|
HC C PEPTIDE LEVEL
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.70
|
| Rate for Payer: BCBS Complete |
$15.80
|
| Rate for Payer: BCBS MAPPO |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$30.79
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: BCN Medicare Advantage |
$9.36
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.83
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Senior Care Partners |
$8.89
|
| Rate for Payer: PACE SWMI |
$9.36
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: Railroad Medicare Medicare |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.36
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$15.05
|
| Rate for Payer: VA VA |
$9.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC C PEPTIDE LEVEL
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
30100464
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.57
|
| Rate for Payer: BCN Commercial |
$28.94
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC CPK
|
Facility
|
IP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.62 |
| Max. Negotiated Rate |
$47.93 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.48
|
| Rate for Payer: BCN Commercial |
$41.16
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$45.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Healthscope Commercial |
$47.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: Nomi Health Commercial |
$43.67
|
| Rate for Payer: PHP Commercial |
$45.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: Priority Health HMO/PPO |
$46.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.87
|
| Rate for Payer: UHC Core |
$44.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.95
|
|
|
HC CPK
|
Facility
|
OP
|
$53.26
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
30100178
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$47.93 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.64
|
| Rate for Payer: BCBS Complete |
$4.94
|
| Rate for Payer: BCBS MAPPO |
$13.31
|
| Rate for Payer: BCBS Trust/PPO |
$43.79
|
| Rate for Payer: BCN Commercial |
$41.41
|
| Rate for Payer: BCN Medicare Advantage |
$13.31
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cash Price |
$42.61
|
| Rate for Payer: Cofinity Commercial |
$45.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.31
|
| Rate for Payer: Healthscope Commercial |
$47.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.95
|
| Rate for Payer: Mclaren Medicaid |
$4.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.98
|
| Rate for Payer: Meridian Medicaid |
$4.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.27
|
| Rate for Payer: Nomi Health Commercial |
$43.67
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.31
|
| Rate for Payer: PHP Commercial |
$45.27
|
| Rate for Payer: PHP Medicare Advantage |
$13.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.62
|
| Rate for Payer: Priority Health HMO/PPO |
$46.34
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.68
|
| Rate for Payer: Railroad Medicare Medicare |
$13.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.87
|
| Rate for Payer: UHC Core |
$44.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.31
|
| Rate for Payer: UHC Exchange |
$13.31
|
| Rate for Payer: UHC Medicare Advantage |
$13.31
|
| Rate for Payer: UHCCP Medicaid |
$4.71
|
| Rate for Payer: VA VA |
$13.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.95
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
OP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$97.92 |
| Max. Negotiated Rate |
$371.06 |
| Rate for Payer: Aetna Commercial |
$350.45
|
| Rate for Payer: Aetna Medicare |
$107.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.84
|
| Rate for Payer: BCBS Complete |
$121.98
|
| Rate for Payer: BCBS MAPPO |
$103.07
|
| Rate for Payer: BCBS Trust/PPO |
$338.94
|
| Rate for Payer: BCN Commercial |
$320.56
|
| Rate for Payer: BCN Medicare Advantage |
$103.07
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$354.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.07
|
| Rate for Payer: Healthscope Commercial |
$371.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.22
|
| Rate for Payer: Mclaren Medicaid |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.23
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: Nomi Health Commercial |
$338.08
|
| Rate for Payer: PACE Senior Care Partners |
$97.92
|
| Rate for Payer: PACE SWMI |
$103.07
|
| Rate for Payer: PHP Commercial |
$350.45
|
| Rate for Payer: PHP Medicare Advantage |
$103.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: Priority Health HMO/PPO |
$358.69
|
| Rate for Payer: Priority Health Medicare |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.23
|
| Rate for Payer: Railroad Medicare Medicare |
$103.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.82
|
| Rate for Payer: UHC Core |
