|
HC FACTOR XI ASSAY
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 85270
|
| Hospital Charge Code |
30500032
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$90.22
|
| Rate for Payer: BCN Commercial |
$90.22
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC FACTOR XII ASSAY
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 85280
|
| Hospital Charge Code |
30500033
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$90.22
|
| Rate for Payer: BCN Commercial |
$90.22
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC FACTOR XII ASSAY
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 85280
|
| Hospital Charge Code |
30500033
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$20.22
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$89.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$19.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$20.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicaid |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$19.26
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC FACTOR XIII, FUNCTIONAL
|
Facility
|
IP
|
$185.19
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$128.89 |
| Max. Negotiated Rate |
$166.67 |
| Rate for Payer: Aetna Commercial |
$157.41
|
| Rate for Payer: BCBS Trust/PPO |
$152.95
|
| Rate for Payer: BCN Commercial |
$152.95
|
| Rate for Payer: Cash Price |
$148.15
|
| Rate for Payer: Cofinity Commercial |
$159.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.15
|
| Rate for Payer: Healthscope Commercial |
$166.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.41
|
| Rate for Payer: Nomi Health Commercial |
$151.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.89
|
| Rate for Payer: PHP Commercial |
$157.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.97
|
| Rate for Payer: UHC Core |
$154.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.89
|
|
|
HC FACTOR XIII, FUNCTIONAL
|
Facility
|
OP
|
$185.19
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$32.65 |
| Max. Negotiated Rate |
$166.67 |
| Rate for Payer: Aetna Commercial |
$157.41
|
| Rate for Payer: Aetna Medicare |
$48.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.87
|
| Rate for Payer: BCBS Complete |
$34.28
|
| Rate for Payer: BCBS MAPPO |
$46.30
|
| Rate for Payer: BCBS Trust/PPO |
$152.24
|
| Rate for Payer: BCN Commercial |
$152.24
|
| Rate for Payer: BCN Medicare Advantage |
$46.30
|
| Rate for Payer: Cash Price |
$148.15
|
| Rate for Payer: Cofinity Commercial |
$159.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.30
|
| Rate for Payer: Healthscope Commercial |
$166.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.89
|
| Rate for Payer: Mclaren Medicaid |
$32.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.61
|
| Rate for Payer: Meridian Medicaid |
$34.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.41
|
| Rate for Payer: Nomi Health Commercial |
$151.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.89
|
| Rate for Payer: PACE Senior Care Partners |
$43.98
|
| Rate for Payer: PACE SWMI |
$46.30
|
| Rate for Payer: PHP Commercial |
$157.41
|
| Rate for Payer: PHP Medicare Advantage |
$46.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.12
|
| Rate for Payer: Priority Health Medicare |
$46.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.89
|
| Rate for Payer: Railroad Medicare Medicare |
$46.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.97
|
| Rate for Payer: UHC Core |
$154.63
|
| Rate for Payer: UHC Exchange |
$46.30
|
| Rate for Payer: UHC Medicaid |
$32.65
|
| Rate for Payer: UHC Medicare Advantage |
$46.30
|
| Rate for Payer: UHCCP Medicaid |
$32.65
|
| Rate for Payer: VA VA |
$46.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.89
|
|
|
HC FACTOR XIII QUAL
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$30.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.74
|
| Rate for Payer: BCBS Complete |
$21.76
|
| Rate for Payer: BCBS MAPPO |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$96.65
|
| Rate for Payer: BCN Commercial |
$96.65
|
| Rate for Payer: BCN Medicare Advantage |
$29.39
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.39
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$20.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$21.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PACE Senior Care Partners |
$27.92
|
| Rate for Payer: PACE SWMI |
$29.39
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Medicare |
