|
HC ANOSCOPY
|
Facility
|
IP
|
$162.92
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$105.90 |
| Max. Negotiated Rate |
$146.63 |
| Rate for Payer: Aetna Commercial |
$138.48
|
| Rate for Payer: BCBS Trust/PPO |
$132.99
|
| Rate for Payer: BCN Commercial |
$125.90
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$140.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Healthscope Commercial |
$146.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.48
|
| Rate for Payer: Nomi Health Commercial |
$133.59
|
| Rate for Payer: PHP Commercial |
$138.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.90
|
| Rate for Payer: Priority Health HMO/PPO |
$141.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.37
|
| Rate for Payer: UHC Core |
$136.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.19
|
|
|
HC ANOSCOPY
|
Facility
|
OP
|
$162.92
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$38.69 |
| Max. Negotiated Rate |
$146.63 |
| Rate for Payer: Aetna Commercial |
$138.48
|
| Rate for Payer: Aetna Medicare |
$42.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.91
|
| Rate for Payer: BCBS Complete |
$65.17
|
| Rate for Payer: BCBS MAPPO |
$40.73
|
| Rate for Payer: BCBS Trust/PPO |
$133.94
|
| Rate for Payer: BCN Commercial |
$126.67
|
| Rate for Payer: BCN Medicare Advantage |
$40.73
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$140.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.73
|
| Rate for Payer: Healthscope Commercial |
$146.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.48
|
| Rate for Payer: Nomi Health Commercial |
$133.59
|
| Rate for Payer: PACE Senior Care Partners |
$38.69
|
| Rate for Payer: PACE SWMI |
$40.73
|
| Rate for Payer: PHP Commercial |
$138.48
|
| Rate for Payer: PHP Medicare Advantage |
$40.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.90
|
| Rate for Payer: Priority Health HMO/PPO |
$141.74
|
| Rate for Payer: Priority Health Medicare |
$41.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.16
|
| Rate for Payer: Railroad Medicare Medicare |
$40.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.37
|
| Rate for Payer: UHC Core |
$136.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.73
|
| Rate for Payer: UHC Exchange |
$40.73
|
| Rate for Payer: UHC Medicare Advantage |
$40.73
|
| Rate for Payer: VA VA |
$40.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.19
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$358.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.02 |
| Max. Negotiated Rate |
$322.20 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: Aetna Medicare |
$93.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.88
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$89.50
|
| Rate for Payer: BCBS Trust/PPO |
$294.31
|
| Rate for Payer: BCN Commercial |
$278.34
|
| Rate for Payer: BCN Medicare Advantage |
$89.50
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$307.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.50
|
| Rate for Payer: Healthscope Commercial |
$322.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.50
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.98
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.30
|
| Rate for Payer: Nomi Health Commercial |
$293.56
|
| Rate for Payer: PACE Senior Care Partners |
$85.02
|
| Rate for Payer: PACE SWMI |
$89.50
|
| Rate for Payer: PHP Commercial |
$304.30
|
| Rate for Payer: PHP Medicare Advantage |
$89.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO |
$311.46
|
| Rate for Payer: Priority Health Medicare |
$90.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.86
|
| Rate for Payer: Railroad Medicare Medicare |
$89.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.04
|
| Rate for Payer: UHC Core |
$298.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.50
|
| Rate for Payer: UHC Exchange |
$89.50
|
| Rate for Payer: UHC Medicare Advantage |
$89.50
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.50
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$358.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.70 |
| Max. Negotiated Rate |
$322.20 |
| Rate for Payer: Aetna Commercial |
$304.30
|
| Rate for Payer: BCBS Trust/PPO |
$292.24
|
| Rate for Payer: BCN Commercial |
$276.66
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$307.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.40
|
| Rate for Payer: Healthscope Commercial |
$322.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.30
|
| Rate for Payer: Nomi Health Commercial |
$293.56
|
| Rate for Payer: PHP Commercial |
$304.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.70
|
| Rate for Payer: Priority Health HMO/PPO |
$311.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.04
|
| Rate for Payer: UHC Core |
$298.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.50
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
OP
|
$1,567.19
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.21 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: Aetna Medicare |
$407.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.75
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$391.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.39
|
| Rate for Payer: BCN Commercial |
$1,218.49
|