$344.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.07
|
| Rate for Payer: UHC Exchange |
$103.07
|
| Rate for Payer: UHC Medicare Advantage |
$103.07
|
| Rate for Payer: UHCCP Medicaid |
$116.16
|
| Rate for Payer: VA VA |
$103.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.22
|
|
|
HC CPLX CHRNC CARE 1ST 60 MIN
|
Facility
|
IP
|
$412.29
|
|
|
Service Code
|
CPT 99487
|
| Hospital Charge Code |
51000108
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$267.99 |
| Max. Negotiated Rate |
$371.06 |
| Rate for Payer: Aetna Commercial |
$350.45
|
| Rate for Payer: BCBS Trust/PPO |
$336.55
|
| Rate for Payer: BCN Commercial |
$318.62
|
| Rate for Payer: Cash Price |
$329.83
|
| Rate for Payer: Cofinity Commercial |
$354.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.83
|
| Rate for Payer: Healthscope Commercial |
$371.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.45
|
| Rate for Payer: Nomi Health Commercial |
$338.08
|
| Rate for Payer: PHP Commercial |
$350.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.99
|
| Rate for Payer: Priority Health HMO/PPO |
$358.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.82
|
| Rate for Payer: UHC Core |
$344.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.22
|
|
|
HC CPR
|
Facility
|
OP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.14 |
| Max. Negotiated Rate |
$882.01 |
| Rate for Payer: Aetna Commercial |
$833.01
|
| Rate for Payer: Aetna Medicare |
$254.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$306.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$306.25
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$245.00
|
| Rate for Payer: BCBS Trust/PPO |
$805.67
|
| Rate for Payer: BCN Commercial |
$761.96
|
| Rate for Payer: BCN Medicare Advantage |
$245.00
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$842.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.00
|
| Rate for Payer: Healthscope Commercial |
$882.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.01
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$257.25
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$281.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: Nomi Health Commercial |
$803.61
|
| Rate for Payer: PACE Senior Care Partners |
$232.75
|
| Rate for Payer: PACE SWMI |
$245.00
|
| Rate for Payer: PHP Commercial |
$833.01
|
| Rate for Payer: PHP Medicare Advantage |
$245.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: Priority Health HMO/PPO |
$852.61
|
| Rate for Payer: Priority Health Medicare |
$247.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.61
|
| Rate for Payer: Railroad Medicare Medicare |
$245.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.41
|
| Rate for Payer: UHC Core |
$818.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$245.00
|
| Rate for Payer: UHC Exchange |
$245.00
|
| Rate for Payer: UHC Medicare Advantage |
$245.00
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$245.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.01
|
|
|
HC CPR
|
Facility
|
IP
|
$980.01
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
45000018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$637.01 |
| Max. Negotiated Rate |
$882.01 |
| Rate for Payer: Aetna Commercial |
$833.01
|
| Rate for Payer: BCBS Trust/PPO |
$799.98
|
| Rate for Payer: BCN Commercial |
$757.35
|
| Rate for Payer: Cash Price |
$784.01
|
| Rate for Payer: Cofinity Commercial |
$842.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$784.01
|
| Rate for Payer: Healthscope Commercial |
$882.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$735.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$833.01
|
| Rate for Payer: Nomi Health Commercial |
$803.61
|
| Rate for Payer: PHP Commercial |
$833.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.01
|
| Rate for Payer: Priority Health HMO/PPO |
$852.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$656.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$862.41
|
| Rate for Payer: UHC Core |
$818.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$735.01
|
|
|
HC CRAB IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CRAB IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200037
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CRE
|
Facility
|
OP
|
$1,453.22
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$345.14 |
| Max. Negotiated Rate |
$1,307.90 |
| Rate for Payer: Aetna Commercial |
$1,235.24
|
| Rate for Payer: Aetna Medicare |
$377.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$454.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$454.13
|
| Rate for Payer: BCBS Complete |
$581.29
|
| Rate for Payer: BCBS MAPPO |
$363.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,194.69
|
| Rate for Payer: BCN Commercial |
$1,129.88
|
| Rate for Payer: BCN Medicare Advantage |
$363.31
|
| Rate for Payer: Cash Price |
$1,162.58
|
