|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
IP
|
$44.57
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.02 |
| Max. Negotiated Rate |
$40.11 |
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: BCBS Trust/PPO |
$36.81
|
| Rate for Payer: BCN Commercial |
$36.81
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Healthscope Commercial |
$40.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Nomi Health Commercial |
$36.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: PHP Commercial |
$37.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.22
|
| Rate for Payer: UHC Core |
$37.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.43
|
|
|
HC ALPHA 1 ANTITRPSIN PHENOTYPING CMPT
|
Facility
|
OP
|
$44.57
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100519
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$40.11 |
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: Aetna Medicare |
$11.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.93
|
| Rate for Payer: BCBS Complete |
$8.25
|
| Rate for Payer: BCBS MAPPO |
$11.14
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.14
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.14
|
| Rate for Payer: Healthscope Commercial |
$40.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$7.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.70
|
| Rate for Payer: Meridian Medicaid |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Nomi Health Commercial |
$36.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: PACE Senior Care Partners |
$10.59
|
| Rate for Payer: PACE SWMI |
$11.14
|
| Rate for Payer: PHP Commercial |
$37.88
|
| Rate for Payer: PHP Medicare Advantage |
$11.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.78
|
| Rate for Payer: Priority Health Medicare |
$11.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.02
|
| Rate for Payer: Railroad Medicare Medicare |
$11.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.22
|
| Rate for Payer: UHC Core |
$37.22
|
| Rate for Payer: UHC Exchange |
$11.14
|
| Rate for Payer: UHC Medicaid |
$7.86
|
| Rate for Payer: UHC Medicare Advantage |
$11.14
|
| Rate for Payer: UHCCP Medicaid |
$7.86
|
| Rate for Payer: VA VA |
$11.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.43
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.85 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: BCBS Trust/PPO |
$30.67
|
| Rate for Payer: BCN Commercial |
$30.67
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.68
|
| Rate for Payer: UHC Core |
$31.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$9.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.61
|
| Rate for Payer: BCBS Complete |
$6.87
|
| Rate for Payer: BCBS MAPPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$30.53
|
| Rate for Payer: BCN Commercial |
$30.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.29
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.29
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.75
|
| Rate for Payer: Meridian Medicaid |
$6.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.82
|
| Rate for Payer: PACE SWMI |
$9.29
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.31
|
| Rate for Payer: Priority Health Medicare |
$9.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.85
|
| Rate for Payer: Railroad Medicare Medicare |
$9.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.68
|
| Rate for Payer: UHC Core |
$31.01
|
| Rate for Payer: UHC Exchange |
$9.29
|
| Rate for Payer: UHC Medicaid |
$6.55
|
| Rate for Payer: UHC Medicare Advantage |
$9.29
|
| Rate for Payer: UHCCP Medicaid |
$6.55
|
| Rate for Payer: VA VA |
$9.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC ALPHA 1 ANTITRYPSIN GENOTYPE
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$15.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.69
|
| Rate for Payer: BCBS Complete |
$11.07
|
| Rate for Payer: BCBS MAPPO |
$14.96
|
| Rate for Payer: BCBS Trust/PPO |
$49.18
|
| Rate for Payer: BCN Commercial |
$49.18
|
| Rate for Payer: BCN Medicare Advantage |
$14.96
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.96
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Mclaren Medicaid |
$10.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.70
|
| Rate for Payer: Meridian Medicaid |
$11.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PACE Senior Care Partners |
$14.21
|
| Rate for Payer: PACE SWMI |
$14.96
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Medicare |
$15.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.63
|
| Rate for Payer: Railroad Medicare Medicare |
$14.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: UHC Exchange |
$14.96
|
| Rate for Payer: UHC Medicaid |
$10.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.96
|
| Rate for Payer: UHCCP Medicaid |
$10.55
|
| Rate for Payer: VA VA |
$14.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC ALPHA-1-ANTITRYPSIN PHENOTYPE, S
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
30100612
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.63 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: BCBS Trust/PPO |
$49.41
|
| Rate for Payer: BCN Commercial |
$49.41
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
OP
|
$176.87
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: Aetna Medicare |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.27
|
| Rate for Payer: BCBS Complete |
$32.74
|
| Rate for Payer: BCBS MAPPO |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$145.40
|
| Rate for Payer: BCN Commercial |
$145.40
|
| Rate for Payer: BCN Medicare Advantage |
$44.22
