|
HC C DIFF TOXIN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$130.76
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$117.68 |
| Rate for Payer: Aetna Commercial |
$111.15
|
| Rate for Payer: BCBS Trust/PPO |
$106.74
|
| Rate for Payer: BCN Commercial |
$101.05
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Healthscope Commercial |
$117.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: Nomi Health Commercial |
$107.22
|
| Rate for Payer: PHP Commercial |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: Priority Health HMO/PPO |
$113.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.07
|
| Rate for Payer: UHC Core |
$109.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.07
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$130.76
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$117.68 |
| Rate for Payer: Aetna Commercial |
$111.15
|
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.86
|
| Rate for Payer: BCBS Complete |
$14.39
|
| Rate for Payer: BCBS MAPPO |
$32.69
|
| Rate for Payer: BCBS Trust/PPO |
$107.50
|
| Rate for Payer: BCN Commercial |
$101.67
|
| Rate for Payer: BCN Medicare Advantage |
$32.69
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.69
|
| Rate for Payer: Healthscope Commercial |
$117.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.07
|
| Rate for Payer: Mclaren Medicaid |
$13.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.32
|
| Rate for Payer: Meridian Medicaid |
$14.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: Nomi Health Commercial |
$107.22
|
| Rate for Payer: PACE Senior Care Partners |
$31.06
|
| Rate for Payer: PACE SWMI |
$32.69
|
| Rate for Payer: PHP Commercial |
$111.15
|
| Rate for Payer: PHP Medicare Advantage |
$32.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: Priority Health HMO/PPO |
$113.76
|
| Rate for Payer: Priority Health Medicare |
$33.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.61
|
| Rate for Payer: Railroad Medicare Medicare |
$32.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.07
|
| Rate for Payer: UHC Core |
$109.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.69
|
| Rate for Payer: UHC Exchange |
$32.69
|
| Rate for Payer: UHC Medicare Advantage |
$32.69
|
| Rate for Payer: UHCCP Medicaid |
$13.71
|
| Rate for Payer: VA VA |
$32.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.07
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$184.37
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$165.93 |
| Rate for Payer: Aetna Commercial |
$156.71
|
| Rate for Payer: Aetna Medicare |
$47.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.62
|
| Rate for Payer: BCBS Complete |
$14.39
|
| Rate for Payer: BCBS MAPPO |
$46.09
|
| Rate for Payer: BCBS Trust/PPO |
$151.57
|
| Rate for Payer: BCN Commercial |
$143.35
|
| Rate for Payer: BCN Medicare Advantage |
$46.09
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cofinity Commercial |
$158.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.09
|
| Rate for Payer: Healthscope Commercial |
$165.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.28
|
| Rate for Payer: Mclaren Medicaid |
$13.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.40
|
| Rate for Payer: Meridian Medicaid |
$14.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.71
|
| Rate for Payer: Nomi Health Commercial |
$151.18
|
| Rate for Payer: PACE Senior Care Partners |
$43.79
|
| Rate for Payer: PACE SWMI |
$46.09
|
| Rate for Payer: PHP Commercial |
$156.71
|
| Rate for Payer: PHP Medicare Advantage |
$46.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.84
|
| Rate for Payer: Priority Health HMO/PPO |
$160.40
|
| Rate for Payer: Priority Health Medicare |
$46.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.53
|
| Rate for Payer: Railroad Medicare Medicare |
$46.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.25
|
| Rate for Payer: UHC Core |
$153.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.09
|
| Rate for Payer: UHC Exchange |
$46.09
|
| Rate for Payer: UHC Medicare Advantage |
$46.09
|
| Rate for Payer: UHCCP Medicaid |
$13.71
|
| Rate for Payer: VA VA |
$46.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.28
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$184.37
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.84 |
| Max. Negotiated Rate |
$165.93 |
| Rate for Payer: Aetna Commercial |
$156.71
|
| Rate for Payer: BCBS Trust/PPO |
$150.50
|
| Rate for Payer: BCN Commercial |
$142.48
|
| Rate for Payer: Cash Price |
$147.50
|
| Rate for Payer: Cofinity Commercial |
$158.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.50
|
| Rate for Payer: Healthscope Commercial |
$165.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.71
|
| Rate for Payer: Nomi Health Commercial |
$151.18
|
| Rate for Payer: PHP Commercial |
$156.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.84
|
| Rate for Payer: Priority Health HMO/PPO |
$160.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.25
|
| Rate for Payer: UHC Core |
$153.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.28