$29.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: Railroad Medicare Medicare |
$29.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicaid |
$20.73
|
| Rate for Payer: UHC Medicare Advantage |
$29.39
|
| Rate for Payer: UHCCP Medicaid |
$20.73
|
| Rate for Payer: VA VA |
$29.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC FACTOR XIII QUAL
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 85290
|
| Hospital Charge Code |
30500034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$81.83 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$97.10
|
| Rate for Payer: BCN Commercial |
$97.10
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
IP
|
$93.28
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$83.95 |
| Rate for Payer: Aetna Commercial |
$79.29
|
| Rate for Payer: BCBS Trust/PPO |
$77.04
|
| Rate for Payer: BCN Commercial |
$77.04
|
| Rate for Payer: Cash Price |
$74.62
|
| Rate for Payer: Cofinity Commercial |
$80.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.62
|
| Rate for Payer: Healthscope Commercial |
$83.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.29
|
| Rate for Payer: Nomi Health Commercial |
$76.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.96
|
| Rate for Payer: PHP Commercial |
$79.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.92
|
| Rate for Payer: UHC Core |
$77.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.96
|
|
|
HC FAMILY PSYCHTHRPY 50 MIN W/O PATIENT
|
Facility
|
OP
|
$93.28
|
|
|
Service Code
|
CPT 90846
|
| Hospital Charge Code |
91600001
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$16.45 |
| Max. Negotiated Rate |
$83.95 |
| Rate for Payer: Aetna Commercial |
$79.29
|
| Rate for Payer: Aetna Medicare |
$24.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.15
|
| Rate for Payer: BCBS Complete |
$17.27
|
| Rate for Payer: BCBS MAPPO |
$23.32
|
| Rate for Payer: BCBS Trust/PPO |
$76.69
|
| Rate for Payer: BCN Commercial |
$76.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.32
|
| Rate for Payer: Cash Price |
$74.62
|
| Rate for Payer: Cofinity Commercial |
$80.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$83.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.96
|
| Rate for Payer: Mclaren Medicaid |
$16.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.49
|
| Rate for Payer: Meridian Medicaid |
$17.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.29
|
| Rate for Payer: Nomi Health Commercial |
$76.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.96
|
| Rate for Payer: PACE Senior Care Partners |
$22.15
|
| Rate for Payer: PACE SWMI |
$23.32
|
| Rate for Payer: PHP Commercial |
$79.29
|
| Rate for Payer: PHP Medicare Advantage |
$23.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.15
|
| Rate for Payer: Priority Health Medicare |
$23.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.92
|
| Rate for Payer: Railroad Medicare Medicare |
$23.32
|
| Rate for Payer: UHC Core |
$77.89
|
| Rate for Payer: UHC Exchange |
$23.32
|
| Rate for Payer: UHC Medicaid |
$16.45
|
| Rate for Payer: UHC Medicare Advantage |
$23.32
|
| Rate for Payer: UHCCP Medicaid |
$16.45
|
| Rate for Payer: VA VA |
$23.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.96
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
OP
|
$4,423.22
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$779.81 |
| Max. Negotiated Rate |
$3,980.90 |
| Rate for Payer: Aetna Commercial |
$3,759.74
|
| Rate for Payer: Aetna Medicare |
$1,150.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,382.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,382.26
|
| Rate for Payer: BCBS Complete |
$818.74
|
| Rate for Payer: BCBS MAPPO |
$1,105.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,636.33
|
| Rate for Payer: BCN Commercial |
$3,636.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.81
|
| Rate for Payer: Cash Price |
$3,538.58
|
| Rate for Payer: Cofinity Commercial |
$3,803.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,538.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.81
|
| Rate for Payer: Healthscope Commercial |
$3,980.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,317.41
|
| Rate for Payer: Mclaren Medicaid |
$779.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,161.10
|
| Rate for Payer: Meridian Medicaid |
$818.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,271.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,216.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,759.74