| Rate for Payer: Cofinity Commercial |
$1,249.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.31
|
| Rate for Payer: Healthscope Commercial |
$1,307.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,089.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$417.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,235.24
|
| Rate for Payer: Nomi Health Commercial |
$1,191.64
|
| Rate for Payer: PACE Senior Care Partners |
$345.14
|
| Rate for Payer: PACE SWMI |
$363.31
|
| Rate for Payer: PHP Commercial |
$1,235.24
|
| Rate for Payer: PHP Medicare Advantage |
$363.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$944.59
|
| Rate for Payer: Priority Health HMO/PPO |
$1,264.30
|
| Rate for Payer: Priority Health Medicare |
$366.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$973.66
|
| Rate for Payer: Railroad Medicare Medicare |
$363.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,278.83
|
| Rate for Payer: UHC Core |
$1,213.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.31
|
| Rate for Payer: UHC Exchange |
$363.31
|
| Rate for Payer: UHC Medicare Advantage |
$363.31
|
| Rate for Payer: VA VA |
$363.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,089.91
|
|
|
HC CRE
|
Facility
|
IP
|
$1,453.22
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$944.59 |
| Max. Negotiated Rate |
$1,307.90 |
| Rate for Payer: Aetna Commercial |
$1,235.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.26
|
| Rate for Payer: BCN Commercial |
$1,123.05
|
| Rate for Payer: Cash Price |
$1,162.58
|
| Rate for Payer: Cofinity Commercial |
$1,249.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,162.58
|
| Rate for Payer: Healthscope Commercial |
$1,307.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,089.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,235.24
|
| Rate for Payer: Nomi Health Commercial |
$1,191.64
|
| Rate for Payer: PHP Commercial |
$1,235.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$944.59
|
| Rate for Payer: Priority Health HMO/PPO |
$1,264.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$973.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,278.83
|
| Rate for Payer: UHC Core |
$1,213.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,089.91
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
OP
|
$61.61
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.25
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$15.40
|
| Rate for Payer: BCBS Trust/PPO |
$50.65
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$15.40
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.40
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.17
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PACE Senior Care Partners |
$14.63
|
| Rate for Payer: PACE SWMI |
$15.40
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: PHP Medicare Advantage |
$15.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: Railroad Medicare Medicare |
$15.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.40
|
| Rate for Payer: UHC Exchange |
$15.40
|
| Rate for Payer: UHC Medicare Advantage |
$15.40
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC C REACTIVE PROTEIN
|
Facility
|
IP
|
$61.61
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200137
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.05 |
| Max. Negotiated Rate |
$55.45 |
| Rate for Payer: Aetna Commercial |
$52.37
|
| Rate for Payer: BCBS Trust/PPO |
$50.29
|
| Rate for Payer: BCN Commercial |
$47.61
|
| Rate for Payer: Cash Price |
$49.29
|
| Rate for Payer: Cofinity Commercial |
$52.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.29
|
| Rate for Payer: Healthscope Commercial |
$55.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.37
|
| Rate for Payer: Nomi Health Commercial |
$50.52
|
| Rate for Payer: PHP Commercial |
$52.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.05
|
| Rate for Payer: Priority Health HMO/PPO |
$53.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.22
|
| Rate for Payer: UHC Core |
$51.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.21
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
OP
|
$5,158.30
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,225.10 |
| Max. Negotiated Rate |
$4,642.47 |
| Rate for Payer: Aetna Commercial |
$4,384.56
|
| Rate for Payer: Aetna Medicare |
$1,341.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,611.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,611.97
|
| Rate for Payer: BCBS Complete |
$2,862.94
|
| Rate for Payer: BCBS MAPPO |
$1,289.58
|
| Rate for Payer: BCBS Trust/PPO |
$4,240.64
|
| Rate for Payer: BCN Commercial |
$4,010.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,289.58
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cofinity Commercial |
$4,436.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,126.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,289.58
|
