|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.41 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: BCBS Trust/PPO |
$57.54
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
OP
|
$73.05
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$65.74 |
| Rate for Payer: Aetna Commercial |
$62.09
|
| Rate for Payer: Aetna Medicare |
$18.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.83
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$18.26
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$56.80
|
| Rate for Payer: BCN Medicare Advantage |
$18.26
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cofinity Commercial |
$62.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.26
|
| Rate for Payer: Healthscope Commercial |
$65.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.79
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.35
|
| Rate for Payer: PACE SWMI |
$18.26
|
| Rate for Payer: PHP Commercial |
$62.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.55
|
| Rate for Payer: Priority Health Medicare |
$18.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.55
|
| Rate for Payer: Railroad Medicare Medicare |
$18.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.28
|
| Rate for Payer: UHC Core |
$61.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.26
|
| Rate for Payer: UHC Medicare Advantage |
$18.81
|
| Rate for Payer: VA VA |
$18.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.79
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
IP
|
$73.05
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.55 |
| Max. Negotiated Rate |
$65.74 |
| Rate for Payer: Aetna Commercial |
$62.09
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$56.45
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Cofinity Commercial |
$62.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.44
|
| Rate for Payer: Healthscope Commercial |
$65.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.09
|
| Rate for Payer: PHP Commercial |
$62.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.28
|
| Rate for Payer: UHC Core |
$61.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.79
|
|
|
HC C1Q BINDING
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.70 |
| Max. Negotiated Rate |
$99.90 |
| Rate for Payer: Aetna Commercial |
$94.35
|
| Rate for Payer: BCBS Trust/PPO |
$85.78
|
| Rate for Payer: BCN Commercial |
$85.78
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$95.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.80
|
| Rate for Payer: Healthscope Commercial |
$99.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.35
|
| Rate for Payer: PHP Commercial |
$94.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.68
|
| Rate for Payer: UHC Core |
$92.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.25
|
|
|
HC C1Q BINDING
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$99.90 |
| Rate for Payer: Aetna Commercial |
$94.35
|
| Rate for Payer: Aetna Medicare |
$28.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.69
|
| Rate for Payer: BCBS Complete |
$18.88
|
| Rate for Payer: BCBS MAPPO |
$27.75
|
| Rate for Payer: BCBS Trust/PPO |
$86.30
|
| Rate for Payer: BCN Commercial |
$86.30
|
| Rate for Payer: BCN Medicare Advantage |
$27.75
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$95.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.75
|
| Rate for Payer: Healthscope Commercial |
$99.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.25
|
| Rate for Payer: Mclaren Medicaid |
$17.99
|
| Rate for Payer: Meridian Medicaid |
$18.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.35
|
| Rate for Payer: PACE Senior Care Partners |
$26.36
|
| Rate for Payer: PACE SWMI |
$27.75
|
| Rate for Payer: PHP Commercial |
$94.35
|
| Rate for Payer: PHP Medicare Advantage |
$27.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.57
|
| Rate for Payer: Priority Health Medicare |
$27.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.70
|
| Rate for Payer: Railroad Medicare Medicare |
$27.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.68
|
| Rate for Payer: UHC Core |
$92.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.75
|
| Rate for Payer: UHC Medicare Advantage |
$28.58
|
| Rate for Payer: VA VA |
$27.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.25
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.04
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PACE Senior Care Partners |
$15.99
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.57
|
| Rate for Payer: Priority Health Medicare |
$16.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: Railroad Medicare Medicare |
$16.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$17.33
|
| Rate for Payer: VA VA |
$16.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.06 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$52.02
|
| Rate for Payer: BCN Commercial |
$52.02
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
IP
|
$74.64
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.52 |
| Max. Negotiated Rate |
$67.18 |
| Rate for Payer: Aetna Commercial |
$63.44
|
| Rate for Payer: BCBS Trust/PPO |
$57.68
|
| Rate for Payer: BCN Commercial |
$57.68
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cofinity Commercial |
$64.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.71
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.44
|
| Rate for Payer: PHP Commercial |
$63.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.68
|
| Rate for Payer: UHC Core |
$62.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.98
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
OP
|
$74.64
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$67.18 |
| Rate for Payer: Aetna Commercial |
$63.44
|
| Rate for Payer: Aetna Medicare |
$19.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.32
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$18.66
|
| Rate for Payer: BCBS Trust/PPO |
$58.03
|
| Rate for Payer: BCN Commercial |
$58.03
|
