|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
OP
|
$89.66
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$21.29 |
| Max. Negotiated Rate |
$109.82 |
| Rate for Payer: Aetna Commercial |
$76.21
|
| Rate for Payer: Aetna Medicare |
$23.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.02
|
| Rate for Payer: BCBS Complete |
$109.82
|
| Rate for Payer: BCBS MAPPO |
$22.42
|
| Rate for Payer: BCBS Trust/PPO |
$69.71
|
| Rate for Payer: BCN Commercial |
$69.71
|
| Rate for Payer: BCN Medicare Advantage |
$22.42
|
| Rate for Payer: Cash Price |
$71.73
|
| Rate for Payer: Cash Price |
$71.73
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.42
|
| Rate for Payer: Healthscope Commercial |
$80.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.24
|
| Rate for Payer: Mclaren Medicaid |
$104.59
|
| Rate for Payer: Meridian Medicaid |
$109.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.21
|
| Rate for Payer: PACE Senior Care Partners |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.42
|
| Rate for Payer: PHP Commercial |
$76.21
|
| Rate for Payer: PHP Medicare Advantage |
$22.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.00
|
| Rate for Payer: Priority Health Medicare |
$22.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.68
|
| Rate for Payer: Railroad Medicare Medicare |
$22.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.90
|
| Rate for Payer: UHC Core |
$74.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.42
|
| Rate for Payer: UHC Medicare Advantage |
$23.09
|
| Rate for Payer: VA VA |
$22.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.24
|
|
|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
IP
|
$89.66
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$54.68 |
| Max. Negotiated Rate |
$80.69 |
| Rate for Payer: Aetna Commercial |
$76.21
|
| Rate for Payer: BCBS Trust/PPO |
$69.29
|
| Rate for Payer: BCN Commercial |
$69.29
|
| Rate for Payer: Cash Price |
$71.73
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.73
|
| Rate for Payer: Healthscope Commercial |
$80.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.21
|
| Rate for Payer: PHP Commercial |
$76.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.90
|
| Rate for Payer: UHC Core |
$74.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.24
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
IP
|
$4,251.46
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,592.97 |
| Max. Negotiated Rate |
$3,826.31 |
| Rate for Payer: Aetna Commercial |
$3,613.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,285.53
|
| Rate for Payer: BCN Commercial |
$3,285.53
|
| Rate for Payer: Cash Price |
$3,401.17
|
| Rate for Payer: Cofinity Commercial |
$3,656.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.17
|
| Rate for Payer: Healthscope Commercial |
$3,826.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,188.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,613.74
|
| Rate for Payer: PHP Commercial |
$3,613.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,976.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,698.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,592.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,741.28
|
| Rate for Payer: UHC Core |
$3,549.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,188.60
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
OP
|
$4,251.46
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,009.72 |
| Max. Negotiated Rate |
$3,826.31 |
| Rate for Payer: Aetna Commercial |
$3,613.74
|
| Rate for Payer: Aetna Medicare |
$1,105.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,328.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,328.58
|
| Rate for Payer: BCBS Complete |
$1,700.58
|
| Rate for Payer: BCBS MAPPO |
$1,062.86
|
| Rate for Payer: BCBS Trust/PPO |
$3,305.51
|
| Rate for Payer: BCN Commercial |
$3,305.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,062.86
|
| Rate for Payer: Cash Price |
$3,401.17
|
| Rate for Payer: Cofinity Commercial |
$3,656.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,401.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,062.86
|
| Rate for Payer: Healthscope Commercial |
$3,826.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,188.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,222.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,613.74
|
| Rate for Payer: PACE Senior Care Partners |
$1,009.72
|
| Rate for Payer: PACE SWMI |
$1,062.86
|
| Rate for Payer: PHP Commercial |
$3,613.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,062.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,976.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,698.77
|
| Rate for Payer: Priority Health Medicare |
$1,062.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,592.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,062.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,741.28
|
| Rate for Payer: UHC Core |
$3,549.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,062.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,094.75
|
| Rate for Payer: VA VA |
$1,062.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,188.60
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
IP
|
$8,555.36
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,217.91 |
| Max. Negotiated Rate |
$7,699.82 |
| Rate for Payer: Aetna Commercial |
$7,272.06
|
| Rate for Payer: BCBS Trust/PPO |
$6,611.58
|
| Rate for Payer: BCN Commercial |
$6,611.58
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cofinity Commercial |
$7,357.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,844.29
|
| Rate for Payer: Healthscope Commercial |
$7,699.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,416.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,272.06
