|
HC FRESH FROZEN PLASMA 2X CMPT
|
Facility
|
IP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000050
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$160.31 |
| Max. Negotiated Rate |
$236.56 |
| Rate for Payer: Aetna Commercial |
$223.42
|
| Rate for Payer: BCBS Trust/PPO |
$203.13
|
| Rate for Payer: BCN Commercial |
$203.13
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Healthscope Commercial |
$236.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PHP Commercial |
$223.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.31
|
| Rate for Payer: UHC Core |
$219.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.14
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$138.61 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: BCBS Trust/PPO |
$175.63
|
| Rate for Payer: BCN Commercial |
$175.63
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$59.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.02
|
| Rate for Payer: BCBS Complete |
$57.81
|
| Rate for Payer: BCBS MAPPO |
$56.82
|
| Rate for Payer: BCBS Trust/PPO |
$176.69
|
| Rate for Payer: BCN Commercial |
$176.69
|
| Rate for Payer: BCN Medicare Advantage |
$56.82
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$55.05
|
| Rate for Payer: Meridian Medicaid |
$57.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Senior Care Partners |
$53.97
|
| Rate for Payer: PACE SWMI |
$56.82
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$56.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Medicare |
$56.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: Railroad Medicare Medicare |
$56.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.82
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: VA VA |
$56.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$138.61 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: BCBS Trust/PPO |
$175.63
|
| Rate for Payer: BCN Commercial |
$175.63
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$59.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.02
|
| Rate for Payer: BCBS Complete |
$57.81
|
| Rate for Payer: BCBS MAPPO |
$56.82
|
| Rate for Payer: BCBS Trust/PPO |
$176.69
|
| Rate for Payer: BCN Commercial |
$176.69
|
| Rate for Payer: BCN Medicare Advantage |
$56.82
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$55.05
|
| Rate for Payer: Meridian Medicaid |
$57.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Senior Care Partners |
$53.97
|
| Rate for Payer: PACE SWMI |
$56.82
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$56.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Medicare |
$56.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: Railroad Medicare Medicare |
$56.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.82
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: VA VA |
$56.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.97 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$59.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.02
|
| Rate for Payer: BCBS Complete |
$57.81
|
| Rate for Payer: BCBS MAPPO |
$56.82
|
| Rate for Payer: BCBS Trust/PPO |
$176.69
|
| Rate for Payer: BCN Commercial |
$176.69
|
| Rate for Payer: BCN Medicare Advantage |
$56.82
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.82
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$55.05
|
| Rate for Payer: Meridian Medicaid |
$57.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Senior Care Partners |
$53.97
|
| Rate for Payer: PACE SWMI |
$56.82
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$56.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Medicare |
$56.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: Railroad Medicare Medicare |
$56.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.82
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: VA VA |
$56.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$138.61 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: BCBS Trust/PPO |
$175.63
|
| Rate for Payer: BCN Commercial |
$175.63
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.99
|
| Rate for Payer: UHC Core |
$189.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
IP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$57.76 |
| Max. Negotiated Rate |
$85.23 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: BCBS Trust/PPO |
$73.18
|
| Rate for Payer: BCN Commercial |
$73.18
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$81.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Healthscope Commercial |
$85.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: PHP Commercial |
$80.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.34
|
| Rate for Payer: UHC Core |
$79.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.02
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
OP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$85.23 |
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.59
|
| Rate for Payer: BCBS Complete |
$57.81
|
| Rate for Payer: BCBS MAPPO |
$23.68
|
| Rate for Payer: BCBS Trust/PPO |
$73.63
|
| Rate for Payer: BCN Commercial |
$73.63
|
| Rate for Payer: BCN Medicare Advantage |
$23.68
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$81.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.68
|
| Rate for Payer: Healthscope Commercial |
$85.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.02
|
| Rate for Payer: Mclaren Medicaid |
$55.05
|
| Rate for Payer: Meridian Medicaid |
$57.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: PACE Senior Care Partners |
$22.49
|
| Rate for Payer: PACE SWMI |
$23.68
|
| Rate for Payer: PHP Commercial |
$80.50
|
| Rate for Payer: PHP Medicare Advantage |
$23.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.39
|
| Rate for Payer: Priority Health Medicare |
$23.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.76
|
| Rate for Payer: Railroad Medicare Medicare |
$23.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.34
|
| Rate for Payer: UHC Core |
$79.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.68
|
| Rate for Payer: UHC Medicare Advantage |
$24.39
|
| Rate for Payer: VA VA |
