|
HC ALLERGEN SPEC IGE RECOMB EA
|
Facility
|
IP
|
$32.12
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.36 |
| Max. Negotiated Rate |
$28.91 |
| Rate for Payer: Aetna Commercial |
$27.30
|
| Rate for Payer: BCBS Trust/PPO |
$26.53
|
| Rate for Payer: BCN Commercial |
$26.53
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$27.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$28.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Nomi Health Commercial |
$26.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.09
|
| Rate for Payer: PHP Commercial |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.27
|
| Rate for Payer: UHC Core |
$26.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.09
|
|
|
HC ALLERGY SCREEN CRUSTACEANS
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200019
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN CRUSTACEANS
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200019
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN FISH
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200020
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN FISH
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200020
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN INDOOR 1 ALLERG
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN MOLDS
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200023
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN MOLLUSKS
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALLERGY SCREEN OUTDOOR ALLERGEN
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200018
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: Aetna Medicare |
$6.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.30
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$5.84
|
| Rate for Payer: BCBS Trust/PPO |
$19.20
|
| Rate for Payer: BCN Commercial |
$19.20
|
| Rate for Payer: BCN Medicare Advantage |
$5.84
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.84
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Mclaren Medicaid |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.13
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Senior Care Partners |
$5.55
|
| Rate for Payer: PACE SWMI |
$5.84
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Medicare |
$5.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UHC Medicaid |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$5.84
|
| Rate for Payer: UHCCP Medicaid |
$4.12
|
| Rate for Payer: VA VA |
$5.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT Q0112
|
| Hospital Charge Code |
30000115
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.28
|
| Rate for Payer: BCN Commercial |
$19.28
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC ALMONDS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALMONDS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200026
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
OP
|
$50.40
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$9.33
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$41.43
|
| Rate for Payer: BCN Commercial |
$41.43
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.80
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$9.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Nomi Health Commercial |
$41.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PACE Senior Care Partners |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.85
|
| Rate for Payer: Priority Health Medicare |
$12.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.35
|
| Rate for Payer: UHC Core |
$42.08
|
| Rate for Payer: UHC Exchange |
$12.60
|
| Rate for Payer: UHC Medicaid |
$8.89
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$8.89
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.80
|
|
|
HC ALOE VESTA ANTIFUNGAL 5 OZ
|
Facility
|
IP
|
$50.40
|
|
| Hospital Charge Code |
27100002
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$35.08 |
| Max. Negotiated Rate |
$45.36 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| Rate for Payer: BCN Commercial |
$41.63
|
| Rate for Payer: Cash Price |
$40.32
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.32
|
| Rate for Payer: Healthscope Commercial |
$45.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.84
|
| Rate for Payer: Nomi Health Commercial |
$41.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.80
|
| Rate for Payer: PHP Commercial |
$42.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.35
|
| Rate for Payer: UHC Core |
$42.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.80
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
OP
|
$17.12
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.02 |
| Max. Negotiated Rate |
$15.41 |
| Rate for Payer: Aetna Commercial |
$14.55
|
| Rate for Payer: Aetna Medicare |
$4.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.35
|
| Rate for Payer: BCBS Complete |
$3.17
|
| Rate for Payer: BCBS MAPPO |
$4.28
|
| Rate for Payer: BCBS Trust/PPO |
$14.07
|
| Rate for Payer: BCN Commercial |
$14.07
|
| Rate for Payer: BCN Medicare Advantage |
$4.28
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.28
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.84
|
| Rate for Payer: Mclaren Medicaid |
$3.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.49
|
| Rate for Payer: Meridian Medicaid |
