|
HC CORTISOL URINE RANDOM
|
Facility
|
IP
|
$73.42
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.78 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: BCBS Trust/PPO |
$56.74
|
| Rate for Payer: BCN Commercial |
$56.74
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.41
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.61
|
| Rate for Payer: UHC Core |
$61.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.06
|
|
|
HC CORTISOL URINE RANDOM
|
Facility
|
OP
|
$73.42
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
30100473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$66.08 |
| Rate for Payer: Aetna Commercial |
$62.41
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.94
|
| Rate for Payer: BCBS Complete |
$12.95
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$57.08
|
| Rate for Payer: BCN Commercial |
$57.08
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cash Price |
$58.74
|
| Rate for Payer: Cofinity Commercial |
$63.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.06
|
| Rate for Payer: Mclaren Medicaid |
$12.33
|
| Rate for Payer: Meridian Medicaid |
$12.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.41
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.41
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.88
|
| Rate for Payer: Priority Health Medicare |
$18.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.78
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.61
|
| Rate for Payer: UHC Core |
$61.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$18.91
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.06
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
IP
|
$26.93
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$24.24 |
| Rate for Payer: Aetna Commercial |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$20.81
|
| Rate for Payer: BCN Commercial |
$20.81
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.54
|
| Rate for Payer: Healthscope Commercial |
$24.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.89
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.70
|
| Rate for Payer: UHC Core |
$22.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.20
|
|
|
HC CORTISOL URINE RANDOM CMPT
|
Facility
|
OP
|
$26.93
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$24.24 |
| Rate for Payer: Aetna Commercial |
$22.89
|
| Rate for Payer: Aetna Medicare |
$7.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.42
|
| Rate for Payer: BCBS Complete |
$18.67
|
| Rate for Payer: BCBS MAPPO |
$6.73
|
| Rate for Payer: BCBS Trust/PPO |
$20.94
|
| Rate for Payer: BCN Commercial |
$20.94
|
| Rate for Payer: BCN Medicare Advantage |
$6.73
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.73
|
| Rate for Payer: Healthscope Commercial |
$24.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.20
|
| Rate for Payer: Mclaren Medicaid |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$18.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.89
|
| Rate for Payer: PACE Senior Care Partners |
$6.40
|
| Rate for Payer: PACE SWMI |
$6.73
|
| Rate for Payer: PHP Commercial |
$22.89
|
| Rate for Payer: PHP Medicare Advantage |
$6.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.43
|
| Rate for Payer: Priority Health Medicare |
$6.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: Railroad Medicare Medicare |
$6.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.70
|
| Rate for Payer: UHC Core |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$6.93
|
| Rate for Payer: VA VA |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.20
|
|
|
HC COTTONWOOD IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC COTTONWOOD IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200082
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$51.06 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: Aetna Medicare |
$55.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.19
|
| Rate for Payer: BCBS Complete |
$61.40
|
| Rate for Payer: BCBS MAPPO |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$167.16
|
| Rate for Payer: BCN Commercial |
$167.16
|
| Rate for Payer: BCN Medicare Advantage |
$53.75
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.75
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Mclaren Medicaid |
$58.47
|
| Rate for Payer: Meridian Medicaid |
$61.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.75
|
| Rate for Payer: PACE Senior Care Partners |
$51.06
|
| Rate for Payer: PACE SWMI |
$53.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: PHP Medicare Advantage |
$53.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.05
|
| Rate for Payer: Priority Health Medicare |
$53.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.13
|
| Rate for Payer: Railroad Medicare Medicare |
$53.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.75
|
| Rate for Payer: UHC Medicare Advantage |
$55.36
|
| Rate for Payer: VA VA |
$53.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
HC COUNSELING LUNG CA SCREENING
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
HCPCS G0296
|
| Hospital Charge Code |
77000011
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$131.13 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna Commercial |
$182.75
|
| Rate for Payer: BCBS Trust/PPO |
$166.15
|
| Rate for Payer: BCN Commercial |
$166.15
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cofinity Commercial |
$184.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.00
|
| Rate for Payer: Healthscope Commercial |
$193.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.75
|
| Rate for Payer: PHP Commercial |
$182.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.20
|
| Rate for Payer: UHC Core |
$179.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.25
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC COURT ORDERED BLOOD ALCOHOL
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100733
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
OP
|
$6,397.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,519.29 |
| Max. Negotiated Rate |
$5,757.30 |
| Rate for Payer: Aetna Commercial |
$5,437.45
|
| Rate for Payer: Aetna Medicare |
$1,663.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,999.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,999.06
|
| Rate for Payer: BCBS Complete |
$2,558.80
|
| Rate for Payer: BCBS MAPPO |
$1,599.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,973.67
|
| Rate for Payer: BCN Commercial |
$4,973.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,599.25
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cofinity Commercial |
$5,501.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,117.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,599.25
|
| Rate for Payer: Healthscope Commercial |
$5,757.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,797.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,679.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,839.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,437.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,519.29
|
| Rate for Payer: PACE SWMI |
$1,599.25
|
| Rate for Payer: PHP Commercial |
$5,437.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,599.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,477.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,565.39
|
| Rate for Payer: Priority Health Medicare |
$1,599.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,901.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,599.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,629.36
|
| Rate for Payer: UHC Core |
$5,341.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,599.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,647.23
|
| Rate for Payer: VA VA |
$1,599.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,797.75
|
|
|
HC COVERED STENT GRAFT
|