$23.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.02
|
|
|
HC FROZEN SECTION
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$29.58 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.92
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$31.14
|
| Rate for Payer: BCBS Trust/PPO |
$96.83
|
| Rate for Payer: BCCCP Commercial |
$102.87
|
| Rate for Payer: BCN Commercial |
$96.83
|
| Rate for Payer: BCN Medicare Advantage |
$31.14
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.40
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.86
|
| Rate for Payer: PACE Senior Care Partners |
$29.58
|
| Rate for Payer: PACE SWMI |
$31.14
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: PHP Medicare Advantage |
$31.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.35
|
| Rate for Payer: Priority Health Medicare |
$31.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.96
|
| Rate for Payer: Railroad Medicare Medicare |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$103.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.14
|
| Rate for Payer: UHC Medicare Advantage |
$32.07
|
| Rate for Payer: VA VA |
$31.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.40
|
|
|
HC FROZEN SECTION
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.96 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: BCBS Trust/PPO |
$96.24
|
| Rate for Payer: BCN Commercial |
$96.24
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.86
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.60
|
| Rate for Payer: UHC Core |
$103.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.40
|
|
|
HC FRUCTOSAMINE
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC FRUCTOSAMINE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$12.99
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$12.37
|
| Rate for Payer: Meridian Medicaid |
$12.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
IP
|
$94.90
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.88 |
| Max. Negotiated Rate |
$85.41 |
| Rate for Payer: Aetna Commercial |
$80.66
|
| Rate for Payer: BCBS Trust/PPO |
$73.34
|
| Rate for Payer: BCN Commercial |
$73.34
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cofinity Commercial |
$81.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.92
|
| Rate for Payer: Healthscope Commercial |
$85.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.66
|
| Rate for Payer: PHP Commercial |
$80.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.51
|
| Rate for Payer: UHC Core |
$79.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.18
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
OP
|
$94.90
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$85.41 |
| Rate for Payer: Aetna Commercial |
$80.66
|
| Rate for Payer: Aetna Medicare |
$24.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.66
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.72
|
| Rate for Payer: BCBS Trust/PPO |
$73.78
|
| Rate for Payer: BCN Commercial |
$73.78
|
| Rate for Payer: BCN Medicare Advantage |
$23.72
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cash Price |
$75.92
|
| Rate for Payer: Cofinity Commercial |
$81.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.72
|
| Rate for Payer: Healthscope Commercial |
$85.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.18
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.66
|
| Rate for Payer: PACE Senior Care Partners |
$22.54
|
| Rate for Payer: PACE SWMI |
$23.72
|
| Rate for Payer: PHP Commercial |
$80.66
|
| Rate for Payer: PHP Medicare Advantage |
$23.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.56
|
| Rate for Payer: Priority Health Medicare |
$23.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.88
|
| Rate for Payer: Railroad Medicare Medicare |
$23.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.51
|
| Rate for Payer: UHC Core |
$79.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.72
|
| Rate for Payer: UHC Medicare Advantage |
$24.44
|
| Rate for Payer: VA VA |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.18
|
|
|
HC F/U EP STUDY
|
Facility
|
OP
|
$5,503.49
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,307.08 |
| Max. Negotiated Rate |
$5,144.02 |
| Rate for Payer: Aetna Commercial |
$4,677.97
|
| Rate for Payer: Aetna Medicare |
$1,430.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,719.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,719.84
|
| Rate for Payer: BCBS Complete |
$5,144.02
|
| Rate for Payer: BCBS MAPPO |
$1,375.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,278.96
|
| Rate for Payer: BCN Commercial |
$4,278.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,375.87
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cofinity Commercial |
$4,733.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,402.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,375.87
|
| Rate for Payer: Healthscope Commercial |
$4,953.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,127.62
|
| Rate for Payer: Mclaren Medicaid |
$4,899.07
|
| Rate for Payer: Meridian Medicaid |
$5,144.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,444.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,582.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,677.97
|
| Rate for Payer: PACE Senior Care Partners |
$1,307.08
|
| Rate for Payer: PACE SWMI |
$1,375.87
|
| Rate for Payer: PHP Commercial |
$4,677.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,375.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,788.04
|
| Rate for Payer: Priority Health Medicare |
$1,375.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,375.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,843.07
|
| Rate for Payer: UHC Core |
$4,595.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,375.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,417.15
|
| Rate for Payer: VA VA |
$1,375.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,127.62
|
|
|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,503.49
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,356.58 |
| Max. Negotiated Rate |
$4,953.14 |
| Rate for Payer: Aetna Commercial |
