|
HC CHICKEN FEATHERS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
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 CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
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 CHILDBIRTH EDUCATION
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$25.62 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: BCBS Trust/PPO |
$32.46
|
| Rate for Payer: BCN Commercial |
$32.46
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: Aetna Medicare |
$10.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.12
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$10.50
|
| Rate for Payer: BCBS Trust/PPO |
$32.66
|
| Rate for Payer: BCN Commercial |
$32.66
|
| Rate for Payer: BCN Medicare Advantage |
$10.50
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.50
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.98
|
| Rate for Payer: PACE SWMI |
$10.50
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: PHP Medicare Advantage |
$10.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.62
|
| Rate for Payer: Railroad Medicare Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.50
|
| Rate for Payer: UHC Medicare Advantage |
$10.82
|
| Rate for Payer: VA VA |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
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 CHILDHOOD ALLERGEN PROFILE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
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 CHLAMYDIA AB IGG
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare |
$4.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.68
|
| Rate for Payer: BCBS Complete |
$9.16
|
| Rate for Payer: BCBS MAPPO |
$4.54
|
| Rate for Payer: BCBS Trust/PPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.64
|
| Rate for Payer: Mclaren Medicaid |
$8.72
|
| Rate for Payer: Meridian Medicaid |
$9.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PACE Senior Care Partners |
$4.32
|
| Rate for Payer: PACE SWMI |
$4.54
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$4.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.09
|
| Rate for Payer: Railroad Medicare Medicare |
$4.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.54
|
| Rate for Payer: UHC Medicare Advantage |
$4.68
|
| Rate for Payer: VA VA |
$4.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.64
|
|
|
HC CHLAMYDIA AB IGG
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200239
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: BCBS Trust/PPO |
$14.05
|
| Rate for Payer: BCN Commercial |
$14.05
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.64
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC CHLAMYDIA AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
30600149
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: BCBS Trust/PPO |
$14.05
|
| Rate for Payer: BCN Commercial |
$14.05
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.64
|
|
|
HC CHLAMYDIA ANTIBODIES
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 86631
|
| Hospital Charge Code |
30200355
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare |
$4.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.68
|
| Rate for Payer: BCBS Complete |
$9.16
|
| Rate for Payer: BCBS MAPPO |
$4.54
|
| Rate for Payer: BCBS Trust/PPO |
$14.13
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.64
|
| Rate for Payer: Mclaren Medicaid |
$8.72
|
| Rate for Payer: Meridian Medicaid |
$9.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.45
|
| Rate for Payer: PACE Senior Care Partners |
$4.32
|
| Rate for Payer: PACE SWMI |
$4.54
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$4.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.09
|
| Rate for Payer: Railroad Medicare Medicare |
$4.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.54
|
| Rate for Payer: UHC Medicare Advantage |
$4.68
|
| Rate for Payer: VA VA |
$4.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.64
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
OP
|
$19.50
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$16.58
|
| Rate for Payer: Aetna Medicare |
$5.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.09
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$4.88
|
| Rate for Payer: BCBS Trust/PPO |
$15.16
|
| Rate for Payer: BCN Commercial |
$15.16
|
| Rate for Payer: BCN Medicare Advantage |
$4.88
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$16.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.88
|
| Rate for Payer: Healthscope Commercial |
$17.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.62
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.58
|
| Rate for Payer: PACE Senior Care Partners |
$4.63
|
| Rate for Payer: PACE SWMI |
$4.88
|
| Rate for Payer: PHP Commercial |
$16.58
|
| Rate for Payer: PHP Medicare Advantage |
$4.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.96
|
| Rate for Payer: Priority Health Medicare |
$4.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.89
|
| Rate for Payer: Railroad Medicare Medicare |
$4.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.16
|
| Rate for Payer: UHC Core |
$16.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.88
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: VA VA |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.62
|
|
|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
IP
|
$19.50
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Commercial |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: BCN Commercial |
$15.07
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cofinity Commercial |
$16.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.60
|
| Rate for Payer: Healthscope Commercial |
$17.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.58
|
| Rate for Payer: PHP Commercial |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.16
|
| Rate for Payer: UHC Core |
$16.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.62
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
30600088
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: BCBS Trust/PPO |
$61.82
|
| Rate for Payer: BCN Commercial |
$61.82
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
30600088
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.46 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: Aetna Medicare |
$20.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.00
|
| Rate for Payer: BCBS Complete |
$15.19
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.20
|
| Rate for Payer: BCN Commercial |
$62.20
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Mclaren Medicaid |
$14.46
|
| Rate for Payer: Meridian Medicaid |
$15.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$20.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$20.60
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE REF LAB
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
30600090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.18
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE REF LAB
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
30600090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.32
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$4.11
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.72
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC CHLORAMPHENICOL LEVEL
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 82415
|
| Hospital Charge Code |
30100151
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC CHLORAMPHENICOL LEVEL
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 82415
|
| Hospital Charge Code |
30100151
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$20.80
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.07
|
| Rate for Payer: BCN Commercial |
$16.07
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$20.80
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.07
|
| Rate for Payer: BCN Commercial |
$16.07
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$20.80
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.87
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.17
|
| Rate for Payer: BCN Commercial |
$16.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Mclaren Medicaid |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$3.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.36
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$20.80
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$18.72 |
| Rate for Payer: Aetna Commercial |
$17.68
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.87
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.17
|
| Rate for Payer: BCN Commercial |
$16.17
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cash Price |
$16.64
|
| Rate for Payer: Cofinity Commercial |
$17.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
| Rate for Payer: Mclaren Medicaid |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$3.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.68
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.30
|
| Rate for Payer: UHC Core |
$17.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.36
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
|
HC CHLORIDE SERUM
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$16.50
|
| Rate for Payer: BCN Commercial |
$16.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.39
|
| Rate for Payer: Meridian Medicaid |
$3.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.46
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
