|
HC CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
IP
|
$635.11
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$412.82 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: BCBS Trust/PPO |
$518.44
|
| Rate for Payer: BCN Commercial |
$490.81
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
OP
|
$635.11
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.84 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: Aetna Medicare |
$165.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.47
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$158.78
|
| Rate for Payer: BCBS Trust/PPO |
$522.12
|
| Rate for Payer: BCN Commercial |
$493.80
|
| Rate for Payer: BCN Medicare Advantage |
$158.78
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.78
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: PACE Senior Care Partners |
$150.84
|
| Rate for Payer: PACE SWMI |
$158.78
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: PHP Medicare Advantage |
$158.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Medicare |
$160.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$425.52
|
| Rate for Payer: Railroad Medicare Medicare |
$158.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.78
|
| Rate for Payer: UHC Exchange |
$158.78
|
| Rate for Payer: UHC Medicare Advantage |
$158.78
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$158.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
IP
|
$328.51
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.53 |
| Max. Negotiated Rate |
$295.66 |
| Rate for Payer: Aetna Commercial |
$279.23
|
| Rate for Payer: BCBS Trust/PPO |
$268.16
|
| Rate for Payer: BCN Commercial |
$253.87
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cofinity Commercial |
$282.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.81
|
| Rate for Payer: Healthscope Commercial |
$295.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.23
|
| Rate for Payer: Nomi Health Commercial |
$269.38
|
| Rate for Payer: PHP Commercial |
$279.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.53
|
| Rate for Payer: Priority Health HMO/PPO |
$285.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.09
|
| Rate for Payer: UHC Core |
$274.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.38
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
OP
|
$328.51
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.02 |
| Max. Negotiated Rate |
$295.66 |
| Rate for Payer: Aetna Commercial |
$279.23
|
| Rate for Payer: Aetna Medicare |
$85.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.66
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$82.13
|
| Rate for Payer: BCBS Trust/PPO |
$270.07
|
| Rate for Payer: BCN Commercial |
$255.42
|
| Rate for Payer: BCN Medicare Advantage |
$82.13
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cofinity Commercial |
$282.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.13
|
| Rate for Payer: Healthscope Commercial |
$295.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.38
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.23
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.23
|
| Rate for Payer: Nomi Health Commercial |
$269.38
|
| Rate for Payer: PACE Senior Care Partners |
$78.02
|
| Rate for Payer: PACE SWMI |
$82.13
|
| Rate for Payer: PHP Commercial |
$279.23
|
| Rate for Payer: PHP Medicare Advantage |
$82.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.53
|
| Rate for Payer: Priority Health HMO/PPO |
$285.80
|
| Rate for Payer: Priority Health Medicare |
$82.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.10
|
| Rate for Payer: Railroad Medicare Medicare |
$82.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.09
|
| Rate for Payer: UHC Core |
$274.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.13
|
| Rate for Payer: UHC Exchange |
$82.13
|
| Rate for Payer: UHC Medicare Advantage |
$82.13
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$82.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.38
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$397.80 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: BCBS Trust/PPO |
$499.58
|
| Rate for Payer: BCN Commercial |
$472.95
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$501.84
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$532.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.25
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$153.00
|
| Rate for Payer: BCBS Trust/PPO |
$503.13
|
| Rate for Payer: BCN Commercial |
$475.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.65
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$501.84
|
| Rate for Payer: PACE Senior Care Partners |
$145.35
|
| Rate for Payer: PACE SWMI |
$153.00
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$153.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$532.44
|
| Rate for Payer: Priority Health Medicare |
$154.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.04
|
| Rate for Payer: Railroad Medicare Medicare |
$153.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.00
|
| Rate for Payer: UHC Exchange |
$153.00
|
| Rate for Payer: UHC Medicare Advantage |
$153.00
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$153.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.94 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: Aetna Medicare |
$172.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.81
|
| Rate for Payer: BCBS Complete |
$178.43
|
| Rate for Payer: BCBS MAPPO |
$166.25
|
| Rate for Payer: BCBS Trust/PPO |
$546.70
|
| Rate for Payer: BCN Commercial |
$517.04
|
| Rate for Payer: BCN Medicare Advantage |
$166.25
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.25
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.75
|
| Rate for Payer: Mclaren Medicaid |
$169.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.56
|
| Rate for Payer: Meridian Medicaid |
$178.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$545.30
|
| Rate for Payer: PACE Senior Care Partners |
$157.94
|
| Rate for Payer: PACE SWMI |
$166.25
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: PHP Medicare Advantage |
