|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$301.24 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: BCBS Trust/PPO |
$378.31
|
| Rate for Payer: BCN Commercial |
$358.15
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO |
$403.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.84
|
| Rate for Payer: UHC Core |
$386.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$110.07 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.83
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$381.00
|
| Rate for Payer: BCN Commercial |
$360.33
|
| Rate for Payer: BCN Medicare Advantage |
$115.86
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.66
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| Rate for Payer: PACE Senior Care Partners |
$110.07
|
| Rate for Payer: PACE SWMI |
$115.86
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: PHP Medicare Advantage |
$115.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO |
$403.20
|
| Rate for Payer: Priority Health Medicare |
$117.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.51
|
| Rate for Payer: Railroad Medicare Medicare |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.84
|
| Rate for Payer: UHC Core |
$386.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Exchange |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$115.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$110.07 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.83
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$381.00
|
| Rate for Payer: BCN Commercial |
$360.33
|
| Rate for Payer: BCN Medicare Advantage |
$115.86
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.86
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.66
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| Rate for Payer: PACE Senior Care Partners |
$110.07
|
| Rate for Payer: PACE SWMI |
$115.86
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: PHP Medicare Advantage |
$115.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO |
$403.20
|
| Rate for Payer: Priority Health Medicare |
$117.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.51
|
| Rate for Payer: Railroad Medicare Medicare |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.84
|
| Rate for Payer: UHC Core |
$386.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.86
|
| Rate for Payer: UHC Exchange |
$115.86
|
| Rate for Payer: UHC Medicare Advantage |
$115.86
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$115.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$301.24 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: BCBS Trust/PPO |
$378.31
|
| Rate for Payer: BCN Commercial |
$358.15
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$380.03
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO |
$403.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.84
|
| Rate for Payer: UHC Core |
$386.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$236.64
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$212.98 |
| Rate for Payer: Aetna Commercial |
$201.14
|
| Rate for Payer: Aetna Medicare |
$61.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.95
|
| Rate for Payer: BCBS Complete |
$14.90
|
| Rate for Payer: BCBS MAPPO |
$59.16
|
| Rate for Payer: BCBS Trust/PPO |
$194.54
|
| Rate for Payer: BCN Commercial |
$183.99
|
| Rate for Payer: BCN Medicare Advantage |
$59.16
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cofinity Commercial |
$203.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.16
|
| Rate for Payer: Healthscope Commercial |
$212.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.48
|
| Rate for Payer: Mclaren Medicaid |
$14.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.12
|
| Rate for Payer: Meridian Medicaid |
$14.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.14
|
| Rate for Payer: Nomi Health Commercial |
$194.04
|
| Rate for Payer: PACE Senior Care Partners |
$56.20
|
| Rate for Payer: PACE SWMI |
$59.16
|
| Rate for Payer: PHP Commercial |
$201.14
|
| Rate for Payer: PHP Medicare Advantage |
$59.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.82
|
| Rate for Payer: Priority Health HMO/PPO |
$205.88
|
| Rate for Payer: Priority Health Medicare |
$59.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.55
|
| Rate for Payer: Railroad Medicare Medicare |
$59.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.24
|
| Rate for Payer: UHC Core |
$197.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.16
|
| Rate for Payer: UHC Exchange |
$59.16
|
| Rate for Payer: UHC Medicare Advantage |
$59.16
|
| Rate for Payer: UHCCP Medicaid |
$14.19
|
| Rate for Payer: VA VA |
$59.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.48
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$236.64
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$153.82 |
| Max. Negotiated Rate |
$212.98 |
| Rate for Payer: Aetna Commercial |
$201.14
|
| Rate for Payer: BCBS Trust/PPO |
$193.17
|
| Rate for Payer: BCN Commercial |
$182.88
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cofinity Commercial |
$203.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.31
|
| Rate for Payer: Healthscope Commercial |
$212.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.14
|
| Rate for Payer: Nomi Health Commercial |
$194.04
|
| Rate for Payer: PHP Commercial |
$201.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.82
|
| Rate for Payer: Priority Health HMO/PPO |
$205.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.24
|
| Rate for Payer: UHC Core |
$197.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.48
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| 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 |
$14.90
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.54
|
| 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 |
$14.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$14.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| 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 |
$14.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| 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 Exchange |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$14.19
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| 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 Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| 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
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$673.24
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.94 |
