|
HC ANTIBODY ELUTION
|
Facility
|
IP
|
$305.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$212.82 |
| Max. Negotiated Rate |
$275.20 |
| Rate for Payer: Aetna Commercial |
$259.91
|
| Rate for Payer: BCBS Trust/PPO |
$252.54
|
| Rate for Payer: BCN Commercial |
$252.54
|
| Rate for Payer: Cash Price |
$244.62
|
| Rate for Payer: Cofinity Commercial |
$262.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.62
|
| Rate for Payer: Healthscope Commercial |
$275.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.91
|
| Rate for Payer: Nomi Health Commercial |
$250.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.34
|
| Rate for Payer: PHP Commercial |
$259.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.09
|
| Rate for Payer: UHC Core |
$255.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.34
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
OP
|
$305.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$275.20 |
| Rate for Payer: Aetna Commercial |
$259.91
|
| Rate for Payer: Aetna Medicare |
$79.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.56
|
| Rate for Payer: BCBS Complete |
$56.60
|
| Rate for Payer: BCBS MAPPO |
$76.44
|
| Rate for Payer: BCBS Trust/PPO |
$251.38
|
| Rate for Payer: BCN Commercial |
$251.38
|
| Rate for Payer: BCN Medicare Advantage |
$76.44
|
| Rate for Payer: Cash Price |
$244.62
|
| Rate for Payer: Cofinity Commercial |
$262.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.44
|
| Rate for Payer: Healthscope Commercial |
$275.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.34
|
| Rate for Payer: Mclaren Medicaid |
$53.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.27
|
| Rate for Payer: Meridian Medicaid |
$56.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.91
|
| Rate for Payer: Nomi Health Commercial |
$250.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.34
|
| Rate for Payer: PACE Senior Care Partners |
$72.62
|
| Rate for Payer: PACE SWMI |
$76.44
|
| Rate for Payer: PHP Commercial |
$259.91
|
| Rate for Payer: PHP Medicare Advantage |
$76.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.03
|
| Rate for Payer: Priority Health Medicare |
$77.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.82
|
| Rate for Payer: Railroad Medicare Medicare |
$76.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.09
|
| Rate for Payer: UHC Core |
$255.33
|
| Rate for Payer: UHC Exchange |
$76.44
|
| Rate for Payer: UHC Medicaid |
$53.91
|
| Rate for Payer: UHC Medicare Advantage |
$76.44
|
| Rate for Payer: UHCCP Medicaid |
$53.91
|
| Rate for Payer: VA VA |
$76.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.34
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$151.41 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: BCBS Trust/PPO |
$179.67
|
| Rate for Payer: BCN Commercial |
$179.67
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.44
|
| Rate for Payer: UHC Core |
$181.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna Medicare |
$56.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.98
|
| Rate for Payer: BCBS Complete |
$40.27
|
| Rate for Payer: BCBS MAPPO |
$54.39
|
| Rate for Payer: BCBS Trust/PPO |
$178.85
|
| Rate for Payer: BCN Commercial |
$178.85
|
| Rate for Payer: BCN Medicare Advantage |
$54.39
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.39
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: Mclaren Medicaid |
$38.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.11
|
| Rate for Payer: Meridian Medicaid |
$40.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PACE Senior Care Partners |
$51.67
|
| Rate for Payer: PACE SWMI |
$54.39
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: PHP Medicare Advantage |
$54.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.27
|
| Rate for Payer: Priority Health Medicare |
$54.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.41
|
| Rate for Payer: Railroad Medicare Medicare |
$54.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.44
|
| Rate for Payer: UHC Core |
$181.65
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$38.35
|
| Rate for Payer: UHC Medicare Advantage |
$54.39
|
| Rate for Payer: UHCCP Medicaid |
$38.35
|
| Rate for Payer: VA VA |
$54.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
OP
|
$95.72
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Medicare |
$24.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.91
|
| Rate for Payer: BCBS Complete |
$17.72
|
| Rate for Payer: BCBS MAPPO |
$23.93
|
| Rate for Payer: BCBS Trust/PPO |
$78.69
|
| Rate for Payer: BCN Commercial |
$78.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.93
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.93
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Mclaren Medicaid |
$16.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.13
|
| Rate for Payer: Meridian Medicaid |
$17.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.79
|