$3.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.84
|
| Rate for Payer: PACE Senior Care Partners |
$4.07
|
| Rate for Payer: PACE SWMI |
$4.28
|
| Rate for Payer: PHP Commercial |
$14.55
|
| Rate for Payer: PHP Medicare Advantage |
$4.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.89
|
| Rate for Payer: Priority Health Medicare |
$4.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.92
|
| Rate for Payer: Railroad Medicare Medicare |
$4.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.07
|
| Rate for Payer: UHC Core |
$14.30
|
| Rate for Payer: UHC Exchange |
$4.28
|
| Rate for Payer: UHC Medicaid |
$3.02
|
| Rate for Payer: UHC Medicare Advantage |
$4.28
|
| Rate for Payer: UHCCP Medicaid |
$3.02
|
| Rate for Payer: VA VA |
$4.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.84
|
|
|
HC ALOE VESTA LOTION 8OZ
|
Facility
|
IP
|
$17.12
|
|
| Hospital Charge Code |
27100004
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$15.41 |
| Rate for Payer: Aetna Commercial |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$14.14
|
| Rate for Payer: BCN Commercial |
$14.14
|
| Rate for Payer: Cash Price |
$13.70
|
| Rate for Payer: Cofinity Commercial |
$14.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.70
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.55
|
| Rate for Payer: Nomi Health Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.84
|
| Rate for Payer: PHP Commercial |
$14.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.07
|
| Rate for Payer: UHC Core |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.84
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
IP
|
$43.16
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.04 |
| Max. Negotiated Rate |
$38.84 |
| Rate for Payer: Aetna Commercial |
$36.69
|
| Rate for Payer: BCBS Trust/PPO |
$35.65
|
| Rate for Payer: BCN Commercial |
$35.65
|
| Rate for Payer: Cash Price |
$34.53
|
| Rate for Payer: Cofinity Commercial |
$37.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.53
|
| Rate for Payer: Healthscope Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.69
|
| Rate for Payer: Nomi Health Commercial |
$35.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.37
|
| Rate for Payer: PHP Commercial |
$36.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.98
|
| Rate for Payer: UHC Core |
$36.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.37
|
|
|
HC ALOE VESTA OINTMENT
|
Facility
|
OP
|
$43.16
|
|
| Hospital Charge Code |
27100005
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$38.84 |
| Rate for Payer: Aetna Commercial |
$36.69
|
| Rate for Payer: Aetna Medicare |
$11.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.49
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$10.79
|
| Rate for Payer: BCBS Trust/PPO |
$35.48
|
| Rate for Payer: BCN Commercial |
$35.48
|
| Rate for Payer: BCN Medicare Advantage |
$10.79
|
| Rate for Payer: Cash Price |
$34.53
|
| Rate for Payer: Cofinity Commercial |
$37.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.79
|
| Rate for Payer: Healthscope Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.37
|
| Rate for Payer: Mclaren Medicaid |
$7.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.33
|
| Rate for Payer: Meridian Medicaid |
$7.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.69
|
| Rate for Payer: Nomi Health Commercial |
$35.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.37
|
| Rate for Payer: PACE Senior Care Partners |
$10.25
|
| Rate for Payer: PACE SWMI |
$10.79
|
| Rate for Payer: PHP Commercial |
$36.69
|
| Rate for Payer: PHP Medicare Advantage |
$10.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.55
|
| Rate for Payer: Priority Health Medicare |
$10.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.04
|
| Rate for Payer: Railroad Medicare Medicare |
$10.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.98
|
| Rate for Payer: UHC Core |
$36.04
|
| Rate for Payer: UHC Exchange |
$10.79
|
| Rate for Payer: UHC Medicaid |
$7.61
|
| Rate for Payer: UHC Medicare Advantage |
$10.79
|
| Rate for Payer: UHCCP Medicaid |
$7.61
|
| Rate for Payer: VA VA |
$10.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.37
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: BCBS Trust/PPO |
$49.83
|
| Rate for Payer: BCN Commercial |
$49.83
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100085
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: BCBS Complete |
$11.17
|
| Rate for Payer: BCBS MAPPO |
$15.09
|
| Rate for Payer: BCBS Trust/PPO |
$49.61
|
| Rate for Payer: BCN Commercial |
$49.61
|
| Rate for Payer: BCN Medicare Advantage |
$15.09
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.09
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Mclaren Medicaid |
$10.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: Meridian Medicaid |
$11.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PACE Senior Care Partners |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.09
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: UHC Exchange |
$15.09
|
| Rate for Payer: UHC Medicaid |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$15.09
|
| Rate for Payer: UHCCP Medicaid |
$10.64
|
| Rate for Payer: VA VA |
$15.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
