|
HC ANTIBODY LYME DISEASE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200234
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| 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: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
OP
|
$34.33
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.73
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$8.58
|
| Rate for Payer: BCBS Trust/PPO |
$28.22
|
| Rate for Payer: BCN Commercial |
$26.69
|
| Rate for Payer: BCN Medicare Advantage |
$8.58
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.58
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.75
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.01
|
| Rate for Payer: Meridian Medicaid |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.18
|
| Rate for Payer: Nomi Health Commercial |
$28.15
|
| Rate for Payer: PACE Senior Care Partners |
$8.15
|
| Rate for Payer: PACE SWMI |
$8.58
|
| Rate for Payer: PHP Commercial |
$29.18
|
| Rate for Payer: PHP Medicare Advantage |
$8.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.31
|
| Rate for Payer: Priority Health HMO/PPO |
$29.87
|
| Rate for Payer: Priority Health Medicare |
$8.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.58
|
| Rate for Payer: UHC Exchange |
$8.58
|
| Rate for Payer: UHC Medicare Advantage |
$8.58
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$8.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.75
|
|
|
HC ANTIBODY LYME DISEASE CONFIRMATION
|
Facility
|
IP
|
$34.33
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200233
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.31 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.02
|
| Rate for Payer: BCN Commercial |
$26.53
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.46
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.18
|
| Rate for Payer: Nomi Health Commercial |
$28.15
|
| Rate for Payer: PHP Commercial |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.31
|
| Rate for Payer: Priority Health HMO/PPO |
$29.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.75
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.28 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: BCBS Trust/PPO |
$54.36
|
| Rate for Payer: BCN Commercial |
$51.46
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ANTIBODY LYME DISEASE CSF
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200235
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.81
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$51.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.65
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.48
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PACE Senior Care Partners |
$15.82
|
| Rate for Payer: PACE SWMI |
$16.65
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Medicare |
$16.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: Railroad Medicare Medicare |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.65
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$16.65
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: VA VA |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
IP
|
$85.58
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.63 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: BCBS Trust/PPO |
$69.86
|
| Rate for Payer: BCN Commercial |
$66.14
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health HMO/PPO |
$74.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.31
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.18
|
|
|
HC ANTIBODY THYROGLOBULIN
|
Facility
|
OP
|
$85.58
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200334
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$22.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.74
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$21.40
|
| Rate for Payer: BCBS Trust/PPO |
$70.36
|
| Rate for Payer: BCN Commercial |
$66.54
|
| Rate for Payer: BCN Medicare Advantage |
$21.40
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.18
|
| Rate for Payer: Mclaren Medicaid |
$11.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.46
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: PACE Senior Care Partners |
$20.33
|
| Rate for Payer: PACE SWMI |
$21.40
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: PHP Medicare Advantage |
$21.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health HMO/PPO |
$74.45
|
| Rate for Payer: Priority Health Medicare |
$21.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.34
|
| Rate for Payer: Railroad Medicare Medicare |
$21.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.31
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.40
|
| Rate for Payer: UHC Exchange |
$21.40
|
| Rate for Payer: UHC Medicare Advantage |
$21.40
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: VA VA |
$21.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.18
|
|
|
HC ANTIBODY TITER
|
Facility
|
IP
|
$271.93
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$176.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Aetna Commercial |
$231.14
|
| Rate for Payer: BCBS Trust/PPO |
$221.98
|
| Rate for Payer: BCN Commercial |
$210.15
|
| Rate for Payer: Cash Price |
$217.54
|
| Rate for Payer: Cofinity Commercial |
$233.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.54
|
| Rate for Payer: Healthscope Commercial |
$244.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.14
|
| Rate for Payer: Nomi Health Commercial |
$222.98
|
| Rate for Payer: PHP Commercial |
$231.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.75
