|
HC FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| 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: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| 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 FECAL OCCULT BLOOD IMMUNOASSAY
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
30100123
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| 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 |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| 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 |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| 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 |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| 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 Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.78
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicaid |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.50
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.78
|
| Rate for Payer: BCN Commercial |
$25.78
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC FECAL PH
|
Facility
|
IP
|
$24.41
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$21.97 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: BCBS Trust/PPO |
$20.16
|
| Rate for Payer: BCN Commercial |
$20.16
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$20.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Healthscope Commercial |
$21.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PHP Commercial |
$20.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.48
|
| Rate for Payer: UHC Core |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.31
|
|
|
HC FECAL PH
|
Facility
|
OP
|
$24.41
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$21.97 |
| Rate for Payer: Aetna Commercial |
$20.75
|
| Rate for Payer: Aetna Medicare |
$6.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.63
|
| Rate for Payer: BCBS Complete |
$4.52
|
| Rate for Payer: BCBS MAPPO |
$6.10
|
| Rate for Payer: BCBS Trust/PPO |
$20.07
|
| Rate for Payer: BCN Commercial |
$20.07
|
| Rate for Payer: BCN Medicare Advantage |
$6.10
|
| Rate for Payer: Cash Price |
$19.53
|
| Rate for Payer: Cofinity Commercial |
$20.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.10
|
| Rate for Payer: Healthscope Commercial |
$21.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.31
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.41
|
| Rate for Payer: Meridian Medicaid |
$4.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$20.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.31
|
| Rate for Payer: PACE Senior Care Partners |
$5.80
|
| Rate for Payer: PACE SWMI |
$6.10
|
| Rate for Payer: PHP Commercial |
$20.75
|
| Rate for Payer: PHP Medicare Advantage |
$6.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.24
|
| Rate for Payer: Priority Health Medicare |
$6.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.48
|
| Rate for Payer: UHC Core |
$20.38
|
| Rate for Payer: UHC Exchange |
$6.10
|
| Rate for Payer: UHC Medicaid |
$4.30
|
| Rate for Payer: UHC Medicare Advantage |
$6.10
|
| Rate for Payer: UHCCP Medicaid |
$4.30
|
| Rate for Payer: VA VA |
$6.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.31
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.43 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$43.23
|
| Rate for Payer: BCN Commercial |
$43.23
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PACE Senior Care Partners |
$12.43
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Medicare |
$13.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: UHC Exchange |
$13.09
|
| Rate for Payer: UHC Medicaid |
$9.23
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
IP
|
$76.84
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.48 |
| Max. Negotiated Rate |
$69.16 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: BCBS Trust/PPO |
$63.46
|
| Rate for Payer: BCN Commercial |
$63.46
|
| Rate for Payer: Cash Price |
$61.47
|
| Rate for Payer: Cofinity Commercial |
$66.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Healthscope Commercial |
$69.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.63
|
| Rate for Payer: PHP Commercial |
$65.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.62
|
| Rate for Payer: UHC Core |
$64.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.63
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
OP
|
$76.84
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.55 |
| Max. Negotiated Rate |
$69.16 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.01
|
| Rate for Payer: BCBS Complete |
$14.22
|
| Rate for Payer: BCBS MAPPO |
$19.21
|
| Rate for Payer: BCBS Trust/PPO |
$63.17
|
| Rate for Payer: BCN Commercial |
$63.17
|
| Rate for Payer: BCN Medicare Advantage |
$19.21
|
| Rate for Payer: Cash Price |
$61.47
|
| Rate for Payer: Cofinity Commercial |
