|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$77.11
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$69.40 |
| Rate for Payer: Aetna Commercial |
$65.54
|
| Rate for Payer: Aetna Medicare |
$20.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.10
|
| Rate for Payer: BCBS Complete |
$14.27
|
| Rate for Payer: BCBS MAPPO |
$19.28
|
| Rate for Payer: BCBS Trust/PPO |
$63.39
|
| Rate for Payer: BCN Commercial |
$63.39
|
| Rate for Payer: BCN Medicare Advantage |
$19.28
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cofinity Commercial |
$66.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.28
|
| Rate for Payer: Healthscope Commercial |
$69.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.83
|
| Rate for Payer: Mclaren Medicaid |
$13.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.24
|
| Rate for Payer: Meridian Medicaid |
$14.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.54
|
| Rate for Payer: Nomi Health Commercial |
$63.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.83
|
| Rate for Payer: PACE Senior Care Partners |
$18.31
|
| Rate for Payer: PACE SWMI |
$19.28
|
| Rate for Payer: PHP Commercial |
$65.54
|
| Rate for Payer: PHP Medicare Advantage |
$19.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.09
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: Railroad Medicare Medicare |
$19.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.86
|
| Rate for Payer: UHC Core |
$64.39
|
| Rate for Payer: UHC Exchange |
$19.28
|
| Rate for Payer: UHC Medicaid |
$13.59
|
| Rate for Payer: UHC Medicare Advantage |
$19.28
|
| Rate for Payer: UHCCP Medicaid |
$13.59
|
| Rate for Payer: VA VA |
$19.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.83
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.98 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna Medicare |
$27.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.64
|
| Rate for Payer: BCBS Complete |
$19.92
|
| Rate for Payer: BCBS MAPPO |
$26.91
|
| Rate for Payer: BCBS Trust/PPO |
$88.49
|
| Rate for Payer: BCN Commercial |
$88.49
|
| Rate for Payer: BCN Medicare Advantage |
$26.91
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.91
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Mclaren Medicaid |
$18.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.26
|
| Rate for Payer: Meridian Medicaid |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Nomi Health Commercial |
$88.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: PACE Senior Care Partners |
$25.56
|
| Rate for Payer: PACE SWMI |
$26.91
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: PHP Medicare Advantage |
$26.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.65
|
| Rate for Payer: Priority Health Medicare |
$27.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.92
|
| Rate for Payer: Railroad Medicare Medicare |
$26.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.72
|
| Rate for Payer: UHC Core |
$89.88
|
| Rate for Payer: UHC Exchange |
$26.91
|
| Rate for Payer: UHC Medicaid |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$26.91
|
| Rate for Payer: UHCCP Medicaid |
$18.98
|
| Rate for Payer: VA VA |
$26.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: BCBS Trust/PPO |
$88.90
|
| Rate for Payer: BCN Commercial |
$88.90
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Nomi Health Commercial |
$88.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.72
|
| Rate for Payer: UHC Core |
$89.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.93 |
| Max. Negotiated Rate |
$596.90 |
| Rate for Payer: Aetna Commercial |
$563.74
|
| Rate for Payer: Aetna Medicare |
$172.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$207.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$207.26
|
| Rate for Payer: BCBS Complete |
$122.76
|
| Rate for Payer: BCBS MAPPO |
$165.81
|
| Rate for Payer: BCBS Trust/PPO |
$545.23
|
| Rate for Payer: BCN Commercial |
$545.23
|
| Rate for Payer: BCN Medicare Advantage |
$165.81
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Commercial |
$570.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.81
|
| Rate for Payer: Healthscope Commercial |
$596.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.42
|
| Rate for Payer: Mclaren Medicaid |
$116.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$174.10
|
| Rate for Payer: Meridian Medicaid |
$122.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$182.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Nomi Health Commercial |
$543.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: PACE Senior Care Partners |
$157.51
|
| Rate for Payer: PACE SWMI |
$165.81
|
| Rate for Payer: PHP Commercial |
$563.74
|
| Rate for Payer: PHP Medicare Advantage |
$165.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$577.00
|
| Rate for Payer: Priority Health Medicare |
$167.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.60
|
| Rate for Payer: Railroad Medicare Medicare |
$165.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.63
|
| Rate for Payer: UHC Core |
$553.79
|
| Rate for Payer: UHC Exchange |
$165.81
|
| Rate for Payer: UHC Medicaid |
$116.93
|
| Rate for Payer: UHC Medicare Advantage |
$165.81
|
| Rate for Payer: UHCCP Medicaid |
$116.93
|
| Rate for Payer: VA VA |
$165.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.42
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$461.60 |
| Max. Negotiated Rate |
$596.90 |
| Rate for Payer: Aetna Commercial |
$563.74
|
| Rate for Payer: BCBS Trust/PPO |
$547.75
|
| Rate for Payer: BCN Commercial |
$547.75
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Commercial |
$570.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Healthscope Commercial |
$596.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Nomi Health Commercial |
$543.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: PHP Commercial |
