|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$75.60
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$68.04 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$19.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.62
|
| Rate for Payer: BCBS Complete |
$30.24
|
| Rate for Payer: BCBS MAPPO |
$18.90
|
| Rate for Payer: BCBS Trust/PPO |
$62.15
|
| Rate for Payer: BCN Commercial |
$58.78
|
| Rate for Payer: BCN Medicare Advantage |
$18.90
|
| Rate for Payer: Cash Price |
$60.48
|
| Rate for Payer: Cofinity Commercial |
$65.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.90
|
| Rate for Payer: Healthscope Commercial |
$68.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.26
|
| Rate for Payer: Nomi Health Commercial |
$61.99
|
| Rate for Payer: PACE Senior Care Partners |
$17.95
|
| Rate for Payer: PACE SWMI |
$18.90
|
| Rate for Payer: PHP Commercial |
$64.26
|
| Rate for Payer: PHP Medicare Advantage |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.14
|
| Rate for Payer: Priority Health HMO/PPO |
$65.77
|
| Rate for Payer: Priority Health Medicare |
$19.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: Railroad Medicare Medicare |
$18.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.53
|
| Rate for Payer: UHC Core |
$63.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.90
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicare Advantage |
$18.90
|
| Rate for Payer: VA VA |
$18.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.70
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$105.53
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$94.98 |
| Rate for Payer: Aetna Commercial |
$89.70
|
| Rate for Payer: BCBS Trust/PPO |
$86.14
|
| Rate for Payer: BCN Commercial |
$81.55
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Cofinity Commercial |
$90.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.42
|
| Rate for Payer: Healthscope Commercial |
$94.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.70
|
| Rate for Payer: Nomi Health Commercial |
$86.53
|
| Rate for Payer: PHP Commercial |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.59
|
| Rate for Payer: Priority Health HMO/PPO |
$91.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.87
|
| Rate for Payer: UHC Core |
$88.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.15
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$105.53
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.06 |
| Max. Negotiated Rate |
$94.98 |
| Rate for Payer: Aetna Commercial |
$89.70
|
| Rate for Payer: Aetna Medicare |
$27.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.98
|
| Rate for Payer: BCBS Complete |
$42.21
|
| Rate for Payer: BCBS MAPPO |
$26.38
|
| Rate for Payer: BCBS Trust/PPO |
$86.76
|
| Rate for Payer: BCN Commercial |
$82.05
|
| Rate for Payer: BCN Medicare Advantage |
$26.38
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Cofinity Commercial |
$90.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.38
|
| Rate for Payer: Healthscope Commercial |
$94.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.70
|
| Rate for Payer: Nomi Health Commercial |
$86.53
|
| Rate for Payer: PACE Senior Care Partners |
$25.06
|
| Rate for Payer: PACE SWMI |
$26.38
|
| Rate for Payer: PHP Commercial |
$89.70
|
| Rate for Payer: PHP Medicare Advantage |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.59
|
| Rate for Payer: Priority Health HMO/PPO |
$91.81
|
| Rate for Payer: Priority Health Medicare |
$26.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.87
|
| Rate for Payer: UHC Core |
$88.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.38
|
| Rate for Payer: UHC Exchange |
$26.38
|
| Rate for Payer: UHC Medicare Advantage |
$26.38
|
| Rate for Payer: VA VA |
$26.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.15
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$650.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$422.64 |
| Max. Negotiated Rate |
$585.20 |
| Rate for Payer: Aetna Commercial |
$552.69
|
| Rate for Payer: BCBS Trust/PPO |
$530.77
|
| Rate for Payer: BCN Commercial |
$502.49
|
| Rate for Payer: Cash Price |
$520.18
|
| Rate for Payer: Cofinity Commercial |
$559.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.18
|
| Rate for Payer: Healthscope Commercial |
$585.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.69
|
| Rate for Payer: Nomi Health Commercial |
$533.18
|
| Rate for Payer: PHP Commercial |
$552.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.64
|
| Rate for Payer: Priority Health HMO/PPO |
$565.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.19
|
| Rate for Payer: UHC Core |
$542.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.67
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$650.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$585.20 |
| Rate for Payer: Aetna Commercial |
$552.69
|
| Rate for Payer: Aetna Medicare |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.19
|
| Rate for Payer: BCBS Complete |
$260.09
|
| Rate for Payer: BCBS MAPPO |
$162.56
|
| Rate for Payer: BCBS Trust/PPO |
$534.55
|
| Rate for Payer: BCN Commercial |
$505.55
|
| Rate for Payer: BCN Medicare Advantage |
$162.56
|
| Rate for Payer: Cash Price |
$520.18
|
| Rate for Payer: Cofinity Commercial |
$559.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.56
|
| Rate for Payer: Healthscope Commercial |
$585.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.69
|
| Rate for Payer: Nomi Health Commercial |
$533.18
|
| Rate for Payer: PACE Senior Care Partners |
$154.43
|
| Rate for Payer: PACE SWMI |
$162.56
|
| Rate for Payer: PHP Commercial |
$552.69
|
| Rate for Payer: PHP Medicare Advantage |
$162.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.64
|
| Rate for Payer: Priority Health HMO/PPO |
$565.69
|
| Rate for Payer: Priority Health Medicare |
$164.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.65
|
| Rate for Payer: Railroad Medicare Medicare |
$162.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.19
|