| Rate for Payer: BCN Medicare Advantage |
$18.66
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cash Price |
$59.71
|
| Rate for Payer: Cofinity Commercial |
$64.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.66
|
| Rate for Payer: Healthscope Commercial |
$67.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.98
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.44
|
| Rate for Payer: PACE Senior Care Partners |
$17.73
|
| Rate for Payer: PACE SWMI |
$18.66
|
| Rate for Payer: PHP Commercial |
$63.44
|
| Rate for Payer: PHP Medicare Advantage |
$18.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.94
|
| Rate for Payer: Priority Health Medicare |
$18.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.52
|
| Rate for Payer: Railroad Medicare Medicare |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.68
|
| Rate for Payer: UHC Core |
$62.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.66
|
| Rate for Payer: UHC Medicare Advantage |
$19.22
|
| Rate for Payer: VA VA |
$18.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.98
|
|
|
HC CA 125
|
Facility
|
IP
|
$143.10
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$87.28 |
| Max. Negotiated Rate |
$128.79 |
| Rate for Payer: Aetna Commercial |
$121.64
|
| Rate for Payer: BCBS Trust/PPO |
$110.59
|
| Rate for Payer: BCN Commercial |
$110.59
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$123.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Healthscope Commercial |
$128.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: PHP Commercial |
$121.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.93
|
| Rate for Payer: UHC Core |
$119.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.32
|
|
|
HC CA 125
|
Facility
|
OP
|
$143.10
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$128.79 |
| Rate for Payer: Aetna Commercial |
$121.64
|
| Rate for Payer: Aetna Medicare |
$37.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.72
|
| Rate for Payer: BCBS Complete |
$16.13
|
| Rate for Payer: BCBS MAPPO |
$35.78
|
| Rate for Payer: BCBS Trust/PPO |
$111.26
|
| Rate for Payer: BCN Commercial |
$111.26
|
| Rate for Payer: BCN Medicare Advantage |
$35.78
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cash Price |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$123.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.78
|
| Rate for Payer: Healthscope Commercial |
$128.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.32
|
| Rate for Payer: Mclaren Medicaid |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.64
|
| Rate for Payer: PACE Senior Care Partners |
$33.99
|
| Rate for Payer: PACE SWMI |
$35.78
|
| Rate for Payer: PHP Commercial |
$121.64
|
| Rate for Payer: PHP Medicare Advantage |
$35.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.50
|
| Rate for Payer: Priority Health Medicare |
$35.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.28
|
| Rate for Payer: Railroad Medicare Medicare |
$35.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.93
|
| Rate for Payer: UHC Core |
$119.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.78
|
| Rate for Payer: UHC Medicare Advantage |
$36.85
|
| Rate for Payer: VA VA |
$35.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.32
|
|
|
HC CADMIUM LEVEL
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.63 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$140.25
|
| Rate for Payer: BCBS Trust/PPO |
$127.51
|
| Rate for Payer: BCN Commercial |
$127.51
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$141.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.00
|
| Rate for Payer: Healthscope Commercial |
$148.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.25
|
| Rate for Payer: PHP Commercial |
$140.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.20
|
| Rate for Payer: UHC Core |
$137.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.75
|
|
|
HC CADMIUM LEVEL
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.45 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$140.25
|
| Rate for Payer: Aetna Medicare |
$42.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.56
|
| Rate for Payer: BCBS Complete |
$18.32
|
| Rate for Payer: BCBS MAPPO |
$41.25
|
| Rate for Payer: BCBS Trust/PPO |
$128.29
|
| Rate for Payer: BCN Commercial |
$128.29
|
| Rate for Payer: BCN Medicare Advantage |
$41.25
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$141.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.25
|
| Rate for Payer: Healthscope Commercial |
$148.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.75
|
| Rate for Payer: Mclaren Medicaid |
$17.45
|
| Rate for Payer: Meridian Medicaid |
$18.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.25
|
| Rate for Payer: PACE Senior Care Partners |
$39.19
|
| Rate for Payer: PACE SWMI |
$41.25
|
| Rate for Payer: PHP Commercial |
$140.25
|
| Rate for Payer: PHP Medicare Advantage |
$41.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.55
|
| Rate for Payer: Priority Health Medicare |
$41.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.63
|
| Rate for Payer: Railroad Medicare Medicare |
$41.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.20
|
| Rate for Payer: UHC Core |
$137.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.25
|
| Rate for Payer: UHC Medicare Advantage |
$42.49
|
| Rate for Payer: VA VA |
$41.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.75
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.30 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: BCBS Trust/PPO |
$89.07
|
| Rate for Payer: BCN Commercial |
$89.07
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$29.89
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$89.61
|
| Rate for Payer: BCN Commercial |
$89.61
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Meridian Medicaid |
$29.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.97
|
| Rate for Payer: PACE Senior Care Partners |
$27.37
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.28
