|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$38.07
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$17.77
|
| Rate for Payer: Meridian Medicaid |
$18.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.61
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$6.56
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$10.48
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$9.98
|
| Rate for Payer: Meridian Medicaid |
$10.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
OP
|
$41.72
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Aetna Commercial |
$35.46
|
| Rate for Payer: Aetna Medicare |
$10.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.04
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$32.44
|
| Rate for Payer: BCN Commercial |
$32.44
|
| Rate for Payer: BCN Medicare Advantage |
$10.43
|
| Rate for Payer: Cash Price |
$33.38
|
| Rate for Payer: Cash Price |
$33.38
|
| Rate for Payer: Cofinity Commercial |
$35.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.43
|
| Rate for Payer: Healthscope Commercial |
$37.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.29
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.46
|
| Rate for Payer: PACE Senior Care Partners |
$9.91
|
| Rate for Payer: PACE SWMI |
$10.43
|
| Rate for Payer: PHP Commercial |
$35.46
|
| Rate for Payer: PHP Medicare Advantage |
$10.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.30
|
| Rate for Payer: Priority Health Medicare |
$10.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.45
|
| Rate for Payer: Railroad Medicare Medicare |
$10.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.71
|
| Rate for Payer: UHC Core |
$34.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.43
|
| Rate for Payer: UHC Medicare Advantage |
$10.74
|
| Rate for Payer: VA VA |
$10.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.29
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
IP
|
$41.72
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.45 |
| Max. Negotiated Rate |
$37.55 |
| Rate for Payer: Aetna Commercial |
$35.46
|
| Rate for Payer: BCBS Trust/PPO |
$32.24
|
| Rate for Payer: BCN Commercial |
$32.24
|
| Rate for Payer: Cash Price |
$33.38
|
| Rate for Payer: Cofinity Commercial |
$35.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.38
|
| Rate for Payer: Healthscope Commercial |
$37.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.46
|
| Rate for Payer: PHP Commercial |
$35.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.71
|
| Rate for Payer: UHC Core |
$34.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.29
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
IP
|
$428.40
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$261.28 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$364.14
|
| Rate for Payer: BCBS Trust/PPO |
$331.07
|
| Rate for Payer: BCN Commercial |
$331.07
|
| Rate for Payer: Cash Price |
$342.72
|
| Rate for Payer: Cofinity Commercial |
$368.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.72
|
| Rate for Payer: Healthscope Commercial |
$385.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.14
|
| Rate for Payer: PHP Commercial |
$364.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.99
|
| Rate for Payer: UHC Core |
$357.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.30
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
OP
|
$428.40
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$101.74 |
| Max. Negotiated Rate |
$385.56 |
| Rate for Payer: Aetna Commercial |
$364.14
|
| Rate for Payer: Aetna Medicare |
$111.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.88
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$107.10
|
| Rate for Payer: BCBS Trust/PPO |
$333.08
|
| Rate for Payer: BCN Commercial |
$333.08
|
| Rate for Payer: BCN Medicare Advantage |
$107.10
|
| Rate for Payer: Cash Price |
$342.72
|
| Rate for Payer: Cash Price |
$342.72
|
| Rate for Payer: Cofinity Commercial |
$368.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.10
|
| Rate for Payer: Healthscope Commercial |
$385.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.30
|
| Rate for Payer: Mclaren Medicaid |
$190.00
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.14
|
| Rate for Payer: PACE Senior Care Partners |
$101.74
|
| Rate for Payer: PACE SWMI |
$107.10
|
| Rate for Payer: PHP Commercial |
$364.14
|
| Rate for Payer: PHP Medicare Advantage |
$107.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$372.71
|
| Rate for Payer: Priority Health Medicare |
$107.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.28
|
| Rate for Payer: Railroad Medicare Medicare |
$107.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.99
|
| Rate for Payer: UHC Core |
$357.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.10
|
| Rate for Payer: UHC Medicare Advantage |
$110.31
|
| Rate for Payer: VA VA |
$107.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.30
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: Aetna Medicare |
$22.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.56
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$66.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.25
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Mclaren Medicaid |
$14.28
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PACE Senior Care Partners |
$20.19
|
| Rate for Payer: PACE SWMI |
$21.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: PHP Medicare Advantage |
$21.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Medicare |
$21.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.25
|
| Rate for Payer: UHC Medicare Advantage |
$21.89
|
| Rate for Payer: VA VA |
$21.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.84 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: BCBS Trust/PPO |
$65.69
|
| Rate for Payer: BCN Commercial |
$65.69
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC HIV ANTIBODY
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.12 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: BCBS Complete |
$10.62
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$37.32
|
| Rate for Payer: BCN Commercial |
$37.32
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Mclaren Medicaid |
$10.12
|
| Rate for Payer: Meridian Medicaid |
$10.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PACE Senior Care Partners |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
| Rate for Payer: UHC Core |
$40.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.36
|
| Rate for Payer: VA VA |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC HIV ANTIBODY
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.28 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: BCBS Trust/PPO |
$37.09
|
| Rate for Payer: BCN Commercial |
$37.09
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
| Rate for Payer: UHC Core |
$40.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC HIV DNA BY PCR
|
Facility
|
IP
|
$87.72
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.50 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: BCBS Trust/PPO |
$67.79
|
| Rate for Payer: BCN Commercial |
$67.79
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC HIV DNA BY PCR
|
Facility
|
OP
|
$87.72
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.41
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$68.20