|
| Rate for Payer: Priority Health HMO/PPO |
$236.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.30
|
| Rate for Payer: UHC Core |
$227.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.95
|
|
|
HC ANTIBODY TITER
|
Facility
|
OP
|
$271.93
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.58 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Aetna Commercial |
$231.14
|
| Rate for Payer: Aetna Medicare |
$70.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.98
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$67.98
|
| Rate for Payer: BCBS Trust/PPO |
$223.55
|
| Rate for Payer: BCN Commercial |
$211.43
|
| Rate for Payer: BCN Medicare Advantage |
$67.98
|
| Rate for Payer: Cash Price |
$217.54
|
| Rate for Payer: Cash Price |
$217.54
|
| Rate for Payer: Cofinity Commercial |
$233.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.98
|
| Rate for Payer: Healthscope Commercial |
$244.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.95
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.38
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.14
|
| Rate for Payer: Nomi Health Commercial |
$222.98
|
| Rate for Payer: PACE Senior Care Partners |
$64.58
|
| Rate for Payer: PACE SWMI |
$67.98
|
| Rate for Payer: PHP Commercial |
$231.14
|
| Rate for Payer: PHP Medicare Advantage |
$67.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.75
|
| Rate for Payer: Priority Health HMO/PPO |
$236.58
|
| Rate for Payer: Priority Health Medicare |
$68.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.19
|
| Rate for Payer: Railroad Medicare Medicare |
$67.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.30
|
| Rate for Payer: UHC Core |
$227.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.98
|
| Rate for Payer: UHC Exchange |
$67.98
|
| Rate for Payer: UHC Medicare Advantage |
$67.98
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$67.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.95
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.86 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: BCBS Trust/PPO |
$46.28
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.20
|
| Rate for Payer: Nomi Health Commercial |
$46.49
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC ANTIBODY TO ENA
|
Facility
|
OP
|
$56.70
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$14.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$44.08
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.88
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.20
|
| Rate for Payer: Nomi Health Commercial |
$46.49
|
| Rate for Payer: PACE Senior Care Partners |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49.33
|
| Rate for Payer: Priority Health Medicare |
$14.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.99
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.86 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: BCBS Trust/PPO |
$46.28
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.20
|
| Rate for Payer: Nomi Health Commercial |
$46.49
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC ANTIBODY TO ENA CMPT
|
Facility
|
OP
|
$56.70
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200400
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$14.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$46.61
|
| Rate for Payer: BCN Commercial |
$44.08
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.88
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.20
|
| Rate for Payer: Nomi Health Commercial |
$46.49
|
| Rate for Payer: PACE Senior Care Partners |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49.33
|
| Rate for Payer: Priority Health Medicare |
$14.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.99
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
IP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.39 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: BCBS Trust/PPO |
$148.68
|
| Rate for Payer: BCN Commercial |
$140.76
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.39
|
| Rate for Payer: Priority Health HMO/PPO |
$158.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTICOAG EST PATIENT LEVEL I
|
Facility
|
OP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$163.93 |
| Rate for Payer: Aetna Commercial |
$154.82
|
| Rate for Payer: Aetna Medicare |
$47.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.92
|
| Rate for Payer: BCBS Complete |
$72.86
|
| Rate for Payer: BCBS MAPPO |
$45.54
|
| Rate for Payer: BCBS Trust/PPO |
$149.74
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$141.61
|
| Rate for Payer: BCN Medicare Advantage |
$45.54
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cash Price |
$145.71
|
| Rate for Payer: Cofinity Commercial |
$156.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.54
|
| Rate for Payer: Healthscope Commercial |
$163.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.82
|
| Rate for Payer: Nomi Health Commercial |
$149.35
|
| Rate for Payer: PACE Senior Care Partners |
$43.26
|
| Rate for Payer: PACE SWMI |
$45.54
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.39
|
| Rate for Payer: Priority Health HMO/PPO |
$158.46
|
| Rate for Payer: Priority Health Medicare |
$45.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$122.03
|
| Rate for Payer: Railroad Medicare Medicare |
$45.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.54
|
| Rate for Payer: UHC Exchange |
$45.54
|
| Rate for Payer: UHC Medicare Advantage |
$45.54
|
| Rate for Payer: VA VA |
