|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.36 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: BCBS Trust/PPO |
$46.92
|
| Rate for Payer: BCN Commercial |
$44.42
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$47.13
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO |
$50.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.58
|
| Rate for Payer: UHC Core |
$48.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$14.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.96
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$14.37
|
| Rate for Payer: BCBS Trust/PPO |
$47.25
|
| Rate for Payer: BCN Commercial |
$44.69
|
| Rate for Payer: BCN Medicare Advantage |
$14.37
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.37
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.09
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$47.13
|
| Rate for Payer: PACE Senior Care Partners |
$13.65
|
| Rate for Payer: PACE SWMI |
$14.37
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: PHP Medicare Advantage |
$14.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO |
$50.01
|
| Rate for Payer: Priority Health Medicare |
$14.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.51
|
| Rate for Payer: Railroad Medicare Medicare |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.58
|
| Rate for Payer: UHC Core |
$48.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.37
|
| Rate for Payer: UHC Exchange |
$14.37
|
| Rate for Payer: UHC Medicare Advantage |
$14.37
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$14.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$14.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.96
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$14.37
|
| Rate for Payer: BCBS Trust/PPO |
$47.25
|
| Rate for Payer: BCN Commercial |
$44.69
|
| Rate for Payer: BCN Medicare Advantage |
$14.37
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.37
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.09
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$47.13
|
| Rate for Payer: PACE Senior Care Partners |
$13.65
|
| Rate for Payer: PACE SWMI |
$14.37
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: PHP Medicare Advantage |
$14.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO |
$50.01
|
| Rate for Payer: Priority Health Medicare |
$14.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.51
|
| Rate for Payer: Railroad Medicare Medicare |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.58
|
| Rate for Payer: UHC Core |
$48.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.37
|
| Rate for Payer: UHC Exchange |
$14.37
|
| Rate for Payer: UHC Medicare Advantage |
$14.37
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$14.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.36 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: BCBS Trust/PPO |
$46.92
|
| Rate for Payer: BCN Commercial |
$44.42
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$47.13
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO |
$50.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.58
|
| Rate for Payer: UHC Core |
$48.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$24.75
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: Priority Health HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.96
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$25.98
|
| Rate for Payer: BCN Commercial |
$24.60
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: Priority Health HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
OP
|
$18.73
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna Medicare |
$4.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.85
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS MAPPO |
$4.68
|
| Rate for Payer: BCBS Trust/PPO |
$15.40
|
| Rate for Payer: BCN Commercial |
$14.56
|
| Rate for Payer: BCN Medicare Advantage |
$4.68
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.68
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: PACE Senior Care Partners |
$4.45
|
| Rate for Payer: PACE SWMI |
$4.68
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: PHP Medicare Advantage |
$4.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: Priority Health HMO/PPO |
$16.30
|
| Rate for Payer: Priority Health Medicare |
$4.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.55
|
| Rate for Payer: Railroad Medicare Medicare |
$4.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$15.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.68
|
| Rate for Payer: UHC Exchange |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$4.68
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: VA VA |
$4.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
IP
|
$18.73
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$15.29
|
| Rate for Payer: BCN Commercial |
$14.47
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: Priority Health HMO/PPO |
$16.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$15.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.13
