|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$14.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.61
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$14.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.81
|
| Rate for Payer: BCN Commercial |
$43.81
|
| Rate for Payer: BCN Medicare Advantage |
$14.09
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.26
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PACE Senior Care Partners |
$13.38
|
| Rate for Payer: PACE SWMI |
$14.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.02
|
| Rate for Payer: Priority Health Medicare |
$14.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.37
|
| Rate for Payer: Railroad Medicare Medicare |
$14.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.59
|
| Rate for Payer: UHC Core |
$47.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$14.51
|
| Rate for Payer: VA VA |
$14.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.26
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
IP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.37 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: BCBS Trust/PPO |
$43.55
|
| Rate for Payer: BCN Commercial |
$43.55
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.59
|
| Rate for Payer: UHC Core |
$47.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.26
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$14.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.61
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$14.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.81
|
| Rate for Payer: BCN Commercial |
$43.81
|
| Rate for Payer: BCN Medicare Advantage |
$14.09
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.26
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PACE Senior Care Partners |
$13.38
|
| Rate for Payer: PACE SWMI |
$14.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.02
|
| Rate for Payer: Priority Health Medicare |
$14.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.37
|
| Rate for Payer: Railroad Medicare Medicare |
$14.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.59
|
| Rate for Payer: UHC Core |
$47.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$14.51
|
| Rate for Payer: VA VA |
$14.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.26
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.03 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.12
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$10.03
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$24.27
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$10.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.04
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$14.19
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Medicare |
$4.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.74
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$4.59
|
| Rate for Payer: BCBS Trust/PPO |
$14.27
|
| Rate for Payer: BCN Commercial |
$14.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.59
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.59
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Mclaren Medicaid |
$4.93
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PACE Senior Care Partners |
$4.36
|
| Rate for Payer: PACE SWMI |
$4.59
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: PHP Medicare Advantage |
$4.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$4.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: Railroad Medicare Medicare |
$4.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.16
|
| Rate for Payer: UHC Core |
$15.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.59
|
| Rate for Payer: UHC Medicare Advantage |
$4.73
|
| Rate for Payer: VA VA |
$4.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: BCBS Trust/PPO |
$36.32
|
| Rate for Payer: BCN Commercial |
$36.32
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$36.54
|
| Rate for Payer: BCN Commercial |
$36.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.75
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.75
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.16
|
| Rate for Payer: PACE SWMI |
$11.75
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Medicare |
$11.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.10
|
| Rate for Payer: VA VA |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC CYCLOSPORINE
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$13.32
|
| Rate for Payer: Meridian Medicaid |
$13.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYCLOSPORINE
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$16.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.31
|
| Rate for Payer: BCBS Complete |
$14.35
|
| Rate for Payer: BCBS MAPPO |
$16.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$50.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$13.67
|
| Rate for Payer: Meridian Medicaid |
$14.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$16.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.25
|
| Rate for Payer: UHC Medicare Advantage |
$16.74
|
| Rate for Payer: VA VA |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.23
|
| Rate for Payer: BCN Commercial |
$50.23
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
IP
|
$66.46
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.53 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: BCBS Trust/PPO |
$51.36
|
| Rate for Payer: BCN Commercial |
$51.36
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cofinity Commercial |
$57.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.17
|
| Rate for Payer: Healthscope Commercial |
$59.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.49
|
| Rate for Payer: PHP Commercial |
$56.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.48
|
| Rate for Payer: UHC Core |
$55.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.84
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
OP
|
$66.46
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.67 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: Aetna Medicare |
$17.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.77
|
| Rate for Payer: BCBS Complete |
$14.35
|
| Rate for Payer: BCBS MAPPO |
