|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$27.42
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$7.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.57
|
| Rate for Payer: BCBS Complete |
$5.08
|
| Rate for Payer: BCBS MAPPO |
$6.86
|
| Rate for Payer: BCBS Trust/PPO |
$22.54
|
| Rate for Payer: BCN Commercial |
$22.54
|
| Rate for Payer: BCN Medicare Advantage |
$6.86
|
| Rate for Payer: Cash Price |
$21.94
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.86
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.57
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.20
|
| Rate for Payer: Meridian Medicaid |
$5.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.31
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.57
|
| Rate for Payer: PACE Senior Care Partners |
$6.51
|
| Rate for Payer: PACE SWMI |
$6.86
|
| Rate for Payer: PHP Commercial |
$23.31
|
| Rate for Payer: PHP Medicare Advantage |
$6.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.86
|
| Rate for Payer: Priority Health Medicare |
$6.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.13
|
| Rate for Payer: UHC Core |
$22.90
|
| Rate for Payer: UHC Exchange |
$6.86
|
| Rate for Payer: UHC Medicaid |
$4.83
|
| Rate for Payer: UHC Medicare Advantage |
$6.86
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: VA VA |
$6.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.57
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$27.42
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: BCBS Trust/PPO |
$22.65
|
| Rate for Payer: BCN Commercial |
$22.65
|
| Rate for Payer: Cash Price |
$21.94
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.94
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.31
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.57
|
| Rate for Payer: PHP Commercial |
$23.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.13
|
| Rate for Payer: UHC Core |
$22.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.57
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: BCBS Trust/PPO |
$15.91
|
| Rate for Payer: BCN Commercial |
$15.91
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Nomi Health Commercial |
$15.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.95
|
| Rate for Payer: UHC Core |
$16.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.45
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna Medicare |
$5.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: BCBS Complete |
$3.57
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$15.83
|
| Rate for Payer: BCN Commercial |
$15.83
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.45
|
| Rate for Payer: Mclaren Medicaid |
$3.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: Meridian Medicaid |
$3.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Nomi Health Commercial |
$15.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PACE Senior Care Partners |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.76
|
| Rate for Payer: Priority Health Medicare |
$4.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.40
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.95
|
| Rate for Payer: UHC Core |
$16.08
|
| Rate for Payer: UHC Exchange |
$4.82
|
| Rate for Payer: UHC Medicaid |
$3.40
|
| Rate for Payer: UHC Medicare Advantage |
$4.82
|
| Rate for Payer: UHCCP Medicaid |
$3.40
|
| Rate for Payer: VA VA |
$4.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.45
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.24 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: BCBS Trust/PPO |
$45.37
|
| Rate for Payer: BCN Commercial |
$45.37
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.17
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$45.17
|
| Rate for Payer: BCN Commercial |
$45.17
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$9.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Senior Care Partners |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Medicare |
$13.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: UHC Exchange |
$13.73
|
| Rate for Payer: UHC Medicaid |
$9.69
|
| Rate for Payer: UHC Medicare Advantage |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$9.69
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC CALCULI
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.28 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$35.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.29
|
| Rate for Payer: UHC Core |
$36.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CALCULI
|
Facility
|
OP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$11.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.60
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS MAPPO |
$10.88
|
| Rate for Payer: BCBS Trust/PPO |
$35.77
|
| Rate for Payer: BCN Commercial |
$35.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.88
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.88
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Mclaren Medicaid |
$7.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.42
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$35.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PACE Senior Care Partners |
$10.33
|
| Rate for Payer: PACE SWMI |
$10.88
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$10.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.85
|
| Rate for Payer: Priority Health Medicare |
$10.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: Railroad Medicare Medicare |
$10.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.29
|
| Rate for Payer: UHC Core |
$36.33
|
| Rate for Payer: UHC Exchange |
$10.88
|
| Rate for Payer: UHC Medicaid |
$7.67
|
| Rate for Payer: UHC Medicare Advantage |
$10.88
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: VA VA |
$10.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$329.01 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: BCBS Trust/PPO |
$390.42
|
| Rate for Payer: BCN Commercial |
$390.42
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$122.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.72
|
| Rate for Payer: BCBS Complete |
$87.50
|
| Rate for Payer: BCBS MAPPO |
$118.18
|
| Rate for Payer: BCBS Trust/PPO |
$388.62
|
| Rate for Payer: BCN Commercial |
$388.62
|
| Rate for Payer: BCN Medicare Advantage |
$118.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$83.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.09
|
| Rate for Payer: Meridian Medicaid |
$87.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Senior Care Partners |
$112.27
|
| Rate for Payer: PACE SWMI |
$118.18
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$118.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: Railroad Medicare Medicare |
$118.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: UHC Exchange |
$118.18
|
| Rate for Payer: UHC Medicaid |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$118.18
|
| Rate for Payer: UHCCP Medicaid |
$83.34
|
| Rate for Payer: VA VA |
$118.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$122.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.72
|
| Rate for Payer: BCBS Complete |
$87.50
|
| Rate for Payer: BCBS MAPPO |
$118.18
|
| Rate for Payer: BCBS Trust/PPO |
$388.62
|
| Rate for Payer: BCN Commercial |
$388.62
|
| Rate for Payer: BCN Medicare Advantage |
$118.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$83.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.09
|
| Rate for Payer: Meridian Medicaid |
$87.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Senior Care Partners |
$112.27
|
| Rate for Payer: PACE SWMI |