| Rate for Payer: BCN Medicare Advantage |
$391.80
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.80
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.39
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$1,285.10
|
| Rate for Payer: PACE Senior Care Partners |
$372.21
|
| Rate for Payer: PACE SWMI |
$391.80
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: PHP Medicare Advantage |
$391.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,363.46
|
| Rate for Payer: Priority Health Medicare |
$395.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.02
|
| Rate for Payer: Railroad Medicare Medicare |
$391.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.13
|
| Rate for Payer: UHC Core |
$1,308.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.80
|
| Rate for Payer: UHC Exchange |
$391.80
|
| Rate for Payer: UHC Medicare Advantage |
$391.80
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$391.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
IP
|
$1,567.19
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,018.67 |
| Max. Negotiated Rate |
$1,410.47 |
| Rate for Payer: Aetna Commercial |
$1,332.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.30
|
| Rate for Payer: BCN Commercial |
$1,211.12
|
| Rate for Payer: Cash Price |
$1,253.75
|
| Rate for Payer: Cofinity Commercial |
$1,347.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,253.75
|
| Rate for Payer: Healthscope Commercial |
$1,410.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.11
|
| Rate for Payer: Nomi Health Commercial |
$1,285.10
|
| Rate for Payer: PHP Commercial |
$1,332.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,018.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,363.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.13
|
| Rate for Payer: UHC Core |
$1,308.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.39
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
OP
|
$2,074.35
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$492.66 |
| Max. Negotiated Rate |
$1,866.92 |
| Rate for Payer: Aetna Commercial |
$1,763.20
|
| Rate for Payer: Aetna Medicare |
$539.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.23
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$518.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.32
|
| Rate for Payer: BCN Commercial |
$1,612.81
|
| Rate for Payer: BCN Medicare Advantage |
$518.59
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cofinity Commercial |
$1,783.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.59
|
| Rate for Payer: Healthscope Commercial |
$1,866.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.76
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.52
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.20
|
| Rate for Payer: Nomi Health Commercial |
$1,700.97
|
| Rate for Payer: PACE Senior Care Partners |
$492.66
|
| Rate for Payer: PACE SWMI |
$518.59
|
| Rate for Payer: PHP Commercial |
$1,763.20
|
| Rate for Payer: PHP Medicare Advantage |
$518.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,804.68
|
| Rate for Payer: Priority Health Medicare |
$523.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,389.81
|
| Rate for Payer: Railroad Medicare Medicare |
$518.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.43
|
| Rate for Payer: UHC Core |
$1,732.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.59
|
| Rate for Payer: UHC Exchange |
$518.59
|
| Rate for Payer: UHC Medicare Advantage |
$518.59
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$518.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.76
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
IP
|
$2,074.35
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,348.33 |
| Max. Negotiated Rate |
$1,866.92 |
| Rate for Payer: Aetna Commercial |
$1,763.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.29
|
| Rate for Payer: BCN Commercial |
$1,603.06
|
| Rate for Payer: Cash Price |
$1,659.48
|
| Rate for Payer: Cofinity Commercial |
$1,783.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.48
|
| Rate for Payer: Healthscope Commercial |
$1,866.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.20
|
| Rate for Payer: Nomi Health Commercial |
$1,700.97
|
| Rate for Payer: PHP Commercial |
$1,763.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,804.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,389.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.43
|
| Rate for Payer: UHC Core |
$1,732.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.76
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$117.81
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$106.03 |
| Rate for Payer: Aetna Commercial |
$100.14
|
| Rate for Payer: Aetna Medicare |
$30.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.82
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$29.45
|
| Rate for Payer: BCBS Trust/PPO |
$96.85
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$29.45
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cofinity Commercial |
$101.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.45
|
| Rate for Payer: Healthscope Commercial |
$106.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.36
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.93
