|
HC CAT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
OP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.48 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: BCBS Complete |
$5.75
|
| Rate for Payer: BCBS MAPPO |
$7.76
|
| Rate for Payer: BCBS Trust/PPO |
$25.53
|
| Rate for Payer: BCN Commercial |
$25.53
|
| Rate for Payer: BCN Medicare Advantage |
$7.76
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.76
|
| Rate for Payer: Healthscope Commercial |
$27.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.30
|
| Rate for Payer: Mclaren Medicaid |
$5.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.15
|
| Rate for Payer: Meridian Medicaid |
$5.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Nomi Health Commercial |
$25.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: PACE Senior Care Partners |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.76
|
| Rate for Payer: PHP Commercial |
$26.40
|
| Rate for Payer: PHP Medicare Advantage |
$7.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.02
|
| Rate for Payer: Priority Health Medicare |
$7.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.62
|
| Rate for Payer: Railroad Medicare Medicare |
$7.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.33
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: UHC Exchange |
$7.76
|
| Rate for Payer: UHC Medicaid |
$5.48
|
| Rate for Payer: UHC Medicare Advantage |
$7.76
|
| Rate for Payer: UHCCP Medicaid |
$5.48
|
| Rate for Payer: VA VA |
$7.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.30
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
IP
|
$31.06
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$26.40
|
| Rate for Payer: BCBS Trust/PPO |
$25.65
|
| Rate for Payer: BCN Commercial |
$25.65
|
| Rate for Payer: Cash Price |
$24.85
|
| Rate for Payer: Cofinity Commercial |
$26.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.85
|
| Rate for Payer: Healthscope Commercial |
$27.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.40
|
| Rate for Payer: Nomi Health Commercial |
$25.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.30
|
| Rate for Payer: PHP Commercial |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.33
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.30
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$4.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.97
|
| Rate for Payer: BCBS Complete |
$3.54
|
| Rate for Payer: BCBS MAPPO |
$4.78
|
| Rate for Payer: BCBS Trust/PPO |
$15.70
|
| Rate for Payer: BCN Commercial |
$15.70
|
| Rate for Payer: BCN Medicare Advantage |
$4.78
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.78
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Mclaren Medicaid |
$3.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.01
|
| Rate for Payer: Meridian Medicaid |
$3.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PACE Senior Care Partners |
$4.54
|
| Rate for Payer: PACE SWMI |
$4.78
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: PHP Medicare Advantage |
$4.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.62
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.29
|
| Rate for Payer: Railroad Medicare Medicare |
$4.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.81
|
| Rate for Payer: UHC Core |
$15.95
|
| Rate for Payer: UHC Exchange |
$4.78
|
| Rate for Payer: UHC Medicaid |
$3.37
|
| Rate for Payer: UHC Medicare Advantage |
$4.78
|
| Rate for Payer: UHCCP Medicaid |
$3.37
|
| Rate for Payer: VA VA |
$4.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.29 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Nomi Health Commercial |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.81
|
| Rate for Payer: UHC Core |
$15.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$129.12 |
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.83
|
| Rate for Payer: BCBS Complete |
$26.56
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS Trust/PPO |
$117.95
|
| Rate for Payer: BCN Commercial |
$117.95
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Healthscope Commercial |
$129.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.60
|
| Rate for Payer: Mclaren Medicaid |
$25.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Medicaid |
$26.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Nomi Health Commercial |
$117.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: PACE Senior Care Partners |
$34.07
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PHP Commercial |
$121.95
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$124.82
|
| Rate for Payer: Priority Health Medicare |
$36.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.86
|
| Rate for Payer: Railroad Medicare Medicare |
$35.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.25
|
| Rate for Payer: UHC Core |
$119.80
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UHC Medicaid |
$25.29
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHCCP Medicaid |
$25.29
|
| Rate for Payer: VA VA |
$35.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.60
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$143.47