$66.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.21
|
| Rate for Payer: Healthscope Commercial |
$69.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.63
|
| Rate for Payer: Mclaren Medicaid |
$13.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.17
|
| Rate for Payer: Meridian Medicaid |
$14.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.31
|
| Rate for Payer: Nomi Health Commercial |
$63.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.63
|
| Rate for Payer: PACE Senior Care Partners |
$18.25
|
| Rate for Payer: PACE SWMI |
$19.21
|
| Rate for Payer: PHP Commercial |
$65.31
|
| Rate for Payer: PHP Medicare Advantage |
$19.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.85
|
| Rate for Payer: Priority Health Medicare |
$19.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.48
|
| Rate for Payer: Railroad Medicare Medicare |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.62
|
| Rate for Payer: UHC Core |
$64.16
|
| Rate for Payer: UHC Exchange |
$19.21
|
| Rate for Payer: UHC Medicaid |
$13.55
|
| Rate for Payer: UHC Medicare Advantage |
$19.21
|
| Rate for Payer: UHCCP Medicaid |
$13.55
|
| Rate for Payer: VA VA |
$19.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.63
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC FEMOSTOP
|
Facility
|
OP
|
$489.41
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.28 |
| Max. Negotiated Rate |
$440.47 |
| Rate for Payer: Aetna Commercial |
$416.00
|
| Rate for Payer: Aetna Medicare |
$127.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.94
|
| Rate for Payer: BCBS Complete |
$90.59
|
| Rate for Payer: BCBS MAPPO |
$122.35
|
| Rate for Payer: BCBS Trust/PPO |
$402.34
|
| Rate for Payer: BCN Commercial |
$402.34
|
| Rate for Payer: BCN Medicare Advantage |
$122.35
|
| Rate for Payer: Cash Price |
$391.53
|
| Rate for Payer: Cofinity Commercial |
$420.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.35
|
| Rate for Payer: Healthscope Commercial |
$440.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.06
|
| Rate for Payer: Mclaren Medicaid |
$86.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.47
|
| Rate for Payer: Meridian Medicaid |
$90.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.00
|
| Rate for Payer: Nomi Health Commercial |
$401.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.06
|
| Rate for Payer: PACE Senior Care Partners |
$116.23
|
| Rate for Payer: PACE SWMI |
$122.35
|
| Rate for Payer: PHP Commercial |
$416.00
|
| Rate for Payer: PHP Medicare Advantage |
$122.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$425.79
|
| Rate for Payer: Priority Health Medicare |
$123.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.63
|
| Rate for Payer: Railroad Medicare Medicare |
$122.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.68
|
| Rate for Payer: UHC Core |
$408.66
|
| Rate for Payer: UHC Exchange |
$122.35
|
| Rate for Payer: UHC Medicaid |
$86.28
|
| Rate for Payer: UHC Medicare Advantage |
$122.35
|
| Rate for Payer: UHCCP Medicaid |
$86.28
|
| Rate for Payer: VA VA |
$122.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.06
|
|
|
HC FEMOSTOP
|
Facility
|
IP
|
$489.41
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$340.63 |
| Max. Negotiated Rate |
$440.47 |
| Rate for Payer: Aetna Commercial |
$416.00
|
| Rate for Payer: BCBS Trust/PPO |
$404.20
|
| Rate for Payer: BCN Commercial |
$404.20
|
| Rate for Payer: Cash Price |
$391.53
|
| Rate for Payer: Cofinity Commercial |
$420.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.53
|
| Rate for Payer: Healthscope Commercial |
$440.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.00
|
| Rate for Payer: Nomi Health Commercial |
$401.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.06
|
| Rate for Payer: PHP Commercial |
$416.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$425.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$340.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.68
|
| Rate for Payer: UHC Core |
$408.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.06
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
OP
|
$363.63
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$327.27 |
| Rate for Payer: Aetna Commercial |
$309.09
|
| Rate for Payer: Aetna Medicare |
$94.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.63
|
| Rate for Payer: BCBS Complete |
$67.31
|
| Rate for Payer: BCBS MAPPO |
$90.91
|
| Rate for Payer: BCBS Trust/PPO |
$298.94
|
| Rate for Payer: BCN Commercial |
$298.94
|
| Rate for Payer: BCN Medicare Advantage |
$90.91
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cofinity Commercial |
$312.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.91
|
| Rate for Payer: Healthscope Commercial |
$327.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.72
|
| Rate for Payer: Mclaren Medicaid |
$64.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.45
