|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
IP
|
$869.96
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$530.59 |
| Max. Negotiated Rate |
$782.96 |
| Rate for Payer: Aetna Commercial |
$739.47
|
| Rate for Payer: BCBS Trust/PPO |
$672.31
|
| Rate for Payer: BCN Commercial |
$672.31
|
| Rate for Payer: Cash Price |
$695.97
|
| Rate for Payer: Cofinity Commercial |
$748.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$695.97
|
| Rate for Payer: Healthscope Commercial |
$782.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$652.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$739.47
|
| Rate for Payer: PHP Commercial |
$739.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$608.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$756.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$530.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$765.56
|
| Rate for Payer: UHC Core |
$726.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$652.47
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
IP
|
$1,202.46
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$733.38 |
| Max. Negotiated Rate |
$1,082.21 |
| Rate for Payer: Aetna Commercial |
$1,022.09
|
| Rate for Payer: BCBS Trust/PPO |
$929.26
|
| Rate for Payer: BCN Commercial |
$929.26
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,034.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Healthscope Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: PHP Commercial |
$1,022.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,058.16
|
| Rate for Payer: UHC Core |
$1,004.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.84
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
OP
|
$1,202.46
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$285.58 |
| Max. Negotiated Rate |
$1,082.21 |
| Rate for Payer: Aetna Commercial |
$1,022.09
|
| Rate for Payer: Aetna Medicare |
$312.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.77
|
| Rate for Payer: BCBS Complete |
$624.38
|
| Rate for Payer: BCBS MAPPO |
$300.62
|
| Rate for Payer: BCBS Trust/PPO |
$934.91
|
| Rate for Payer: BCN Commercial |
$934.91
|
| Rate for Payer: BCN Medicare Advantage |
$300.62
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cash Price |
$961.97
|
| Rate for Payer: Cofinity Commercial |
$1,034.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.62
|
| Rate for Payer: Healthscope Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.84
|
| Rate for Payer: Mclaren Medicaid |
$594.64
|
| Rate for Payer: Meridian Medicaid |
$624.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,022.09
|
| Rate for Payer: PACE Senior Care Partners |
$285.58
|
| Rate for Payer: PACE SWMI |
$300.62
|
| Rate for Payer: PHP Commercial |
$1,022.09
|
| Rate for Payer: PHP Medicare Advantage |
$300.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$594.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,046.14
|
| Rate for Payer: Priority Health Medicare |
$300.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$733.38
|
| Rate for Payer: Railroad Medicare Medicare |
$300.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,058.16
|
| Rate for Payer: UHC Core |
$1,004.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.62
|
| Rate for Payer: UHC Medicare Advantage |
$309.63
|
| Rate for Payer: VA VA |
$300.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.84
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Senior Care Partners |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.77 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$27.59
|
| Rate for Payer: BCN Commercial |
$27.59
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.52
|
| Rate for Payer: BCN Commercial |
$21.52
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.17
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$38.10
|
| Rate for Payer: BCN Commercial |
$38.10
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.75
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.65
|
| Rate for Payer: PACE Senior Care Partners |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.63
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.89
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.12
|
| Rate for Payer: UHC Core |
$40.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Medicare Advantage |
$12.62
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.75
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.89 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$41.65
|
| Rate for Payer: BCBS Trust/PPO |
$37.87
|
| Rate for Payer: BCN Commercial |
$37.87
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$42.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.20
|
| Rate for Payer: Healthscope Commercial |
$44.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.65
|
| Rate for Payer: PHP Commercial |
$41.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.12
|
| Rate for Payer: UHC Core |
$40.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.75
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
IP
|
$303.18
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.91 |
| Max. Negotiated Rate |
$272.86 |
| Rate for Payer: Aetna Commercial |
$257.70
|
| Rate for Payer: BCBS Trust/PPO |
$234.30
|
| Rate for Payer: BCN Commercial |
$234.30
|
| Rate for Payer: Cash Price |
$242.54
|
| Rate for Payer: Cofinity Commercial |
$260.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.54
|
| Rate for Payer: Healthscope Commercial |
$272.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.70
|
| Rate for Payer: PHP Commercial |
$257.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.80
|
| Rate for Payer: UHC Core |
$253.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.38
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
OP
|
$303.18
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.01 |
| Max. Negotiated Rate |
$272.86 |
| Rate for Payer: Aetna Commercial |
$257.70
|
| Rate for Payer: Aetna Medicare |
$78.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.74
|
| Rate for Payer: BCBS Complete |
$121.27
|
| Rate for Payer: BCBS MAPPO |
$75.80
|
| Rate for Payer: BCBS Trust/PPO |
$235.72
|
| Rate for Payer: BCN Commercial |
$235.72
|
| Rate for Payer: BCN Medicare Advantage |
$75.80
|
| Rate for Payer: Cash Price |
$242.54
|
| Rate for Payer: Cofinity Commercial |
$260.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.80
|
| Rate for Payer: Healthscope Commercial |
$272.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.70
|
| Rate for Payer: PACE Senior Care Partners |
$72.01
|
| Rate for Payer: PACE SWMI |
$75.80
|
| Rate for Payer: PHP Commercial |