|
| Rate for Payer: PHP Commercial |
$7,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,988.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,443.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,217.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.72
|
| Rate for Payer: UHC Core |
$7,143.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,416.52
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
OP
|
$8,555.36
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,031.90 |
| Max. Negotiated Rate |
$7,699.82 |
| Rate for Payer: Aetna Commercial |
$7,272.06
|
| Rate for Payer: Aetna Medicare |
$2,224.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,673.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,673.55
|
| Rate for Payer: BCBS Complete |
$2,229.50
|
| Rate for Payer: BCBS MAPPO |
$2,138.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,651.79
|
| Rate for Payer: BCN Commercial |
$6,651.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,138.84
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cash Price |
$6,844.29
|
| Rate for Payer: Cofinity Commercial |
$7,357.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,844.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,138.84
|
| Rate for Payer: Healthscope Commercial |
$7,699.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,416.52
|
| Rate for Payer: Mclaren Medicaid |
$2,123.34
|
| Rate for Payer: Meridian Medicaid |
$2,229.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,245.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,459.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,272.06
|
| Rate for Payer: PACE Senior Care Partners |
$2,031.90
|
| Rate for Payer: PACE SWMI |
$2,138.84
|
| Rate for Payer: PHP Commercial |
$7,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,138.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,123.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,988.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,443.16
|
| Rate for Payer: Priority Health Medicare |
$2,138.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,217.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,138.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.72
|
| Rate for Payer: UHC Core |
$7,143.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,138.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,203.01
|
| Rate for Payer: VA VA |
$2,138.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,416.52
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
IP
|
$151.08
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.14 |
| Max. Negotiated Rate |
$135.97 |
| Rate for Payer: Aetna Commercial |
$128.42
|
| Rate for Payer: BCBS Trust/PPO |
$116.75
|
| Rate for Payer: BCN Commercial |
$116.75
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$129.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.86
|
| Rate for Payer: Healthscope Commercial |
$135.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.42
|
| Rate for Payer: PHP Commercial |
$128.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.95
|
| Rate for Payer: UHC Core |
$126.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.31
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
OP
|
$151.08
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$135.97 |
| Rate for Payer: Aetna Commercial |
$128.42
|
| Rate for Payer: Aetna Medicare |
$39.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.21
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS MAPPO |
$37.77
|
| Rate for Payer: BCBS Trust/PPO |
$117.46
|
| Rate for Payer: BCN Commercial |
$117.46
|
| Rate for Payer: BCN Medicare Advantage |
$37.77
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cash Price |
$120.86
|
| Rate for Payer: Cofinity Commercial |
$129.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.77
|
| Rate for Payer: Healthscope Commercial |
$135.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.31
|
| Rate for Payer: Mclaren Medicaid |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.42
|
| Rate for Payer: PACE Senior Care Partners |
$35.88
|
| Rate for Payer: PACE SWMI |
$37.77
|
| Rate for Payer: PHP Commercial |
$128.42
|
| Rate for Payer: PHP Medicare Advantage |
$37.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.44
|
| Rate for Payer: Priority Health Medicare |
$37.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.14
|
| Rate for Payer: Railroad Medicare Medicare |
$37.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.95
|
| Rate for Payer: UHC Core |
$126.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.77
|
| Rate for Payer: UHC Medicare Advantage |
$38.90
|
| Rate for Payer: VA VA |
$37.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.31
|
|
|
HC FDG PER DOSE
|
Facility
|
OP
|
$762.71
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$181.14 |
| Max. Negotiated Rate |
$686.44 |
| Rate for Payer: Aetna Commercial |
$648.30
|
| Rate for Payer: Aetna Medicare |
$198.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$238.35
|
| Rate for Payer: BCBS Complete |
$305.08
|
| Rate for Payer: BCBS MAPPO |
$190.68
|
| Rate for Payer: BCBS Trust/PPO |
$593.01
|
| Rate for Payer: BCN Commercial |
$593.01
|
| Rate for Payer: BCN Medicare Advantage |
$190.68
|
| Rate for Payer: Cash Price |
$610.17
|
| Rate for Payer: Cofinity Commercial |
$655.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.68
|
| Rate for Payer: Healthscope Commercial |
$686.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.30
|
| Rate for Payer: PACE Senior Care Partners |
$181.14
|
| Rate for Payer: PACE SWMI |
$190.68
|
| Rate for Payer: PHP Commercial |
$648.30
|
| Rate for Payer: PHP Medicare Advantage |
$190.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.56
|
