|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$531.36
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: Aetna Medicare |
$138.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.05
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$132.84
|
| Rate for Payer: BCBS Trust/PPO |
$413.13
|
| Rate for Payer: BCN Commercial |
$413.13
|
| Rate for Payer: BCN Medicare Advantage |
$132.84
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.84
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PACE Senior Care Partners |
$126.20
|
| Rate for Payer: PACE SWMI |
$132.84
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: PHP Medicare Advantage |
$132.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.28
|
| Rate for Payer: Priority Health Medicare |
$132.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.08
|
| Rate for Payer: Railroad Medicare Medicare |
$132.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.60
|
| Rate for Payer: UHC Core |
$443.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.84
|
| Rate for Payer: UHC Medicare Advantage |
$136.83
|
| Rate for Payer: VA VA |
$132.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$90.02 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: BCBS Trust/PPO |
$114.06
|
| Rate for Payer: BCN Commercial |
$114.06
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.88
|
| Rate for Payer: UHC Core |
$123.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.05 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna Medicare |
$38.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.12
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$36.90
|
| Rate for Payer: BCBS Trust/PPO |
$114.75
|
| Rate for Payer: BCN Commercial |
$114.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.90
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.90
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PACE Senior Care Partners |
$35.05
|
| Rate for Payer: PACE SWMI |
$36.90
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: PHP Medicare Advantage |
$36.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.40
|
| Rate for Payer: Priority Health Medicare |
$36.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.02
|
| Rate for Payer: Railroad Medicare Medicare |
$36.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.88
|
| Rate for Payer: UHC Core |
$123.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.90
|
| Rate for Payer: UHC Medicare Advantage |
$38.00
|
| Rate for Payer: VA VA |
$36.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$180.04 |
| Max. Negotiated Rate |
$265.68 |
| Rate for Payer: Aetna Commercial |
$250.92
|
| Rate for Payer: BCBS Trust/PPO |
$228.13
|
| Rate for Payer: BCN Commercial |
$228.13
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$253.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Healthscope Commercial |
$265.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: PHP Commercial |
$250.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.78
|
| Rate for Payer: UHC Core |
$246.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.40
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$265.68 |
| Rate for Payer: Aetna Commercial |
$250.92
|
| Rate for Payer: Aetna Medicare |
$76.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.25
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$73.80
|
| Rate for Payer: BCBS Trust/PPO |
$229.52
|
| Rate for Payer: BCN Commercial |
$229.52
|
| Rate for Payer: BCN Medicare Advantage |
$73.80
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$253.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.80
|
| Rate for Payer: Healthscope Commercial |
$265.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.40
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: PACE Senior Care Partners |
$70.11
|
| Rate for Payer: PACE SWMI |
$73.80
|
| Rate for Payer: PHP Commercial |
$250.92
|
| Rate for Payer: PHP Medicare Advantage |
$73.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.82
|
| Rate for Payer: Priority Health Medicare |
$73.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.04
|
| Rate for Payer: Railroad Medicare Medicare |
$73.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.78
|
| Rate for Payer: UHC Core |
$246.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.80
|
| Rate for Payer: UHC Medicare Advantage |
$76.01
|
| Rate for Payer: VA VA |
$73.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.40
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$234.05 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: BCBS Trust/PPO |
$296.56
|
| Rate for Payer: BCN Commercial |
$296.56
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.70
|
| Rate for Payer: UHC Core |
$320.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: Aetna Medicare |
$99.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.92
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$95.94
|
| Rate for Payer: BCBS Trust/PPO |
$298.37
|
| Rate for Payer: BCN Commercial |
$298.37
|
| Rate for Payer: BCN Medicare Advantage |
$95.94
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.94
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PACE Senior Care Partners |
$91.14
|
| Rate for Payer: PACE SWMI |
$95.94
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: PHP Medicare Advantage |
$95.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.86
|
| Rate for Payer: Priority Health Medicare |
