|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Medicare |
$4.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.74
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$4.59
|
| Rate for Payer: BCBS Trust/PPO |
$14.27
|
| Rate for Payer: BCN Commercial |
$14.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.59
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.59
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PACE Senior Care Partners |
$4.36
|
| Rate for Payer: PACE SWMI |
$4.59
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: PHP Medicare Advantage |
$4.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$4.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: Railroad Medicare Medicare |
$4.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.59
|
| Rate for Payer: UHC Medicare Advantage |
$4.73
|
| Rate for Payer: VA VA |
$4.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$14.19
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$137.90
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$84.11 |
| Max. Negotiated Rate |
$124.11 |
| Rate for Payer: Aetna Commercial |
$117.22
|
| Rate for Payer: BCBS Trust/PPO |
$106.57
|
| Rate for Payer: BCN Commercial |
$106.57
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cofinity Commercial |
$118.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.32
|
| Rate for Payer: Healthscope Commercial |
$124.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.22
|
| Rate for Payer: PHP Commercial |
$117.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.35
|
| Rate for Payer: UHC Core |
$115.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.42
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$137.90
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$124.11 |
| Rate for Payer: Aetna Commercial |
$117.22
|
| Rate for Payer: Aetna Medicare |
$35.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.09
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$34.48
|
| Rate for Payer: BCBS Trust/PPO |
$107.22
|
| Rate for Payer: BCN Commercial |
$107.22
|
| Rate for Payer: BCN Medicare Advantage |
$34.48
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cofinity Commercial |
$118.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$124.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.42
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.22
|
| Rate for Payer: PACE Senior Care Partners |
$32.75
|
| Rate for Payer: PACE SWMI |
$34.48
|
| Rate for Payer: PHP Commercial |
$117.22
|
| Rate for Payer: PHP Medicare Advantage |
$34.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.97
|
| Rate for Payer: Priority Health Medicare |
$34.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.11
|
| Rate for Payer: Railroad Medicare Medicare |
$34.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.35
|
| Rate for Payer: UHC Core |
$115.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.48
|
| Rate for Payer: UHC Medicare Advantage |
$35.51
|
| Rate for Payer: VA VA |
$34.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.42
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$128.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$115.38 |
| Rate for Payer: Aetna Commercial |
$108.97
|
| Rate for Payer: Aetna Medicare |
$33.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.06
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$32.05
|
| Rate for Payer: BCBS Trust/PPO |
$99.68
|
| Rate for Payer: BCN Commercial |
$99.68
|
| Rate for Payer: BCN Medicare Advantage |
$32.05
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cofinity Commercial |
$110.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.05
|
| Rate for Payer: Healthscope Commercial |
$115.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.15
|
| Rate for Payer: Mclaren Medicaid |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.97
|
| Rate for Payer: PACE Senior Care Partners |
$30.45
|
| Rate for Payer: PACE SWMI |
$32.05
|
| Rate for Payer: PHP Commercial |
$108.97
|
| Rate for Payer: PHP Medicare Advantage |
$32.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.53
|
| Rate for Payer: Priority Health Medicare |
$32.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.19
|
| Rate for Payer: Railroad Medicare Medicare |
$32.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.82
|
| Rate for Payer: UHC Core |
$107.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.05
|
| Rate for Payer: UHC Medicare Advantage |
$33.01
|
| Rate for Payer: VA VA |
$32.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.15
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$128.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.19 |
| Max. Negotiated Rate |
$115.38 |
| Rate for Payer: Aetna Commercial |
$108.97
|
| Rate for Payer: BCBS Trust/PPO |
$99.07
|
| Rate for Payer: BCN Commercial |
$99.07
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cofinity Commercial |
$110.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.56
|
| Rate for Payer: Healthscope Commercial |
$115.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.97
|
| Rate for Payer: PHP Commercial |
$108.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.82
|
| Rate for Payer: UHC Core |
$107.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.15
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$180.75
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$162.68 |
| Rate for Payer: Aetna Commercial |
$153.64
|
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.48
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$45.19
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$140.53
|
| Rate for Payer: BCN Medicare Advantage |
$45.19
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cofinity Commercial |
$155.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.19
|
| Rate for Payer: Healthscope Commercial |
$162.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.56
|