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.14
|
| Rate for Payer: Nomi Health Commercial |
$96.60
|
| Rate for Payer: PACE Senior Care Partners |
$27.98
|
| Rate for Payer: PACE SWMI |
$29.45
|
| Rate for Payer: PHP Commercial |
$100.14
|
| Rate for Payer: PHP Medicare Advantage |
$29.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.58
|
| Rate for Payer: Priority Health HMO/PPO |
$102.49
|
| Rate for Payer: Priority Health Medicare |
$29.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.93
|
| Rate for Payer: Railroad Medicare Medicare |
$29.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.67
|
| Rate for Payer: UHC Core |
$98.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.45
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicare Advantage |
$29.45
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$29.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.36
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$117.81
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.58 |
| Max. Negotiated Rate |
$106.03 |
| Rate for Payer: Aetna Commercial |
$100.14
|
| Rate for Payer: BCBS Trust/PPO |
$96.17
|
| Rate for Payer: BCN Commercial |
$91.04
|
| Rate for Payer: Cash Price |
$94.25
|
| Rate for Payer: Cofinity Commercial |
$101.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.25
|
| Rate for Payer: Healthscope Commercial |
$106.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.14
|
| Rate for Payer: Nomi Health Commercial |
$96.60
|
| Rate for Payer: PHP Commercial |
$100.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.58
|
| Rate for Payer: Priority Health HMO/PPO |
$102.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.67
|
| Rate for Payer: UHC Core |
$98.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.36
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$9.42
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$9.42
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.15
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Exchange |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$9.42
|
| Rate for Payer: VA VA |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$18.69
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$18.69
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.15
|
| Rate for Payer: BCBS Complete |
$9.89
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$9.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$9.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Exchange |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$9.42
|
| Rate for Payer: VA VA |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
IP
|
$299.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$194.86 |
| Max. Negotiated Rate |
$269.80 |
| Rate for Payer: Aetna Commercial |
$254.81
|
| Rate for Payer: BCBS Trust/PPO |
$244.71
|
| Rate for Payer: BCN Commercial |
$231.67
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cofinity Commercial |
$257.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.82
|
| Rate for Payer: Healthscope Commercial |
$269.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.81
|
| Rate for Payer: Nomi Health Commercial |
$245.82
|
| Rate for Payer: PHP Commercial |
$254.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.86
|
| Rate for Payer: Priority Health HMO/PPO |
$260.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.81
|
| Rate for Payer: UHC Core |
$250.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.84
|
|
|
HC ANTIBODY ELUTION
|
Facility
|
OP
|
$299.78
|
|
|
Service Code
|
CPT 86860
|
| Hospital Charge Code |
30200341
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.20 |
| Max. Negotiated Rate |
$269.80 |
| Rate for Payer: Aetna Commercial |
$254.81
|
| Rate for Payer: Aetna Medicare |
$77.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.68
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$74.94
|
| Rate for Payer: BCBS Trust/PPO |
$246.45
|
| Rate for Payer: BCN Commercial |
$233.08
|
| Rate for Payer: BCN Medicare Advantage |
$74.94
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cash Price |
$239.82
|
| Rate for Payer: Cofinity Commercial |
$257.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.94
|
| Rate for Payer: Healthscope Commercial |
$269.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.84
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.69
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.81
|
| Rate for Payer: Nomi Health Commercial |
$245.82
|
| Rate for Payer: PACE Senior Care Partners |
$71.20
|
| Rate for Payer: PACE SWMI |
$74.94
|
| Rate for Payer: PHP Commercial |
$254.81
|
| Rate for Payer: PHP Medicare Advantage |
$74.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.86
|
| Rate for Payer: Priority Health HMO/PPO |
$260.81
|
| Rate for Payer: Priority Health Medicare |
$75.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.85
|
| Rate for Payer: Railroad Medicare Medicare |
$74.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.81
|
| Rate for Payer: UHC Core |
$250.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.94
|
| Rate for Payer: UHC Exchange |
$74.94
|
| Rate for Payer: UHC Medicare Advantage |
$74.94
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$74.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.84