$563.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$577.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.63
|
| Rate for Payer: UHC Core |
$553.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.42
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$173.97 |
| Max. Negotiated Rate |
$888.09 |
| Rate for Payer: Aetna Commercial |
$838.75
|
| Rate for Payer: Aetna Medicare |
$256.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$308.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$308.37
|
| Rate for Payer: BCBS Complete |
$182.65
|
| Rate for Payer: BCBS MAPPO |
$246.69
|
| Rate for Payer: BCBS Trust/PPO |
$811.22
|
| Rate for Payer: BCN Commercial |
$811.22
|
| Rate for Payer: BCN Medicare Advantage |
$246.69
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Commercial |
$848.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.69
|
| Rate for Payer: Healthscope Commercial |
$888.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.08
|
| Rate for Payer: Mclaren Medicaid |
$173.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.03
|
| Rate for Payer: Meridian Medicaid |
$182.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Nomi Health Commercial |
$809.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: PACE Senior Care Partners |
$234.36
|
| Rate for Payer: PACE SWMI |
$246.69
|
| Rate for Payer: PHP Commercial |
$838.75
|
| Rate for Payer: PHP Medicare Advantage |
$246.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$858.49
|
| Rate for Payer: Priority Health Medicare |
$249.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.79
|
| Rate for Payer: Railroad Medicare Medicare |
$246.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.36
|
| Rate for Payer: UHC Core |
$823.95
|
| Rate for Payer: UHC Exchange |
$246.69
|
| Rate for Payer: UHC Medicaid |
$173.97
|
| Rate for Payer: UHC Medicare Advantage |
$246.69
|
| Rate for Payer: UHCCP Medicaid |
$173.97
|
| Rate for Payer: VA VA |
$246.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.08
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$686.79 |
| Max. Negotiated Rate |
$888.09 |
| Rate for Payer: Aetna Commercial |
$838.75
|
| Rate for Payer: BCBS Trust/PPO |
$814.97
|
| Rate for Payer: BCN Commercial |
$814.97
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Commercial |
$848.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Healthscope Commercial |
$888.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Nomi Health Commercial |
$809.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: PHP Commercial |
$838.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$858.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$686.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.36
|
| Rate for Payer: UHC Core |
$823.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.08
|
|
|
HC DUST MITE DF IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DUST MITE DF IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DUST MITE DP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DUST MITE DP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$555.77 |
| Max. Negotiated Rate |
$718.67 |
| Rate for Payer: Aetna Commercial |
$678.74
|
| Rate for Payer: BCBS Trust/PPO |
$659.50
|
| Rate for Payer: BCN Commercial |
$659.50
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Commercial |
$686.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Healthscope Commercial |
$718.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Nomi Health Commercial |
$654.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: PHP Commercial |
$678.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$694.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$555.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.70
|
| Rate for Payer: UHC Core |
$666.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.89
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$140.78 |
| Max. Negotiated Rate |
$718.67 |
| Rate for Payer: Aetna Commercial |
$678.74
|
| Rate for Payer: Aetna Medicare |
$207.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.54
|
| Rate for Payer: BCBS Complete |
$147.81
|
| Rate for Payer: BCBS MAPPO |
$199.63
|
| Rate for Payer: BCBS Trust/PPO |
$656.46
|
| Rate for Payer: BCN Commercial |
$656.46
|
| Rate for Payer: BCN Medicare Advantage |
$199.63
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Commercial |
$686.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.63
|
| Rate for Payer: Healthscope Commercial |
$718.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.89
|
| Rate for Payer: Mclaren Medicaid |
$140.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.61
|
| Rate for Payer: Meridian Medicaid |
$147.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Nomi Health Commercial |
$654.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: PACE Senior Care Partners |
$189.65
|
| Rate for Payer: PACE SWMI |
$199.63
|
| Rate for Payer: PHP Commercial |
$678.74
|
| Rate for Payer: PHP Medicare Advantage |
$199.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$694.71
|
| Rate for Payer: Priority Health Medicare |
$201.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$555.77
|
| Rate for Payer: Railroad Medicare Medicare |
$199.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.70
|
| Rate for Payer: UHC Core |
$666.76
|
| Rate for Payer: UHC Exchange |
$199.63
|
| Rate for Payer: UHC Medicaid |
$140.78
|
| Rate for Payer: UHC Medicare Advantage |
$199.63
|
| Rate for Payer: UHCCP Medicaid |
$140.78
|
| Rate for Payer: VA VA |
$199.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.89
|
|
|
HC E72 MOUSE URINE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC E72 MOUSE URINE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
IP
|
$12.79
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Aetna Commercial |
$10.87
|
| Rate for Payer: BCBS Trust/PPO |
