|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
IP
|
$74.51
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.43 |
| Max. Negotiated Rate |
$67.06 |
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: BCBS Trust/PPO |
$60.82
|
| Rate for Payer: BCN Commercial |
$57.58
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.61
|
| Rate for Payer: Healthscope Commercial |
$67.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Nomi Health Commercial |
$61.10
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.43
|
| Rate for Payer: Priority Health HMO/PPO |
$64.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.57
|
| Rate for Payer: UHC Core |
$62.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
|
|
HC C1Q BINDING
|
Facility
|
IP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.59 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: BCBS Trust/PPO |
$92.42
|
| Rate for Payer: BCN Commercial |
$87.50
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: Nomi Health Commercial |
$92.84
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health HMO/PPO |
$98.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.63
|
| Rate for Payer: UHC Core |
$94.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC C1Q BINDING
|
Facility
|
OP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.62 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: Aetna Medicare |
$29.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.38
|
| Rate for Payer: BCBS Complete |
$18.50
|
| Rate for Payer: BCBS MAPPO |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$93.08
|
| Rate for Payer: BCN Commercial |
$88.03
|
| Rate for Payer: BCN Medicare Advantage |
$28.30
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Mclaren Medicaid |
$17.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.72
|
| Rate for Payer: Meridian Medicaid |
$18.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: Nomi Health Commercial |
$92.84
|
| Rate for Payer: PACE Senior Care Partners |
$26.89
|
| Rate for Payer: PACE SWMI |
$28.30
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: PHP Medicare Advantage |
$28.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health HMO/PPO |
$98.50
|
| Rate for Payer: Priority Health Medicare |
$28.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.86
|
| Rate for Payer: Railroad Medicare Medicare |
$28.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.63
|
| Rate for Payer: UHC Core |
$94.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.30
|
| Rate for Payer: UHC Exchange |
$28.30
|
| Rate for Payer: UHC Medicare Advantage |
$28.30
|
| Rate for Payer: UHCCP Medicaid |
$17.62
|
| Rate for Payer: VA VA |
$28.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$8.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$9.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.17
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$8.68
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.06
|
| Rate for Payer: BCN Commercial |
$53.07
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
IP
|
$76.13
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.48 |
| Max. Negotiated Rate |
$68.52 |
| Rate for Payer: Aetna Commercial |
$64.71
|
| Rate for Payer: BCBS Trust/PPO |
$62.14
|
| Rate for Payer: BCN Commercial |
$58.83
|
| Rate for Payer: Cash Price |
$60.90
|
| Rate for Payer: Cofinity Commercial |
$65.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.90
|
| Rate for Payer: Healthscope Commercial |
$68.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.71
|
| Rate for Payer: Nomi Health Commercial |
$62.43
|
| Rate for Payer: PHP Commercial |
$64.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO |
$66.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.99
|
| Rate for Payer: UHC Core |
$63.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.10
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
OP
|
$76.13
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$68.52 |
| Rate for Payer: Aetna Commercial |
$64.71
|
| Rate for Payer: Aetna Medicare |
$19.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.79
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS MAPPO |
$19.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.59
|
| Rate for Payer: BCN Commercial |
$59.19
|
| Rate for Payer: BCN Medicare Advantage |
$19.03
|
| Rate for Payer: Cash Price |
$60.90
|
| Rate for Payer: Cash Price |
$60.90
|
| Rate for Payer: Cofinity Commercial |
$65.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.03
|
| Rate for Payer: Healthscope Commercial |
$68.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.10
|
| Rate for Payer: Mclaren Medicaid |
$8.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.98
|
| Rate for Payer: Meridian Medicaid |
$9.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.71
|
| Rate for Payer: Nomi Health Commercial |
$62.43
|
| Rate for Payer: PACE Senior Care Partners |
$18.08
|
| Rate for Payer: PACE SWMI |
$19.03
|
| Rate for Payer: PHP Commercial |
$64.71
|
| Rate for Payer: PHP Medicare Advantage |
$19.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health HMO/PPO |
$66.23
|
| Rate for Payer: Priority Health Medicare |
$19.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.01
|
| Rate for Payer: Railroad Medicare Medicare |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.99
|
| Rate for Payer: UHC Core |
$63.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.03
|
| Rate for Payer: UHC Exchange |
$19.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.03
|
| Rate for Payer: UHCCP Medicaid |
$8.68
|
| Rate for Payer: VA VA |
$19.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.10
|
|
|
HC CA 125
|
Facility
|
IP
|
$145.96
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$94.87 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: BCBS Trust/PPO |