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.48 |
| Max. Negotiated Rate |
$179.94 |
| Rate for Payer: Aetna Commercial |
$169.94
|
| Rate for Payer: Aetna Medicare |
$51.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.48
|
| Rate for Payer: BCBS Complete |
$92.79
|
| Rate for Payer: BCBS MAPPO |
$49.98
|
| Rate for Payer: BCBS Trust/PPO |
$164.36
|
| Rate for Payer: BCN Commercial |
$155.45
|
| Rate for Payer: BCN Medicare Advantage |
$49.98
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$171.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.98
|
| Rate for Payer: Healthscope Commercial |
$179.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.95
|
| Rate for Payer: Mclaren Medicaid |
$88.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.48
|
| Rate for Payer: Meridian Medicaid |
$92.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PACE Senior Care Partners |
$47.48
|
| Rate for Payer: PACE SWMI |
$49.98
|
| Rate for Payer: PHP Commercial |
$169.94
|
| Rate for Payer: PHP Medicare Advantage |
$49.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO |
$173.94
|
| Rate for Payer: Priority Health Medicare |
$50.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.95
|
| Rate for Payer: Railroad Medicare Medicare |
$49.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.94
|
| Rate for Payer: UHC Core |
$166.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.98
|
| Rate for Payer: UHC Exchange |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$49.98
|
| Rate for Payer: UHCCP Medicaid |
$88.37
|
| Rate for Payer: VA VA |
$49.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.95
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$190.74
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$171.67 |
| Rate for Payer: Aetna Commercial |
$162.13
|
| Rate for Payer: Aetna Medicare |
$49.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.61
|
| Rate for Payer: BCBS Complete |
$19.59
|
| Rate for Payer: BCBS MAPPO |
$47.69
|
| Rate for Payer: BCBS Trust/PPO |
$156.81
|
| Rate for Payer: BCN Commercial |
$148.30
|
| Rate for Payer: BCN Medicare Advantage |
$47.69
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$164.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.69
|
| Rate for Payer: Healthscope Commercial |
$171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.06
|
| Rate for Payer: Mclaren Medicaid |
$18.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.07
|
| Rate for Payer: Meridian Medicaid |
$19.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.13
|
| Rate for Payer: Nomi Health Commercial |
$156.41
|
| Rate for Payer: PACE Senior Care Partners |
$45.30
|
| Rate for Payer: PACE SWMI |
$47.69
|
| Rate for Payer: PHP Commercial |
$162.13
|
| Rate for Payer: PHP Medicare Advantage |
$47.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.98
|
| Rate for Payer: Priority Health HMO/PPO |
$165.94
|
| Rate for Payer: Priority Health Medicare |
$48.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.80
|
| Rate for Payer: Railroad Medicare Medicare |
$47.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$159.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.69
|
| Rate for Payer: UHC Exchange |
$47.69
|
| Rate for Payer: UHC Medicare Advantage |
$47.69
|
| Rate for Payer: UHCCP Medicaid |
$18.66
|
| Rate for Payer: VA VA |
$47.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.06
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$179.94 |
| Rate for Payer: Aetna Commercial |
$169.94
|
| Rate for Payer: BCBS Trust/PPO |
$163.20
|
| Rate for Payer: BCN Commercial |
$154.51
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$171.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Healthscope Commercial |
$179.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PHP Commercial |
$169.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO |
$173.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.94
|
| Rate for Payer: UHC Core |
$166.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.95
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$190.74
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$123.98 |
| Max. Negotiated Rate |
$171.67 |
| Rate for Payer: Aetna Commercial |
$162.13
|
| Rate for Payer: BCBS Trust/PPO |
$155.70
|
| Rate for Payer: BCN Commercial |
$147.40
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$164.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.13
|
| Rate for Payer: Nomi Health Commercial |
$156.41
|
| Rate for Payer: PHP Commercial |
$162.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.98
|
| Rate for Payer: Priority Health HMO/PPO |
$165.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$159.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.06
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.48 |
| Max. Negotiated Rate |
$179.94 |
| Rate for Payer: Aetna Commercial |
$169.94
|
| Rate for Payer: Aetna Medicare |
$51.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.48
|
| Rate for Payer: BCBS Complete |
$92.79
|