|
| Rate for Payer: Nomi Health Commercial |
$3,627.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,317.41
|
| Rate for Payer: PACE Senior Care Partners |
$1,050.51
|
| Rate for Payer: PACE SWMI |
$1,105.81
|
| Rate for Payer: PHP Commercial |
$3,759.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$779.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,848.20
|
| Rate for Payer: Priority Health Medicare |
$1,116.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,078.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,105.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,892.43
|
| Rate for Payer: UHC Core |
$3,693.39
|
| Rate for Payer: UHC Exchange |
$1,105.81
|
| Rate for Payer: UHC Medicaid |
$779.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,105.81
|
| Rate for Payer: UHCCP Medicaid |
$779.81
|
| Rate for Payer: VA VA |
$1,105.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,317.41
|
|
|
HC FASCIECTOMY PLANTAR FASCIA PARTIAL
|
Facility
|
IP
|
$4,423.22
|
|
| Hospital Charge Code |
36000100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,078.56 |
| Max. Negotiated Rate |
$3,980.90 |
| Rate for Payer: Aetna Commercial |
$3,759.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,653.14
|
| Rate for Payer: BCN Commercial |
$3,653.14
|
| Rate for Payer: Cash Price |
$3,538.58
|
| Rate for Payer: Cofinity Commercial |
$3,803.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,538.58
|
| Rate for Payer: Healthscope Commercial |
$3,980.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,317.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,759.74
|
| Rate for Payer: Nomi Health Commercial |
$3,627.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,317.41
|
| Rate for Payer: PHP Commercial |
$3,759.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,848.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,078.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,892.43
|
| Rate for Payer: UHC Core |
$3,693.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,317.41
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
OP
|
$8,901.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,569.25 |
| Max. Negotiated Rate |
$8,010.90 |
| Rate for Payer: Aetna Commercial |
$7,565.85
|
| Rate for Payer: Aetna Medicare |
$2,314.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,781.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,781.56
|
| Rate for Payer: BCBS Complete |
$1,647.58
|
| Rate for Payer: BCBS MAPPO |
$2,225.25
|
| Rate for Payer: BCBS Trust/PPO |
$7,317.51
|
| Rate for Payer: BCN Commercial |
$7,317.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,225.25
|
| Rate for Payer: Cash Price |
$7,120.80
|
| Rate for Payer: Cofinity Commercial |
$7,654.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,120.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,225.25
|
| Rate for Payer: Healthscope Commercial |
$8,010.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,675.75
|
| Rate for Payer: Mclaren Medicaid |
$1,569.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,336.51
|
| Rate for Payer: Meridian Medicaid |
$1,647.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,559.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,447.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,565.85
|
| Rate for Payer: Nomi Health Commercial |
$7,298.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,675.75
|
| Rate for Payer: PACE Senior Care Partners |
$2,113.99
|
| Rate for Payer: PACE SWMI |
$2,225.25
|
| Rate for Payer: PHP Commercial |
$7,565.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,225.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,569.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,743.87
|
| Rate for Payer: Priority Health Medicare |
$2,247.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,195.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,225.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,832.88
|
| Rate for Payer: UHC Core |
$7,432.34
|
| Rate for Payer: UHC Exchange |
$2,225.25
|
| Rate for Payer: UHC Medicaid |
$1,569.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,225.25
|
| Rate for Payer: UHCCP Medicaid |
$1,569.25
|
| Rate for Payer: VA VA |
$2,225.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,675.75
|
|
|
HC FASCIOTOMY FOOT AND OR TOE
|
Facility
|
IP
|
$8,901.00
|
|
|
Service Code
