|
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
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$10.48
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$9.98
|
| Rate for Payer: Meridian Medicaid |
$10.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
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 WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| 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 |
$14.99
|
| 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 |
$14.28
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| 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 |
$14.28
|
| 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 HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$260.84
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$61.95 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna Commercial |
$221.71
|
| Rate for Payer: Aetna Medicare |
$67.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.51
|
| Rate for Payer: BCBS Complete |
$131.66
|
| Rate for Payer: BCBS MAPPO |
$65.21
|
| Rate for Payer: BCBS Trust/PPO |
$202.80
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$65.21
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cofinity Commercial |
$224.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.21
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.63
|
| Rate for Payer: Mclaren Medicaid |
$125.39
|
| Rate for Payer: Meridian Medicaid |
$131.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.71
|
| Rate for Payer: PACE Senior Care Partners |
$61.95
|
| Rate for Payer: PACE SWMI |
$65.21
|
| Rate for Payer: PHP Commercial |
$221.71
|
| Rate for Payer: PHP Medicare Advantage |
$65.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.93
|
| Rate for Payer: Priority Health Medicare |
$65.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.09
|
| Rate for Payer: Railroad Medicare Medicare |
$65.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.54
|
| Rate for Payer: UHC Core |
$217.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.21
|
| Rate for Payer: UHC Medicare Advantage |
$67.17
|
| Rate for Payer: VA VA |
$65.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.63
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$260.84
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$159.09 |
| Max. Negotiated Rate |
$234.76 |
| Rate for Payer: Aetna Commercial |
$221.71
|
| Rate for Payer: BCBS Trust/PPO |
$201.58
|
| Rate for Payer: BCN Commercial |
$201.58
|
| Rate for Payer: Cash Price |
$208.67
|
| Rate for Payer: Cofinity Commercial |
$224.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.67
|
| Rate for Payer: Healthscope Commercial |
$234.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.71
|
| Rate for Payer: PHP Commercial |
$221.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.54
|
| Rate for Payer: UHC Core |
$217.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.63
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| 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 |
$20.00
|
| 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 |
$19.05
|
| Rate for Payer: Meridian Medicaid |
$20.00
|
| 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 |
$19.05
|
| 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 HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| 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 HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,702.70
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,648.38 |
| Max. Negotiated Rate |
$2,432.43 |
| Rate for Payer: Aetna Commercial |
$2,297.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,088.65
|
| Rate for Payer: BCN Commercial |
$2,088.65
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cofinity Commercial |
$2,324.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,162.16
|
| Rate for Payer: Healthscope Commercial |
$2,432.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,027.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,297.30
|
| Rate for Payer: PHP Commercial |
$2,297.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,648.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,378.38
|
| Rate for Payer: UHC Core |
$2,256.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,027.02
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,702.70
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$496.18 |
| Max. Negotiated Rate |
$2,432.43 |
| Rate for Payer: Aetna Commercial |
$2,297.30
|
| Rate for Payer: Aetna Medicare |
$702.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.59
|
| Rate for Payer: BCBS Complete |
$520.99
|
| Rate for Payer: BCBS MAPPO |
$675.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,101.35
|
| Rate for Payer: BCN Commercial |
$2,101.35
|
| Rate for Payer: BCN Medicare Advantage |
$675.68
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cash Price |
$2,162.16
|
| Rate for Payer: Cofinity Commercial |
$2,324.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,162.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.68
|
| Rate for Payer: Healthscope Commercial |
$2,432.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,027.02
|
| Rate for Payer: Mclaren Medicaid |
$496.18
|
| Rate for Payer: Meridian Medicaid |
$520.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$709.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$777.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,297.30
|
| Rate for Payer: PACE Senior Care Partners |
$641.89
|
| Rate for Payer: PACE SWMI |
$675.68
|
| Rate for Payer: PHP Commercial |
$2,297.30
|
| Rate for Payer: PHP Medicare Advantage |
$675.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.35
|
| Rate for Payer: Priority Health Medicare |
$675.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,648.38
|
| Rate for Payer: Railroad Medicare Medicare |
$675.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,378.38
|
| Rate for Payer: UHC Core |
$2,256.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.68
|
| Rate for Payer: UHC Medicare Advantage |
$695.95
|
| Rate for Payer: VA VA |
$675.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,027.02
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$652.67
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$587.40 |
| Rate for Payer: Aetna Commercial |
$554.77
|
| Rate for Payer: Aetna Medicare |
$169.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.96
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$163.17
|
| Rate for Payer: BCBS Trust/PPO |
$507.45
|
| Rate for Payer: BCN Commercial |
$507.45
|
| Rate for Payer: BCN Medicare Advantage |
$163.17
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cofinity Commercial |
$561.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.17
|
| Rate for Payer: Healthscope Commercial |
$587.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.50
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$554.77
|
| Rate for Payer: PACE Senior Care Partners |
$155.01
|
| Rate for Payer: PACE SWMI |
$163.17
|
| Rate for Payer: PHP Commercial |
$554.77
|
| Rate for Payer: PHP Medicare Advantage |
$163.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$567.82
|
| Rate for Payer: Priority Health Medicare |
$163.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.06
|
| Rate for Payer: Railroad Medicare Medicare |