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$213.28
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.65 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$181.29
|
| Rate for Payer: Aetna Medicare |
$55.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.65
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$53.32
|
| Rate for Payer: BCBS Trust/PPO |
$175.34
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$53.32
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$183.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.32
|
| Rate for Payer: Healthscope Commercial |
$191.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.96
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.99
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: PACE Senior Care Partners |
$50.65
|
| Rate for Payer: PACE SWMI |
$53.32
|
| Rate for Payer: PHP Commercial |
$181.29
|
| Rate for Payer: PHP Medicare Advantage |
$53.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health HMO/PPO |
$185.55
|
| Rate for Payer: Priority Health Medicare |
$53.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.90
|
| Rate for Payer: Railroad Medicare Medicare |
$53.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.69
|
| Rate for Payer: UHC Core |
$178.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.32
|
| Rate for Payer: UHC Exchange |
$53.32
|
| Rate for Payer: UHC Medicare Advantage |
$53.32
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$53.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.96
|
|
|
HC ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$213.28
|
|
|
Service Code
|
CPT 86870
|
| Hospital Charge Code |
30200342
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$138.63 |
| Max. Negotiated Rate |
$191.95 |
| Rate for Payer: Aetna Commercial |
$181.29
|
| Rate for Payer: BCBS Trust/PPO |
$174.10
|
| Rate for Payer: BCN Commercial |
$164.82
|
| Rate for Payer: Cash Price |
$170.62
|
| Rate for Payer: Cofinity Commercial |
$183.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.62
|
| Rate for Payer: Healthscope Commercial |
$191.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.29
|
| Rate for Payer: Nomi Health Commercial |
$174.89
|
| Rate for Payer: PHP Commercial |
$181.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.63
|
| Rate for Payer: Priority Health HMO/PPO |
$185.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.69
|
| Rate for Payer: UHC Core |
$178.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.96
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
OP
|
$93.84
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$84.46 |
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: Aetna Medicare |
$24.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.32
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$23.46
|
| Rate for Payer: BCBS Trust/PPO |
$77.15
|
| Rate for Payer: BCN Commercial |
$72.96
|
| Rate for Payer: BCN Medicare Advantage |
$23.46
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.38
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.63
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.76
|
| Rate for Payer: Nomi Health Commercial |
$76.95
|
| Rate for Payer: PACE Senior Care Partners |
$22.29
|
| Rate for Payer: PACE SWMI |
$23.46
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: PHP Medicare Advantage |
$23.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.00
|
| Rate for Payer: Priority Health HMO/PPO |
$81.64
|
| Rate for Payer: Priority Health Medicare |
$23.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.58
|
| Rate for Payer: UHC Core |
$78.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.46
|
| Rate for Payer: UHC Exchange |
$23.46
|
| Rate for Payer: UHC Medicare Advantage |
$23.46
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$23.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.38
|
|
|
HC ANTIBODY ID: LEUKOCYTE ANTIBODY
|
Facility
|
IP
|
$93.84
|
|
|
Service Code
|
CPT 86021
|
| Hospital Charge Code |
30200127
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.00 |
| Max. Negotiated Rate |
$84.46 |
| Rate for Payer: Aetna Commercial |
$79.76
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$72.52
|
| Rate for Payer: Cash Price |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$80.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.07
|
| Rate for Payer: Healthscope Commercial |
$84.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.76
|
| Rate for Payer: Nomi Health Commercial |
$76.95
|
| Rate for Payer: PHP Commercial |
$79.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.00
|
| Rate for Payer: Priority Health HMO/PPO |
$81.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.58
|
| Rate for Payer: UHC Core |
$78.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.38
|
|
|
HC ANTIBODY LYME DISEASE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$11.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.70
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.70
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.70
|
| Rate for Payer: UHC Exchange |
$11.70
|
| Rate for Payer: UHC Medicare Advantage |
$11.70
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: VA VA |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