$257.70
|
| Rate for Payer: PHP Medicare Advantage |
$75.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.77
|
| Rate for Payer: Priority Health Medicare |
$75.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.91
|
| Rate for Payer: Railroad Medicare Medicare |
$75.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.80
|
| Rate for Payer: UHC Core |
$253.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.80
|
| Rate for Payer: UHC Medicare Advantage |
$78.07
|
| Rate for Payer: VA VA |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.38
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$41.21
|
| Rate for Payer: BCN Commercial |
$41.21
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Mclaren Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.05
|
| Rate for Payer: PACE Senior Care Partners |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.11
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.64
|
| Rate for Payer: UHC Core |
$44.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: VA VA |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.32 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: BCBS Trust/PPO |
$40.96
|
| Rate for Payer: BCN Commercial |
$40.96
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.05
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.64
|
| Rate for Payer: UHC Core |
$44.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: BCBS Trust/PPO |
$62.60
|
| Rate for Payer: BCN Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.85
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$21.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.31
|
| Rate for Payer: BCBS Complete |
$11.07
|
| Rate for Payer: BCBS MAPPO |
$20.25
|
| Rate for Payer: BCBS Trust/PPO |
$62.98
|
| Rate for Payer: BCN Commercial |
$62.98
|
| Rate for Payer: BCN Medicare Advantage |
$20.25
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Mclaren Medicaid |
$10.55
|
| Rate for Payer: Meridian Medicaid |
$11.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.85
|
| Rate for Payer: PACE Senior Care Partners |
$19.24
|
| Rate for Payer: PACE SWMI |
$20.25
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: PHP Medicare Advantage |
$20.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.47
|
| Rate for Payer: Priority Health Medicare |
$20.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.40
|
| Rate for Payer: Railroad Medicare Medicare |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.25
|
| Rate for Payer: UHC Medicare Advantage |
$20.86
|
| Rate for Payer: VA VA |
$20.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
IP
|
$133.31
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$81.31 |
| Max. Negotiated Rate |
$119.98 |
| Rate for Payer: Aetna Commercial |
$113.31
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$103.02
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Cofinity Commercial |
$114.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.65
|
| Rate for Payer: Healthscope Commercial |
$119.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.31
|
| Rate for Payer: PHP Commercial |
$113.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.31
|
| Rate for Payer: UHC Core |
$111.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.98
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
OP
|
$133.31
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$119.98 |
| Rate for Payer: Aetna Commercial |
$113.31
|
| Rate for Payer: Aetna Medicare |
$34.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.66
|
| Rate for Payer: BCBS Complete |
$53.32
|
| Rate for Payer: BCBS MAPPO |
$33.33
|
| Rate for Payer: BCBS Trust/PPO |
$103.65
|
| Rate for Payer: BCN Commercial |
$103.65
|
| Rate for Payer: BCN Medicare Advantage |
$33.33
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Cofinity Commercial |
$114.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.33
|
| Rate for Payer: Healthscope Commercial |
$119.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.31
|
| Rate for Payer: PACE Senior Care Partners |
$31.66
|
| Rate for Payer: PACE SWMI |
$33.33
|
| Rate for Payer: PHP Commercial |
$113.31
|
| Rate for Payer: PHP Medicare Advantage |
$33.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$115.98
|
| Rate for Payer: Priority Health Medicare |
$33.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.31
|
| Rate for Payer: Railroad Medicare Medicare |
$33.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.31
|
| Rate for Payer: UHC Core |
$111.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.33
|
| Rate for Payer: UHC Medicare Advantage |
$34.33
|
| Rate for Payer: VA VA |
$33.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.98
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$3.04
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$2.89
|
| Rate for Payer: Meridian Medicaid |
$3.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC GLUCOSE BODY FLUID NOT BLOOD
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
30100222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC GLUCOSE BODY FLUID NOT BLOOD
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
30100222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$2.90
|
| Rate for Payer: Meridian Medicaid |
$3.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC GLUCOSE LEVEL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$2.90
|
| Rate for Payer: Meridian Medicaid |
$3.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC GLUCOSE LEVEL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
30100224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.19
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$11.35
|
| Rate for Payer: BCBS Trust/PPO |
$35.30
|
| Rate for Payer: BCN Commercial |
$35.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.35
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.35
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Mclaren Medicaid |
$3.51
|
| Rate for Payer: Meridian Medicaid |
$3.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Senior Care Partners |
$10.78
|
| Rate for Payer: PACE SWMI |
$11.35
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$11.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Medicare |
$11.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.35
|
| Rate for Payer: UHC Medicare Advantage |
$11.69
|
| Rate for Payer: VA VA |
$11.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
30100224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: BCBS Trust/PPO |
$35.09
|
| Rate for Payer: BCN Commercial |
$35.09
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