$163.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$574.35
|
| Rate for Payer: UHC Core |
$544.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.17
|
| Rate for Payer: UHC Medicare Advantage |
$168.06
|
| Rate for Payer: VA VA |
$163.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.50
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$652.67
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$398.06 |
| Max. Negotiated Rate |
$587.40 |
| Rate for Payer: Aetna Commercial |
$554.77
|
| Rate for Payer: BCBS Trust/PPO |
$504.38
|
| Rate for Payer: BCN Commercial |
$504.38
|
| Rate for Payer: Cash Price |
$522.14
|
| Rate for Payer: Cofinity Commercial |
$561.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.14
|
| Rate for Payer: Healthscope Commercial |
$587.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$554.77
|
| Rate for Payer: PHP Commercial |
$554.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$456.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$567.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$398.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$574.35
|
| Rate for Payer: UHC Core |
$544.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.50
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,033.01
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$929.71 |
| Rate for Payer: Aetna Commercial |
$878.06
|
| Rate for Payer: Aetna Medicare |
$268.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.82
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$258.25
|
| Rate for Payer: BCBS Trust/PPO |
$803.17
|
| Rate for Payer: BCN Commercial |
$803.17
|
| Rate for Payer: BCN Medicare Advantage |
$258.25
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cofinity Commercial |
$888.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.25
|
| Rate for Payer: Healthscope Commercial |
$929.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.76
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.06
|
| Rate for Payer: PACE Senior Care Partners |
$245.34
|
| Rate for Payer: PACE SWMI |
$258.25
|
| Rate for Payer: PHP Commercial |
$878.06
|
| Rate for Payer: PHP Medicare Advantage |
$258.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.72
|
| Rate for Payer: Priority Health Medicare |
$258.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.03
|
| Rate for Payer: Railroad Medicare Medicare |
$258.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.05
|
| Rate for Payer: UHC Core |
$862.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.25
|
| Rate for Payer: UHC Medicare Advantage |
$266.00
|
| Rate for Payer: VA VA |
$258.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.76
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,033.01
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$630.03 |
| Max. Negotiated Rate |
$929.71 |
| Rate for Payer: Aetna Commercial |
$878.06
|
| Rate for Payer: BCBS Trust/PPO |
$798.31
|
| Rate for Payer: BCN Commercial |
$798.31
|
| Rate for Payer: Cash Price |
$826.41
|
| Rate for Payer: Cofinity Commercial |
$888.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.41
|
| Rate for Payer: Healthscope Commercial |
$929.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$774.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.06
|
| Rate for Payer: PHP Commercial |
$878.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$898.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$630.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$909.05
|
| Rate for Payer: UHC Core |
$862.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$774.76
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$187.21 |
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna Medicare |
$54.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.00
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$52.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.73
|
| Rate for Payer: BCN Commercial |
$161.73
|
| Rate for Payer: BCN Medicare Advantage |
$52.00
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Senior Care Partners |
$49.40
|
| Rate for Payer: PACE SWMI |
$52.00
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: PHP Medicare Advantage |
$52.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.97
|
| Rate for Payer: Priority Health Medicare |
$52.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.87
|
| Rate for Payer: Railroad Medicare Medicare |
$52.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.05
|
| Rate for Payer: UHC Core |
$173.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.00
|
| Rate for Payer: UHC Medicare Advantage |
$53.56
|
| Rate for Payer: VA VA |
$52.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$187.21 |
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: BCBS Trust/PPO |
$160.75
|
| Rate for Payer: BCN Commercial |
$160.75
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.05
|
| Rate for Payer: UHC Core |
$173.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$216.20 |
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna Medicare |
$54.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.00
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$52.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.73
|
| Rate for Payer: BCN Commercial |
$161.73
|
| Rate for Payer: BCN Medicare Advantage |
$52.00
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Senior Care Partners |
$49.40
|
| Rate for Payer: PACE SWMI |
$52.00
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: PHP Medicare Advantage |
$52.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.97
|
| Rate for Payer: Priority Health Medicare |
$52.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.87
|
| Rate for Payer: Railroad Medicare Medicare |
$52.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.05
|
| Rate for Payer: UHC Core |
$173.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.00
|
| Rate for Payer: UHC Medicare Advantage |
$53.56
|
| Rate for Payer: VA VA |
$52.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$187.21 |
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: BCBS Trust/PPO |
$160.75
|
| Rate for Payer: BCN Commercial |
$160.75
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.05
|
| Rate for Payer: UHC Core |
$173.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC HOMOCYSTEINE SERUM
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
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 HOMOCYSTEINE SERUM
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| 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 |
$13.89
|
| 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 |
$13.22
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| 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 |
$13.22
|
| 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 HOMOVANILLIC ACID RANDOM URINE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100474
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HOMOVANILLIC ACID RANDOM URINE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100474
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HOMOVANILLIC ACID URINE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HOMOVANILLIC ACID URINE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100244
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