| Rate for Payer: Healthscope Commercial |
$4,642.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,868.72
|
| Rate for Payer: Mclaren Medicaid |
$2,726.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,354.05
|
| Rate for Payer: Meridian Medicaid |
$2,862.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,483.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,384.56
|
| Rate for Payer: Nomi Health Commercial |
$4,229.81
|
| Rate for Payer: PACE Senior Care Partners |
$1,225.10
|
| Rate for Payer: PACE SWMI |
$1,289.58
|
| Rate for Payer: PHP Commercial |
$4,384.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,289.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,726.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.89
|
| Rate for Payer: Priority Health HMO/PPO |
$4,487.72
|
| Rate for Payer: Priority Health Medicare |
$1,302.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,456.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,289.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,539.30
|
| Rate for Payer: UHC Core |
$4,307.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,289.58
|
| Rate for Payer: UHC Exchange |
$1,289.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,289.58
|
| Rate for Payer: UHCCP Medicaid |
$2,726.43
|
| Rate for Payer: VA VA |
$1,289.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,868.72
|
|
|
HC CREATE TEAR SAC DRAIN
|
Facility
|
IP
|
$5,158.30
|
|
|
Service Code
|
CPT 68720
|
| Hospital Charge Code |
76100308
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,352.89 |
| Max. Negotiated Rate |
$4,642.47 |
| Rate for Payer: Aetna Commercial |
$4,384.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,210.72
|
| Rate for Payer: BCN Commercial |
$3,986.33
|
| Rate for Payer: Cash Price |
$4,126.64
|
| Rate for Payer: Cofinity Commercial |
$4,436.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,126.64
|
| Rate for Payer: Healthscope Commercial |
$4,642.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,868.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,384.56
|
| Rate for Payer: Nomi Health Commercial |
$4,229.81
|
| Rate for Payer: PHP Commercial |
$4,384.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,352.89
|
| Rate for Payer: Priority Health HMO/PPO |
$4,487.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,456.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,539.30
|
| Rate for Payer: UHC Core |
$4,307.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,868.72
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.18
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.84
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CREATININE SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$3.89
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$3.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$3.70
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health HMO/PPO |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.89
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$16.77
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: Meridian Medicaid |
$3.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health HMO/PPO |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Exchange |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.10
|
| Rate for Payer: UHCCP Medicaid |
$3.70
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$39.99
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$35.99 |
| Rate for Payer: Aetna Commercial |
$33.99
|
| Rate for Payer: Aetna Medicare |
$10.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.50
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$10.00
|
| Rate for Payer: BCBS Trust/PPO |
$32.88
|
| Rate for Payer: BCN Commercial |
$31.09
|
| Rate for Payer: BCN Medicare Advantage |
$10.00
|
| Rate for Payer: Cash Price |
$31.99
|
| Rate for Payer: Cofinity Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.00
|
| Rate for Payer: Healthscope Commercial |
$35.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.99
|
| Rate for Payer: Nomi Health Commercial |
$32.79
|
| Rate for Payer: PACE Senior Care Partners |
$9.50
|
| Rate for Payer: PACE SWMI |
$10.00
|
| Rate for Payer: PHP Commercial |
$33.99
|
| Rate for Payer: PHP Medicare Advantage |
$10.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.99
|
| Rate for Payer: Priority Health HMO/PPO |
$34.79
|
| Rate for Payer: Priority Health Medicare |
$10.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.79
|
| Rate for Payer: Railroad Medicare Medicare |
$10.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.19
|
| Rate for Payer: UHC Core |
$33.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.00
|
| Rate for Payer: UHC Exchange |
$10.00
|
| Rate for Payer: UHC Medicare Advantage |
$10.00
|
| Rate for Payer: VA VA |
$10.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.99
|
|