$166.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO |
$578.55
|
| Rate for Payer: Priority Health Medicare |
$167.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$445.55
|
| Rate for Payer: Railroad Medicare Medicare |
$166.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.20
|
| Rate for Payer: UHC Core |
$555.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.25
|
| Rate for Payer: UHC Exchange |
$166.25
|
| Rate for Payer: UHC Medicare Advantage |
$166.25
|
| Rate for Payer: UHCCP Medicaid |
$169.93
|
| Rate for Payer: VA VA |
$166.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.75
|
|
|
HC CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$432.25 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: BCBS Trust/PPO |
$542.84
|
| Rate for Payer: BCN Commercial |
$513.91
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$545.30
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO |
$578.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$445.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$585.20
|
| Rate for Payer: UHC Core |
$555.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.75
|
|
|
HC CMS CLINIC SUPPORT
|
Facility
|
IP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.67 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: BCBS Trust/PPO |
$115.12
|
| Rate for Payer: BCN Commercial |
$108.99
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: Nomi Health Commercial |
$115.64
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.67
|
| Rate for Payer: Priority Health HMO/PPO |
$122.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.11
|
| Rate for Payer: UHC Core |
$117.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
|
HC CMS CLINIC SUPPORT
|
Facility
|
OP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.49 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: Aetna Medicare |
$36.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.07
|
| Rate for Payer: BCBS Complete |
$56.41
|
| Rate for Payer: BCBS MAPPO |
$35.26
|
| Rate for Payer: BCBS Trust/PPO |
$115.94
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$109.65
|
| Rate for Payer: BCN Medicare Advantage |
$35.26
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.26
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: Nomi Health Commercial |
$115.64
|
| Rate for Payer: PACE Senior Care Partners |
$33.49
|
| Rate for Payer: PACE SWMI |
$35.26
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: PHP Medicare Advantage |
$35.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.67
|
| Rate for Payer: Priority Health HMO/PPO |
$122.70
|
| Rate for Payer: Priority Health Medicare |
$35.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.49
|
| Rate for Payer: Railroad Medicare Medicare |
$35.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.11
|
| Rate for Payer: UHC Core |
$117.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.26
|
| Rate for Payer: UHC Exchange |
$35.26
|
| Rate for Payer: UHC Medicare Advantage |
$35.26
|
| Rate for Payer: VA VA |
$35.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
|
HC CMV BY PCR CSF & BODY FLUIDS
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600151
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.16 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.03
|
| Rate for Payer: BCN Commercial |
$69.14
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC CMV BY PCR CSF & BODY FLUIDS
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600151
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$69.56
|
| Rate for Payer: BCN Medicare Advantage |
$22.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.49
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PACE Senior Care Partners |
$21.25
|
| Rate for Payer: PACE SWMI |
$22.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$22.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Medicare |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: Railroad Medicare Medicare |
$22.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.37
|
| Rate for Payer: UHC Exchange |
$22.37
|
| Rate for Payer: UHC Medicare Advantage |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$22.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC CMV DNA PCR QUANTITATIVE
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
30600152
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$112.71 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: BCBS Trust/PPO |
$141.55
|
| 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 Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO |
$150.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| 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
|
|
|
HC CMV DNA PCR QUANTITATIVE
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
30600152
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.97 |
| 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 |
$32.52
|
| Rate for Payer: BCBS MAPPO |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$142.55
|
| 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 |
$30.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.52
|
| Rate for Payer: Meridian Medicaid |
$32.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$142.19
|
| 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 |
$30.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO |
$150.86
|
| Rate for Payer: Priority Health Medicare |
$43.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.18
|
| 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 Exchange |
$43.35
|
| Rate for Payer: UHC Medicare Advantage |
$43.35
|
| Rate for Payer: UHCCP Medicaid |
$30.97
|
| Rate for Payer: VA VA |
$43.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC COAGULATION INTERPRETATION
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 85390
|
| Hospital Charge Code |
30500075
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| 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 Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| 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 COAGULATION INTERPRETATION