$119.15
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO |
$126.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.44
|
| Rate for Payer: UHC Core |
$121.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC CA 125
|
Facility
|
OP
|
$145.96
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna Medicare |
$37.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.61
|
| Rate for Payer: BCBS Complete |
$15.80
|
| Rate for Payer: BCBS MAPPO |
$36.49
|
| Rate for Payer: BCBS Trust/PPO |
$119.99
|
| Rate for Payer: BCN Commercial |
$113.48
|
| Rate for Payer: BCN Medicare Advantage |
$36.49
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.49
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.31
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: PACE Senior Care Partners |
$34.67
|
| Rate for Payer: PACE SWMI |
$36.49
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: PHP Medicare Advantage |
$36.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO |
$126.99
|
| Rate for Payer: Priority Health Medicare |
$36.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.79
|
| Rate for Payer: Railroad Medicare Medicare |
$36.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.44
|
| Rate for Payer: UHC Core |
$121.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.49
|
| Rate for Payer: UHC Exchange |
$36.49
|
| Rate for Payer: UHC Medicare Advantage |
$36.49
|
| Rate for Payer: UHCCP Medicaid |
$15.05
|
| Rate for Payer: VA VA |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC CADMIUM LEVEL
|
Facility
|
IP
|
$48.64
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.62 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: BCBS Trust/PPO |
$39.70
|
| Rate for Payer: BCN Commercial |
$37.59
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$39.88
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.62
|
| Rate for Payer: Priority Health HMO/PPO |
$42.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.80
|
| Rate for Payer: UHC Core |
$40.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC CADMIUM LEVEL
|
Facility
|
OP
|
$48.64
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$12.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.20
|
| Rate for Payer: BCBS Complete |
$17.95
|
| Rate for Payer: BCBS MAPPO |
$12.16
|
| Rate for Payer: BCBS Trust/PPO |
$39.99
|
| Rate for Payer: BCN Commercial |
$37.82
|
| Rate for Payer: BCN Medicare Advantage |
$12.16
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.16
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Mclaren Medicaid |
$17.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.77
|
| Rate for Payer: Meridian Medicaid |
$17.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$39.88
|
| Rate for Payer: PACE Senior Care Partners |
$11.55
|
| Rate for Payer: PACE SWMI |
$12.16
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: PHP Medicare Advantage |
$12.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.62
|
| Rate for Payer: Priority Health HMO/PPO |
$42.32
|
| Rate for Payer: Priority Health Medicare |
$12.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$12.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.80
|
| Rate for Payer: UHC Core |
$40.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.16
|
| Rate for Payer: UHC Exchange |
$12.16
|
| Rate for Payer: UHC Medicare Advantage |
$12.16
|
| Rate for Payer: UHCCP Medicaid |
$17.09
|
| Rate for Payer: VA VA |
$12.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$95.97
|
| Rate for Payer: BCN Commercial |
$90.86
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.42
|
| Rate for Payer: Priority Health HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$30.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.74
|
| Rate for Payer: BCBS Complete |
$29.28
|
| Rate for Payer: BCBS MAPPO |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$96.65
|
| Rate for Payer: BCN Commercial |
$91.41
|
| Rate for Payer: BCN Medicare Advantage |
$29.39
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.39
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$29.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: PACE Senior Care Partners |
$27.92
|
| Rate for Payer: PACE SWMI |
$29.39
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.42
|
| Rate for Payer: Priority Health HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Medicare |
$29.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.77
|
| Rate for Payer: Railroad Medicare Medicare |
$29.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.39
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicare Advantage |
$29.39
|
| Rate for Payer: UHCCP Medicaid |
$27.89
|
| Rate for Payer: VA VA |
$29.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.31 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$20.34
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$19.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$20.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.17
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$19.37
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.06
|
| Rate for Payer: BCN Commercial |
$53.07
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$26.88
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$24.19 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$6.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.40
|
| Rate for Payer: BCBS Complete |
$10.75
|
| Rate for Payer: BCBS MAPPO |
$6.72
|
| Rate for Payer: BCBS Trust/PPO |
$22.10
|
| Rate for Payer: BCN Commercial |
$20.90
|
| Rate for Payer: BCN Medicare Advantage |
$6.72
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$23.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.72
|
| Rate for Payer: Healthscope Commercial |