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.30
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.82
|
| Rate for Payer: UHC Medicare Advantage |
$29.68
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.06 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$52.02
|
| Rate for Payer: BCN Commercial |
$52.02
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.99 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.04
|
| Rate for Payer: BCBS Complete |
$20.76
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$19.77
|
| Rate for Payer: Meridian Medicaid |
$20.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.22
|
| Rate for Payer: PACE Senior Care Partners |
$15.99
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.57
|
| Rate for Payer: Priority Health Medicare |
$16.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.06
|
| Rate for Payer: Railroad Medicare Medicare |
$16.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$17.33
|
| Rate for Payer: VA VA |
$16.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$26.35
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.26 |
| Max. Negotiated Rate |
$23.72 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: Aetna Medicare |
$6.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.23
|
| Rate for Payer: BCBS Complete |
$10.54
|
| Rate for Payer: BCBS MAPPO |
$6.59
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.59
|
| Rate for Payer: Cash Price |
$21.08
|
| Rate for Payer: Cofinity Commercial |
$22.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.59
|
| Rate for Payer: Healthscope Commercial |
$23.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.40
|
| Rate for Payer: PACE Senior Care Partners |
$6.26
|
| Rate for Payer: PACE SWMI |
$6.59
|
| Rate for Payer: PHP Commercial |
$22.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.92
|
| Rate for Payer: Priority Health Medicare |
$6.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.07
|
| Rate for Payer: Railroad Medicare Medicare |
$6.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.19
|
| Rate for Payer: UHC Core |
$22.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.59
|
| Rate for Payer: UHC Medicare Advantage |
$6.79
|
| Rate for Payer: VA VA |
$6.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.76
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$26.35
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$23.72 |
| Rate for Payer: Aetna Commercial |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$20.36
|
| Rate for Payer: BCN Commercial |
$20.36
|
| Rate for Payer: Cash Price |
$21.08
|
| Rate for Payer: Cofinity Commercial |
$22.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.08
|
| Rate for Payer: Healthscope Commercial |
$23.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.40
|
| Rate for Payer: PHP Commercial |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.19
|
| Rate for Payer: UHC Core |
$22.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.76
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$18.51
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$16.66 |
| Rate for Payer: Aetna Commercial |
$15.73
|
| Rate for Payer: Aetna Medicare |
$4.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.78
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS MAPPO |
$4.63
|
| Rate for Payer: BCBS Trust/PPO |
$14.39
|
| Rate for Payer: BCN Commercial |
$14.39
|
| Rate for Payer: BCN Medicare Advantage |
$4.63
|
| Rate for Payer: Cash Price |
$14.81
|
| Rate for Payer: Cofinity Commercial |
$15.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.63
|
| Rate for Payer: Healthscope Commercial |
$16.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.73
|
| Rate for Payer: PACE Senior Care Partners |
$4.40
|
| Rate for Payer: PACE SWMI |
$4.63
|
| Rate for Payer: PHP Commercial |
$15.73
|
| Rate for Payer: PHP Medicare Advantage |
$4.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.10
|
| Rate for Payer: Priority Health Medicare |
$4.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.29
|
| Rate for Payer: UHC Core |
$15.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.63
|
| Rate for Payer: UHC Medicare Advantage |
$4.77
|
| Rate for Payer: VA VA |
$4.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.88
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$18.51
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$16.66 |
| Rate for Payer: Aetna Commercial |
$15.73
|
| Rate for Payer: BCBS Trust/PPO |
$14.30
|
| Rate for Payer: BCN Commercial |
$14.30
|
| Rate for Payer: Cash Price |
$14.81
|
| Rate for Payer: Cofinity Commercial |
$15.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.81
|
| Rate for Payer: Healthscope Commercial |
$16.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.73
|
| Rate for Payer: PHP Commercial |
$15.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.29
|
| Rate for Payer: UHC Core |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.88
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.81
|
| Rate for Payer: Meridian Medicaid |
$4.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: BCBS Trust/PPO |
$40.80
|
| Rate for Payer: BCN Commercial |
$40.80
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.50
|
| Rate for Payer: BCBS Complete |
$4.67
|
| Rate for Payer: BCBS MAPPO |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$13.20
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.20
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Mclaren Medicaid |
$4.45
|
| Rate for Payer: Meridian Medicaid |
$4.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Senior Care Partners |
$12.54
|
| Rate for Payer: PACE SWMI |
$13.20
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: PHP Medicare Advantage |
$13.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Medicare |
$13.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.60
|
| Rate for Payer: VA VA |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