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.22
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Mclaren Medicaid |
$31.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$32.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: PACE Senior Care Partners |
$42.01
|
| Rate for Payer: PACE SWMI |
$44.22
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: PHP Medicare Advantage |
$44.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Medicare |
$44.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.10
|
| Rate for Payer: Railroad Medicare Medicare |
$44.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: UHC Exchange |
$44.22
|
| Rate for Payer: UHC Medicaid |
$31.18
|
| Rate for Payer: UHC Medicare Advantage |
$44.22
|
| Rate for Payer: UHCCP Medicaid |
$31.18
|
| Rate for Payer: VA VA |
$44.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC ALPHA DEFENSINS-SF
|
Facility
|
IP
|
$176.87
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200405
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$123.10 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: BCBS Trust/PPO |
$146.08
|
| Rate for Payer: BCN Commercial |
$146.08
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.65
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
IP
|
$76.05
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.93 |
| Max. Negotiated Rate |
$68.44 |
| Rate for Payer: Aetna Commercial |
$64.64
|
| Rate for Payer: BCBS Trust/PPO |
$62.81
|
| Rate for Payer: BCN Commercial |
$62.81
|
| Rate for Payer: Cash Price |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$65.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.84
|
| Rate for Payer: Healthscope Commercial |
$68.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$62.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.04
|
| Rate for Payer: PHP Commercial |
$64.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.92
|
| Rate for Payer: UHC Core |
$63.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.04
|
|
|
HC ALPHA FETOPROTEIN AMNIOTIC
|
Facility
|
OP
|
$76.05
|
|
|
Service Code
|
CPT 82106
|
| Hospital Charge Code |
30200001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.41 |
| Max. Negotiated Rate |
$68.44 |
| Rate for Payer: Aetna Commercial |
$64.64
|
| Rate for Payer: Aetna Medicare |
$19.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.77
|
| Rate for Payer: BCBS Complete |
$14.08
|
| Rate for Payer: BCBS MAPPO |
$19.01
|
| Rate for Payer: BCBS Trust/PPO |
$62.52
|
| Rate for Payer: BCN Commercial |
$62.52
|
| Rate for Payer: BCN Medicare Advantage |
$19.01
|
| Rate for Payer: Cash Price |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$65.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.01
|
| Rate for Payer: Healthscope Commercial |
$68.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.04
|
| Rate for Payer: Mclaren Medicaid |
$13.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.96
|
| Rate for Payer: Meridian Medicaid |
$14.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.64
|
| Rate for Payer: Nomi Health Commercial |
$62.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.04
|
| Rate for Payer: PACE Senior Care Partners |
$18.06
|
| Rate for Payer: PACE SWMI |
$19.01
|
| Rate for Payer: PHP Commercial |
$64.64
|
| Rate for Payer: PHP Medicare Advantage |
$19.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.16
|
| Rate for Payer: Priority Health Medicare |
$19.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.93
|
| Rate for Payer: Railroad Medicare Medicare |
$19.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.92
|
| Rate for Payer: UHC Core |
$63.50
|
| Rate for Payer: UHC Exchange |
$19.01
|
| Rate for Payer: UHC Medicaid |
$13.41
|
| Rate for Payer: UHC Medicare Advantage |
$19.01
|
| Rate for Payer: UHCCP Medicaid |
$13.41
|
| Rate for Payer: VA VA |
$19.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.04
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$9.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.61
|
| Rate for Payer: BCBS Complete |
$6.87
|
| Rate for Payer: BCBS MAPPO |
$9.29
|
| Rate for Payer: BCBS Trust/PPO |
$30.53
|
| Rate for Payer: BCN Commercial |
$30.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.29
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.29
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.75
|
| Rate for Payer: Meridian Medicaid |
$6.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.82
|
| Rate for Payer: PACE SWMI |
$9.29
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.31
|
| Rate for Payer: Priority Health Medicare |
$9.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.85
|
| Rate for Payer: Railroad Medicare Medicare |
$9.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.68
|
| Rate for Payer: UHC Core |
$31.01
|
| Rate for Payer: UHC Exchange |
$9.29
|
| Rate for Payer: UHC Medicaid |
$6.55
|
| Rate for Payer: UHC Medicare Advantage |
$9.29
|
| Rate for Payer: UHCCP Medicaid |
$6.55
|
| Rate for Payer: VA VA |
$9.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC ALPHA FETOPROTEIN SERUM
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100087
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.85 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: BCBS Trust/PPO |
$30.67
|
| Rate for Payer: BCN Commercial |
$30.67
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$30.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.68
|
| Rate for Payer: UHC Core |
$31.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
IP
|
$65.79
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.79 |