$16.62
|
| Rate for Payer: BCBS Trust/PPO |
$51.67
|
| Rate for Payer: BCN Commercial |
$51.67
|
| Rate for Payer: BCN Medicare Advantage |
$16.62
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cash Price |
$53.17
|
| Rate for Payer: Cofinity Commercial |
$57.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$59.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.84
|
| Rate for Payer: Mclaren Medicaid |
$13.67
|
| Rate for Payer: Meridian Medicaid |
$14.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.49
|
| Rate for Payer: PACE Senior Care Partners |
$15.78
|
| Rate for Payer: PACE SWMI |
$16.62
|
| Rate for Payer: PHP Commercial |
$56.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.82
|
| Rate for Payer: Priority Health Medicare |
$16.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.53
|
| Rate for Payer: Railroad Medicare Medicare |
$16.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.48
|
| Rate for Payer: UHC Core |
$55.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.62
|
| Rate for Payer: UHC Medicare Advantage |
$17.11
|
| Rate for Payer: VA VA |
$16.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.84
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
IP
|
$1,715.49
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,046.28 |
| Max. Negotiated Rate |
$1,543.94 |
| Rate for Payer: Aetna Commercial |
$1,458.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,325.73
|
| Rate for Payer: BCN Commercial |
$1,325.73
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cofinity Commercial |
$1,475.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.39
|
| Rate for Payer: Healthscope Commercial |
$1,543.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,286.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,458.17
|
| Rate for Payer: PHP Commercial |
$1,458.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,492.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,046.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,509.63
|
| Rate for Payer: UHC Core |
$1,432.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,286.62
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
OP
|
$1,715.49
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$407.43 |
| Max. Negotiated Rate |
$1,543.94 |
| Rate for Payer: Aetna Commercial |
$1,458.17
|
| Rate for Payer: Aetna Medicare |
$446.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$536.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$536.09
|
| Rate for Payer: BCBS Complete |
$431.31
|
| Rate for Payer: BCBS MAPPO |
$428.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.79
|
| Rate for Payer: BCN Commercial |
$1,333.79
|
| Rate for Payer: BCN Medicare Advantage |
$428.87
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cash Price |
$1,372.39
|
| Rate for Payer: Cofinity Commercial |
$1,475.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,372.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$428.87
|
| Rate for Payer: Healthscope Commercial |
$1,543.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,286.62
|
| Rate for Payer: Mclaren Medicaid |
$410.77
|
| Rate for Payer: Meridian Medicaid |
$431.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$450.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$493.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,458.17
|
| Rate for Payer: PACE Senior Care Partners |
$407.43
|
| Rate for Payer: PACE SWMI |
$428.87
|
| Rate for Payer: PHP Commercial |
$1,458.17
|
| Rate for Payer: PHP Medicare Advantage |
$428.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$410.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,492.48
|
| Rate for Payer: Priority Health Medicare |
$428.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,046.28
|
| Rate for Payer: Railroad Medicare Medicare |
$428.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,509.63
|
| Rate for Payer: UHC Core |
$1,432.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.87
|
| Rate for Payer: UHC Medicare Advantage |
$441.74
|
| Rate for Payer: VA VA |
$428.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,286.62
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.47 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$14.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Aetna Commercial |
$0.23
|
| Rate for Payer: Aetna Medicare |
$0.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.08
|
| Rate for Payer: BCBS Complete |
$0.11
|
| Rate for Payer: BCBS MAPPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.21
|
| Rate for Payer: BCN Commercial |
$0.21
|
| Rate for Payer: BCN Medicare Advantage |
$0.07
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.07
|
| Rate for Payer: Healthscope Commercial |
$0.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.23
|
| Rate for Payer: PACE Senior Care Partners |
$0.06
|
| Rate for Payer: PACE SWMI |
$0.07
|
| Rate for Payer: PHP Commercial |
$0.23
|
| Rate for Payer: PHP Medicare Advantage |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.23
|
| Rate for Payer: Priority Health Medicare |
$0.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.16
|
| Rate for Payer: Railroad Medicare Medicare |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.24
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.07
|
| Rate for Payer: UHC Medicare Advantage |
$0.07
|
| Rate for Payer: VA VA |
$0.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.20
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
IP
|
$0.27
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Aetna Commercial |
$0.23
|
| Rate for Payer: BCBS Trust/PPO |
$0.21
|
| Rate for Payer: BCN Commercial |
$0.21
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Healthscope Commercial |
$0.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.23
|
| Rate for Payer: PHP Commercial |
$0.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.24
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.20
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
IP
|
$6,151.43
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,751.76 |
| Max. Negotiated Rate |
$5,536.29 |
| Rate for Payer: Aetna Commercial |