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 85390
|
| Hospital Charge Code |
30500075
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.19 |
| 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 |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| 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 |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| 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 |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| 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 Exchange |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC COAGULATION TIME ACTIVATED
|
Facility
|
IP
|
$76.63
|
|
|
Service Code
|
CPT 85347
|
| Hospital Charge Code |
30000166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$49.81 |
| Max. Negotiated Rate |
$68.97 |
| Rate for Payer: Aetna Commercial |
$65.14
|
| Rate for Payer: BCBS Trust/PPO |
$62.55
|
| Rate for Payer: BCN Commercial |
$59.22
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$65.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.30
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.14
|
| Rate for Payer: Nomi Health Commercial |
$62.84
|
| Rate for Payer: PHP Commercial |
$65.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.81
|
| Rate for Payer: Priority Health HMO/PPO |
$66.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.43
|
| Rate for Payer: UHC Core |
$63.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.47
|
|
|
HC COAGULATION TIME ACTIVATED
|
Facility
|
OP
|
$76.63
|
|
|
Service Code
|
CPT 85347
|
| Hospital Charge Code |
30000166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$68.97 |
| Rate for Payer: Aetna Commercial |
$65.14
|
| Rate for Payer: Aetna Medicare |
$19.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.95
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$19.16
|
| Rate for Payer: BCBS Trust/PPO |
$63.00
|
| Rate for Payer: BCN Commercial |
$59.58
|
| Rate for Payer: BCN Medicare Advantage |
$19.16
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$65.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.16
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.47
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.12
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.14
|
| Rate for Payer: Nomi Health Commercial |
$62.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.20
|
| Rate for Payer: PACE SWMI |
$19.16
|
| Rate for Payer: PHP Commercial |
$65.14
|
| Rate for Payer: PHP Medicare Advantage |
$19.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.81
|
| Rate for Payer: Priority Health HMO/PPO |
$66.67
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.34
|
| Rate for Payer: Railroad Medicare Medicare |
$19.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.43
|
| Rate for Payer: UHC Core |
$63.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.16
|
| Rate for Payer: UHC Exchange |
$19.16
|
| Rate for Payer: UHC Medicare Advantage |
$19.16
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$19.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.47
|
|
|
HC COBALT SERUM
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
30100639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: BCBS Trust/PPO |
$72.44
|
| Rate for Payer: BCN Commercial |
$68.58
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO |
$77.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC COBALT SERUM
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
30100639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.73
|
| Rate for Payer: BCBS Complete |
$16.67
|
| Rate for Payer: BCBS MAPPO |
$22.18
|
| Rate for Payer: BCBS Trust/PPO |
$72.95
|
| Rate for Payer: BCN Commercial |
$69.00
|
| Rate for Payer: BCN Medicare Advantage |
$22.18
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.18
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$15.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.29
|
| Rate for Payer: Meridian Medicaid |
$16.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PACE Senior Care Partners |
$21.08
|
| Rate for Payer: PACE SWMI |
$22.18
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO |
$77.20
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.46
|
| Rate for Payer: Railroad Medicare Medicare |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.18
|
| Rate for Payer: UHC Exchange |
$22.18
|
| Rate for Payer: UHC Medicare Advantage |
$22.18
|
| Rate for Payer: UHCCP Medicaid |
$15.88
|
| Rate for Payer: VA VA |
$22.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC COCAINE CONFIRMATION URINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100597
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna Medicare |
$16.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.76
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$51.99
|
| Rate for Payer: BCN Commercial |
$49.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.81
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.81
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.81
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: PHP Medicare Advantage |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: Railroad Medicare Medicare |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.81
|
| Rate for Payer: UHC Exchange |
$15.81
|
| Rate for Payer: UHC Medicare Advantage |
$15.81
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC COCAINE CONFIRMATION URINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100597
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$51.62
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC COCAINE URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.08 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: BCBS Trust/PPO |
$82.99
|
| Rate for Payer: BCN Commercial |
$78.56
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$83.36
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO |
$88.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.46
|
| Rate for Payer: UHC Core |
$84.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