| Rate for Payer: PACE Senior Care Partners |
$22.73
|
| Rate for Payer: PACE SWMI |
$23.93
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: PHP Medicare Advantage |
$23.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Medicare |
$24.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.62
|
| Rate for Payer: Railroad Medicare Medicare |
$23.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: UHC Exchange |
$23.93
|
| Rate for Payer: UHC Medicaid |
$16.88
|
| Rate for Payer: UHC Medicare Advantage |
$23.93
|
| Rate for Payer: UHCCP Medicaid |
$16.88
|
| Rate for Payer: VA VA |
$23.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: BCBS Trust/PPO |
$79.06
|
| Rate for Payer: BCN Commercial |
$79.06
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.79
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
OP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.17 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: Aetna Medicare |
$9.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.94
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS MAPPO |
$8.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.79
|
| Rate for Payer: BCN Commercial |
$28.79
|
| Rate for Payer: BCN Medicare Advantage |
$8.76
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.76
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Mclaren Medicaid |
$6.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.19
|
| Rate for Payer: Meridian Medicaid |
$6.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PACE Senior Care Partners |
$8.32
|
| Rate for Payer: PACE SWMI |
$8.76
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: PHP Medicare Advantage |
$8.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.47
|
| Rate for Payer: Priority Health Medicare |
$8.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.37
|
| Rate for Payer: Railroad Medicare Medicare |
$8.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.82
|
| Rate for Payer: UHC Core |
$29.24
|
| Rate for Payer: UHC Exchange |
$8.76
|
| Rate for Payer: UHC Medicaid |
$6.17
|
| Rate for Payer: UHC Medicare Advantage |
$8.76
|
| Rate for Payer: UHCCP Medicaid |
$6.17
|
| Rate for Payer: VA VA |
$8.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
IP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.37 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: BCBS Trust/PPO |
$28.92
|
| Rate for Payer: BCN Commercial |
$28.92
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.82
|
| Rate for Payer: UHC Core |
$29.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$17.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.23
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$16.98
|
| Rate for Payer: BCBS Trust/PPO |
$55.84
|
| Rate for Payer: BCN Commercial |
$55.84
|
| Rate for Payer: BCN Medicare Advantage |
$16.98
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.83
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Senior Care Partners |
$16.13
|
| Rate for Payer: PACE SWMI |
$16.98
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$16.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Medicare |
$17.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: UHC Exchange |
$16.98
|
| Rate for Payer: UHC Medicaid |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$16.98
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: VA VA |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.27 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: BCBS Trust/PPO |
$56.10
|
| Rate for Payer: BCN Commercial |
$56.10
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
OP
|
$87.29
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.39 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.28
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS MAPPO |
$21.82
|
| Rate for Payer: BCBS Trust/PPO |
$71.76
|
| Rate for Payer: BCN Commercial |
$71.76
|
| Rate for Payer: BCN Medicare Advantage |
$21.82
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.82
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Mclaren Medicaid |
$15.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.91
|
| Rate for Payer: Meridian Medicaid |
$16.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PACE Senior Care Partners |
$20.73
|
| Rate for Payer: PACE SWMI |
$21.82
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.94
|
| Rate for Payer: Priority Health Medicare |
$22.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.82
|
| Rate for Payer: UHC Core |
$72.89
|
| Rate for Payer: UHC Exchange |
$21.82
|
| Rate for Payer: UHC Medicaid |
$15.39
|
| Rate for Payer: UHC Medicare Advantage |
$21.82
|
| Rate for Payer: UHCCP Medicaid |
$15.39
|
| Rate for Payer: VA VA |
$21.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
IP
|
$87.29
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$60.75 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: BCBS Trust/PPO |
$72.09
|
| Rate for Payer: BCN Commercial |
$72.09