| Rate for Payer: Priority Health Medicare |
$190.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.18
|
| Rate for Payer: Railroad Medicare Medicare |
$190.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.18
|
| Rate for Payer: UHC Core |
$636.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.68
|
| Rate for Payer: UHC Medicare Advantage |
$196.40
|
| Rate for Payer: VA VA |
$190.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.03
|
|
|
HC FDG PER DOSE
|
Facility
|
IP
|
$762.71
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$465.18 |
| Max. Negotiated Rate |
$686.44 |
| Rate for Payer: Aetna Commercial |
$648.30
|
| Rate for Payer: BCBS Trust/PPO |
$589.42
|
| Rate for Payer: BCN Commercial |
$589.42
|
| Rate for Payer: Cash Price |
$610.17
|
| Rate for Payer: Cofinity Commercial |
$655.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$610.17
|
| Rate for Payer: Healthscope Commercial |
$686.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$572.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.30
|
| Rate for Payer: PHP Commercial |
$648.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$671.18
|
| Rate for Payer: UHC Core |
$636.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$572.03
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
IP
|
$33.55
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$30.20 |
| Rate for Payer: Aetna Commercial |
$28.52
|
| Rate for Payer: BCBS Trust/PPO |
$25.93
|
| Rate for Payer: BCN Commercial |
$25.93
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$28.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.84
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.52
|
| Rate for Payer: PHP Commercial |
$28.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
OP
|
$33.55
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$30.20 |
| Rate for Payer: Aetna Commercial |
$28.52
|
| Rate for Payer: Aetna Medicare |
$8.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.48
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$8.39
|
| Rate for Payer: BCBS Trust/PPO |
$26.09
|
| Rate for Payer: BCN Commercial |
$26.09
|
| Rate for Payer: BCN Medicare Advantage |
$8.39
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cash Price |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$28.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.39
|
| Rate for Payer: Healthscope Commercial |
$30.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.16
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.52
|
| Rate for Payer: PACE Senior Care Partners |
$7.97
|
| Rate for Payer: PACE SWMI |
$8.39
|
| Rate for Payer: PHP Commercial |
$28.52
|
| Rate for Payer: PHP Medicare Advantage |
$8.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.19
|
| Rate for Payer: Priority Health Medicare |
$8.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.52
|
| Rate for Payer: UHC Core |
$28.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.39
|
| Rate for Payer: UHC Medicare Advantage |
$8.64
|
| Rate for Payer: VA VA |
$8.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.16
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.69 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$59.50
|
| Rate for Payer: BCBS Trust/PPO |
$54.10
|
| Rate for Payer: BCN Commercial |
$54.10
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Healthscope Commercial |
$63.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: PHP Commercial |
$59.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.60
|
| Rate for Payer: UHC Core |
$58.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$59.50
|
| Rate for Payer: Aetna Medicare |
$18.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.88
|
| Rate for Payer: BCBS Complete |
$13.02
|
| Rate for Payer: BCBS MAPPO |
$17.50
|
| Rate for Payer: BCBS Trust/PPO |
$54.42
|
| Rate for Payer: BCN Commercial |
$54.42
|
| Rate for Payer: BCN Medicare Advantage |
$17.50
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$60.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$63.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
| Rate for Payer: Mclaren Medicaid |
$12.40
|
| Rate for Payer: Meridian Medicaid |
$13.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
| Rate for Payer: PACE Senior Care Partners |
$16.62
|
| Rate for Payer: PACE SWMI |
$17.50
|
| Rate for Payer: PHP Commercial |
$59.50
|
| Rate for Payer: PHP Medicare Advantage |
$17.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.90
|
| Rate for Payer: Priority Health Medicare |
$17.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.60
|
| Rate for Payer: UHC Core |
$58.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.50
|
| Rate for Payer: UHC Medicare Advantage |
$18.02
|
| Rate for Payer: VA VA |
$17.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: BCBS Trust/PPO |
$40.80
|
| Rate for Payer: BCN Commercial |
$40.80
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$47.52 |
| Rate for Payer: Aetna Commercial |
$44.88
|
| Rate for Payer: Aetna Medicare |
$13.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.50
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$13.20
|
| Rate for Payer: BCBS Trust/PPO |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$13.20
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cash Price |
$42.24
|
| Rate for Payer: Cofinity Commercial |
$45.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.20
|
| Rate for Payer: Healthscope Commercial |
$47.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.60
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.88
|
| Rate for Payer: PACE Senior Care Partners |
$12.54
|
| Rate for Payer: PACE SWMI |
$13.20
|
| Rate for Payer: PHP Commercial |
$44.88
|
| Rate for Payer: PHP Medicare Advantage |
$13.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.94