|
CPT 28008
|
| Hospital Charge Code |
36000099
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,195.10 |
| Max. Negotiated Rate |
$8,010.90 |
| Rate for Payer: Aetna Commercial |
$7,565.85
|
| Rate for Payer: BCBS Trust/PPO |
$7,351.34
|
| Rate for Payer: BCN Commercial |
$7,351.34
|
| Rate for Payer: Cash Price |
$7,120.80
|
| Rate for Payer: Cofinity Commercial |
$7,654.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,120.80
|
| Rate for Payer: Healthscope Commercial |
$8,010.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,675.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,565.85
|
| Rate for Payer: Nomi Health Commercial |
$7,298.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,675.75
|
| Rate for Payer: PHP Commercial |
$7,565.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,743.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,195.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,832.88
|
| Rate for Payer: UHC Core |
$7,432.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,675.75
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
OP
|
$157.18
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.71 |
| Max. Negotiated Rate |
$141.46 |
| Rate for Payer: Aetna Commercial |
$133.60
|
| Rate for Payer: Aetna Medicare |
$40.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.12
|
| Rate for Payer: BCBS Complete |
$29.09
|
| Rate for Payer: BCBS MAPPO |
$39.30
|
| Rate for Payer: BCBS Trust/PPO |
$129.22
|
| Rate for Payer: BCN Commercial |
$129.22
|
| Rate for Payer: BCN Medicare Advantage |
$39.30
|
| Rate for Payer: Cash Price |
$125.74
|
| Rate for Payer: Cofinity Commercial |
$135.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.30
|
| Rate for Payer: Healthscope Commercial |
$141.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.89
|
| Rate for Payer: Mclaren Medicaid |
$27.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.26
|
| Rate for Payer: Meridian Medicaid |
$29.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.60
|
| Rate for Payer: Nomi Health Commercial |
$128.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.89
|
| Rate for Payer: PACE Senior Care Partners |
$37.33
|
| Rate for Payer: PACE SWMI |
$39.30
|
| Rate for Payer: PHP Commercial |
$133.60
|
| Rate for Payer: PHP Medicare Advantage |
$39.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.75
|
| Rate for Payer: Priority Health Medicare |
$39.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.40
|
| Rate for Payer: Railroad Medicare Medicare |
$39.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.32
|
| Rate for Payer: UHC Core |
$131.25
|
| Rate for Payer: UHC Exchange |
$39.30
|
| Rate for Payer: UHC Medicaid |
$27.71
|
| Rate for Payer: UHC Medicare Advantage |
$39.30
|
| Rate for Payer: UHCCP Medicaid |
$27.71
|
| Rate for Payer: VA VA |
$39.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.89
|
|
|
HC FATTY ACID PROFILE, ESSENTIAL, S
|
Facility
|
IP
|
$157.18
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100745
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.40 |
| Max. Negotiated Rate |
$141.46 |
| Rate for Payer: Aetna Commercial |
$133.60
|
| Rate for Payer: BCBS Trust/PPO |
$129.81
|
| Rate for Payer: BCN Commercial |
$129.81
|
| Rate for Payer: Cash Price |
$125.74
|
| Rate for Payer: Cofinity Commercial |
$135.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.74
|
| Rate for Payer: Healthscope Commercial |
$141.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.60
|
| Rate for Payer: Nomi Health Commercial |
$128.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.89
|
| Rate for Payer: PHP Commercial |
$133.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.32
|
| Rate for Payer: UHC Core |
$131.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.89
|
|
|
HC FDG PER DOSE
|
Facility
|
IP
|
$793.52
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$552.29 |
| Max. Negotiated Rate |
$714.17 |
| Rate for Payer: Aetna Commercial |
$674.49
|
| Rate for Payer: BCBS Trust/PPO |
$655.37
|
| Rate for Payer: BCN Commercial |
$655.37
|
| Rate for Payer: Cash Price |
$634.82
|
| Rate for Payer: Cofinity Commercial |
$682.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.82
|
| Rate for Payer: Healthscope Commercial |
$714.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$595.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.49
|
| Rate for Payer: Nomi Health Commercial |