| Max. Negotiated Rate |
$59.21 |
| Rate for Payer: Aetna Commercial |
$55.92
|
| Rate for Payer: BCBS Trust/PPO |
$54.34
|
| Rate for Payer: BCN Commercial |
$54.34
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$59.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: PHP Commercial |
$55.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.90
|
| Rate for Payer: UHC Core |
$54.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.34
|
|
|
HC ALPHA FETOPROTEIN TUMOR MARKER
|
Facility
|
OP
|
$65.79
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$59.21 |
| Rate for Payer: Aetna Commercial |
$55.92
|
| Rate for Payer: Aetna Medicare |
$17.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.56
|
| Rate for Payer: BCBS Complete |
$12.18
|
| Rate for Payer: BCBS MAPPO |
$16.45
|
| Rate for Payer: BCBS Trust/PPO |
$54.09
|
| Rate for Payer: BCN Commercial |
$54.09
|
| Rate for Payer: BCN Medicare Advantage |
$16.45
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.45
|
| Rate for Payer: Healthscope Commercial |
$59.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.34
|
| Rate for Payer: Mclaren Medicaid |
$11.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$12.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$53.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: PACE Senior Care Partners |
$15.63
|
| Rate for Payer: PACE SWMI |
$16.45
|
| Rate for Payer: PHP Commercial |
$55.92
|
| Rate for Payer: PHP Medicare Advantage |
$16.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.24
|
| Rate for Payer: Priority Health Medicare |
$16.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: Railroad Medicare Medicare |
$16.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.90
|
| Rate for Payer: UHC Core |
$54.93
|
| Rate for Payer: UHC Exchange |
$16.45
|
| Rate for Payer: UHC Medicaid |
$11.60
|
| Rate for Payer: UHC Medicare Advantage |
$16.45
|
| Rate for Payer: UHCCP Medicaid |
$11.60
|
| Rate for Payer: VA VA |
$16.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.34
|
|
|
HC ALPHA-GLOBIN GENE ANALYSIS
|
Facility
|
IP
|
$430.04
|
|
|
Service Code
|
CPT 81269
|
| Hospital Charge Code |
31000088
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$299.31 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.53
|
| Rate for Payer: BCBS Trust/PPO |
$355.17
|
| Rate for Payer: BCN Commercial |
$355.17
|
| Rate for Payer: Cash Price |
$344.03
|
| Rate for Payer: Cofinity Commercial |
$369.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.03
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.53
|
| Rate for Payer: Nomi Health Commercial |
$352.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.53
|
| Rate for Payer: PHP Commercial |
$365.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$359.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.53
|
|
|
HC ALPHA-GLOBIN GENE ANALYSIS
|
Facility
|
OP
|
$430.04
|
|
|
Service Code
|
CPT 81269
|
| Hospital Charge Code |
31000088
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.82 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.53
|
| Rate for Payer: Aetna Medicare |
$111.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.39
|
| Rate for Payer: BCBS Complete |
$79.60
|
| Rate for Payer: BCBS MAPPO |
$107.51
|
| Rate for Payer: BCBS Trust/PPO |
$353.54
|
| Rate for Payer: BCN Commercial |
$353.54
|
| Rate for Payer: BCN Medicare Advantage |
$107.51
|
| Rate for Payer: Cash Price |
$344.03
|
| Rate for Payer: Cofinity Commercial |
$369.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.51
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.53
|
| Rate for Payer: Mclaren Medicaid |
$75.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.89
|
| Rate for Payer: Meridian Medicaid |
$79.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.53
|
| Rate for Payer: Nomi Health Commercial |
$352.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.53
|
| Rate for Payer: PACE Senior Care Partners |
$102.13
|
| Rate for Payer: PACE SWMI |
$107.51
|
| Rate for Payer: PHP Commercial |
$365.53
|
| Rate for Payer: PHP Medicare Advantage |
$107.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.13
|
| Rate for Payer: Priority Health Medicare |
$108.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.31
|
| Rate for Payer: Railroad Medicare Medicare |
$107.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$359.08
|
| Rate for Payer: UHC Exchange |
$107.51
|
| Rate for Payer: UHC Medicaid |
$75.82
|
| Rate for Payer: UHC Medicare Advantage |
$107.51
|
| Rate for Payer: UHCCP Medicaid |
$75.82
|
| Rate for Payer: VA VA |
$107.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.53
|
|
|
HC ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
OP
|
$90.20
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$81.18 |
| Rate for Payer: Aetna Commercial |
$76.67
|
| Rate for Payer: Aetna Medicare |
$23.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.19
|
| Rate for Payer: BCBS Complete |
$16.70
|
| Rate for Payer: BCBS MAPPO |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$74.15
|
| Rate for Payer: BCN Commercial |
$74.15
|
| Rate for Payer: BCN Medicare Advantage |
$22.55
|
| Rate for Payer: Cash Price |
$72.16
|
| Rate for Payer: Cofinity Commercial |
$77.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.55
|
| Rate for Payer: Healthscope Commercial |
$81.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.65
|
| Rate for Payer: Mclaren Medicaid |
$15.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.68
|
| Rate for Payer: Meridian Medicaid |
$16.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.67
|