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$71.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.82
|
| Rate for Payer: UHC Core |
$72.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC ANTIBODY TITER
|
Facility
|
IP
|
$277.37
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$193.05 |
| Max. Negotiated Rate |
$249.63 |
| Rate for Payer: Aetna Commercial |
$235.76
|
| Rate for Payer: BCBS Trust/PPO |
$229.08
|
| Rate for Payer: BCN Commercial |
$229.08
|
| Rate for Payer: Cash Price |
$221.90
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.90
|
| Rate for Payer: Healthscope Commercial |
$249.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.76
|
| Rate for Payer: Nomi Health Commercial |
$227.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.03
|
| Rate for Payer: PHP Commercial |
$235.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$241.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.09
|
| Rate for Payer: UHC Core |
$231.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.03
|
|
|
HC ANTIBODY TITER
|
Facility
|
OP
|
$277.37
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.90 |
| Max. Negotiated Rate |
$249.63 |
| Rate for Payer: Aetna Commercial |
$235.76
|
| Rate for Payer: Aetna Medicare |
$72.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.68
|
| Rate for Payer: BCBS Complete |
$51.34
|
| Rate for Payer: BCBS MAPPO |
$69.34
|
| Rate for Payer: BCBS Trust/PPO |
$228.03
|
| Rate for Payer: BCN Commercial |
$228.03
|
| Rate for Payer: BCN Medicare Advantage |
$69.34
|
| Rate for Payer: Cash Price |
$221.90
|
| Rate for Payer: Cofinity Commercial |
$238.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.34
|
| Rate for Payer: Healthscope Commercial |
$249.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.03
|
| Rate for Payer: Mclaren Medicaid |
$48.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.81
|
| Rate for Payer: Meridian Medicaid |
$51.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.76
|
| Rate for Payer: Nomi Health Commercial |
$227.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.03
|
| Rate for Payer: PACE Senior Care Partners |
$65.88
|
| Rate for Payer: PACE SWMI |
$69.34
|
| Rate for Payer: PHP Commercial |
$235.76
|
| Rate for Payer: PHP Medicare Advantage |
$69.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$241.31
|
| Rate for Payer: Priority Health Medicare |
$70.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.05
|
| Rate for Payer: Railroad Medicare Medicare |
$69.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.09
|
| Rate for Payer: UHC Core |
$231.60
|
| Rate for Payer: UHC Exchange |
$69.34
|
| Rate for Payer: UHC Medicaid |
$48.90
|
| Rate for Payer: UHC Medicare Advantage |
$69.34
|
| Rate for Payer: UHCCP Medicaid |
$48.90
|
| Rate for Payer: VA VA |
$69.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.03
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
OP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$49.16
|
| Rate for Payer: Aetna Medicare |
$15.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$47.54
|
| Rate for Payer: BCN Commercial |
$47.54
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$49.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$52.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.37
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$10.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PACE Senior Care Partners |
$13.73
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$49.16
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.31
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.25
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.89
|
| Rate for Payer: UHC Core |
$48.29
|
| Rate for Payer: UHC Exchange |
$14.46
|
| Rate for Payer: UHC Medicaid |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$10.20
|
| Rate for Payer: VA VA |
$14.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.37
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
IP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$49.16
|
| Rate for Payer: BCBS Trust/PPO |
$47.76
|
| Rate for Payer: BCN Commercial |
$47.76
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$49.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Healthscope Commercial |
$52.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PHP Commercial |
$49.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.89
|
| Rate for Payer: UHC Core |
$48.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.37
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
OP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$49.16
|
| Rate for Payer: Aetna Medicare |
$15.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.07
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS MAPPO |
$14.46
|
| Rate for Payer: BCBS Trust/PPO |
$47.54
|
| Rate for Payer: BCN Commercial |
$47.54
|
| Rate for Payer: BCN Medicare Advantage |
$14.46