$650.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.14
|
| Rate for Payer: PHP Commercial |
$674.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$690.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.30
|
| Rate for Payer: UHC Core |
$662.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$595.14
|
|
|
HC FDG PER DOSE
|
Facility
|
OP
|
$793.52
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300006
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$139.90 |
| Max. Negotiated Rate |
$714.17 |
| Rate for Payer: Aetna Commercial |
$674.49
|
| Rate for Payer: Aetna Medicare |
$206.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.97
|
| Rate for Payer: BCBS Complete |
$146.88
|
| Rate for Payer: BCBS MAPPO |
$198.38
|
| Rate for Payer: BCBS Trust/PPO |
$652.35
|
| Rate for Payer: BCN Commercial |
$652.35
|
| Rate for Payer: BCN Medicare Advantage |
$198.38
|
| Rate for Payer: Cash Price |
$634.82
|
| Rate for Payer: Cofinity Commercial |
$682.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.38
|
| Rate for Payer: Healthscope Commercial |
$714.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$595.14
|
| Rate for Payer: Mclaren Medicaid |
$139.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.30
|
| Rate for Payer: Meridian Medicaid |
$146.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.49
|
| Rate for Payer: Nomi Health Commercial |
$650.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$595.14
|
| Rate for Payer: PACE Senior Care Partners |
$188.46
|
| Rate for Payer: PACE SWMI |
$198.38
|
| Rate for Payer: PHP Commercial |
$674.49
|
| Rate for Payer: PHP Medicare Advantage |
$198.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$690.36
|
| Rate for Payer: Priority Health Medicare |
$200.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.29
|
| Rate for Payer: Railroad Medicare Medicare |
$198.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.30
|
| Rate for Payer: UHC Core |
$662.59
|
| Rate for Payer: UHC Exchange |
$198.38
|
| Rate for Payer: UHC Medicaid |
$139.90
|
| Rate for Payer: UHC Medicare Advantage |
$198.38
|
| Rate for Payer: UHCCP Medicaid |
$139.90
|
| Rate for Payer: VA VA |
$198.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$595.14
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
OP
|
$34.90
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.15 |
| Max. Negotiated Rate |
$31.41 |
| Rate for Payer: Aetna Commercial |
$29.66
|
| Rate for Payer: Aetna Medicare |
$9.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.91
|
| Rate for Payer: BCBS Complete |
$6.46
|
| Rate for Payer: BCBS MAPPO |
$8.72
|
| Rate for Payer: BCBS Trust/PPO |
$28.69
|
| Rate for Payer: BCN Commercial |
$28.69
|
| Rate for Payer: BCN Medicare Advantage |
$8.72
|
| Rate for Payer: Cash Price |
$27.92
|
| Rate for Payer: Cofinity Commercial |
$30.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.72
|
| Rate for Payer: Healthscope Commercial |
$31.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.18
|
| Rate for Payer: Mclaren Medicaid |
$6.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.16
|
| Rate for Payer: Meridian Medicaid |
$6.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.66
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.18
|
| Rate for Payer: PACE Senior Care Partners |
$8.29
|
| Rate for Payer: PACE SWMI |
$8.72
|
| Rate for Payer: PHP Commercial |
$29.66
|
| Rate for Payer: PHP Medicare Advantage |
$8.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.36
|
| Rate for Payer: Priority Health Medicare |
$8.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.29
|
| Rate for Payer: Railroad Medicare Medicare |
$8.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.71
|
| Rate for Payer: UHC Core |
$29.14
|
| Rate for Payer: UHC Exchange |
$8.72
|
| Rate for Payer: UHC Medicaid |
$6.15
|
| Rate for Payer: UHC Medicare Advantage |
$8.72
|
| Rate for Payer: UHCCP Medicaid |
$6.15
|
| Rate for Payer: VA VA |
$8.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.18
|
|
|
HC FECAL FAT QUALITATIVE
|
Facility
|
IP
|
$34.90
|
|
|
Service Code
|
CPT 82705
|
| Hospital Charge Code |
30100198
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.29 |
| Max. Negotiated Rate |
$31.41 |
| Rate for Payer: Aetna Commercial |
$29.66
|
| Rate for Payer: BCBS Trust/PPO |
$28.82
|
| Rate for Payer: BCN Commercial |
$28.82
|
| Rate for Payer: Cash Price |
$27.92
|
| Rate for Payer: Cofinity Commercial |