| Rate for Payer: Nomi Health Commercial |
$73.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.65
|
| Rate for Payer: PACE Senior Care Partners |
$21.42
|
| Rate for Payer: PACE SWMI |
$22.55
|
| Rate for Payer: PHP Commercial |
$76.67
|
| Rate for Payer: PHP Medicare Advantage |
$22.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.47
|
| Rate for Payer: Priority Health Medicare |
$22.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.78
|
| Rate for Payer: Railroad Medicare Medicare |
$22.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.38
|
| Rate for Payer: UHC Core |
$75.32
|
| Rate for Payer: UHC Exchange |
$22.55
|
| Rate for Payer: UHC Medicaid |
$15.90
|
| Rate for Payer: UHC Medicare Advantage |
$22.55
|
| Rate for Payer: UHCCP Medicaid |
$15.90
|
| Rate for Payer: VA VA |
$22.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.65
|
|
|
HC ALTEPLASE RECOMBINANT, PER 1 MG
|
Facility
|
IP
|
$90.20
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
63600144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$62.78 |
| Max. Negotiated Rate |
$81.18 |
| Rate for Payer: Aetna Commercial |
$76.67
|
| Rate for Payer: BCBS Trust/PPO |
$74.50
|
| Rate for Payer: BCN Commercial |
$74.50
|
| Rate for Payer: Cash Price |
$72.16
|
| Rate for Payer: Cofinity Commercial |
$77.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.16
|
| Rate for Payer: Healthscope Commercial |
$81.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.67
|
| Rate for Payer: Nomi Health Commercial |
$73.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.65
|
| Rate for Payer: PHP Commercial |
$76.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.38
|
| Rate for Payer: UHC Core |
$75.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.65
|
|
|
HC ALTERNARIA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALTERNARIA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200027
|
|
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 ALUMINUM
|
Facility
|
OP
|
$57.30
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: Aetna Medicare |
$14.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.91
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS MAPPO |
$14.32
|
| Rate for Payer: BCBS Trust/PPO |
$47.11
|
| Rate for Payer: BCN Commercial |
$47.11
|
| Rate for Payer: BCN Medicare Advantage |
$14.32
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$10.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.04
|
| Rate for Payer: Meridian Medicaid |
$10.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.98
|
| Rate for Payer: PACE Senior Care Partners |
$13.61
|
| Rate for Payer: PACE SWMI |
$14.32
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: PHP Medicare Advantage |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.85
|
| Rate for Payer: Priority Health Medicare |
$14.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.88
|
| Rate for Payer: Railroad Medicare Medicare |
$14.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.42
|
| Rate for Payer: UHC Core |
$47.85
|
| Rate for Payer: UHC Exchange |
$14.32
|
| Rate for Payer: UHC Medicaid |
$10.10
|
| Rate for Payer: UHC Medicare Advantage |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$10.10
|
| Rate for Payer: VA VA |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC ALUMINUM
|
Facility
|
IP
|
$57.30
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
30100088
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.88 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: BCBS Trust/PPO |
$47.32
|
| Rate for Payer: BCN Commercial |
$47.32
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.98
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.42
|
| Rate for Payer: UHC Core |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC AMBIT PUMP
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.83 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Aetna Commercial |
$558.45
|
| Rate for Payer: Aetna Medicare |
$170.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.31
|
| Rate for Payer: BCBS Complete |
$121.61
|
| Rate for Payer: BCBS MAPPO |
$164.25
|
| Rate for Payer: BCBS Trust/PPO |
$540.12
|
| Rate for Payer: BCN Commercial |
$540.12
|
| Rate for Payer: BCN Medicare Advantage |
$164.25
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$565.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$525.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.25
|
| Rate for Payer: Healthscope Commercial |
$591.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.75
|
| Rate for Payer: Mclaren Medicaid |
$115.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.46
|
| Rate for Payer: Meridian Medicaid |
$121.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.45
|
| Rate for Payer: Nomi Health Commercial |
$538.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.75
|
| Rate for Payer: PACE Senior Care Partners |
$156.04
|
| Rate for Payer: PACE SWMI |
$164.25
|
| Rate for Payer: PHP Commercial |
$558.45
|
| Rate for Payer: PHP Medicare Advantage |
$164.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$571.59
|
| Rate for Payer: Priority Health Medicare |
$165.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.27
|
| Rate for Payer: Railroad Medicare Medicare |
$164.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.16
|
| Rate for Payer: UHC Core |
$548.60
|
| Rate for Payer: UHC Exchange |
$164.25
|
| Rate for Payer: UHC Medicaid |
$115.83
|
| Rate for Payer: UHC Medicare Advantage |
$164.25
|
| Rate for Payer: UHCCP Medicaid |
$115.83
|
| Rate for Payer: VA VA |
$164.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.75
|
|
