|
HC CALCULI
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$10.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.07
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$10.46
|
| Rate for Payer: BCBS Trust/PPO |
$32.52
|
| Rate for Payer: BCN Commercial |
$32.52
|
| Rate for Payer: BCN Medicare Advantage |
$10.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Mclaren Medicaid |
$9.52
|
| Rate for Payer: Meridian Medicaid |
$10.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PACE Senior Care Partners |
$9.93
|
| Rate for Payer: PACE SWMI |
$10.46
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.38
|
| Rate for Payer: Priority Health Medicare |
$10.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.51
|
| Rate for Payer: Railroad Medicare Medicare |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.77
|
| Rate for Payer: VA VA |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC CALCULI
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: BCBS Trust/PPO |
$32.32
|
| Rate for Payer: BCN Commercial |
$32.32
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$454.36
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$408.92 |
| Rate for Payer: Aetna Commercial |
$386.21
|
| Rate for Payer: Aetna Medicare |
$118.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.99
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$113.59
|
| Rate for Payer: BCBS Trust/PPO |
$353.26
|
| Rate for Payer: BCN Commercial |
$353.26
|
| Rate for Payer: BCN Medicare Advantage |
$113.59
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$390.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.59
|
| Rate for Payer: Healthscope Commercial |
$408.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.77
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PACE Senior Care Partners |
$107.91
|
| Rate for Payer: PACE SWMI |
$113.59
|
| Rate for Payer: PHP Commercial |
$386.21
|
| Rate for Payer: PHP Medicare Advantage |
$113.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.29
|
| Rate for Payer: Priority Health Medicare |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: Railroad Medicare Medicare |
$113.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.84
|
| Rate for Payer: UHC Core |
$379.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.59
|
| Rate for Payer: UHC Medicare Advantage |
$117.00
|
| Rate for Payer: VA VA |
$113.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.77
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$454.36
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$277.11 |
| Max. Negotiated Rate |
$408.92 |
| Rate for Payer: Aetna Commercial |
$386.21
|
| Rate for Payer: BCBS Trust/PPO |
$351.13
|
| Rate for Payer: BCN Commercial |
$351.13
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$390.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Healthscope Commercial |
$408.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PHP Commercial |
$386.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.84
|
| Rate for Payer: UHC Core |
$379.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.77
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$454.36
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$277.11 |
| Max. Negotiated Rate |
$408.92 |
| Rate for Payer: Aetna Commercial |
$386.21
|
| Rate for Payer: BCBS Trust/PPO |
$351.13
|
| Rate for Payer: BCN Commercial |
$351.13
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$390.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Healthscope Commercial |
$408.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PHP Commercial |
$386.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.84
|
| Rate for Payer: UHC Core |
$379.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.77
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$454.36
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$408.92 |
| Rate for Payer: Aetna Commercial |
$386.21
|
| Rate for Payer: Aetna Medicare |
$118.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.99
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$113.59
|
| Rate for Payer: BCBS Trust/PPO |
$353.26
|
| Rate for Payer: BCN Commercial |
$353.26
|
| Rate for Payer: BCN Medicare Advantage |
$113.59
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cash Price |
$363.49
|
| Rate for Payer: Cofinity Commercial |
$390.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.59
|
| Rate for Payer: Healthscope Commercial |
$408.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.77
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$386.21
|
| Rate for Payer: PACE Senior Care Partners |
$107.91
|
| Rate for Payer: PACE SWMI |
$113.59
|
| Rate for Payer: PHP Commercial |
$386.21
|
| Rate for Payer: PHP Medicare Advantage |
$113.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.29
|
| Rate for Payer: Priority Health Medicare |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.11
|
| Rate for Payer: Railroad Medicare Medicare |
$113.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.84
|
| Rate for Payer: UHC Core |
$379.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.59
|
| Rate for Payer: UHC Medicare Advantage |
$117.00
|
| Rate for Payer: VA VA |
$113.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.77
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$232.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$141.50 |
| Max. Negotiated Rate |
$208.80 |
| Rate for Payer: Aetna Commercial |
$197.20
|
| Rate for Payer: BCBS Trust/PPO |
$179.29
|
| Rate for Payer: BCN Commercial |
$179.29
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$199.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.60
|
| Rate for Payer: Healthscope Commercial |
$208.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$197.20
|
| Rate for Payer: PHP Commercial |
$197.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.16
|
| Rate for Payer: UHC Core |
