19
|
| Rate for Payer: UHC Medicare Advantage |
$8.43
|
| Rate for Payer: VA VA |
$8.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.56
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
IP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$29.48 |
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: BCBS Trust/PPO |
$25.31
|
| Rate for Payer: BCN Commercial |
$25.31
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.82
|
| Rate for Payer: UHC Core |
$27.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.56
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.75 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: Aetna Medicare |
$130.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.25
|
| Rate for Payer: BCBS Complete |
$137.25
|
| Rate for Payer: BCBS MAPPO |
$125.00
|
| Rate for Payer: BCBS Trust/PPO |
$388.75
|
| Rate for Payer: BCN Commercial |
$388.75
|
| Rate for Payer: BCN Medicare Advantage |
$125.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Mclaren Medicaid |
$130.71
|
| Rate for Payer: Meridian Medicaid |
$137.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PACE Senior Care Partners |
$118.75
|
| Rate for Payer: PACE SWMI |
$125.00
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: PHP Medicare Advantage |
$125.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.00
|
| Rate for Payer: Priority Health Medicare |
$125.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.95
|
| Rate for Payer: Railroad Medicare Medicare |
$125.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.00
|
| Rate for Payer: UHC Core |
$417.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.00
|
| Rate for Payer: UHC Medicare Advantage |
$128.75
|
| Rate for Payer: VA VA |
$125.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$304.95 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: BCBS Trust/PPO |
$386.40
|
| Rate for Payer: BCN Commercial |
$386.40
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.00
|
| Rate for Payer: UHC Core |
$417.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$1,020.22
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$242.30 |
| Max. Negotiated Rate |
$918.20 |
| Rate for Payer: Aetna Commercial |
$867.19
|
| Rate for Payer: Aetna Medicare |
$265.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$318.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$318.82
|
| Rate for Payer: BCBS Complete |
$408.09
|
| Rate for Payer: BCBS MAPPO |
$255.06
|
| Rate for Payer: BCBS Trust/PPO |
$793.22
|
| Rate for Payer: BCN Commercial |
$793.22
|
| Rate for Payer: BCN Medicare Advantage |
$255.06
|
| Rate for Payer: Cash Price |
$816.18
|
| Rate for Payer: Cofinity Commercial |
$877.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.06
|
| Rate for Payer: Healthscope Commercial |
$918.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$267.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$867.19
|
| Rate for Payer: PACE Senior Care Partners |
$242.30
|
| Rate for Payer: PACE SWMI |
$255.06
|
| Rate for Payer: PHP Commercial |
$867.19
|
| Rate for Payer: PHP Medicare Advantage |
$255.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.59
|
| Rate for Payer: Priority Health Medicare |
$255.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.23
|
| Rate for Payer: Railroad Medicare Medicare |
$255.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.79
|
| Rate for Payer: UHC Core |
$851.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.06
|
| Rate for Payer: UHC Medicare Advantage |
$262.71
|
| Rate for Payer: VA VA |
$255.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.16
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$1,020.22
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$622.23 |
| Max. Negotiated Rate |
$918.20 |
| Rate for Payer: Aetna Commercial |
$867.19
|
| Rate for Payer: BCBS Trust/PPO |
$788.43
|
| Rate for Payer: BCN Commercial |
$788.43
|
| Rate for Payer: Cash Price |
$816.18
|
| Rate for Payer: Cofinity Commercial |
$877.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.18
|
| Rate for Payer: Healthscope Commercial |
$918.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$867.19
|
| Rate for Payer: PHP Commercial |
$867.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$887.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$897.79
|
| Rate for Payer: UHC Core |
$851.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.16
|
|
|
HC ANOSCOPY
|
Facility
|
OP
|
$159.73
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$37.94 |
| Max. Negotiated Rate |
$143.76 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna Medicare |
$41.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.92
|
| Rate for Payer: BCBS Complete |
$63.89
|
| Rate for Payer: BCBS MAPPO |
$39.93
|
| Rate for Payer: BCBS Trust/PPO |
$124.19
|
| Rate for Payer: BCN Commercial |
$124.19
|
| Rate for Payer: BCN Medicare Advantage |
$39.93
|
| Rate for Payer: Cash Price |
$127.78
|
| Rate for Payer: Cofinity Commercial |
$137.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.93
|
| Rate for Payer: Healthscope Commercial |
$143.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.77
|
| Rate for Payer: PACE Senior Care Partners |
$37.94
|
| Rate for Payer: PACE SWMI |
$39.93
|
| Rate for Payer: PHP Commercial |
$135.77
|
| Rate for Payer: PHP Medicare Advantage |