$30.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.92
|
| Rate for Payer: Healthscope Commercial |
$31.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.66
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.18
|
| Rate for Payer: PHP Commercial |
$29.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.71
|
| Rate for Payer: UHC Core |
$29.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.18
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC FECAL FAT QUANTITATIVE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 82710
|
| Hospital Charge Code |
30100200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.17
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$45.17
|
| Rate for Payer: BCN Commercial |
$45.17
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$9.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Senior Care Partners |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Medicare |
$13.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: UHC Exchange |
$13.73
|
| Rate for Payer: UHC Medicaid |
$9.69
|
| Rate for Payer: UHC Medicare Advantage |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$9.69
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC FECAL LEUKOCYTE ASSESSMENT
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600110
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.24 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: BCBS Trust/PPO |
$45.37
|
| Rate for Payer: BCN Commercial |
$45.37
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
IP
|
$1,333.47
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$928.10 |
| Max. Negotiated Rate |
$1,200.12 |
| Rate for Payer: Aetna Commercial |
$1,133.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,101.31
|
| Rate for Payer: BCN Commercial |
$1,101.31
|
| Rate for Payer: Cash Price |
$1,066.78
|
| Rate for Payer: Cofinity Commercial |
$1,146.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.78
|
| Rate for Payer: Healthscope Commercial |
$1,200.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.45
|
| Rate for Payer: Nomi Health Commercial |
$1,093.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.10
|
| Rate for Payer: PHP Commercial |
$1,133.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,160.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.45
|
| Rate for Payer: UHC Core |
$1,113.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.10
|
|
|
HC FECAL MICROBIOTA INSTILLATION
|
Facility
|
OP
|
$1,333.47
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
36100568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$235.09 |
| Max. Negotiated Rate |
$1,200.12 |
| Rate for Payer: Aetna Commercial |
$1,133.45
|
| Rate for Payer: Aetna Medicare |
$346.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.71
|
| Rate for Payer: BCBS Complete |
$246.83
|
| Rate for Payer: BCBS MAPPO |
$333.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.25
|
| Rate for Payer: BCN Commercial |
$1,096.25
|
| Rate for Payer: BCN Medicare Advantage |
$333.37
|
| Rate for Payer: Cash Price |
$1,066.78
|
| Rate for Payer: Cofinity Commercial |
$1,146.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.37
|
| Rate for Payer: Healthscope Commercial |
$1,200.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,000.10
|
| Rate for Payer: Mclaren Medicaid |
$235.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.04
|
| Rate for Payer: Meridian Medicaid |
$246.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$366.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,133.45
|
| Rate for Payer: Nomi Health Commercial |
$1,093.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,000.10
|
| Rate for Payer: PACE Senior Care Partners |
$316.70
|
| Rate for Payer: PACE SWMI |
$333.37
|
| Rate for Payer: PHP Commercial |
$1,133.45
|
| Rate for Payer: PHP Medicare Advantage |
$333.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,160.12
|
| Rate for Payer: Priority Health Medicare |
$336.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$928.10
|
| Rate for Payer: Railroad Medicare Medicare |
$333.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.45
|
| Rate for Payer: UHC Core |
$1,113.45
|
| Rate for Payer: UHC Exchange |
$333.37
|
| Rate for Payer: UHC Medicaid |
$235.09
|
| Rate for Payer: UHC Medicare Advantage |
$333.37
|
| Rate for Payer: UHCCP Medicaid |
$235.09
|
| Rate for Payer: VA VA |
$333.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,000.10
|
|