|
| Rate for Payer: Meridian Medicaid |
$67.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.09
|
| Rate for Payer: Nomi Health Commercial |
$298.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.72
|
| Rate for Payer: PACE Senior Care Partners |
$86.36
|
| Rate for Payer: PACE SWMI |
$90.91
|
| Rate for Payer: PHP Commercial |
$309.09
|
| Rate for Payer: PHP Medicare Advantage |
$90.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.36
|
| Rate for Payer: Priority Health Medicare |
$91.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.09
|
| Rate for Payer: Railroad Medicare Medicare |
$90.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.99
|
| Rate for Payer: UHC Core |
$303.63
|
| Rate for Payer: UHC Exchange |
$90.91
|
| Rate for Payer: UHC Medicaid |
$64.11
|
| Rate for Payer: UHC Medicare Advantage |
$90.91
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
| Rate for Payer: VA VA |
$90.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.72
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
IP
|
$363.63
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.09 |
| Max. Negotiated Rate |
$327.27 |
| Rate for Payer: Aetna Commercial |
$309.09
|
| Rate for Payer: BCBS Trust/PPO |
$300.32
|
| Rate for Payer: BCN Commercial |
$300.32
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cofinity Commercial |
$312.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.90
|
| Rate for Payer: Healthscope Commercial |
$327.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.09
|
| Rate for Payer: Nomi Health Commercial |
$298.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.72
|
| Rate for Payer: PHP Commercial |
$309.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.99
|
| Rate for Payer: UHC Core |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.72
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
OP
|
$363.63
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$327.27 |
| Rate for Payer: Aetna Commercial |
$309.09
|
| Rate for Payer: Aetna Medicare |
$94.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.63
|
| Rate for Payer: BCBS Complete |
$67.31
|
| Rate for Payer: BCBS MAPPO |
$90.91
|
| Rate for Payer: BCBS Trust/PPO |
$298.94
|
| Rate for Payer: BCN Commercial |
$298.94
|
| Rate for Payer: BCN Medicare Advantage |
$90.91
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cofinity Commercial |
$312.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.91
|
| Rate for Payer: Healthscope Commercial |
$327.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.72
|
| Rate for Payer: Mclaren Medicaid |
$64.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.45
|
| Rate for Payer: Meridian Medicaid |
$67.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.09
|
| Rate for Payer: Nomi Health Commercial |
$298.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.72
|
| Rate for Payer: PACE Senior Care Partners |
$86.36
|
| Rate for Payer: PACE SWMI |
$90.91
|
| Rate for Payer: PHP Commercial |
$309.09
|
| Rate for Payer: PHP Medicare Advantage |
$90.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.36
|
| Rate for Payer: Priority Health Medicare |
$91.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.09
|
| Rate for Payer: Railroad Medicare Medicare |
$90.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.99
|
| Rate for Payer: UHC Core |
$303.63
|
| Rate for Payer: UHC Exchange |
$90.91
|
| Rate for Payer: UHC Medicaid |
$64.11
|
| Rate for Payer: UHC Medicare Advantage |
$90.91
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
| Rate for Payer: VA VA |
$90.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.72
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
IP
|
$363.63
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.09 |
| Max. Negotiated Rate |
$327.27 |
| Rate for Payer: Aetna Commercial |
$309.09
|
| Rate for Payer: BCBS Trust/PPO |
$300.32
|
| Rate for Payer: BCN Commercial |
$300.32
|
| Rate for Payer: Cash Price |
$290.90
|
| Rate for Payer: Cofinity Commercial |
$312.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.90
|
| Rate for Payer: Healthscope Commercial |
$327.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.09
|
| Rate for Payer: Nomi Health Commercial |
$298.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.72
|
| Rate for Payer: PHP Commercial |
$309.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.99
|
| Rate for Payer: UHC Core |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.72
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
IP
|
$207.04
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.10 |
| Max. Negotiated Rate |
$186.34 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: BCBS Trust/PPO |
$170.99
|
| Rate for Payer: BCN Commercial |
$170.99
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.28
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$180.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.20