$24.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.85
|
| Rate for Payer: Nomi Health Commercial |
$22.04
|
| Rate for Payer: PACE Senior Care Partners |
$6.38
|
| Rate for Payer: PACE SWMI |
$6.72
|
| Rate for Payer: PHP Commercial |
$22.85
|
| Rate for Payer: PHP Medicare Advantage |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health HMO/PPO |
$23.39
|
| Rate for Payer: Priority Health Medicare |
$6.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.65
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.72
|
| Rate for Payer: UHC Exchange |
$6.72
|
| Rate for Payer: UHC Medicare Advantage |
$6.72
|
| Rate for Payer: VA VA |
$6.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.16
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$26.88
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$24.19 |
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: BCBS Trust/PPO |
$21.94
|
| Rate for Payer: BCN Commercial |
$20.77
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$23.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.85
|
| Rate for Payer: Nomi Health Commercial |
$22.04
|
| Rate for Payer: PHP Commercial |
$22.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health HMO/PPO |
$23.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.65
|
| Rate for Payer: UHC Core |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.16
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$18.88
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: BCBS Trust/PPO |
$15.41
|
| Rate for Payer: BCN Commercial |
$14.59
|
| Rate for Payer: Cash Price |
$15.10
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.10
|
| Rate for Payer: Healthscope Commercial |
$16.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.05
|
| Rate for Payer: Nomi Health Commercial |
$15.48
|
| Rate for Payer: PHP Commercial |
$16.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.27
|
| Rate for Payer: Priority Health HMO/PPO |
$16.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.61
|
| Rate for Payer: UHC Core |
$15.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.16
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$18.88
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.90
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$15.52
|
| Rate for Payer: BCN Commercial |
$14.68
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$15.10
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$16.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.05
|
| Rate for Payer: Nomi Health Commercial |
$15.48
|
| Rate for Payer: PACE Senior Care Partners |
$4.48
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Commercial |
$16.05
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.27
|
| Rate for Payer: Priority Health HMO/PPO |
$16.43
|
| Rate for Payer: Priority Health Medicare |
$4.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.65
|
| Rate for Payer: Railroad Medicare Medicare |
$4.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.61
|
| Rate for Payer: UHC Core |
$15.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Exchange |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
| Rate for Payer: VA VA |
$4.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.16
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$3.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$3.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$3.73
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.01 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: BCBS Trust/PPO |
$43.97
|
| Rate for Payer: BCN Commercial |
$41.62
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO |
$46.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.83
|
| Rate for Payer: BCBS Complete |
$4.58
|
| Rate for Payer: BCBS MAPPO |
$13.46
|
| Rate for Payer: BCBS Trust/PPO |
$44.28
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.46
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$4.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.14
|
| Rate for Payer: Meridian Medicaid |
$4.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: PACE Senior Care Partners |
$12.79
|
| Rate for Payer: PACE SWMI |
$13.46
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$13.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO |
$46.86
|
| Rate for Payer: Priority Health Medicare |
$13.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: Railroad Medicare Medicare |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.46
|
| Rate for Payer: UHC Exchange |
$13.46
|
| Rate for Payer: UHC Medicare Advantage |
$13.46
|
| Rate for Payer: UHCCP Medicaid |
$4.36
|
| Rate for Payer: VA VA |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC CALCULI
|
Facility
|
OP
|
$42.66
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.33
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS MAPPO |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.07
|
| Rate for Payer: BCN Commercial |
$33.17
|
| Rate for Payer: BCN Medicare Advantage |
$10.66
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.20
|
| Rate for Payer: Meridian Medicaid |
$9.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PACE Senior Care Partners |
$10.13
|
| Rate for Payer: PACE SWMI |
$10.66
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Medicare |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: Railroad Medicare Medicare |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.66
|
| Rate for Payer: UHC Exchange |
$10.66
|
| Rate for Payer: UHC Medicare Advantage |
$10.66
|
| Rate for Payer: UHCCP Medicaid |
$9.33
|
| Rate for Payer: VA VA |
$10.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CALCULI
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: BCBS Trust/PPO |
$34.82
|
| Rate for Payer: BCN Commercial |
$32.97
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