$193.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.00
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$232.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$208.80 |
| Rate for Payer: Aetna Commercial |
$197.20
|
| Rate for Payer: Aetna Medicare |
$60.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.50
|
| Rate for Payer: BCBS Complete |
$15.21
|
| Rate for Payer: BCBS MAPPO |
$58.00
|
| Rate for Payer: BCBS Trust/PPO |
$180.38
|
| Rate for Payer: BCN Commercial |
$180.38
|
| Rate for Payer: BCN Medicare Advantage |
$58.00
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$199.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.00
|
| Rate for Payer: Healthscope Commercial |
$208.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.00
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Meridian Medicaid |
$15.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$197.20
|
| Rate for Payer: PACE Senior Care Partners |
$55.10
|
| Rate for Payer: PACE SWMI |
$58.00
|
| Rate for Payer: PHP Commercial |
$197.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$201.84
|
| Rate for Payer: Priority Health Medicare |
$58.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.50
|
| Rate for Payer: Railroad Medicare Medicare |
$58.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.16
|
| Rate for Payer: UHC Core |
$193.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.00
|
| Rate for Payer: UHC Medicare Advantage |
$59.74
|
| Rate for Payer: VA VA |
$58.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.00
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$30.91
|
| Rate for Payer: BCN Commercial |
$30.91
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$34.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$36.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.00
|
| Rate for Payer: PHP Commercial |
$34.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.20
|
| Rate for Payer: UHC Core |
$33.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.00
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$34.00
|
| Rate for Payer: Aetna Medicare |
$10.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.50
|
| Rate for Payer: BCBS Complete |
$15.21
|
| Rate for Payer: BCBS MAPPO |
$10.00
|
| Rate for Payer: BCBS Trust/PPO |
$31.10
|
| Rate for Payer: BCN Commercial |
$31.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$34.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.00
|
| Rate for Payer: Healthscope Commercial |
$36.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.00
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Meridian Medicaid |
$15.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.00
|
| Rate for Payer: PACE Senior Care Partners |
$9.50
|
| Rate for Payer: PACE SWMI |
$10.00
|
| Rate for Payer: PHP Commercial |
$34.00
|
| Rate for Payer: PHP Medicare Advantage |
$10.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.80
|
| Rate for Payer: Priority Health Medicare |
$10.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.20
|
| Rate for Payer: UHC Core |
$33.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.30
|
| Rate for Payer: VA VA |
$10.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.00
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$660.04
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$402.56 |
| Max. Negotiated Rate |
$594.04 |
| Rate for Payer: Aetna Commercial |
$561.03
|
| Rate for Payer: BCBS Trust/PPO |
$510.08
|
| Rate for Payer: BCN Commercial |
$510.08
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cofinity Commercial |
$567.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.03
|
| Rate for Payer: Healthscope Commercial |
$594.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.03
|
| Rate for Payer: PHP Commercial |
$561.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.84
|
| Rate for Payer: UHC Core |
$551.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.03
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$660.04
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$594.04 |
| Rate for Payer: Aetna Commercial |
$561.03
|
| Rate for Payer: Aetna Medicare |
$171.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$206.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$206.26
|
| Rate for Payer: BCBS Complete |
$94.25
|
| Rate for Payer: BCBS MAPPO |
$165.01
|
| Rate for Payer: BCBS Trust/PPO |
$513.18
|
| Rate for Payer: BCN Commercial |
$513.18
|
| Rate for Payer: BCN Medicare Advantage |
$165.01
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cash Price |
$528.03
|
| Rate for Payer: Cofinity Commercial |
$567.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.01
|
| Rate for Payer: Healthscope Commercial |
$594.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.03
|
| Rate for Payer: Mclaren Medicaid |
$89.76
|
| Rate for Payer: Meridian Medicaid |
$94.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.03
|
| Rate for Payer: PACE Senior Care Partners |
$156.76
|
| Rate for Payer: PACE SWMI |
$165.01
|
| Rate for Payer: PHP Commercial |
$561.03
|
| Rate for Payer: PHP Medicare Advantage |
$165.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.23
|
| Rate for Payer: Priority Health Medicare |
$165.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.56
|
| Rate for Payer: Railroad Medicare Medicare |
$165.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.84
|
| Rate for Payer: UHC Core |
$551.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.01
|
| Rate for Payer: UHC Medicare Advantage |
$169.96
|
| Rate for Payer: VA VA |
$165.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.03
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$129.03
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.64 |
| Max. Negotiated Rate |
$116.13 |
| Rate for Payer: Aetna Commercial |
$109.68
|
| Rate for Payer: Aetna Medicare |
$33.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.32
|
