|
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
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.28
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$29.02
|
| Rate for Payer: BCBS Trust/PPO |
$95.45
|
| Rate for Payer: BCN Commercial |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$29.02
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.02
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Mclaren Medicaid |
$20.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Senior Care Partners |
$27.57
|
| Rate for Payer: PACE SWMI |
$29.02
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$29.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: Railroad Medicare Medicare |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: UHC Exchange |
$29.02
|
| Rate for Payer: UHC Medicaid |
$20.47
|
| Rate for Payer: UHC Medicare Advantage |
$29.02
|
| Rate for Payer: UHCCP Medicaid |
$20.47
|
| Rate for Payer: VA VA |
$29.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$80.81 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$95.89
|
| Rate for Payer: BCN Commercial |
$95.89
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.28
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$29.02
|
| Rate for Payer: BCBS Trust/PPO |
$95.45
|
| Rate for Payer: BCN Commercial |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$29.02
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.02
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Mclaren Medicaid |
$20.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Senior Care Partners |
$27.57
|
| Rate for Payer: PACE SWMI |
$29.02
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$29.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: Railroad Medicare Medicare |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: UHC Exchange |
$29.02
|
| Rate for Payer: UHC Medicaid |
$20.47
|
| Rate for Payer: UHC Medicare Advantage |
$29.02
|
| Rate for Payer: UHCCP Medicaid |
$20.47
|
| Rate for Payer: VA VA |
$29.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$80.81 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$95.89
|
| Rate for Payer: BCN Commercial |
$95.89
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$80.81 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$95.89
|
| Rate for Payer: BCN Commercial |
$95.89
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$116.10
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$104.49 |
| Rate for Payer: Aetna Commercial |
$98.69
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.28
|
| Rate for Payer: BCBS Complete |
$21.49
|
| Rate for Payer: BCBS MAPPO |
$29.02
|
| Rate for Payer: BCBS Trust/PPO |
$95.45
|
| Rate for Payer: BCN Commercial |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$29.02
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cofinity Commercial |
$99.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.02
|
| Rate for Payer: Healthscope Commercial |
$104.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.08
|
| Rate for Payer: Mclaren Medicaid |
$20.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$21.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.69
|
| Rate for Payer: Nomi Health Commercial |
$95.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.08
|
| Rate for Payer: PACE Senior Care Partners |
$27.57
|
| Rate for Payer: PACE SWMI |
$29.02
|
| Rate for Payer: PHP Commercial |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$29.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.01
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.81
|
| Rate for Payer: Railroad Medicare Medicare |
$29.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.17
|
| Rate for Payer: UHC Core |
$96.94
|
| Rate for Payer: UHC Exchange |
$29.02
|
| Rate for Payer: UHC Medicaid |
$20.47
|
| Rate for Payer: UHC Medicare Advantage |
$29.02
|
| Rate for Payer: UHCCP Medicaid |
$20.47
|
| Rate for Payer: VA VA |
$29.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.08
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.62 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.36
|
| Rate for Payer: UHC Core |
$48.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.77
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$58.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: Aetna Medicare |
$15.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.24
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$14.59
|
| Rate for Payer: BCBS Trust/PPO |
$47.98
|
| Rate for Payer: BCN Commercial |
$47.98
|
| Rate for Payer: BCN Medicare Advantage |
$14.59
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.77
|
| Rate for Payer: Mclaren Medicaid |
$10.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.32
|
| Rate for Payer: Meridian Medicaid |
$10.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Nomi Health Commercial |
$47.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PACE Senior Care Partners |
$13.86
|
| Rate for Payer: PACE SWMI |
$14.59
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: PHP Medicare Advantage |
$14.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.77
|
| Rate for Payer: Priority Health Medicare |
$14.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.62
|
| Rate for Payer: Railroad Medicare Medicare |
$14.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.36
|
| Rate for Payer: UHC Core |
$48.73
|
| Rate for Payer: UHC Exchange |
$14.59
|
| Rate for Payer: UHC Medicaid |
$10.29
|
| Rate for Payer: UHC Medicare Advantage |
$14.59
|
| Rate for Payer: UHCCP Medicaid |
$10.29
|
| Rate for Payer: VA VA |
$14.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.77
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.19 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$107.01
|
| Rate for Payer: Aetna Medicare |
$32.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.34
|
| Rate for Payer: BCBS Complete |
$23.30
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$103.49