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$37.27
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Mclaren Medicaid |
$4.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$39.31
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO |
$41.71
|
| Rate for Payer: Priority Health Medicare |
$12.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
| Rate for Payer: UHC Core |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$4.33
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC CYCLOSPORINE
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$13.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$13.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$13.05
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYCLOSPORINE
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.73
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$16.57
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.57
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.57
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.73
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.57
|
| Rate for Payer: PHP Commercial |
$56.35
|
| Rate for Payer: PHP Medicare Advantage |
$16.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.57
|
| Rate for Payer: UHC Exchange |
$16.57
|
| Rate for Payer: UHC Medicare Advantage |
$16.57
|
| Rate for Payer: UHCCP Medicaid |
$13.39
|
| Rate for Payer: VA VA |
$16.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.73
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
OP
|
$67.79
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$61.01 |
| Rate for Payer: Aetna Commercial |
$57.62
|
| Rate for Payer: Aetna Medicare |
$17.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.18
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$16.95
|
| Rate for Payer: BCBS Trust/PPO |
$55.73
|
| Rate for Payer: BCN Commercial |
$52.71
|
| Rate for Payer: BCN Medicare Advantage |
$16.95
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.95
|
| Rate for Payer: Healthscope Commercial |
$61.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.79
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.62
|
| Rate for Payer: Nomi Health Commercial |
$55.59
|
| Rate for Payer: PACE Senior Care Partners |
$16.10
|
| Rate for Payer: PACE SWMI |
$16.95
|
| Rate for Payer: PHP Commercial |
$57.62
|
| Rate for Payer: PHP Medicare Advantage |
$16.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.06
|
| Rate for Payer: Priority Health HMO/PPO |
$58.98
|
| Rate for Payer: Priority Health Medicare |
$17.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.66
|
| Rate for Payer: UHC Core |
$56.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.95
|
| Rate for Payer: UHC Exchange |
$16.95
|
| Rate for Payer: UHC Medicare Advantage |
$16.95
|
| Rate for Payer: UHCCP Medicaid |
$13.39
|
| Rate for Payer: VA VA |
$16.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
IP
|
$67.79
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.06 |
| Max. Negotiated Rate |
$61.01 |
| Rate for Payer: Aetna Commercial |
$57.62
|
| Rate for Payer: BCBS Trust/PPO |
$55.34
|
| Rate for Payer: BCN Commercial |
$52.39
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.23
|
| Rate for Payer: Healthscope Commercial |
$61.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.62
|
| Rate for Payer: Nomi Health Commercial |
$55.59
|
| Rate for Payer: PHP Commercial |
$57.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.06
|
| Rate for Payer: Priority Health HMO/PPO |
$58.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.66
|
| Rate for Payer: UHC Core |
$56.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
OP
|
$1,749.80
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$402.42 |
| Max. Negotiated Rate |
$1,574.82 |
| Rate for Payer: Aetna Commercial |
$1,487.33
|
| Rate for Payer: Aetna Medicare |
$454.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$546.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$546.81
|
| Rate for Payer: BCBS Complete |
$422.57
|
| Rate for Payer: BCBS MAPPO |
$437.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.51
|
| Rate for Payer: BCN Commercial |
$1,360.47
|
| Rate for Payer: BCN Medicare Advantage |
$437.45
|
| Rate for Payer: Cash Price |
$1,399.84
|
| Rate for Payer: Cash Price |
$1,399.84
|
| Rate for Payer: Cofinity Commercial |
$1,504.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,399.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$437.45
|
| Rate for Payer: Healthscope Commercial |
$1,574.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,312.35
|
| Rate for Payer: Mclaren Medicaid |
$402.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$459.32
|
| Rate for Payer: Meridian Medicaid |
$422.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$503.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,487.33
|
| Rate for Payer: Nomi Health Commercial |
$1,434.84
|