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$99.86 |
| Max. Negotiated Rate |
$129.12 |
| Rate for Payer: Aetna Commercial |
$121.95
|
| Rate for Payer: BCBS Trust/PPO |
$118.49
|
| Rate for Payer: BCN Commercial |
$118.49
|
| Rate for Payer: Cash Price |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$123.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.78
|
| Rate for Payer: Healthscope Commercial |
$129.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.95
|
| Rate for Payer: Nomi Health Commercial |
$117.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.60
|
| Rate for Payer: PHP Commercial |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$124.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.25
|
| Rate for Payer: UHC Core |
$119.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.60
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.83 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: BCBS Trust/PPO |
$110.16
|
| Rate for Payer: BCN Commercial |
$110.16
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$109.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.37
|
| Rate for Payer: UHC Core |
$111.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.03
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$133.38
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.51 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: Aetna Medicare |
$34.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.68
|
| Rate for Payer: BCBS Complete |
$24.69
|
| Rate for Payer: BCBS MAPPO |
$33.34
|
| Rate for Payer: BCBS Trust/PPO |
$109.65
|
| Rate for Payer: BCN Commercial |
$109.65
|
| Rate for Payer: BCN Medicare Advantage |
$33.34
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.34
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.03
|
| Rate for Payer: Mclaren Medicaid |
$23.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.01
|
| Rate for Payer: Meridian Medicaid |
$24.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$109.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PACE Senior Care Partners |
$31.68
|
| Rate for Payer: PACE SWMI |
$33.34
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: PHP Medicare Advantage |
$33.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.04
|
| Rate for Payer: Priority Health Medicare |
$33.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.83
|
| Rate for Payer: Railroad Medicare Medicare |
$33.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.37
|
| Rate for Payer: UHC Core |
$111.37
|
| Rate for Payer: UHC Exchange |
$33.34
|
| Rate for Payer: UHC Medicaid |
$23.51
|
| Rate for Payer: UHC Medicare Advantage |
$33.34
|
| Rate for Payer: UHCCP Medicaid |
$23.51
|
| Rate for Payer: VA VA |
$33.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.03
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$130.89 |
| Max. Negotiated Rate |
$169.25 |
| Rate for Payer: Aetna Commercial |
$159.85
|
| Rate for Payer: BCBS Trust/PPO |
$155.32
|
| Rate for Payer: BCN Commercial |
$155.32
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Commercial |
$161.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Healthscope Commercial |
$169.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Nomi Health Commercial |
$154.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: PHP Commercial |
$159.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$163.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.49
|
| Rate for Payer: UHC Core |
$157.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.04
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$188.06
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$169.25 |
| Rate for Payer: Aetna Commercial |
$159.85
|
| Rate for Payer: Aetna Medicare |
$48.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.77
|
| Rate for Payer: BCBS Complete |
$34.81
|
| Rate for Payer: BCBS MAPPO |
$47.02
|
| Rate for Payer: BCBS Trust/PPO |
$154.60
|
| Rate for Payer: BCN Commercial |
$154.60
|
| Rate for Payer: BCN Medicare Advantage |
$47.02
|
| Rate for Payer: Cash Price |
$150.45
|
| Rate for Payer: Cofinity Commercial |
$161.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.02
|
| Rate for Payer: Healthscope Commercial |
$169.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.04
|
| Rate for Payer: Mclaren Medicaid |
$33.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.37
|
| Rate for Payer: Meridian Medicaid |
$34.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.85
|
| Rate for Payer: Nomi Health Commercial |
$154.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.04
|
| Rate for Payer: PACE Senior Care Partners |
$44.66
|
| Rate for Payer: PACE SWMI |
$47.02
|
| Rate for Payer: PHP Commercial |
$159.85
|
| Rate for Payer: PHP Medicare Advantage |
$47.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$163.61
|
| Rate for Payer: Priority Health Medicare |
$47.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.89
|
| Rate for Payer: Railroad Medicare Medicare |
$47.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.49
|