|
| Rate for Payer: Priority Health Medicare |
$13.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.46
|
| Rate for Payer: UHC Core |
$44.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.60
|
| Rate for Payer: VA VA |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.60
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
IP
|
$1,281.69
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$781.70 |
| Max. Negotiated Rate |
$1,153.52 |
| Rate for Payer: Aetna Commercial |
$1,089.44
|
| Rate for Payer: BCBS Trust/PPO |
$990.49
|
| Rate for Payer: BCN Commercial |
$990.49
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cofinity Commercial |
$1,102.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.35
|
| Rate for Payer: Healthscope Commercial |
$1,153.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$961.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,089.44
|
| Rate for Payer: PHP Commercial |
$1,089.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$781.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,127.89
|
| Rate for Payer: UHC Core |
$1,070.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$961.27
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
OP
|
$1,281.69
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.40 |
| Max. Negotiated Rate |
$1,153.52 |
| Rate for Payer: Aetna Commercial |
$1,089.44
|
| Rate for Payer: Aetna Medicare |
$333.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$400.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$400.53
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$320.42
|
| Rate for Payer: BCBS Trust/PPO |
$996.51
|
| Rate for Payer: BCN Commercial |
$996.51
|
| Rate for Payer: BCN Medicare Advantage |
$320.42
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cash Price |
$1,025.35
|
| Rate for Payer: Cofinity Commercial |
$1,102.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.42
|
| Rate for Payer: Healthscope Commercial |
$1,153.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$961.27
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$336.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$368.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,089.44
|
| Rate for Payer: PACE Senior Care Partners |
$304.40
|
| Rate for Payer: PACE SWMI |
$320.42
|
| Rate for Payer: PHP Commercial |
$1,089.44
|
| Rate for Payer: PHP Medicare Advantage |
$320.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.07
|
| Rate for Payer: Priority Health Medicare |
$320.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$781.70
|
| Rate for Payer: Railroad Medicare Medicare |
$320.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,127.89
|
| Rate for Payer: UHC Core |
$1,070.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.42
|
| Rate for Payer: UHC Medicare Advantage |
$330.04
|
| Rate for Payer: VA VA |
$320.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$961.27
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$12.34
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$11.75
|
| Rate for Payer: Meridian Medicaid |
$12.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.18
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$3.39
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.32
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$3.23
|
| Rate for Payer: Meridian Medicaid |
$3.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.72
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC FECAL PH
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: BCBS Trust/PPO |
$18.13
|
| Rate for Payer: BCN Commercial |
$18.13
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC FECAL PH
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$6.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.33
|
| Rate for Payer: BCBS Complete |
$2.77
|
| Rate for Payer: BCBS MAPPO |
$5.86
|
| Rate for Payer: BCBS Trust/PPO |
$18.24
|
| Rate for Payer: BCN Commercial |
$18.24
|
| Rate for Payer: BCN Medicare Advantage |
$5.86
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.86
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Mclaren Medicaid |
$2.64
|
| Rate for Payer: Meridian Medicaid |
$2.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Senior Care Partners |
$5.57
|
| Rate for Payer: PACE SWMI |
$5.86
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$5.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Medicare |
$5.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.86
|
| Rate for Payer: UHC Medicare Advantage |
$6.04
|
| Rate for Payer: VA VA |
$5.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$50.30
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna Medicare |
$13.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.72
|
| Rate for Payer: BCBS Complete |
$4.26
|
| Rate for Payer: BCBS MAPPO |
$12.58
|
| Rate for Payer: BCBS Trust/PPO |
$39.11
|
| Rate for Payer: BCN Commercial |
$39.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.58
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.58
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Mclaren Medicaid |
$4.06
|
| Rate for Payer: Meridian Medicaid |
$4.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PACE Senior Care Partners |
$11.95
|
| Rate for Payer: PACE SWMI |
$12.58
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$12.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$12.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.68
|
| Rate for Payer: Railroad Medicare Medicare |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.26
|
| Rate for Payer: UHC Core |
$42.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.58
|
| Rate for Payer: UHC Medicare Advantage |
$12.95
|
| Rate for Payer: VA VA |
$12.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