| Rate for Payer: Mclaren Medicaid |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.64
|
| Rate for Payer: PACE Senior Care Partners |
$42.93
|
| Rate for Payer: PACE SWMI |
$45.19
|
| Rate for Payer: PHP Commercial |
$153.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.25
|
| Rate for Payer: Priority Health Medicare |
$45.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.24
|
| Rate for Payer: Railroad Medicare Medicare |
$45.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.06
|
| Rate for Payer: UHC Core |
$150.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.19
|
| Rate for Payer: UHC Medicare Advantage |
$46.54
|
| Rate for Payer: VA VA |
$45.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.56
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$180.75
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$110.24 |
| Max. Negotiated Rate |
$162.68 |
| Rate for Payer: Aetna Commercial |
$153.64
|
| Rate for Payer: BCBS Trust/PPO |
$139.68
|
| Rate for Payer: BCN Commercial |
$139.68
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cofinity Commercial |
$155.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.60
|
| Rate for Payer: Healthscope Commercial |
$162.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.64
|
| Rate for Payer: PHP Commercial |
$153.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.06
|
| Rate for Payer: UHC Core |
$150.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.56
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$173.76 |
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: Aetna Medicare |
$50.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.33
|
| Rate for Payer: BCBS Complete |
$94.71
|
| Rate for Payer: BCBS MAPPO |
$48.27
|
| Rate for Payer: BCBS Trust/PPO |
$150.11
|
| Rate for Payer: BCN Commercial |
$150.11
|
| Rate for Payer: BCN Medicare Advantage |
$48.27
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$173.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.80
|
| Rate for Payer: Mclaren Medicaid |
$90.20
|
| Rate for Payer: Meridian Medicaid |
$94.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PACE Senior Care Partners |
$45.85
|
| Rate for Payer: PACE SWMI |
$48.27
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: PHP Medicare Advantage |
$48.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.97
|
| Rate for Payer: Priority Health Medicare |
$48.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.75
|
| Rate for Payer: Railroad Medicare Medicare |
$48.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.90
|
| Rate for Payer: UHC Core |
$161.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.27
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: VA VA |
$48.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$187.00
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.05 |
| Max. Negotiated Rate |
$168.30 |
| Rate for Payer: Aetna Commercial |
$158.95
|
| Rate for Payer: Aetna Medicare |
$48.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.44
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$46.75
|
| Rate for Payer: BCBS Trust/PPO |
$145.39
|
| Rate for Payer: BCN Commercial |
$145.39
|
| Rate for Payer: BCN Medicare Advantage |
$46.75
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$160.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.75
|
| Rate for Payer: Healthscope Commercial |
$168.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.25
|
| Rate for Payer: Mclaren Medicaid |
$19.05
|
| Rate for Payer: Meridian Medicaid |
$20.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.95
|
| Rate for Payer: PACE Senior Care Partners |
$44.41
|
| Rate for Payer: PACE SWMI |
$46.75
|
| Rate for Payer: PHP Commercial |
$158.95
|
| Rate for Payer: PHP Medicare Advantage |
$46.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.69
|
| Rate for Payer: Priority Health Medicare |
$46.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.05
|
| Rate for Payer: Railroad Medicare Medicare |
$46.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.56
|
| Rate for Payer: UHC Core |
$156.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.75
|
| Rate for Payer: UHC Medicare Advantage |
$48.15
|
| Rate for Payer: VA VA |
$46.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.25
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$187.00
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$114.05 |
| Max. Negotiated Rate |
$168.30 |
| Rate for Payer: Aetna Commercial |
$158.95
|
| Rate for Payer: BCBS Trust/PPO |
$144.51
|
| Rate for Payer: BCN Commercial |
$144.51
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$160.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.60
|
| Rate for Payer: Healthscope Commercial |
$168.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.95
|
| Rate for Payer: PHP Commercial |
$158.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.56
|
| Rate for Payer: UHC Core |
$156.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.25
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.75 |
| Max. Negotiated Rate |
$173.76 |
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: BCBS Trust/PPO |
$149.20
|
| Rate for Payer: BCN Commercial |
$149.20
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.46
|
| Rate for Payer: Healthscope Commercial |
$173.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.90
|
| Rate for Payer: UHC Core |
$161.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.75 |
| Max. Negotiated Rate |
$173.76 |
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: BCBS Trust/PPO |
$149.20
|
| Rate for Payer: BCN Commercial |
$149.20
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.46
|
| Rate for Payer: Healthscope Commercial |
$173.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.90
|
| Rate for Payer: UHC Core |
$161.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.85 |
| Max. Negotiated Rate |
$173.76 |
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: Aetna Medicare |