$5,228.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,753.83
|
| Rate for Payer: BCN Commercial |
$4,753.83
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cofinity Commercial |
$5,290.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,921.14
|
| Rate for Payer: Healthscope Commercial |
$5,536.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,613.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,228.72
|
| Rate for Payer: PHP Commercial |
$5,228.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,306.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,351.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,751.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,413.26
|
| Rate for Payer: UHC Core |
$5,136.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,613.57
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
OP
|
$6,151.43
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,460.96 |
| Max. Negotiated Rate |
$5,536.29 |
| Rate for Payer: Aetna Commercial |
$5,228.72
|
| Rate for Payer: Aetna Medicare |
$1,599.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,922.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,922.32
|
| Rate for Payer: BCBS Complete |
$3,564.05
|
| Rate for Payer: BCBS MAPPO |
$1,537.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,782.74
|
| Rate for Payer: BCN Commercial |
$4,782.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,537.86
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cash Price |
$4,921.14
|
| Rate for Payer: Cofinity Commercial |
$5,290.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,921.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,537.86
|
| Rate for Payer: Healthscope Commercial |
$5,536.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,613.57
|
| Rate for Payer: Mclaren Medicaid |
$3,394.34
|
| Rate for Payer: Meridian Medicaid |
$3,564.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,614.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,768.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,228.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,460.96
|
| Rate for Payer: PACE SWMI |
$1,537.86
|
| Rate for Payer: PHP Commercial |
$5,228.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,537.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,394.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,306.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,351.74
|
| Rate for Payer: Priority Health Medicare |
$1,537.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,751.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,537.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,413.26
|
| Rate for Payer: UHC Core |
$5,136.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,537.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,583.99
|
| Rate for Payer: VA VA |
$1,537.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,613.57
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 4 OR MORE IMPLANTS
|
Facility
|
IP
|
$12,343.94
|
|
|
Service Code
|
HCPCS C9740
|
| Hospital Charge Code |
76100197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,528.57 |
| Max. Negotiated Rate |
$11,109.55 |
| Rate for Payer: Aetna Commercial |
$10,492.35
|
| Rate for Payer: BCBS Trust/PPO |
$9,539.40
|
| Rate for Payer: BCN Commercial |
$9,539.40
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cofinity Commercial |
$10,615.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,875.15
|
| Rate for Payer: Healthscope Commercial |
$11,109.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,257.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,492.35
|
| Rate for Payer: PHP Commercial |
$10,492.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,640.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,739.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,528.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,862.67
|
| Rate for Payer: UHC Core |
$10,307.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,257.96
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 4 OR MORE IMPLANTS
|
Facility
|
OP
|
$12,343.94
|
|
|
Service Code
|
HCPCS C9740
|
| Hospital Charge Code |
76100197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,931.69 |
| Max. Negotiated Rate |
$11,109.55 |
| Rate for Payer: Aetna Commercial |
$10,492.35
|
| Rate for Payer: Aetna Medicare |
$3,209.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,857.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,857.48
|
| Rate for Payer: BCBS Complete |
$6,345.36
|
| Rate for Payer: BCBS MAPPO |
$3,085.98
|
| Rate for Payer: BCBS Trust/PPO |
$9,597.41
|
| Rate for Payer: BCN Commercial |
$9,597.41
|
| Rate for Payer: BCN Medicare Advantage |
$3,085.98
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cash Price |
$9,875.15
|
| Rate for Payer: Cofinity Commercial |
$10,615.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,875.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,085.98
|
| Rate for Payer: Healthscope Commercial |
$11,109.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,257.96
|
| Rate for Payer: Mclaren Medicaid |
$6,043.20
|
| Rate for Payer: Meridian Medicaid |
$6,345.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,240.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,548.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,492.35
|
| Rate for Payer: PACE Senior Care Partners |
$2,931.69
|
| Rate for Payer: PACE SWMI |
$3,085.98
|
| Rate for Payer: PHP Commercial |
$10,492.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,085.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,043.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,640.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,739.23
|
| Rate for Payer: Priority Health Medicare |
$3,085.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,528.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,085.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,862.67
|
| Rate for Payer: UHC Core |
$10,307.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,085.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,178.56
|
| Rate for Payer: VA VA |
$3,085.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,257.96
|
|
