|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.34
|
| Rate for Payer: BCBS Complete |
$18.32
|
| Rate for Payer: BCBS MAPPO |
$9.07
|
| Rate for Payer: BCBS Trust/PPO |
$28.22
|
| Rate for Payer: BCN Commercial |
$28.22
|
| Rate for Payer: BCN Medicare Advantage |
$9.07
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.07
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Mclaren Medicaid |
$17.45
|
| Rate for Payer: Meridian Medicaid |
$18.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PACE Senior Care Partners |
$8.62
|
| Rate for Payer: PACE SWMI |
$9.07
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$9.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.57
|
| Rate for Payer: Priority Health Medicare |
$9.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.13
|
| Rate for Payer: Railroad Medicare Medicare |
$9.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.94
|
| Rate for Payer: UHC Core |
$30.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.07
|
| Rate for Payer: UHC Medicare Advantage |
$9.34
|
| Rate for Payer: VA VA |
$9.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: BCBS Trust/PPO |
$28.04
|
| Rate for Payer: BCN Commercial |
$28.04
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.94
|
| Rate for Payer: UHC Core |
$30.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Medicare |
$5.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.06
|
| Rate for Payer: BCBS Complete |
$9.38
|
| Rate for Payer: BCBS MAPPO |
$4.84
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: BCN Commercial |
$15.07
|
| Rate for Payer: BCN Medicare Advantage |
$4.84
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.84
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Mclaren Medicaid |
$8.94
|
| Rate for Payer: Meridian Medicaid |
$9.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PACE Senior Care Partners |
$4.60
|
| Rate for Payer: PACE SWMI |
$4.84
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: PHP Medicare Advantage |
$4.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.86
|
| Rate for Payer: Priority Health Medicare |
$4.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.84
|
| Rate for Payer: UHC Medicare Advantage |
$4.99
|
| Rate for Payer: VA VA |
$4.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: BCBS Trust/PPO |
$14.98
|
| Rate for Payer: BCN Commercial |
$14.98
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna Medicare |
$7.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.56
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$6.85
|
| Rate for Payer: BCBS Trust/PPO |
$21.30
|
| Rate for Payer: BCN Commercial |
$21.30
|
| Rate for Payer: BCN Medicare Advantage |
$6.85
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.85
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.55
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.51
|
| Rate for Payer: PACE SWMI |
$6.85
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: PHP Medicare Advantage |
$6.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.84
|
| Rate for Payer: Priority Health Medicare |
$6.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.71
|
| Rate for Payer: Railroad Medicare Medicare |
$6.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.11
|
| Rate for Payer: UHC Core |
$22.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.85
|
| Rate for Payer: UHC Medicare Advantage |
$7.06
|
| Rate for Payer: VA VA |
$6.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.55
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: BCBS Trust/PPO |
$21.17
|
| Rate for Payer: BCN Commercial |
$21.17
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.92
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.11
|
| Rate for Payer: UHC Core |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.55
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.63 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: BCBS Trust/PPO |
$83.15
|
| Rate for Payer: BCN Commercial |
$83.15
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$27.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.62
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$26.90
|
| Rate for Payer: BCBS Trust/PPO |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Medicare Advantage |
$26.90
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.90
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Senior Care Partners |
$25.56
|
| Rate for Payer: PACE SWMI |
$26.90
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: PHP Medicare Advantage |
$26.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Medicare |
$26.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: Railroad Medicare Medicare |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.90
|
| Rate for Payer: UHC Medicare Advantage |
$27.71
|
| Rate for Payer: VA VA |
$26.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.31 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: BCBS Trust/PPO |
$118.24
|
| Rate for Payer: BCN Commercial |
$118.24
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.64
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.34 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.81
|
| Rate for Payer: BCBS Complete |
$52.20
|
| Rate for Payer: BCBS MAPPO |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$118.96
|
| Rate for Payer: BCN Commercial |
$118.96
|
| Rate for Payer: BCN Medicare Advantage |
$38.25
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.25
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Mclaren Medicaid |
$49.71
|
| Rate for Payer: Meridian Medicaid |
$52.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PACE Senior Care Partners |
$36.34
|
| Rate for Payer: PACE SWMI |
$38.25
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: PHP Medicare Advantage |