| Max. Negotiated Rate |
$605.92 |
| Rate for Payer: Aetna Commercial |
$572.25
|
| Rate for Payer: Aetna Medicare |
$175.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$210.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$210.39
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS MAPPO |
$168.31
|
| Rate for Payer: BCBS Trust/PPO |
$553.47
|
| Rate for Payer: BCN Commercial |
$523.44
|
| Rate for Payer: BCN Medicare Advantage |
$168.31
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cofinity Commercial |
$578.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.31
|
| Rate for Payer: Healthscope Commercial |
$605.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.93
|
| Rate for Payer: Mclaren Medicaid |
$87.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.73
|
| Rate for Payer: Meridian Medicaid |
$92.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.25
|
| Rate for Payer: Nomi Health Commercial |
$552.06
|
| Rate for Payer: PACE Senior Care Partners |
$159.89
|
| Rate for Payer: PACE SWMI |
$168.31
|
| Rate for Payer: PHP Commercial |
$572.25
|
| Rate for Payer: PHP Medicare Advantage |
$168.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.61
|
| Rate for Payer: Priority Health HMO/PPO |
$585.72
|
| Rate for Payer: Priority Health Medicare |
$169.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$451.07
|
| Rate for Payer: Railroad Medicare Medicare |
$168.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$592.45
|
| Rate for Payer: UHC Core |
$562.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.31
|
| Rate for Payer: UHC Exchange |
$168.31
|
| Rate for Payer: UHC Medicare Advantage |
$168.31
|
| Rate for Payer: UHCCP Medicaid |
$87.94
|
| Rate for Payer: VA VA |
$168.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.93
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$673.24
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$437.61 |
| Max. Negotiated Rate |
$605.92 |
| Rate for Payer: Aetna Commercial |
$572.25
|
| Rate for Payer: BCBS Trust/PPO |
$549.57
|
| Rate for Payer: BCN Commercial |
$520.28
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cofinity Commercial |
$578.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.59
|
| Rate for Payer: Healthscope Commercial |
$605.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.25
|
| Rate for Payer: Nomi Health Commercial |
$552.06
|
| Rate for Payer: PHP Commercial |
$572.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.61
|
| Rate for Payer: Priority Health HMO/PPO |
$585.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$451.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$592.45
|
| Rate for Payer: UHC Core |
$562.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.93
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$131.61
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$85.55 |
| Max. Negotiated Rate |
$118.45 |
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: BCBS Trust/PPO |
$107.43
|
| Rate for Payer: BCN Commercial |
$101.71
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Healthscope Commercial |
$118.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: Nomi Health Commercial |
$107.92
|
| Rate for Payer: PHP Commercial |
$111.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: Priority Health HMO/PPO |
$114.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.82
|
| Rate for Payer: UHC Core |
$109.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.71
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$131.61
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.26 |
| Max. Negotiated Rate |
$118.45 |
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: Aetna Medicare |
$34.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.13
|
| Rate for Payer: BCBS Complete |
$52.64
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$108.20
|
| Rate for Payer: BCN Commercial |
$102.33
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$118.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: Nomi Health Commercial |
$107.92
|
| Rate for Payer: PACE Senior Care Partners |
$31.26
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$111.87
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: Priority Health HMO/PPO |
$114.50
|
| Rate for Payer: Priority Health Medicare |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.18
|
| Rate for Payer: Railroad Medicare Medicare |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.82
|
| Rate for Payer: UHC Core |
$109.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: VA VA |
$32.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.71
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$15.80
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.22
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$15.05
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.78 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$37.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$15.80
|
| Rate for Payer: BCBS MAPPO |
$11.44
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$11.44
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.44
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.44
|
| Rate for Payer: UHC Exchange |
$11.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.44
|
| Rate for Payer: UHCCP Medicaid |
$15.05
|
| Rate for Payer: VA VA |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.37
|
| Rate for Payer: BCN Commercial |
$35.38
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$41.20
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.78 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$35.02
|
| Rate for Payer: Aetna Medicare |
$10.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.88
|
| Rate for Payer: BCBS Complete |
$15.80
|
| Rate for Payer: BCBS MAPPO |
$10.30
|
| Rate for Payer: BCBS Trust/PPO |
$33.87
|
| Rate for Payer: BCN Commercial |
$32.03
|
| Rate for Payer: BCN Medicare Advantage |
$10.30
|
| Rate for Payer: Cash Price |
$32.96
|
| Rate for Payer: Cash Price |
$32.96
|
| Rate for Payer: Cofinity Commercial |
$35.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.30
|
| Rate for Payer: Healthscope Commercial |
$37.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.90
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.82
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.02
|
| Rate for Payer: Nomi Health Commercial |
$33.78
|
| Rate for Payer: PACE Senior Care Partners |
$9.78
|
| Rate for Payer: PACE SWMI |