$50.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.33
|
| Rate for Payer: BCBS Complete |
$94.71
|
| Rate for Payer: BCBS MAPPO |
$48.27
|
| Rate for Payer: BCBS Trust/PPO |
$150.11
|
| Rate for Payer: BCN Commercial |
$150.11
|
| Rate for Payer: BCN Medicare Advantage |
$48.27
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$173.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.80
|
| Rate for Payer: Mclaren Medicaid |
$90.20
|
| Rate for Payer: Meridian Medicaid |
$94.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PACE Senior Care Partners |
$45.85
|
| Rate for Payer: PACE SWMI |
$48.27
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: PHP Medicare Advantage |
$48.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.97
|
| Rate for Payer: Priority Health Medicare |
$48.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.75
|
| Rate for Payer: Railroad Medicare Medicare |
$48.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.90
|
| Rate for Payer: UHC Core |
$161.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.27
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: VA VA |
$48.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.52
|
| Rate for Payer: BCN Commercial |
$21.52
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.17
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.17
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.52
|
| Rate for Payer: BCN Commercial |
$21.52
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,187.52
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$282.04 |
| Max. Negotiated Rate |
$1,068.77 |
| Rate for Payer: Aetna Commercial |
$1,009.39
|
| Rate for Payer: Aetna Medicare |
$308.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$371.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$371.10
|
| Rate for Payer: BCBS Complete |
$627.82
|
| Rate for Payer: BCBS MAPPO |
$296.88
|
| Rate for Payer: BCBS Trust/PPO |
$923.30
|
| Rate for Payer: BCN Commercial |
$923.30
|
| Rate for Payer: BCN Medicare Advantage |
$296.88
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cofinity Commercial |
$1,021.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.88
|
| Rate for Payer: Healthscope Commercial |
$1,068.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.64
|
| Rate for Payer: Mclaren Medicaid |
$597.92
|
| Rate for Payer: Meridian Medicaid |
$627.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$311.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.39
|
| Rate for Payer: PACE Senior Care Partners |
$282.04
|
| Rate for Payer: PACE SWMI |
$296.88
|
| Rate for Payer: PHP Commercial |
$1,009.39
|
| Rate for Payer: PHP Medicare Advantage |
$296.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$597.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.14
|
| Rate for Payer: Priority Health Medicare |
$296.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.27
|
| Rate for Payer: Railroad Medicare Medicare |
$296.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,045.02
|
| Rate for Payer: UHC Core |
$991.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.88
|
| Rate for Payer: UHC Medicare Advantage |
$305.79
|
| Rate for Payer: VA VA |
$296.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.64
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,187.52
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$724.27 |
| Max. Negotiated Rate |
$1,068.77 |
| Rate for Payer: Aetna Commercial |
$1,009.39
|
| Rate for Payer: BCBS Trust/PPO |
$917.72
|
| Rate for Payer: BCN Commercial |
$917.72
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cofinity Commercial |
$1,021.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.02
|
| Rate for Payer: Healthscope Commercial |
$1,068.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.39
|
| Rate for Payer: PHP Commercial |
$1,009.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,045.02
|
| Rate for Payer: UHC Core |
$991.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.64
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna Medicare |
$43.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.50
|
| Rate for Payer: BCBS Complete |
$9.66
|
| Rate for Payer: BCBS MAPPO |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$130.62
|
| Rate for Payer: BCN Commercial |
$130.62
|
| Rate for Payer: BCN Medicare Advantage |
$42.00
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Mclaren Medicaid |
$9.20
|
| Rate for Payer: Meridian Medicaid |
$9.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: PACE Senior Care Partners |
$39.90
|
| Rate for Payer: PACE SWMI |
$42.00
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: PHP Medicare Advantage |
$42.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.16
|
| Rate for Payer: Priority Health Medicare |
$42.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.00
|
| Rate for Payer: UHC Medicare Advantage |
$43.26
|
| Rate for Payer: VA VA |
$42.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$102.46 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$129.83
|
| Rate for Payer: BCN Commercial |
$129.83
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.25
|
| Rate for Payer: BCBS Complete |
$4.34
|
| Rate for Payer: BCBS MAPPO |
$22.60
|
| Rate for Payer: BCBS Trust/PPO |
$70.29
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$22.60
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$4.13
|
| Rate for Payer: Meridian Medicaid |
$4.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Senior Care Partners |
$21.47
|
| Rate for Payer: PACE SWMI |
$22.60
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$22.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$22.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: Railroad Medicare Medicare |
$22.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.60
|
| Rate for Payer: UHC Medicare Advantage |
$23.28
|
| Rate for Payer: VA VA |
$22.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