$38.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.11
|
| Rate for Payer: Priority Health Medicare |
$38.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.31
|
| Rate for Payer: Railroad Medicare Medicare |
$38.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.64
|
| Rate for Payer: UHC Core |
$127.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.25
|
| Rate for Payer: UHC Medicare Advantage |
$39.40
|
| Rate for Payer: VA VA |
$38.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC HEMATOCRIT
|
Facility
|
OP
|
$23.40
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: Aetna Commercial |
$19.89
|
| Rate for Payer: Aetna Medicare |
$6.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.31
|
| Rate for Payer: BCBS Complete |
$1.84
|
| Rate for Payer: BCBS MAPPO |
$5.85
|
| Rate for Payer: BCBS Trust/PPO |
$18.19
|
| Rate for Payer: BCN Commercial |
$18.19
|
| Rate for Payer: BCN Medicare Advantage |
$5.85
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.85
|
| Rate for Payer: Healthscope Commercial |
$21.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.55
|
| Rate for Payer: Mclaren Medicaid |
$1.75
|
| Rate for Payer: Meridian Medicaid |
$1.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.89
|
| Rate for Payer: PACE Senior Care Partners |
$5.56
|
| Rate for Payer: PACE SWMI |
$5.85
|
| Rate for Payer: PHP Commercial |
$19.89
|
| Rate for Payer: PHP Medicare Advantage |
$5.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.36
|
| Rate for Payer: Priority Health Medicare |
$5.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.27
|
| Rate for Payer: Railroad Medicare Medicare |
$5.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.59
|
| Rate for Payer: UHC Core |
$19.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.85
|
| Rate for Payer: UHC Medicare Advantage |
$6.03
|
| Rate for Payer: VA VA |
$5.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.55
|
|
|
HC HEMATOCRIT
|
Facility
|
IP
|
$23.40
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: Aetna Commercial |
$19.89
|
| Rate for Payer: BCBS Trust/PPO |
$18.08
|
| Rate for Payer: BCN Commercial |
$18.08
|
| Rate for Payer: Cash Price |
$18.72
|
| Rate for Payer: Cofinity Commercial |
$20.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.72
|
| Rate for Payer: Healthscope Commercial |
$21.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.89
|
| Rate for Payer: PHP Commercial |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.59
|
| Rate for Payer: UHC Core |
$19.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.55
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$158.63 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: BCBS Trust/PPO |
$201.01
|
| Rate for Payer: BCN Commercial |
$201.01
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.08
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.24 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$50.65
|
| Rate for Payer: BCBS MAPPO |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$202.23
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$65.02
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.02
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Mclaren Medicaid |
$48.24
|
| Rate for Payer: Meridian Medicaid |
$50.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.08
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.02
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: PHP Medicare Advantage |
$65.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.63
|
| Rate for Payer: Railroad Medicare Medicare |
$65.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.02
|
| Rate for Payer: UHC Medicare Advantage |
$66.98
|
| Rate for Payer: VA VA |
$65.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC HEMO CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$182.97 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$231.84
|
| Rate for Payer: BCN Commercial |
$231.84
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC HEMO CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$233.25
|
| Rate for Payer: BCN Commercial |
$233.25
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$77.25
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC HEMO CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$29.69 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.06
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$97.19
|
| Rate for Payer: BCCCP Commercial |
$72.85
|
| Rate for Payer: BCN Commercial |
$97.19
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Medicare |
$31.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.25
|
| Rate for Payer: UHC Medicare Advantage |
$32.19
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC HEMO CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$96.60
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC HEMO CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.62
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$349.88
|
| Rate for Payer: BCN Commercial |
$349.88
|
| Rate for Payer: BCN Medicare Advantage |
$112.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.50
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.50
|
| Rate for Payer: PACE Senior Care Partners |
$106.88
|
| Rate for Payer: PACE SWMI |
$112.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: PHP Medicare Advantage |
$112.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.50
|
| Rate for Payer: Priority Health Medicare |
$112.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.46
|
| Rate for Payer: Railroad Medicare Medicare |
$112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.50
|
| Rate for Payer: UHC Medicare Advantage |
$115.88
|
| Rate for Payer: VA VA |
$112.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