$10.30
|
| Rate for Payer: PHP Commercial |
$35.02
|
| Rate for Payer: PHP Medicare Advantage |
$10.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO |
$35.84
|
| Rate for Payer: Priority Health Medicare |
$10.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.60
|
| Rate for Payer: Railroad Medicare Medicare |
$10.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Core |
$34.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.30
|
| Rate for Payer: UHC Exchange |
$10.30
|
| Rate for Payer: UHC Medicare Advantage |
$10.30
|
| Rate for Payer: UHCCP Medicaid |
$15.05
|
| Rate for Payer: VA VA |
$10.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.90
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$41.20
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna Commercial |
$35.02
|
| Rate for Payer: BCBS Trust/PPO |
$33.63
|
| Rate for Payer: BCN Commercial |
$31.84
|
| Rate for Payer: Cash Price |
$32.96
|
| Rate for Payer: Cofinity Commercial |
$35.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.96
|
| Rate for Payer: Healthscope Commercial |
$37.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.02
|
| Rate for Payer: Nomi Health Commercial |
$33.78
|
| Rate for Payer: PHP Commercial |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health HMO/PPO |
$35.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Core |
$34.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.90
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.14 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.77
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$25.42
|
| Rate for Payer: BCBS Trust/PPO |
$83.57
|
| Rate for Payer: BCN Commercial |
$79.04
|
| Rate for Payer: BCN Medicare Advantage |
$25.42
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.42
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.69
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: PACE Senior Care Partners |
$24.14
|
| Rate for Payer: PACE SWMI |
$25.42
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO |
$88.44
|
| Rate for Payer: Priority Health Medicare |
$25.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.11
|
| Rate for Payer: Railroad Medicare Medicare |
$25.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.46
|
| Rate for Payer: UHC Core |
$84.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.42
|
| Rate for Payer: UHC Exchange |
$25.42
|
| Rate for Payer: UHC Medicare Advantage |
$25.42
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$25.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC CANNABINOID URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.08 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: BCBS Trust/PPO |
$82.99
|
| Rate for Payer: BCN Commercial |
$78.56
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO |
$88.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.46
|
| Rate for Payer: UHC Core |
$84.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$210.03 |
| Max. Negotiated Rate |
$795.91 |
| Rate for Payer: Aetna Commercial |
$751.69
|
| Rate for Payer: Aetna Medicare |
$229.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.36
|
| Rate for Payer: BCBS Complete |
$353.74
|
| Rate for Payer: BCBS MAPPO |
$221.08
|
| Rate for Payer: BCBS Trust/PPO |
$727.02
|
| Rate for Payer: BCN Commercial |
$687.57
|
| Rate for Payer: BCN Medicare Advantage |
$221.08
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Cofinity Commercial |
$760.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.08
|
| Rate for Payer: Healthscope Commercial |
$795.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: Nomi Health Commercial |
$725.16
|
| Rate for Payer: PACE Senior Care Partners |
$210.03
|
| Rate for Payer: PACE SWMI |
$221.08
|
| Rate for Payer: PHP Commercial |
$751.69
|
| Rate for Payer: PHP Medicare Advantage |
$221.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: Priority Health HMO/PPO |
$769.38
|
| Rate for Payer: Priority Health Medicare |
$223.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.51
|
| Rate for Payer: Railroad Medicare Medicare |
$221.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.22
|
| Rate for Payer: UHC Core |
$738.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.08
|
| Rate for Payer: UHC Exchange |
$221.08
|
| Rate for Payer: UHC Medicare Advantage |
$221.08
|
| Rate for Payer: VA VA |
$221.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.26
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$574.82 |
| Max. Negotiated Rate |
$795.91 |
| Rate for Payer: Aetna Commercial |
$751.69
|
| Rate for Payer: BCBS Trust/PPO |
$721.89
|
| Rate for Payer: BCN Commercial |
$683.42
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Cofinity Commercial |
$760.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Healthscope Commercial |
$795.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: Nomi Health Commercial |
$725.16
|
| Rate for Payer: PHP Commercial |
$751.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: Priority Health HMO/PPO |
$769.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$592.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.22
|
| Rate for Payer: UHC Core |
$738.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.26
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
OP
|
$302.94
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.95 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: Aetna Medicare |
$78.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.67
|
| Rate for Payer: BCBS Complete |
$121.18
|
| Rate for Payer: BCBS MAPPO |
$75.74
|
| Rate for Payer: BCBS Trust/PPO |
$249.05
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: BCN Medicare Advantage |
$75.74
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: PACE Senior Care Partners |
$71.95
|
| Rate for Payer: PACE SWMI |
$75.74
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: PHP Medicare Advantage |
$75.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health HMO/PPO |
$263.56
|
| Rate for Payer: Priority Health Medicare |
$76.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.97
|
| Rate for Payer: Railroad Medicare Medicare |
$75.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.59
|
| Rate for Payer: UHC Core |
$252.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.74
|
| Rate for Payer: UHC Exchange |
$75.74
|
| Rate for Payer: UHC Medicare Advantage |
$75.74
|
| Rate for Payer: VA VA |
$75.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.20
|
|