| Rate for Payer: PACE Senior Care Partners |
$415.58
|
| Rate for Payer: PACE SWMI |
$437.45
|
| Rate for Payer: PHP Commercial |
$1,487.33
|
| Rate for Payer: PHP Medicare Advantage |
$437.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,522.33
|
| Rate for Payer: Priority Health Medicare |
$441.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,172.37
|
| Rate for Payer: Railroad Medicare Medicare |
$437.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,539.82
|
| Rate for Payer: UHC Core |
$1,461.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$437.45
|
| Rate for Payer: UHC Exchange |
$437.45
|
| Rate for Payer: UHC Medicare Advantage |
$437.45
|
| Rate for Payer: UHCCP Medicaid |
$402.42
|
| Rate for Payer: VA VA |
$437.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,312.35
|
|
|
HC CYSTIC FIBROSIS CARRIER DETECT
|
Facility
|
IP
|
$1,749.80
|
|
|
Service Code
|
CPT 81220
|
| Hospital Charge Code |
31000098
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,137.37 |
| Max. Negotiated Rate |
$1,574.82 |
| Rate for Payer: Aetna Commercial |
$1,487.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.36
|
| Rate for Payer: BCN Commercial |
$1,352.25
|
| Rate for Payer: Cash Price |
$1,399.84
|
| Rate for Payer: Cofinity Commercial |
$1,504.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,399.84
|
| Rate for Payer: Healthscope Commercial |
$1,574.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,312.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,487.33
|
| Rate for Payer: Nomi Health Commercial |
$1,434.84
|
| Rate for Payer: PHP Commercial |
$1,487.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,522.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,172.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,539.82
|
| Rate for Payer: UHC Core |
$1,461.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,312.35
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$14.89
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$14.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Medicaid |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$14.18
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC CYSTINE 24HR URINE
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 82136
|
| Hospital Charge Code |
30100090
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
OP
|
$0.28
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: Aetna Commercial |
$0.24
|
| Rate for Payer: Aetna Medicare |
$0.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.09
|
| Rate for Payer: BCBS Complete |
$0.11
|
| Rate for Payer: BCBS MAPPO |
$0.07
|
| Rate for Payer: BCBS Trust/PPO |
$0.23
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: BCN Medicare Advantage |
$0.07
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.07
|
| Rate for Payer: Healthscope Commercial |
$0.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.24
|
| Rate for Payer: Nomi Health Commercial |
$0.23
|
| Rate for Payer: PACE Senior Care Partners |
$0.07
|
| Rate for Payer: PACE SWMI |
$0.07
|
| Rate for Payer: PHP Commercial |
$0.24
|
| Rate for Payer: PHP Medicare Advantage |
$0.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.18
|
| Rate for Payer: Priority Health HMO/PPO |
$0.24
|
| Rate for Payer: Priority Health Medicare |
$0.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.19
|
| Rate for Payer: Railroad Medicare Medicare |
$0.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.07
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHC Medicare Advantage |
$0.07
|
| Rate for Payer: VA VA |
$0.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.21
|
|
|
HC CYSTOGRAFIN DILUTE PER ML
|
Facility
|
IP
|
$0.28
|
|
|
Service Code
|
HCPCS Q9958
|
| Hospital Charge Code |
63600008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.25 |
| Rate for Payer: Aetna Commercial |
$0.24
|
| Rate for Payer: BCBS Trust/PPO |
$0.23
|
| Rate for Payer: BCN Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cofinity Commercial |
$0.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.22
|
| Rate for Payer: Healthscope Commercial |
$0.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.24
|
| Rate for Payer: Nomi Health Commercial |
$0.23
|
| Rate for Payer: PHP Commercial |
$0.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.18
|
| Rate for Payer: Priority Health HMO/PPO |
$0.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC Core |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.21
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
IP
|
$6,274.46
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,078.40 |
| Max. Negotiated Rate |
$5,647.01 |
| Rate for Payer: Aetna Commercial |
$5,333.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,121.84
|
| Rate for Payer: BCN Commercial |
$4,848.90
|
| Rate for Payer: Cash Price |
$5,019.57
|
| Rate for Payer: Cofinity Commercial |
$5,396.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,019.57
|
| Rate for Payer: Healthscope Commercial |
