|
HC ANTIBODY TO ENA
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200399
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.85 |
| 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 |
$36.85
|
| 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 |
$36.85
|
| 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 |
$36.85 |
| 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 |
$36.85
|
| 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 |
$36.85
|
| 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
|
OP
|
$182.14
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.26 |
| 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 |
$45.53
|
| Rate for Payer: BCBS Trust/PPO |
$149.74
|
| Rate for Payer: BCN Commercial |
$141.61
|
| Rate for Payer: BCN Medicare Advantage |
$45.53
|
| 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 |
$45.53
|
| 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 |
$45.53
|
| Rate for Payer: PHP Commercial |
$154.82
|
| Rate for Payer: PHP Medicare Advantage |
$45.53
|
| 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 |
$45.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.28
|
| Rate for Payer: UHC Core |
$152.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.53
|
| Rate for Payer: UHC Exchange |
$45.53
|
| Rate for Payer: UHC Medicare Advantage |
$45.53
|
| Rate for Payer: VA VA |
$45.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.60
|
|
|
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 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 |
$63.67 |
| 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 |
$63.67
|
| 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 |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| 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 |
$63.67
|
| 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
|
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 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 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 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 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 PATIENT
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86905
|
| Hospital Charge Code |
30200350
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.77 |
| Max. Negotiated Rate |
$102.44 |
| 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 |
$2.91
|
| Rate for Payer: BCBS MAPPO |
$28.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.57
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: BCN Medicare Advantage |
$28.45
|
| 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 |
$28.45
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$2.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$2.91
|
| 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 |
$28.45
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.77
|
| 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 |
$28.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.45
|
| Rate for Payer: UHC Exchange |
$28.45
|
| Rate for Payer: UHC Medicare Advantage |
$28.45
|
| Rate for Payer: UHCCP Medicaid |
$2.77
|
| Rate for Payer: VA VA |
$28.45
|
| 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 |
$4.59 |
| Max. Negotiated Rate |
$102.44 |
| 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 |
$4.82
|
| Rate for Payer: BCBS MAPPO |
$28.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.57
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: BCN Medicare Advantage |
$28.45
|
| 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 |
$28.45
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$4.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$4.82
|
| 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 |
$28.45
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.59
|
| 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 |
$28.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.45
|
| Rate for Payer: UHC Exchange |
$28.45
|
| Rate for Payer: UHC Medicare Advantage |
$28.45
|
| Rate for Payer: UHCCP Medicaid |
$4.59
|
| Rate for Payer: VA VA |
$28.45
|
| 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 BMH
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
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 BMH
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$102.44 |
| 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 |
$4.82
|
| Rate for Payer: BCBS MAPPO |
$28.45
|
| Rate for Payer: BCBS Trust/PPO |
$93.57
|
| Rate for Payer: BCN Commercial |
$88.50
|
| Rate for Payer: BCN Medicare Advantage |
$28.45
|
| 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 |
$28.45
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$4.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.88
|
| Rate for Payer: Meridian Medicaid |
$4.82
|
| 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 |
$28.45
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.59
|
| 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 |
$28.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.16
|
| Rate for Payer: UHC Core |
$95.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.45
|
| Rate for Payer: UHC Exchange |
$28.45
|
| Rate for Payer: UHC Medicare Advantage |
$28.45
|
| Rate for Payer: UHCCP Medicaid |
$4.59
|
| Rate for Payer: VA VA |
$28.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.88
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE Senior Care Partners |
$13.59
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Medicare |
$14.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.30
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.30
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$46.71
|
| Rate for Payer: BCN Commercial |
$44.22
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.57
|
| Rate for Payer: BCN Commercial |
$28.94
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.70
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$30.79
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: BCN Medicare Advantage |
$9.36
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.83
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Senior Care Partners |
$8.89
|
| Rate for Payer: PACE SWMI |
$9.36
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: Railroad Medicare Medicare |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.36
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$9.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.22 |
| Max. Negotiated Rate |
$111.08 |
| Rate for Payer: Aetna Commercial |
$104.91
|
| Rate for Payer: BCBS Trust/PPO |
$100.75
|
| Rate for Payer: BCN Commercial |
$95.38
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$106.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Healthscope Commercial |
$111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: Nomi Health Commercial |
$101.20
|
| Rate for Payer: PHP Commercial |
$104.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: Priority Health HMO/PPO |
$107.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.61
|
| Rate for Payer: UHC Core |
$103.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.92 |
| Max. Negotiated Rate |
$111.08 |
| Rate for Payer: Aetna Commercial |
$104.91
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.57
|
| Rate for Payer: BCBS Complete |
$29.32
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$101.46
|
| Rate for Payer: BCN Commercial |
$95.96
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$106.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$111.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
| Rate for Payer: Mclaren Medicaid |
$27.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$29.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: Nomi Health Commercial |
$101.20
|
| Rate for Payer: PACE Senior Care Partners |
$29.31
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$104.91
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: Priority Health HMO/PPO |
$107.38
|
| Rate for Payer: Priority Health Medicare |
$31.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.61
|
| Rate for Payer: UHC Core |
$103.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$30.86
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$27.92
|
| Rate for Payer: VA VA |
$30.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$72.10
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.87 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$58.86
|
| Rate for Payer: BCN Commercial |
$55.72
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$59.12
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.87
|
| Rate for Payer: Priority Health HMO/PPO |
$62.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.45
|
| Rate for Payer: UHC Core |
$60.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