| Rate for Payer: BCBS MAPPO |
$49.98
|
| Rate for Payer: BCBS Trust/PPO |
$164.36
|
| Rate for Payer: BCN Commercial |
$155.45
|
| Rate for Payer: BCN Medicare Advantage |
$49.98
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$171.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.98
|
| Rate for Payer: Healthscope Commercial |
$179.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.95
|
| Rate for Payer: Mclaren Medicaid |
$88.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.48
|
| Rate for Payer: Meridian Medicaid |
$92.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PACE Senior Care Partners |
$47.48
|
| Rate for Payer: PACE SWMI |
$49.98
|
| Rate for Payer: PHP Commercial |
$169.94
|
| Rate for Payer: PHP Medicare Advantage |
$49.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO |
$173.94
|
| Rate for Payer: Priority Health Medicare |
$50.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.95
|
| Rate for Payer: Railroad Medicare Medicare |
$49.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.94
|
| Rate for Payer: UHC Core |
$166.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.98
|
| Rate for Payer: UHC Exchange |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$49.98
|
| Rate for Payer: UHCCP Medicaid |
$88.37
|
| Rate for Payer: VA VA |
$49.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.95
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$199.93
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$179.94 |
| Rate for Payer: Aetna Commercial |
$169.94
|
| Rate for Payer: BCBS Trust/PPO |
$163.20
|
| Rate for Payer: BCN Commercial |
$154.51
|
| Rate for Payer: Cash Price |
$159.94
|
| Rate for Payer: Cofinity Commercial |
$171.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.94
|
| Rate for Payer: Healthscope Commercial |
$179.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.94
|
| Rate for Payer: Nomi Health Commercial |
$163.94
|
| Rate for Payer: PHP Commercial |
$169.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.95
|
| Rate for Payer: Priority Health HMO/PPO |
$173.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.94
|
| Rate for Payer: UHC Core |
$166.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.95
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.10
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE SWMI |
$7.10
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.10
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.10
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: BCBS Trust/PPO |
$23.19
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.10
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE SWMI |
$7.10
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.10
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.10
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: BCBS Trust/PPO |
$23.19
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,211.27
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.68 |
| Max. Negotiated Rate |
$1,090.14 |
| Rate for Payer: Aetna Commercial |
$1,029.58
|
| Rate for Payer: Aetna Medicare |
$314.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.52
|
| Rate for Payer: BCBS Complete |
$675.91
|
| Rate for Payer: BCBS MAPPO |
$302.82
|
| Rate for Payer: BCBS Trust/PPO |
$995.79
|
| Rate for Payer: BCN Commercial |
$941.76
|
| Rate for Payer: BCN Medicare Advantage |
$302.82
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cofinity Commercial |
$1,041.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.82
|
| Rate for Payer: Healthscope Commercial |
$1,090.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.45
|
| Rate for Payer: Mclaren Medicaid |
$643.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.96
|
| Rate for Payer: Meridian Medicaid |
$675.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.58
|
| Rate for Payer: Nomi Health Commercial |
$993.24
|
| Rate for Payer: PACE Senior Care Partners |
$287.68
|
| Rate for Payer: PACE SWMI |
$302.82
|
| Rate for Payer: PHP Commercial |
$1,029.58
|
| Rate for Payer: PHP Medicare Advantage |
$302.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$643.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,053.80
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$811.55
|
| Rate for Payer: Railroad Medicare Medicare |
$302.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.92
|
| Rate for Payer: UHC Core |
$1,011.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.82
|
| Rate for Payer: UHC Exchange |
$302.82
|
| Rate for Payer: UHC Medicare Advantage |
$302.82
|
| Rate for Payer: UHCCP Medicaid |
$643.68
|
| Rate for Payer: VA VA |
$302.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.45
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,211.27
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$787.33 |
| Max. Negotiated Rate |
$1,090.14 |
| Rate for Payer: Aetna Commercial |
$1,029.58
|
| Rate for Payer: BCBS Trust/PPO |
$988.76
|
| Rate for Payer: BCN Commercial |
$936.07
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cofinity Commercial |