$5,647.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,705.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,333.29
|
| Rate for Payer: Nomi Health Commercial |
$5,145.06
|
| Rate for Payer: PHP Commercial |
$5,333.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,078.40
|
| Rate for Payer: Priority Health HMO/PPO |
$5,458.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,203.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,521.52
|
| Rate for Payer: UHC Core |
$5,239.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,705.85
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 1-3 IMPLANTS
|
Facility
|
OP
|
$6,274.46
|
|
|
Service Code
|
HCPCS C9739
|
| Hospital Charge Code |
76100196
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,490.18 |
| Max. Negotiated Rate |
$5,647.01 |
| Rate for Payer: Aetna Commercial |
$5,333.29
|
| Rate for Payer: Aetna Medicare |
$1,631.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.77
|
| Rate for Payer: BCBS Complete |
$3,859.48
|
| Rate for Payer: BCBS MAPPO |
$1,568.62
|
| Rate for Payer: BCBS Trust/PPO |
$5,158.23
|
| Rate for Payer: BCN Commercial |
$4,878.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.62
|
| Rate for Payer: Cash Price |
$5,019.57
|
| Rate for Payer: Cash Price |
$5,019.57
|
| Rate for Payer: Cofinity Commercial |
$5,396.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,019.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.62
|
| Rate for Payer: Healthscope Commercial |
$5,647.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,705.85
|
| Rate for Payer: Mclaren Medicaid |
$3,675.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,647.05
|
| Rate for Payer: Meridian Medicaid |
$3,859.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,333.29
|
| Rate for Payer: Nomi Health Commercial |
$5,145.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,490.18
|
| Rate for Payer: PACE SWMI |
$1,568.62
|
| Rate for Payer: PHP Commercial |
$5,333.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,675.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,078.40
|
| Rate for Payer: Priority Health HMO/PPO |
$5,458.78
|
| Rate for Payer: Priority Health Medicare |
$1,584.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,203.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,521.52
|
| Rate for Payer: UHC Core |
$5,239.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.62
|
| Rate for Payer: UHC Exchange |
$1,568.62
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.62
|
| Rate for Payer: UHCCP Medicaid |
$3,675.46
|
| Rate for Payer: VA VA |
$1,568.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,705.85
|
|
|
HC CYSTO INSERTION TRANSPROSTATIC IMPLANT 4 OR MORE IMPLANTS
|
Facility
|
OP
|
$12,590.82
|
|
|
Service Code
|
HCPCS C9740
|
| Hospital Charge Code |
76100197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,990.32 |
| Max. Negotiated Rate |
$11,331.74 |
| Rate for Payer: Aetna Commercial |
$10,702.20
|
| Rate for Payer: Aetna Medicare |
$3,273.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,934.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,934.63
|
| Rate for Payer: BCBS Complete |
$7,020.44
|
| Rate for Payer: BCBS MAPPO |
$3,147.70
|
| Rate for Payer: BCBS Trust/PPO |
$10,350.91
|
| Rate for Payer: BCN Commercial |
$9,789.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,147.70
|
| Rate for Payer: Cash Price |
$10,072.66
|
| Rate for Payer: Cash Price |
$10,072.66
|
| Rate for Payer: Cofinity Commercial |
$10,828.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,072.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,147.70
|
| Rate for Payer: Healthscope Commercial |
$11,331.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,443.11
|
| Rate for Payer: Mclaren Medicaid |
$6,685.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,305.09
|
| Rate for Payer: Meridian Medicaid |
$7,020.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,619.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,702.20
|
| Rate for Payer: Nomi Health Commercial |
$10,324.47
|
| Rate for Payer: PACE Senior Care Partners |
$2,990.32
|
| Rate for Payer: PACE SWMI |
$3,147.70
|
| Rate for Payer: PHP Commercial |
$10,702.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,147.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,685.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,184.03
|
| Rate for Payer: Priority Health HMO/PPO |
$10,954.01
|
| Rate for Payer: Priority Health Medicare |
$3,179.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,435.85
|
| Rate for Payer: Railroad Medicare Medicare |
$3,147.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,079.92
|
| Rate for Payer: UHC Core |
$10,513.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,147.70
|
| Rate for Payer: UHC Exchange |
$3,147.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,147.70
|
| Rate for Payer: UHCCP Medicaid |
$6,685.69
|
| Rate for Payer: VA VA |
$3,147.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,443.11
|
|