|
| Rate for Payer: UHC Core |
$172.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.28
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
OP
|
$207.04
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.50 |
| Max. Negotiated Rate |
$186.34 |
| Rate for Payer: Aetna Commercial |
$175.98
|
| Rate for Payer: Aetna Medicare |
$53.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.70
|
| Rate for Payer: BCBS Complete |
$38.32
|
| Rate for Payer: BCBS MAPPO |
$51.76
|
| Rate for Payer: BCBS Trust/PPO |
$170.21
|
| Rate for Payer: BCN Commercial |
$170.21
|
| Rate for Payer: BCN Medicare Advantage |
$51.76
|
| Rate for Payer: Cash Price |
$165.63
|
| Rate for Payer: Cofinity Commercial |
$178.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.76
|
| Rate for Payer: Healthscope Commercial |
$186.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.28
|
| Rate for Payer: Mclaren Medicaid |
$36.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.35
|
| Rate for Payer: Meridian Medicaid |
$38.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.98
|
| Rate for Payer: Nomi Health Commercial |
$169.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.28
|
| Rate for Payer: PACE Senior Care Partners |
$49.17
|
| Rate for Payer: PACE SWMI |
$51.76
|
| Rate for Payer: PHP Commercial |
$175.98
|
| Rate for Payer: PHP Medicare Advantage |
$51.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$180.12
|
| Rate for Payer: Priority Health Medicare |
$52.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.10
|
| Rate for Payer: Railroad Medicare Medicare |
$51.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.20
|
| Rate for Payer: UHC Core |
$172.88
|
| Rate for Payer: UHC Exchange |
$51.76
|
| Rate for Payer: UHC Medicaid |
$36.50
|
| Rate for Payer: UHC Medicare Advantage |
$51.76
|
| Rate for Payer: UHCCP Medicaid |
$36.50
|
| Rate for Payer: VA VA |
$51.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.28
|
|
|
HC FENTANYL UR
|
Facility
|
OP
|
$239.29
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$215.36 |
| Rate for Payer: Aetna Commercial |
$203.40
|
| Rate for Payer: Aetna Medicare |
$62.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.78
|
| Rate for Payer: BCBS Complete |
$44.29
|
| Rate for Payer: BCBS MAPPO |
$59.82
|
| Rate for Payer: BCBS Trust/PPO |
$196.72
|
| Rate for Payer: BCN Commercial |
$196.72
|
| Rate for Payer: BCN Medicare Advantage |
$59.82
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cofinity Commercial |
$205.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.82
|
| Rate for Payer: Healthscope Commercial |
$215.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.47
|
| Rate for Payer: Mclaren Medicaid |
$42.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.81
|
| Rate for Payer: Meridian Medicaid |
$44.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.40
|
| Rate for Payer: Nomi Health Commercial |
$196.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.47
|
| Rate for Payer: PACE Senior Care Partners |
$56.83
|
| Rate for Payer: PACE SWMI |
$59.82
|
| Rate for Payer: PHP Commercial |
$203.40
|
| Rate for Payer: PHP Medicare Advantage |
$59.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$208.18
|
| Rate for Payer: Priority Health Medicare |
$60.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.55
|
| Rate for Payer: Railroad Medicare Medicare |
$59.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.58
|
| Rate for Payer: UHC Core |
$199.81
|
| Rate for Payer: UHC Exchange |
$59.82
|
| Rate for Payer: UHC Medicaid |
$42.19
|
| Rate for Payer: UHC Medicare Advantage |
$59.82
|
| Rate for Payer: UHCCP Medicaid |
$42.19
|
| Rate for Payer: VA VA |
$59.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.47
|
|
|
HC FENTANYL UR
|
Facility
|
IP
|
$239.29
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$166.55 |
| Max. Negotiated Rate |
$215.36 |
| Rate for Payer: Aetna Commercial |
$203.40
|
| Rate for Payer: BCBS Trust/PPO |
$197.63
|
| Rate for Payer: BCN Commercial |
$197.63
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cofinity Commercial |
$205.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.43
|
| Rate for Payer: Healthscope Commercial |
$215.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.40
|
| Rate for Payer: Nomi Health Commercial |
$196.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.47
|
| Rate for Payer: PHP Commercial |
$203.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$208.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.58
|
| Rate for Payer: UHC Core |
$199.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.47
|
|
|
HC FENTANYL URINE.
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC FENTANYL URINE.
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC FERRITIN LEVEL
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