$118.18
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$118.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: Railroad Medicare Medicare |
$118.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: UHC Exchange |
$118.18
|
| Rate for Payer: UHC Medicaid |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$118.18
|
| Rate for Payer: UHCCP Medicaid |
$83.34
|
| Rate for Payer: VA VA |
$118.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$329.01 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: BCBS Trust/PPO |
$390.42
|
| Rate for Payer: BCN Commercial |
$390.42
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$387.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$411.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.99
|
| Rate for Payer: UHC Core |
$394.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$167.99 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: BCBS Trust/PPO |
$199.35
|
| Rate for Payer: BCN Commercial |
$199.35
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Nomi Health Commercial |
$197.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$209.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.41
|
| Rate for Payer: UHC Core |
$201.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.03
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: Aetna Medicare |
$62.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.43
|
| Rate for Payer: BCBS Complete |
$44.68
|
| Rate for Payer: BCBS MAPPO |
$60.34
|
| Rate for Payer: BCBS Trust/PPO |
$198.43
|
| Rate for Payer: BCN Commercial |
$198.43
|
| Rate for Payer: BCN Medicare Advantage |
$60.34
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.34
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.03
|
| Rate for Payer: Mclaren Medicaid |
$42.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.36
|
| Rate for Payer: Meridian Medicaid |
$44.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Nomi Health Commercial |
$197.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PACE Senior Care Partners |
$57.33
|
| Rate for Payer: PACE SWMI |
$60.34
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: PHP Medicare Advantage |
$60.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$209.99
|
| Rate for Payer: Priority Health Medicare |
$60.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.99
|
| Rate for Payer: Railroad Medicare Medicare |
$60.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.41
|
| Rate for Payer: UHC Core |
$201.54
|
| Rate for Payer: UHC Exchange |
$60.34
|
| Rate for Payer: UHC Medicaid |
$42.55
|
| Rate for Payer: UHC Medicare Advantage |
$60.34
|
| Rate for Payer: UHCCP Medicaid |
$42.55
|
| Rate for Payer: VA VA |
$60.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.03
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$34.37
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$34.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$477.94 |
| Max. Negotiated Rate |
$618.03 |
| Rate for Payer: Aetna Commercial |
$583.70
|
| Rate for Payer: BCBS Trust/PPO |
$567.15
|
| Rate for Payer: BCN Commercial |
$567.15
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Commercial |
$590.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Healthscope Commercial |
$618.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$563.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: PHP Commercial |
$583.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.30
|
| Rate for Payer: UHC Core |
$573.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.02
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$686.70
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.07 |
| Max. Negotiated Rate |
$618.03 |
| Rate for Payer: Aetna Commercial |
$583.70
|
| Rate for Payer: Aetna Medicare |
$178.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.59
|
| Rate for Payer: BCBS Complete |
$127.11
|
| Rate for Payer: BCBS MAPPO |
$171.68
|
| Rate for Payer: BCBS Trust/PPO |
$564.54
|
| Rate for Payer: BCN Commercial |
$564.54
|
| Rate for Payer: BCN Medicare Advantage |
$171.68
|
| Rate for Payer: Cash Price |
$549.36
|
| Rate for Payer: Cofinity Commercial |
$590.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.68
|
| Rate for Payer: Healthscope Commercial |
$618.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.02
|
| Rate for Payer: Mclaren Medicaid |
$121.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.26
|
| Rate for Payer: Meridian Medicaid |
$127.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Nomi Health Commercial |
$563.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.02
|
| Rate for Payer: PACE Senior Care Partners |
$163.09
|
| Rate for Payer: PACE SWMI |
$171.68
|
| Rate for Payer: PHP Commercial |
$583.70
|
| Rate for Payer: PHP Medicare Advantage |
$171.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$597.43
|
| Rate for Payer: Priority Health Medicare |
$173.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.94
|
| Rate for Payer: Railroad Medicare Medicare |
$171.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.30
|
| Rate for Payer: UHC Core |
$573.39
|
| Rate for Payer: UHC Exchange |
$171.68
|
| Rate for Payer: UHC Medicaid |
$121.07
|
| Rate for Payer: UHC Medicare Advantage |
$171.68
|
| Rate for Payer: UHCCP Medicaid |
$121.07
|
| Rate for Payer: VA VA |
$171.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.02
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna Medicare |
$34.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.95
|
| Rate for Payer: BCBS Complete |
$24.85
|
| Rate for Payer: BCBS MAPPO |
$33.56
|
| Rate for Payer: BCBS Trust/PPO |
$110.36
|
| Rate for Payer: BCN Commercial |
$110.36
|
| Rate for Payer: BCN Medicare Advantage |
$33.56
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.56
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.68
|
| Rate for Payer: Mclaren Medicaid |
$23.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.24
|
| Rate for Payer: Meridian Medicaid |
$24.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PACE Senior Care Partners |
$31.88
|
| Rate for Payer: PACE SWMI |
$33.56
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: PHP Medicare Advantage |
$33.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.79
|
| Rate for Payer: Priority Health Medicare |
$33.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.43
|
| Rate for Payer: Railroad Medicare Medicare |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.13
|
| Rate for Payer: UHC Core |
$112.09
|
| Rate for Payer: UHC Exchange |
$33.56
|
| Rate for Payer: UHC Medicaid |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$33.56
|
| Rate for Payer: UHCCP Medicaid |
$23.67
|
| Rate for Payer: VA VA |
$33.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.68
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$134.24
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$93.43 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: BCBS Trust/PPO |
$110.87
|
| Rate for Payer: BCN Commercial |
$110.87
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.13
|
| Rate for Payer: UHC Core |
$112.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.68
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Senior Care Partners |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Medicare |
$12.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: UHC Exchange |
$12.47
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$12.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$41.20
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