$95.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.05
|
| Rate for Payer: Railroad Medicare Medicare |
$95.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.70
|
| Rate for Payer: UHC Core |
$320.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.94
|
| Rate for Payer: UHC Medicare Advantage |
$98.82
|
| Rate for Payer: VA VA |
$95.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$862.23 |
| Max. Negotiated Rate |
$1,272.35 |
| Rate for Payer: Aetna Commercial |
$1,201.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,092.52
|
| Rate for Payer: BCN Commercial |
$1,092.52
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,215.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Healthscope Commercial |
$1,272.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: PHP Commercial |
$1,201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,229.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,244.07
|
| Rate for Payer: UHC Core |
$1,180.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.29
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$335.76 |
| Max. Negotiated Rate |
$1,272.35 |
| Rate for Payer: Aetna Commercial |
$1,201.66
|
| Rate for Payer: Aetna Medicare |
$367.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.79
|
| Rate for Payer: BCBS Complete |
$565.49
|
| Rate for Payer: BCBS MAPPO |
$353.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.17
|
| Rate for Payer: BCN Commercial |
$1,099.17
|
| Rate for Payer: BCN Medicare Advantage |
$353.43
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,215.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.43
|
| Rate for Payer: Healthscope Commercial |
$1,272.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: PACE Senior Care Partners |
$335.76
|
| Rate for Payer: PACE SWMI |
$353.43
|
| Rate for Payer: PHP Commercial |
$1,201.66
|
| Rate for Payer: PHP Medicare Advantage |
$353.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,229.94
|
| Rate for Payer: Priority Health Medicare |
$353.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$862.23
|
| Rate for Payer: Railroad Medicare Medicare |
$353.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,244.07
|
| Rate for Payer: UHC Core |
$1,180.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.43
|
| Rate for Payer: UHC Medicare Advantage |
$364.03
|
| Rate for Payer: VA VA |
$353.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.29
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC HISTOPLASMA AB
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.98 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: BCBS Trust/PPO |
$45.60
|
| Rate for Payer: BCN Commercial |
$45.60
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.92
|
| Rate for Payer: UHC Core |
$49.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC HISTOPLASMA AB
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna Medicare |
$15.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.44
|
| Rate for Payer: BCBS Complete |
$10.69
|
| Rate for Payer: BCBS MAPPO |
$14.75
|
| Rate for Payer: BCBS Trust/PPO |
$45.87
|
| Rate for Payer: BCN Commercial |
$45.87
|
| Rate for Payer: BCN Medicare Advantage |
$14.75
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.75
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Mclaren Medicaid |
$10.18
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.15
|
| Rate for Payer: PACE Senior Care Partners |
$14.01
|
| Rate for Payer: PACE SWMI |
$14.75
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: PHP Medicare Advantage |
$14.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.33
|
| Rate for Payer: Priority Health Medicare |
$14.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.98
|
| Rate for Payer: Railroad Medicare Medicare |
$14.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.92
|
| Rate for Payer: UHC Core |
$49.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.75
|
| Rate for Payer: UHC Medicare Advantage |
$15.19
|
| Rate for Payer: VA VA |
$14.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.36
|
| Rate for Payer: BCN Commercial |
$16.36
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: BCBS Complete |
$10.69
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$16.46
|
| Rate for Payer: BCN Commercial |
$16.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Mclaren Medicaid |
$10.18
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PACE Senior Care Partners |
$5.03
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.42
|
| Rate for Payer: Priority Health Medicare |
$5.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.29
|
| Rate for Payer: UHC Medicare Advantage |
$5.45
|
| Rate for Payer: VA VA |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
OP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: BCBS Complete |
$10.69
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$16.46
|
| Rate for Payer: BCN Commercial |
$16.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Mclaren Medicaid |
$10.18
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PACE Senior Care Partners |
$5.03
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.42
|
| Rate for Payer: Priority Health Medicare |
$5.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.29
|
| Rate for Payer: UHC Medicare Advantage |
$5.45
|
| Rate for Payer: VA VA |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
IP
|
$21.17
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Aetna Commercial |