$10.56
|
| Rate for Payer: BCN Commercial |
$10.56
|
| Rate for Payer: Cash Price |
$10.23
|
| Rate for Payer: Cofinity Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.23
|
| Rate for Payer: Healthscope Commercial |
$11.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.87
|
| Rate for Payer: Nomi Health Commercial |
$10.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.59
|
| Rate for Payer: PHP Commercial |
$10.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.26
|
| Rate for Payer: UHC Core |
$10.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.59
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
OP
|
$12.79
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Aetna Commercial |
$10.87
|
| Rate for Payer: Aetna Medicare |
$3.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.00
|
| Rate for Payer: BCBS Complete |
$2.37
|
| Rate for Payer: BCBS MAPPO |
$3.20
|
| Rate for Payer: BCBS Trust/PPO |
$10.51
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: BCN Medicare Advantage |
$3.20
|
| Rate for Payer: Cash Price |
$10.23
|
| Rate for Payer: Cofinity Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.20
|
| Rate for Payer: Healthscope Commercial |
$11.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.59
|
| Rate for Payer: Mclaren Medicaid |
$2.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.36
|
| Rate for Payer: Meridian Medicaid |
$2.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.87
|
| Rate for Payer: Nomi Health Commercial |
$10.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.59
|
| Rate for Payer: PACE Senior Care Partners |
$3.04
|
| Rate for Payer: PACE SWMI |
$3.20
|
| Rate for Payer: PHP Commercial |
$10.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.13
|
| Rate for Payer: Priority Health Medicare |
$3.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.26
|
| Rate for Payer: UHC Core |
$10.68
|
| Rate for Payer: UHC Exchange |
$3.20
|
| Rate for Payer: UHC Medicaid |
$2.25
|
| Rate for Payer: UHC Medicare Advantage |
$3.20
|
| Rate for Payer: UHCCP Medicaid |
$2.25
|
| Rate for Payer: VA VA |
$3.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.59
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
OP
|
$32.48
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.73 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.01
|
| Rate for Payer: BCBS MAPPO |
$8.12
|
| Rate for Payer: BCBS Trust/PPO |
$26.70
|
| Rate for Payer: BCN Commercial |
$26.70
|
| Rate for Payer: BCN Medicare Advantage |
$8.12
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.12
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.36
|
| Rate for Payer: Mclaren Medicaid |
$5.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.53
|
| Rate for Payer: Meridian Medicaid |
$6.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PACE Senior Care Partners |
$7.71
|
| Rate for Payer: PACE SWMI |
$8.12
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$8.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.58
|
| Rate for Payer: UHC Core |
$27.12
|
| Rate for Payer: UHC Exchange |
$8.12
|
| Rate for Payer: UHC Medicaid |
$5.73
|
| Rate for Payer: UHC Medicare Advantage |
$8.12
|
| Rate for Payer: UHCCP Medicaid |
$5.73
|
| Rate for Payer: VA VA |
$8.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.36
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$32.48
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.61 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: BCBS Trust/PPO |
$26.83
|
| Rate for Payer: BCN Commercial |
$26.83
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.58
|
| Rate for Payer: UHC Core |
$27.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.36
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$37.76
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$33.98 |
| Rate for Payer: Aetna Commercial |
$32.10
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$31.04
|
| Rate for Payer: BCN Commercial |
$31.04
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$30.21
|
| Rate for Payer: Cofinity Commercial |
$32.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$33.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.32
|
| Rate for Payer: Mclaren Medicaid |
$6.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$6.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.10
|
| Rate for Payer: Nomi Health Commercial |
$30.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.32
|
| Rate for Payer: PACE Senior Care Partners |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$32.10
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.85
|
| Rate for Payer: Priority Health Medicare |
$9.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.23
|
| Rate for Payer: UHC Core |
$31.53
|
| Rate for Payer: UHC Exchange |
$9.44
|
| Rate for Payer: UHC Medicaid |
$6.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$6.66
|
| Rate for Payer: VA VA |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.32
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
IP
|
$37.76
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.28 |
| Max. Negotiated Rate |
$33.98 |
| Rate for Payer: Aetna Commercial |
$32.10
|
| Rate for Payer: BCBS Trust/PPO |
$31.19
|
| Rate for Payer: BCN Commercial |
$31.19
|
| Rate for Payer: Cash Price |
$30.21
|
| Rate for Payer: Cofinity Commercial |
$32.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.21
|
| Rate for Payer: Healthscope Commercial |
$33.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.10
|
| Rate for Payer: Nomi Health Commercial |
$30.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.32
|
| Rate for Payer: PHP Commercial |
$32.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.23
|
| Rate for Payer: UHC Core |
$31.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.32
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