| Rate for Payer: UHC Core |
$157.03
|
| Rate for Payer: UHC Exchange |
$47.02
|
| Rate for Payer: UHC Medicaid |
$33.15
|
| Rate for Payer: UHC Medicare Advantage |
$47.02
|
| Rate for Payer: UHCCP Medicaid |
$33.15
|
| Rate for Payer: VA VA |
$47.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.04
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$194.55
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.30 |
| Max. Negotiated Rate |
$175.09 |
| Rate for Payer: Aetna Commercial |
$165.37
|
| Rate for Payer: Aetna Medicare |
$50.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.80
|
| Rate for Payer: BCBS Complete |
$36.01
|
| Rate for Payer: BCBS MAPPO |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$159.94
|
| Rate for Payer: BCN Commercial |
$159.94
|
| Rate for Payer: BCN Medicare Advantage |
$48.64
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cofinity Commercial |
$167.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.64
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.91
|
| Rate for Payer: Mclaren Medicaid |
$34.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.07
|
| Rate for Payer: Meridian Medicaid |
$36.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.37
|
| Rate for Payer: Nomi Health Commercial |
$159.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.91
|
| Rate for Payer: PACE Senior Care Partners |
$46.21
|
| Rate for Payer: PACE SWMI |
$48.64
|
| Rate for Payer: PHP Commercial |
$165.37
|
| Rate for Payer: PHP Medicare Advantage |
$48.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$169.26
|
| Rate for Payer: Priority Health Medicare |
$49.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.41
|
| Rate for Payer: Railroad Medicare Medicare |
$48.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.20
|
| Rate for Payer: UHC Core |
$162.45
|
| Rate for Payer: UHC Exchange |
$48.64
|
| Rate for Payer: UHC Medicaid |
$34.30
|
| Rate for Payer: UHC Medicare Advantage |
$48.64
|
| Rate for Payer: UHCCP Medicaid |
$34.30
|
| Rate for Payer: VA VA |
$48.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.91
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$194.55
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$135.41 |
| Max. Negotiated Rate |
$175.09 |
| Rate for Payer: Aetna Commercial |
$165.37
|
| Rate for Payer: BCBS Trust/PPO |
$160.68
|
| Rate for Payer: BCN Commercial |
$160.68
|
| Rate for Payer: Cash Price |
$155.64
|
| Rate for Payer: Cofinity Commercial |
$167.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.64
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.37
|
| Rate for Payer: Nomi Health Commercial |
$159.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.91
|
| Rate for Payer: PHP Commercial |
$165.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$169.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.20
|
| Rate for Payer: UHC Core |
$162.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.91
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.28 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: BCBS Trust/PPO |
$180.71
|
| Rate for Payer: BCN Commercial |
$180.71
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Core |
$182.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.10
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna Medicare |
$56.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.38
|
| Rate for Payer: BCBS Complete |
$40.50
|
| Rate for Payer: BCBS MAPPO |
$54.70
|
| Rate for Payer: BCBS Trust/PPO |
$179.88
|
| Rate for Payer: BCN Commercial |
$179.88
|
| Rate for Payer: BCN Medicare Advantage |
$54.70
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.70
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.10
|
| Rate for Payer: Mclaren Medicaid |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.44
|
| Rate for Payer: Meridian Medicaid |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Senior Care Partners |
$51.97
|
| Rate for Payer: PACE SWMI |
$54.70
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: PHP Medicare Advantage |
$54.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.36
|
| Rate for Payer: Priority Health Medicare |
$55.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.28
|
| Rate for Payer: Railroad Medicare Medicare |
$54.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Core |
$182.70
|
| Rate for Payer: UHC Exchange |
$54.70
|
| Rate for Payer: UHC Medicaid |
$38.57
|
| Rate for Payer: UHC Medicare Advantage |
$54.70
|
| Rate for Payer: UHCCP Medicaid |
$38.57
|
| Rate for Payer: VA VA |
$54.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.10
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.28 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: BCBS Trust/PPO |
$180.71
|
| Rate for Payer: BCN Commercial |
$180.71
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Core |
$182.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.10
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$196.92 |
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna Medicare |
$56.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.38
|