$4,677.97
|
| Rate for Payer: BCBS Trust/PPO |
$4,253.10
|
| Rate for Payer: BCN Commercial |
$4,253.10
|
| Rate for Payer: Cash Price |
$4,402.79
|
| Rate for Payer: Cofinity Commercial |
$4,733.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,402.79
|
| Rate for Payer: Healthscope Commercial |
$4,953.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,127.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,677.97
|
| Rate for Payer: PHP Commercial |
$4,677.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,852.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,788.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,356.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,843.07
|
| Rate for Payer: UHC Core |
$4,595.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,127.62
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$123.19
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$75.13 |
| Max. Negotiated Rate |
$110.87 |
| Rate for Payer: Aetna Commercial |
$104.71
|
| Rate for Payer: BCBS Trust/PPO |
$95.20
|
| Rate for Payer: BCN Commercial |
$95.20
|
| Rate for Payer: Cash Price |
$98.55
|
| Rate for Payer: Cofinity Commercial |
$105.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.55
|
| Rate for Payer: Healthscope Commercial |
$110.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.71
|
| Rate for Payer: PHP Commercial |
$104.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.41
|
| Rate for Payer: UHC Core |
$102.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.39
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$123.19
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$29.26 |
| Max. Negotiated Rate |
$110.87 |
| Rate for Payer: Aetna Commercial |
$104.71
|
| Rate for Payer: Aetna Medicare |
$32.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.50
|
| Rate for Payer: BCBS Complete |
$49.28
|
| Rate for Payer: BCBS MAPPO |
$30.80
|
| Rate for Payer: BCBS Trust/PPO |
$95.78
|
| Rate for Payer: BCN Commercial |
$95.78
|
| Rate for Payer: BCN Medicare Advantage |
$30.80
|
| Rate for Payer: Cash Price |
$98.55
|
| Rate for Payer: Cofinity Commercial |
$105.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.80
|
| Rate for Payer: Healthscope Commercial |
$110.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.71
|
| Rate for Payer: PACE Senior Care Partners |
$29.26
|
| Rate for Payer: PACE SWMI |
$30.80
|
| Rate for Payer: PHP Commercial |
$104.71
|
| Rate for Payer: PHP Medicare Advantage |
$30.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.18
|
| Rate for Payer: Priority Health Medicare |
$30.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.13
|
| Rate for Payer: Railroad Medicare Medicare |
$30.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.41
|
| Rate for Payer: UHC Core |
$102.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.80
|
| Rate for Payer: UHC Medicare Advantage |
$31.72
|
| Rate for Payer: VA VA |
$30.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.39
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$66.10
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$17.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.66
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$51.39
|
| Rate for Payer: BCN Commercial |
$51.39
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Mclaren Medicaid |
$7.62
|
| Rate for Payer: Meridian Medicaid |
$8.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PACE Senior Care Partners |
$15.70
|
| Rate for Payer: PACE SWMI |
$16.52
|
| Rate for Payer: PHP Commercial |
$56.18
|
| Rate for Payer: PHP Medicare Advantage |
$16.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.51
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.17
|
| Rate for Payer: UHC Core |
$55.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.52
|
| Rate for Payer: UHC Medicare Advantage |
$17.02
|
| Rate for Payer: VA VA |
$16.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$66.10
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.31 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: BCBS Trust/PPO |
$51.08
|
| Rate for Payer: BCN Commercial |
$51.08
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PHP Commercial |
$56.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.17
|
| Rate for Payer: UHC Core |
$55.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$66.10
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: Aetna Medicare |
$17.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.66
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$51.39
|
| Rate for Payer: BCN Commercial |
$51.39
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Mclaren Medicaid |
$7.62
|
| Rate for Payer: Meridian Medicaid |
$8.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PACE Senior Care Partners |
$15.70
|
| Rate for Payer: PACE SWMI |
$16.52
|
| Rate for Payer: PHP Commercial |
$56.18
|
| Rate for Payer: PHP Medicare Advantage |
$16.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.51
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.17
|
| Rate for Payer: UHC Core |
$55.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.52
|
| Rate for Payer: UHC Medicare Advantage |
$17.02
|
| Rate for Payer: VA VA |
$16.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$66.10
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.31 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Aetna Commercial |
$56.18
|
| Rate for Payer: BCBS Trust/PPO |
$51.08
|
| Rate for Payer: BCN Commercial |
$51.08
|
| Rate for Payer: Cash Price |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$56.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.88
|
| Rate for Payer: Healthscope Commercial |
$59.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.18
|
| Rate for Payer: PHP Commercial |
$56.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.17
|
| Rate for Payer: UHC Core |
$55.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.58
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.90
|
| Rate for Payer: Meridian Medicaid |
$10.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