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$49.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$52.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.37
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.18
|
| Rate for Payer: Meridian Medicaid |
$10.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PACE Senior Care Partners |
$13.73
|
| Rate for Payer: PACE SWMI |
$14.46
|
| Rate for Payer: PHP Commercial |
$49.16
|
| Rate for Payer: PHP Medicare Advantage |
$14.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.31
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.25
|
| Rate for Payer: Railroad Medicare Medicare |
$14.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.89
|
| Rate for Payer: UHC Core |
$48.29
|
| Rate for Payer: UHC Exchange |
$14.46
|
| Rate for Payer: UHC Medicaid |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$14.46
|
| Rate for Payer: UHCCP Medicaid |
$10.20
|
| Rate for Payer: VA VA |
$14.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.37
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
IP
|
$57.83
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$49.16
|
| Rate for Payer: BCBS Trust/PPO |
$47.76
|
| Rate for Payer: BCN Commercial |
$47.76
|
| Rate for Payer: Cash Price |
$46.26
|
| Rate for Payer: Cofinity Commercial |
$49.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.26
|
| Rate for Payer: Healthscope Commercial |
$52.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.16
|
| Rate for Payer: Nomi Health Commercial |
$47.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.37
|
| Rate for Payer: PHP Commercial |
$49.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.89
|
| Rate for Payer: UHC Core |
$48.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.37
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
OP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: Aetna Medicare |
$47.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.92
|
| Rate for Payer: BCBS Complete |
$33.71
|
| Rate for Payer: BCBS MAPPO |
$45.53
|
| Rate for Payer: BCBS Trust/PPO |
$149.74
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$149.74
|
| Rate for Payer: BCN Medicare Advantage |
$45.53
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.53
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Mclaren Medicaid |
$32.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.81
|
| Rate for Payer: Meridian Medicaid |
$33.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.60
|
| Rate for Payer: PACE Senior Care Partners |
$43.26
|
| Rate for Payer: PACE SWMI |
$45.53
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.46
|
| Rate for Payer: Priority Health Medicare |
$45.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.77
|
| Rate for Payer: Railroad Medicare Medicare |
$45.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: UHC Exchange |
$45.53
|
| Rate for Payer: UHC Medicaid |
$32.11
|
| Rate for Payer: UHC Medicare Advantage |
$45.53
|
| Rate for Payer: UHCCP Medicaid |
$32.11
|
| Rate for Payer: VA VA |
$45.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
IP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.77 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: BCBS Trust/PPO |
$150.43
|
| Rate for Payer: BCN Commercial |
$150.43
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.60
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$59.61
|
| Rate for Payer: BCN Commercial |
$59.61
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$18.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$59.33
|
| Rate for Payer: BCN Commercial |
$59.33
|
| Rate for Payer: BCN Medicare Advantage |
$18.04
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.04
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$12.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.94
|
| Rate for Payer: Meridian Medicaid |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Senior Care Partners |
$17.14
|
| Rate for Payer: PACE SWMI |
$18.04
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$18.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Medicare |
$18.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: Railroad Medicare Medicare |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: UHC Exchange |
$18.04
|
| Rate for Payer: UHC Medicaid |
$12.72
|
| Rate for Payer: UHC Medicare Advantage |
$18.04
|
| Rate for Payer: UHCCP Medicaid |
$12.72
|
| Rate for Payer: VA VA |
$18.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
IP
|
$75.35
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna Commercial |
$64.05
|
| Rate for Payer: BCBS Trust/PPO |
$62.23
|
| Rate for Payer: BCN Commercial |
$62.23
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Nomi Health Commercial |
$61.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PHP Commercial |
$64.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.31
|
| Rate for Payer: UHC Core |
$62.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