|
| Rate for Payer: BCN Commercial |
$68.20
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PACE Senior Care Partners |
$20.83
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.32
|
| Rate for Payer: Priority Health Medicare |
$21.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.50
|
| Rate for Payer: Railroad Medicare Medicare |
$21.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.59
|
| Rate for Payer: VA VA |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$140.80
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$126.72 |
| Rate for Payer: Aetna Commercial |
$119.68
|
| Rate for Payer: Aetna Medicare |
$36.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.00
|
| Rate for Payer: BCBS Complete |
$65.94
|
| Rate for Payer: BCBS MAPPO |
$35.20
|
| Rate for Payer: BCBS Trust/PPO |
$109.47
|
| Rate for Payer: BCN Commercial |
$109.47
|
| Rate for Payer: BCN Medicare Advantage |
$35.20
|
| Rate for Payer: Cash Price |
$112.64
|
| Rate for Payer: Cash Price |
$112.64
|
| Rate for Payer: Cofinity Commercial |
$121.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$126.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.60
|
| Rate for Payer: Mclaren Medicaid |
$62.80
|
| Rate for Payer: Meridian Medicaid |
$65.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.68
|
| Rate for Payer: PACE Senior Care Partners |
$33.44
|
| Rate for Payer: PACE SWMI |
$35.20
|
| Rate for Payer: PHP Commercial |
$119.68
|
| Rate for Payer: PHP Medicare Advantage |
$35.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.50
|
| Rate for Payer: Priority Health Medicare |
$35.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.87
|
| Rate for Payer: Railroad Medicare Medicare |
$35.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.90
|
| Rate for Payer: UHC Core |
$117.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.20
|
| Rate for Payer: UHC Medicare Advantage |
$36.26
|
| Rate for Payer: VA VA |
$35.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.60
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$140.80
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.87 |
| Max. Negotiated Rate |
$126.72 |
| Rate for Payer: Aetna Commercial |
$119.68
|
| Rate for Payer: BCBS Trust/PPO |
$108.81
|
| Rate for Payer: BCN Commercial |
$108.81
|
| Rate for Payer: Cash Price |
$112.64
|
| Rate for Payer: Cofinity Commercial |
$121.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.64
|
| Rate for Payer: Healthscope Commercial |
$126.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.68
|
| Rate for Payer: PHP Commercial |
$119.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.90
|
| Rate for Payer: UHC Core |
$117.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.60
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$124.42 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: BCBS Trust/PPO |
$157.65
|
| Rate for Payer: BCN Commercial |
$157.65
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.75
|
| Rate for Payer: BCBS Complete |
$65.94
|
| Rate for Payer: BCBS MAPPO |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$158.61
|
| Rate for Payer: BCN Commercial |
$158.61
|
| Rate for Payer: BCN Medicare Advantage |
$51.00
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.00
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Mclaren Medicaid |
$62.80
|
| Rate for Payer: Meridian Medicaid |
$65.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PACE Senior Care Partners |
$48.45
|
| Rate for Payer: PACE SWMI |
$51.00
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$51.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.48
|
| Rate for Payer: Priority Health Medicare |
$51.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.42
|
| Rate for Payer: Railroad Medicare Medicare |
$51.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.00
|
| Rate for Payer: UHC Medicare Advantage |
$52.53
|
| Rate for Payer: VA VA |
$51.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$79.63 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$100.90
|
| Rate for Payer: BCN Commercial |
$100.90
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.01 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$65.94
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$101.51
|
| Rate for Payer: BCN Commercial |
$101.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$62.80
|
| Rate for Payer: Meridian Medicaid |
$65.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.98
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.59
|
| Rate for Payer: Priority Health Medicare |
$32.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.63
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$33.62
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna Commercial |
$85.85
|
| Rate for Payer: BCBS Trust/PPO |
$78.05
|
| Rate for Payer: BCN Commercial |
$78.05
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Healthscope Commercial |
$90.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.85
|
| Rate for Payer: PHP Commercial |
$85.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.88
|
| Rate for Payer: UHC Core |
$84.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.75
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna Commercial |
$85.85
|
| Rate for Payer: Aetna Medicare |
$26.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$78.53
|
| Rate for Payer: BCN Commercial |
$78.53
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$86.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Healthscope Commercial |
$90.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.75
|
| Rate for Payer: Mclaren Medicaid |
$14.28
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.85
|
| Rate for Payer: PACE Senior Care Partners |
$23.99
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Commercial |
$85.85
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.87
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.60
|
| Rate for Payer: Railroad Medicare Medicare |
$25.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.88
|
| Rate for Payer: UHC Core |
$84.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.25
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: VA VA |
$25.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.75
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$89.25
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.81
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS Trust/PPO |
$81.64
|
| Rate for Payer: BCN Commercial |
$81.64
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Healthscope Commercial |
$94.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.75
|
| Rate for Payer: Mclaren Medicaid |
$14.28
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.25
|
| Rate for Payer: PACE Senior Care Partners |
$24.94
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PHP Commercial |
$89.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.35
|
| Rate for Payer: Priority Health Medicare |
$26.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.04
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.40
|
| Rate for Payer: UHC Core |
$87.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.25
|
| Rate for Payer: UHC Medicare Advantage |
$27.04
|
| Rate for Payer: VA VA |
$26.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.75
|
|