| Rate for Payer: BCBS Complete |
$51.61
|
| Rate for Payer: BCBS MAPPO |
$32.26
|
| Rate for Payer: BCBS Trust/PPO |
$100.32
|
| Rate for Payer: BCN Commercial |
$100.32
|
| Rate for Payer: BCN Medicare Advantage |
$32.26
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$110.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$116.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.68
|
| Rate for Payer: PACE Senior Care Partners |
$30.64
|
| Rate for Payer: PACE SWMI |
$32.26
|
| Rate for Payer: PHP Commercial |
$109.68
|
| Rate for Payer: PHP Medicare Advantage |
$32.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.26
|
| Rate for Payer: Priority Health Medicare |
$32.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.70
|
| Rate for Payer: Railroad Medicare Medicare |
$32.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.55
|
| Rate for Payer: UHC Core |
$107.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.26
|
| Rate for Payer: UHC Medicare Advantage |
$33.23
|
| Rate for Payer: VA VA |
$32.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.77
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$129.03
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$116.13 |
| Rate for Payer: Aetna Commercial |
$109.68
|
| Rate for Payer: BCBS Trust/PPO |
$99.71
|
| Rate for Payer: BCN Commercial |
$99.71
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$110.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Healthscope Commercial |
$116.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.68
|
| Rate for Payer: PHP Commercial |
$109.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.55
|
| Rate for Payer: UHC Core |
$107.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.77
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.24 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$37.05
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$16.13
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$37.27
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$16.13
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$40.39
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.63 |
| Max. Negotiated Rate |
$36.35 |
| Rate for Payer: Aetna Commercial |
$34.33
|
| Rate for Payer: BCBS Trust/PPO |
$31.21
|
| Rate for Payer: BCN Commercial |
$31.21
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cofinity Commercial |
$34.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.31
|
| Rate for Payer: Healthscope Commercial |
$36.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.33
|
| Rate for Payer: PHP Commercial |
$34.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.54
|
| Rate for Payer: UHC Core |
$33.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.29
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$40.39
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$36.35 |
| Rate for Payer: Aetna Commercial |
$34.33
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.62
|
| Rate for Payer: BCBS Complete |
$16.13
|
| Rate for Payer: BCBS MAPPO |
$10.10
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$10.10
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cash Price |
$32.31
|
| Rate for Payer: Cofinity Commercial |
$34.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.10
|
| Rate for Payer: Healthscope Commercial |
$36.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.29
|
| Rate for Payer: Mclaren Medicaid |
$15.36
|
| Rate for Payer: Meridian Medicaid |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.33
|
| Rate for Payer: PACE Senior Care Partners |
$9.59
|
| Rate for Payer: PACE SWMI |
$10.10
|
| Rate for Payer: PHP Commercial |
$34.33
|
| Rate for Payer: PHP Medicare Advantage |
$10.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.14
|
| Rate for Payer: Priority Health Medicare |
$10.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.63
|
| Rate for Payer: Railroad Medicare Medicare |
$10.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.54
|
| Rate for Payer: UHC Core |
$33.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.10
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: VA VA |
$10.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.29
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
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 CANNABINOID URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
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 CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$867.00
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$205.91 |
| Max. Negotiated Rate |
$780.30 |
| Rate for Payer: Aetna Commercial |
$736.95
|
| Rate for Payer: Aetna Medicare |
$225.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.94
|
| Rate for Payer: BCBS Complete |
$346.80
|
| Rate for Payer: BCBS MAPPO |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$674.09
|
| Rate for Payer: BCN Commercial |
$674.09
|
| Rate for Payer: BCN Medicare Advantage |
$216.75
|
| Rate for Payer: Cash Price |
$693.60
|
| Rate for Payer: Cofinity Commercial |
$745.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.75
|
| Rate for Payer: Healthscope Commercial |
$780.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$736.95
|
| Rate for Payer: PACE Senior Care Partners |
$205.91
|
| Rate for Payer: PACE SWMI |
$216.75
|
| Rate for Payer: PHP Commercial |
$736.95
|
| Rate for Payer: PHP Medicare Advantage |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$754.29
|
| Rate for Payer: Priority Health Medicare |
$216.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$528.78
|
| Rate for Payer: Railroad Medicare Medicare |
$216.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.96
|
| Rate for Payer: UHC Core |
$723.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.75
|
| Rate for Payer: UHC Medicare Advantage |
$223.25
|
| Rate for Payer: VA VA |
$216.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.25
|
|