$17.99
|
| Rate for Payer: BCBS Trust/PPO |
$16.36
|
| Rate for Payer: BCN Commercial |
$16.36
|
| Rate for Payer: Cash Price |
$16.94
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$19.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.99
|
| Rate for Payer: PHP Commercial |
$17.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.63
|
| Rate for Payer: UHC Core |
$17.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.88
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.78 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$34.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.88
|
| Rate for Payer: BCBS Complete |
$10.27
|
| Rate for Payer: BCBS MAPPO |
$33.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.18
|
| Rate for Payer: BCN Commercial |
$104.18
|
| Rate for Payer: BCN Medicare Advantage |
$33.50
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.50
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Mclaren Medicaid |
$9.78
|
| Rate for Payer: Meridian Medicaid |
$10.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.82
|
| Rate for Payer: PACE SWMI |
$33.50
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: PHP Medicare Advantage |
$33.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Medicare |
$33.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: Railroad Medicare Medicare |
$33.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.50
|
| Rate for Payer: VA VA |
$33.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: BCBS Trust/PPO |
$103.56
|
| Rate for Payer: BCN Commercial |
$103.56
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: BCBS Trust/PPO |
$103.56
|
| Rate for Payer: BCN Commercial |
$103.56
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.78 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$34.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.88
|
| Rate for Payer: BCBS Complete |
$10.27
|
| Rate for Payer: BCBS MAPPO |
$33.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.18
|
| Rate for Payer: BCN Commercial |
$104.18
|
| Rate for Payer: BCN Medicare Advantage |
$33.50
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.50
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Mclaren Medicaid |
$9.78
|
| Rate for Payer: Meridian Medicaid |
$10.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.82
|
| Rate for Payer: PACE SWMI |
$33.50
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: PHP Medicare Advantage |
$33.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Medicare |
$33.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: Railroad Medicare Medicare |
$33.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.50
|
| Rate for Payer: VA VA |
$33.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.78 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$34.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.88
|
| Rate for Payer: BCBS Complete |
$10.27
|
| Rate for Payer: BCBS MAPPO |
$33.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.18
|
| Rate for Payer: BCN Commercial |
$104.18
|
| Rate for Payer: BCN Medicare Advantage |
$33.50
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.50
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Mclaren Medicaid |
$9.78
|
| Rate for Payer: Meridian Medicaid |
$10.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.82
|
| Rate for Payer: PACE SWMI |
$33.50
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: PHP Medicare Advantage |
$33.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Medicare |
$33.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: Railroad Medicare Medicare |
$33.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.50
|
| Rate for Payer: VA VA |
$33.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: BCBS Trust/PPO |
$103.56
|
| Rate for Payer: BCN Commercial |
$103.56
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC HIT ASSAY
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.56 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: Aetna Medicare |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.19
|
| Rate for Payer: BCBS Complete |
$14.23
|
| Rate for Payer: BCBS MAPPO |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$134.82
|
| Rate for Payer: BCN Commercial |
$134.82
|
| Rate for Payer: BCN Medicare Advantage |
$43.35
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.35
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Mclaren Medicaid |
$13.56
|
| Rate for Payer: Meridian Medicaid |
$14.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: PACE Senior Care Partners |
$41.18
|
| Rate for Payer: PACE SWMI |
$43.35
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: PHP Medicare Advantage |
$43.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.86
|
| Rate for Payer: Priority Health Medicare |
$43.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.76
|
| Rate for Payer: Railroad Medicare Medicare |
$43.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.35
|
| Rate for Payer: UHC Medicare Advantage |
$44.65
|
| Rate for Payer: VA VA |
$43.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC HIT ASSAY
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$105.76 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: BCBS Trust/PPO |
$134.00
|
| Rate for Payer: BCN Commercial |
$134.00
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.59
|
| Rate for Payer: UHC Core |
$144.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