$1,041.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.02
|
| Rate for Payer: Healthscope Commercial |
$1,090.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.58
|
| Rate for Payer: Nomi Health Commercial |
$993.24
|
| Rate for Payer: PHP Commercial |
$1,029.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,053.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$811.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.92
|
| Rate for Payer: UHC Core |
$1,011.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.45
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$111.38 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: BCBS Trust/PPO |
$139.88
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health HMO/PPO |
$149.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$140.88
|
| Rate for Payer: BCN Commercial |
$133.23
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Mclaren Medicaid |
$9.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: PACE Senior Care Partners |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health HMO/PPO |
$149.08
|
| Rate for Payer: Priority Health Medicare |
$43.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.81
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$9.01
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.94 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$71.26
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$4.25
|
| Rate for Payer: BCBS MAPPO |
$23.05
|
| Rate for Payer: BCBS Trust/PPO |
$75.81
|
| Rate for Payer: BCN Commercial |
$71.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.05
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.05
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Mclaren Medicaid |
$4.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: Meridian Medicaid |
$4.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$21.90
|
| Rate for Payer: PACE SWMI |
$23.05
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$23.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: Railroad Medicare Medicare |
$23.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.05
|
| Rate for Payer: UHC Exchange |
$23.05
|
| Rate for Payer: UHC Medicare Advantage |
$23.05
|
| Rate for Payer: UHCCP Medicaid |
$4.05
|
| Rate for Payer: VA VA |
$23.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.45 |
| Max. Negotiated Rate |
$236.66 |
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: Aetna Medicare |
$68.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.17
|
| Rate for Payer: BCBS Complete |
$103.14
|
| Rate for Payer: BCBS MAPPO |
$65.74
|
| Rate for Payer: BCBS Trust/PPO |
$216.18
|
| Rate for Payer: BCN Commercial |
$204.45
|
| Rate for Payer: BCN Medicare Advantage |
$65.74
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.74
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Mclaren Medicaid |
$98.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.03
|
| Rate for Payer: Meridian Medicaid |
$103.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: Nomi Health Commercial |
$215.63
|
| Rate for Payer: PACE Senior Care Partners |
$62.45
|
| Rate for Payer: PACE SWMI |
$65.74
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: PHP Medicare Advantage |
$65.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health HMO/PPO |
$228.78
|
| Rate for Payer: Priority Health Medicare |
$66.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.18
|
| Rate for Payer: Railroad Medicare Medicare |
$65.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.40
|
| Rate for Payer: UHC Core |
$219.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.74
|
| Rate for Payer: UHC Exchange |
$65.74
|
| Rate for Payer: UHC Medicare Advantage |
$65.74
|
| Rate for Payer: UHCCP Medicaid |
$98.23
|
| Rate for Payer: VA VA |
$65.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$170.92 |
| Max. Negotiated Rate |
$236.66 |
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: BCBS Trust/PPO |
$214.65
|
| Rate for Payer: BCN Commercial |
$203.22
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: Nomi Health Commercial |
$215.63
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health HMO/PPO |
$228.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.40
|
| Rate for Payer: UHC Core |
$219.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.32 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: BCBS Trust/PPO |
$120.97
|
| Rate for Payer: BCN Commercial |
$114.52
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.31
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$121.83
|
| Rate for Payer: BCN Commercial |
$115.22
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE Senior Care Partners |
$35.20
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Medicare |
$37.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.29
|
| Rate for Payer: Railroad Medicare Medicare |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Exchange |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$37.05
|
| Rate for Payer: VA VA |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