|
| Rate for Payer: BCN Commercial |
$103.49
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$108.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.42
|
| Rate for Payer: Mclaren Medicaid |
$22.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.05
|
| Rate for Payer: Meridian Medicaid |
$23.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$103.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: PACE Senior Care Partners |
$29.90
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Commercial |
$107.01
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.52
|
| Rate for Payer: Priority Health Medicare |
$31.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.62
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.78
|
| Rate for Payer: UHC Core |
$105.12
|
| Rate for Payer: UHC Exchange |
$31.47
|
| Rate for Payer: UHC Medicaid |
$22.19
|
| Rate for Payer: UHC Medicare Advantage |
$31.47
|
| Rate for Payer: UHCCP Medicaid |
$22.19
|
| Rate for Payer: VA VA |
$31.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.42
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$125.89
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.62 |
| Max. Negotiated Rate |
$113.30 |
| Rate for Payer: Aetna Commercial |
$107.01
|
| Rate for Payer: BCBS Trust/PPO |
$103.97
|
| Rate for Payer: BCN Commercial |
$103.97
|
| Rate for Payer: Cash Price |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$108.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.71
|
| Rate for Payer: Healthscope Commercial |
$113.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.01
|
| Rate for Payer: Nomi Health Commercial |
$103.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.42
|
| Rate for Payer: PHP Commercial |
$107.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.78
|
| Rate for Payer: UHC Core |
$105.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.42
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.97 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna Medicare |
$19.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.98
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$60.46
|
| Rate for Payer: BCN Commercial |
$60.46
|
| Rate for Payer: BCN Medicare Advantage |
$18.39
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.39
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.16
|
| Rate for Payer: Mclaren Medicaid |
$12.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.30
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Senior Care Partners |
$17.47
|
| Rate for Payer: PACE SWMI |
$18.39
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: PHP Medicare Advantage |
$18.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.98
|
| Rate for Payer: Priority Health Medicare |
$18.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.72
|
| Rate for Payer: UHC Core |
$61.41
|
| Rate for Payer: UHC Exchange |
$18.39
|
| Rate for Payer: UHC Medicaid |
$12.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.39
|
| Rate for Payer: UHCCP Medicaid |
$12.97
|
| Rate for Payer: VA VA |
$18.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.16
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.18 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: BCBS Trust/PPO |
$60.74
|
| Rate for Payer: BCN Commercial |
$60.74
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.72
|
| Rate for Payer: UHC Core |
$61.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.16
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.18 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: BCBS Trust/PPO |
$60.74
|
| Rate for Payer: BCN Commercial |
$60.74
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.72
|
| Rate for Payer: UHC Core |
$61.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.16
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$73.54
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.97 |
| Max. Negotiated Rate |
$66.19 |
| Rate for Payer: Aetna Commercial |
$62.51
|
| Rate for Payer: Aetna Medicare |
$19.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.98
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$60.46
|
| Rate for Payer: BCN Commercial |
$60.46
|
| Rate for Payer: BCN Medicare Advantage |
$18.39
|
| Rate for Payer: Cash Price |
$58.83
|
| Rate for Payer: Cofinity Commercial |
$63.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.39
|
| Rate for Payer: Healthscope Commercial |
$66.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.16
|
| Rate for Payer: Mclaren Medicaid |
$12.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.30
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.51
|
| Rate for Payer: Nomi Health Commercial |
$60.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.16
|
| Rate for Payer: PACE Senior Care Partners |
$17.47
|
| Rate for Payer: PACE SWMI |
$18.39
|
| Rate for Payer: PHP Commercial |
$62.51
|
| Rate for Payer: PHP Medicare Advantage |
$18.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.98
|
| Rate for Payer: Priority Health Medicare |
$18.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.18
|
| Rate for Payer: Railroad Medicare Medicare |
$18.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.72
|
| Rate for Payer: UHC Core |
$61.41
|
| Rate for Payer: UHC Exchange |
$18.39
|
| Rate for Payer: UHC Medicaid |
$12.97
|
| Rate for Payer: UHC Medicare Advantage |
$18.39
|
| Rate for Payer: UHCCP Medicaid |
$12.97
|
| Rate for Payer: VA VA |
$18.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.16
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
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 ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
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 ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| 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 ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| 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
|
|