$45.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$63.68 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$57.75
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC ANTIDIURETIC HORMONE
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 84588
|
| Hospital Charge Code |
30100457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$63.68 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$25.77
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$55.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$24.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$25.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.69
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$24.54
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
IP
|
$73.87
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$66.48 |
| Rate for Payer: Aetna Commercial |
$62.79
|
| Rate for Payer: BCBS Trust/PPO |
$60.30
|
| Rate for Payer: BCN Commercial |
$57.09
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Commercial |
$63.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$60.57
|
| Rate for Payer: PHP Commercial |
$62.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: Priority Health HMO/PPO |
$64.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.01
|
| Rate for Payer: UHC Core |
$61.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.40
|
|
|
HC ANTIEMETIC ONDANSETRON ORAL
|
Facility
|
OP
|
$73.87
|
|
|
Service Code
|
HCPCS J8597
|
| Hospital Charge Code |
63600182
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$66.48 |
| Rate for Payer: Aetna Commercial |
$62.79
|
| Rate for Payer: Aetna Medicare |
$19.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.08
|
| Rate for Payer: BCBS Complete |
$29.55
|
| Rate for Payer: BCBS MAPPO |
$18.47
|
| Rate for Payer: BCBS Trust/PPO |
$60.73
|
| Rate for Payer: BCN Commercial |
$57.43
|
| Rate for Payer: BCN Medicare Advantage |
$18.47
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Commercial |
$63.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.47
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$60.57
|
| Rate for Payer: PACE Senior Care Partners |
$17.54
|
| Rate for Payer: PACE SWMI |
$18.47
|
| Rate for Payer: PHP Commercial |
$62.79
|
| Rate for Payer: PHP Medicare Advantage |
$18.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.02
|
| Rate for Payer: Priority Health HMO/PPO |
$64.27
|
| Rate for Payer: Priority Health Medicare |
$18.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.49
|
| Rate for Payer: Railroad Medicare Medicare |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.01
|
| Rate for Payer: UHC Core |
$61.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.47
|
| Rate for Payer: UHC Exchange |
$18.47
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: VA VA |
$18.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.40
|
|
|
HC ANTI FACTOR XA
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$9.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$9.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$9.46
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ANTI FACTOR XA
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$63.70
|
| Rate for Payer: BCN Commercial |
$60.30
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.03 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: Aetna Medicare |
$29.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.57
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$93.57
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PACE Senior Care Partners |
$27.03
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO |
$99.02
|
| Rate for Payer: Priority Health Medicare |
$28.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.26
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.46
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicare Advantage |
$28.46
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTIGEN TYPE PATIENT
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$102.44 |
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: BCBS Trust/PPO |
$92.91
|
| Rate for Payer: BCN Commercial |
$87.96
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO |
$99.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$102.44 |
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: BCBS Trust/PPO |
$92.91
|
| Rate for Payer: BCN Commercial |
$87.96
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO |
$99.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTIGEN TYPE UNIT BBC
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.03 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: Aetna Medicare |
$29.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.57
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$28.46
|
| Rate for Payer: BCBS Trust/PPO |
$93.57
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: BCN Medicare Advantage |
$28.46
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.46
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$93.33
|
| Rate for Payer: PACE Senior Care Partners |
$27.03
|
| Rate for Payer: PACE SWMI |
$28.46
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO |
$99.02
|
| Rate for Payer: Priority Health Medicare |
$28.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.26
|
| Rate for Payer: Railroad Medicare Medicare |
$28.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.46
|
| Rate for Payer: UHC Exchange |
$28.46
|
| Rate for Payer: UHC Medicare Advantage |
$28.46
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$28.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