$39.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.97
|
| Rate for Payer: Priority Health Medicare |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.42
|
| Rate for Payer: Railroad Medicare Medicare |
$39.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.56
|
| Rate for Payer: UHC Core |
$133.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.93
|
| Rate for Payer: UHC Medicare Advantage |
$41.13
|
| Rate for Payer: VA VA |
$39.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.80
|
|
|
HC ANOSCOPY
|
Facility
|
IP
|
$159.73
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$97.42 |
| Max. Negotiated Rate |
$143.76 |
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: BCBS Trust/PPO |
$123.44
|
| Rate for Payer: BCN Commercial |
$123.44
|
| Rate for Payer: Cash Price |
$127.78
|
| Rate for Payer: Cofinity Commercial |
$137.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.78
|
| Rate for Payer: Healthscope Commercial |
$143.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.77
|
| Rate for Payer: PHP Commercial |
$135.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.56
|
| Rate for Payer: UHC Core |
$133.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.80
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$147.32
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.85 |
| Max. Negotiated Rate |
$132.59 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: BCBS Trust/PPO |
$113.85
|
| Rate for Payer: BCN Commercial |
$113.85
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.64
|
| Rate for Payer: UHC Core |
$123.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$147.32
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$132.59 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Medicare |
$38.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.04
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$36.83
|
| Rate for Payer: BCBS Trust/PPO |
$114.54
|
| Rate for Payer: BCN Commercial |
$114.54
|
| Rate for Payer: BCN Medicare Advantage |
$36.83
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.83
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PACE Senior Care Partners |
$34.99
|
| Rate for Payer: PACE SWMI |
$36.83
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: PHP Medicare Advantage |
$36.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.17
|
| Rate for Payer: Priority Health Medicare |
$36.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.85
|
| Rate for Payer: Railroad Medicare Medicare |
$36.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.64
|
| Rate for Payer: UHC Core |
$123.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.83
|
| Rate for Payer: UHC Medicare Advantage |
$37.93
|
| Rate for Payer: VA VA |
$36.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
OP
|
$1,536.46
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$364.91 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna Medicare |
$399.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.14
|
| Rate for Payer: BCBS Complete |
$812.82
|
| Rate for Payer: BCBS MAPPO |
$384.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.60
|
| Rate for Payer: BCN Commercial |
$1,194.60
|
| Rate for Payer: BCN Medicare Advantage |
$384.12
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.12
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Mclaren Medicaid |
$774.12
|
| Rate for Payer: Meridian Medicaid |
$812.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PACE Senior Care Partners |
$364.91
|
| Rate for Payer: PACE SWMI |
$384.12
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: PHP Medicare Advantage |
$384.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.72
|
| Rate for Payer: Priority Health Medicare |
$384.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.09
|
| Rate for Payer: Railroad Medicare Medicare |
$384.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.08
|
| Rate for Payer: UHC Core |
$1,282.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.12
|
| Rate for Payer: UHC Medicare Advantage |
$395.64
|
| Rate for Payer: VA VA |
$384.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
IP
|
$1,536.46
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$937.09 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.38
|
| Rate for Payer: BCN Commercial |
$1,187.38
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,336.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.08
|
| Rate for Payer: UHC Core |
$1,282.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
IP
|
$2,033.68
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,240.34 |
| Max. Negotiated Rate |
$1,830.31 |
| Rate for Payer: Aetna Commercial |
$1,728.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,571.63
|
| Rate for Payer: BCN Commercial |
$1,571.63
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cofinity Commercial |
$1,748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.94
|
| Rate for Payer: Healthscope Commercial |
$1,830.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.63
|
| Rate for Payer: PHP Commercial |
$1,728.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,769.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,240.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,789.64
|
| Rate for Payer: UHC Core |
$1,698.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.26
|
|