| Rate for Payer: BCBS Complete |
$40.50
|
| Rate for Payer: BCBS MAPPO |
$54.70
|
| Rate for Payer: BCBS Trust/PPO |
$179.88
|
| Rate for Payer: BCN Commercial |
$179.88
|
| Rate for Payer: BCN Medicare Advantage |
$54.70
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.70
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.10
|
| Rate for Payer: Mclaren Medicaid |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.44
|
| Rate for Payer: Meridian Medicaid |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$179.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Senior Care Partners |
$51.97
|
| Rate for Payer: PACE SWMI |
$54.70
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: PHP Medicare Advantage |
$54.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.36
|
| Rate for Payer: Priority Health Medicare |
$55.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.28
|
| Rate for Payer: Railroad Medicare Medicare |
$54.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.54
|
| Rate for Payer: UHC Core |
$182.70
|
| Rate for Payer: UHC Exchange |
$54.70
|
| Rate for Payer: UHC Medicaid |
$38.57
|
| Rate for Payer: UHC Medicare Advantage |
$54.70
|
| Rate for Payer: UHCCP Medicaid |
$38.57
|
| Rate for Payer: VA VA |
$54.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.10
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.06
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Commercial |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.25
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.25
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Senior Care Partners |
$6.88
|
| Rate for Payer: PACE SWMI |
$7.25
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$7.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Medicare |
$7.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: UHC Exchange |
$7.25
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHC Medicare Advantage |
$7.25
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: VA VA |
$7.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$23.93
|
| Rate for Payer: BCN Commercial |
$23.93
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.06
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Commercial |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.25
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.25
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Senior Care Partners |
$6.88
|
| Rate for Payer: PACE SWMI |
$7.25
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$7.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Medicare |
$7.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: UHC Exchange |
$7.25
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHC Medicare Advantage |
$7.25
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: VA VA |
$7.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$23.93
|
| Rate for Payer: BCN Commercial |
$23.93
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$859.91 |
| Max. Negotiated Rate |
$1,111.95 |
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,020.40
|
| Rate for Payer: BCN Commercial |
$1,020.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$1,013.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,074.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$859.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.24
|
| Rate for Payer: UHC Core |
$1,031.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.62
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.82 |
| Max. Negotiated Rate |
$1,111.95 |
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: Aetna Medicare |
$321.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$386.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$386.09
|
| Rate for Payer: BCBS Complete |
$228.69
|
| Rate for Payer: BCBS MAPPO |
$308.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.70
|
| Rate for Payer: BCN Commercial |
$1,015.70
|
| Rate for Payer: BCN Medicare Advantage |
$308.88
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.88
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.62
|
| Rate for Payer: Mclaren Medicaid |
$217.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.32
|
| Rate for Payer: Meridian Medicaid |
$228.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$1,013.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PACE Senior Care Partners |
$293.43
|
| Rate for Payer: PACE SWMI |
$308.88
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: PHP Medicare Advantage |
$308.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,074.88
|
| Rate for Payer: Priority Health Medicare |
$311.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$859.91
|
| Rate for Payer: Railroad Medicare Medicare |
$308.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,087.24
|
| Rate for Payer: UHC Core |
$1,031.64
|
| Rate for Payer: UHC Exchange |
$308.88
|
| Rate for Payer: UHC Medicaid |
$217.82
|
| Rate for Payer: UHC Medicare Advantage |
$308.88
|
| Rate for Payer: UHCCP Medicaid |
$217.82
|
| Rate for Payer: VA VA |
$308.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.62
|
|