Facility
|
IP
|
$6,397.00
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800009
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,901.53 |
| Max. Negotiated Rate |
$5,757.30 |
| Rate for Payer: Aetna Commercial |
$5,437.45
|
| Rate for Payer: BCBS Trust/PPO |
$4,943.60
|
| Rate for Payer: BCN Commercial |
$4,943.60
|
| Rate for Payer: Cash Price |
$5,117.60
|
| Rate for Payer: Cofinity Commercial |
$5,501.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,117.60
|
| Rate for Payer: Healthscope Commercial |
$5,757.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,797.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,437.45
|
| Rate for Payer: PHP Commercial |
$5,437.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,477.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,565.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,901.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,629.36
|
| Rate for Payer: UHC Core |
$5,341.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,797.75
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: BCBS Trust/PPO |
$53.60
|
| Rate for Payer: BCN Commercial |
$53.60
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC COVID 19 ANTIBODY TEST
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200478
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$18.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$32.65
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$53.93
|
| Rate for Payer: BCN Commercial |
$53.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$32.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Senior Care Partners |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.34
|
| Rate for Payer: UHC Medicare Advantage |
$17.86
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC COVID 19 PCR
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.07 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna Medicare |
$31.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.25
|
| Rate for Payer: BCBS Complete |
$39.76
|
| Rate for Payer: BCBS MAPPO |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$95.17
|
| Rate for Payer: BCN Commercial |
$95.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.60
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$37.87
|
| Rate for Payer: Meridian Medicaid |
$39.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PACE Senior Care Partners |
$29.07
|
| Rate for Payer: PACE SWMI |
$30.60
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: PHP Medicare Advantage |
$30.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Medicare |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: Railroad Medicare Medicare |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.60
|
| Rate for Payer: UHC Medicare Advantage |
$31.52
|
| Rate for Payer: VA VA |
$30.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC COVID 19 PCR
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
30600307
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.65 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$94.59
|
| Rate for Payer: BCN Commercial |
$94.59
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
IP
|
$147.90
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.20 |
| Max. Negotiated Rate |
$133.11 |
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: BCBS Trust/PPO |
$114.30
|
| Rate for Payer: BCN Commercial |
$114.30
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.15
|
| Rate for Payer: UHC Core |
$123.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC COVID ABBOTT ID NOW
|
Facility
|
OP
|
$147.90
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600310
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$133.11 |
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: Aetna Medicare |
$38.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.22
|
| Rate for Payer: BCBS Complete |
$39.76
|
| Rate for Payer: BCBS MAPPO |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$114.99
|
| Rate for Payer: BCCCP Commercial |
$25.00
|
| Rate for Payer: BCN Commercial |
$114.99
|
| Rate for Payer: BCN Medicare Advantage |
$36.98
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.98
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Mclaren Medicaid |
$37.87
|
| Rate for Payer: Meridian Medicaid |
$39.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PACE Senior Care Partners |
$35.13
|
| Rate for Payer: PACE SWMI |
$36.98
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: PHP Medicare Advantage |
$36.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.67
|
| Rate for Payer: Priority Health Medicare |
$36.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.15
|
| Rate for Payer: UHC Core |
$123.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.98
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: VA VA |
$36.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$194.30
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$64.35
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC COVID FLU AB RSV GENEMARKERS
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 87637
|
| Hospital Charge Code |
30600316
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$152.41 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$193.12
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.42
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC COXIELLA BURNETTI ANTIBODIES
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200247
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.13 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$33.11
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC COXIELLA BURNETTI ANTIBODIES
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200247
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.39
|
| Rate for Payer: BCBS Complete |
$9.39
|
| Rate for Payer: BCBS MAPPO |
$10.71
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Medicare Advantage |
$10.71
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.71
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$8.94
|
| Rate for Payer: Meridian Medicaid |
$9.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PACE Senior Care Partners |
$10.17
|
| Rate for Payer: PACE SWMI |
$10.71
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Medicare |
$10.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: Railroad Medicare Medicare |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.03
|
| Rate for Payer: VA VA |
$10.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
OP
|
$42.84
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.39
|
| Rate for Payer: BCBS Complete |
$9.39
|
| Rate for Payer: BCBS MAPPO |
$10.71
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Medicare Advantage |
$10.71
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.71
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Mclaren Medicaid |
$8.94
|
| Rate for Payer: Meridian Medicaid |
$9.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PACE Senior Care Partners |
$10.17
|
| Rate for Payer: PACE SWMI |
$10.71
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Medicare |
$10.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: Railroad Medicare Medicare |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.03
|
| Rate for Payer: VA VA |
$10.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC COXIELLA BURNETTI ANTIBODY CMP
|
Facility
|
IP
|
$42.84
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200248
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.13 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$33.11
|
| Rate for Payer: BCN Commercial |
$33.11
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC COXSACKIE A AB CMPT
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200266
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$10.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