| Rate for Payer: UHC Core |
$542.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.56
|
| Rate for Payer: UHC Exchange |
$162.56
|
| Rate for Payer: UHC Medicare Advantage |
$162.56
|
| Rate for Payer: VA VA |
$162.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.67
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$967.42
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$870.68 |
| Rate for Payer: Aetna Commercial |
$822.31
|
| Rate for Payer: Aetna Medicare |
$251.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.32
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$241.85
|
| Rate for Payer: BCBS Trust/PPO |
$795.32
|
| Rate for Payer: BCN Commercial |
$752.17
|
| Rate for Payer: BCN Medicare Advantage |
$241.85
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cofinity Commercial |
$831.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.85
|
| Rate for Payer: Healthscope Commercial |
$870.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.57
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.95
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.31
|
| Rate for Payer: Nomi Health Commercial |
$793.28
|
| Rate for Payer: PACE Senior Care Partners |
$229.76
|
| Rate for Payer: PACE SWMI |
$241.85
|
| Rate for Payer: PHP Commercial |
$822.31
|
| Rate for Payer: PHP Medicare Advantage |
$241.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.82
|
| Rate for Payer: Priority Health HMO/PPO |
$841.66
|
| Rate for Payer: Priority Health Medicare |
$244.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.17
|
| Rate for Payer: Railroad Medicare Medicare |
$241.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.33
|
| Rate for Payer: UHC Core |
$807.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.85
|
| Rate for Payer: UHC Exchange |
$241.85
|
| Rate for Payer: UHC Medicare Advantage |
$241.85
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$241.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.57
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$967.42
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$628.82 |
| Max. Negotiated Rate |
$870.68 |
| Rate for Payer: Aetna Commercial |
$822.31
|
| Rate for Payer: BCBS Trust/PPO |
$789.70
|
| Rate for Payer: BCN Commercial |
$747.62
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cofinity Commercial |
$831.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.94
|
| Rate for Payer: Healthscope Commercial |
$870.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.31
|
| Rate for Payer: Nomi Health Commercial |
$793.28
|
| Rate for Payer: PHP Commercial |
$822.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.82
|
| Rate for Payer: Priority Health HMO/PPO |
$841.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.33
|
| Rate for Payer: UHC Core |
$807.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.57
|
|
|
HC DUST MITE DF IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DUST MITE DF IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DUST MITE DP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DUST MITE DP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$782.86
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$704.57 |
| Rate for Payer: Aetna Commercial |
$665.43
|
| Rate for Payer: Aetna Medicare |
$203.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$244.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$244.64
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$195.72
|
| Rate for Payer: BCBS Trust/PPO |
$643.59
|
| Rate for Payer: BCN Commercial |
$608.67
|
| Rate for Payer: BCN Medicare Advantage |
$195.72
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cofinity Commercial |
$673.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.72
|
| Rate for Payer: Healthscope Commercial |
$704.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.14
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.50
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.43
|
| Rate for Payer: Nomi Health Commercial |
$641.95
|
| Rate for Payer: PACE Senior Care Partners |
$185.93
|
| Rate for Payer: PACE SWMI |
$195.72
|
| Rate for Payer: PHP Commercial |
$665.43
|
| Rate for Payer: PHP Medicare Advantage |
$195.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.86
|
| Rate for Payer: Priority Health HMO/PPO |
$681.09
|
| Rate for Payer: Priority Health Medicare |
$197.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.52
|
| Rate for Payer: Railroad Medicare Medicare |
$195.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.92
|
| Rate for Payer: UHC Core |
$653.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.72
|
| Rate for Payer: UHC Exchange |
$195.72
|
| Rate for Payer: UHC Medicare Advantage |
$195.72
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$195.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.14
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$782.86
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$704.57 |
| Rate for Payer: Aetna Commercial |
$665.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.05
|
| Rate for Payer: BCN Commercial |
$604.99
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cofinity Commercial |
$673.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.29
|
| Rate for Payer: Healthscope Commercial |
$704.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.43
|
| Rate for Payer: Nomi Health Commercial |
$641.95
|
| Rate for Payer: PHP Commercial |
$665.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.86
|
| Rate for Payer: Priority Health HMO/PPO |
$681.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.92
|
| Rate for Payer: UHC Core |
$653.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.14
|
|
|
HC E72 MOUSE URINE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC E72 MOUSE URINE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
IP
|
$12.54
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$11.29 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$10.24
|
| Rate for Payer: BCN Commercial |
$9.69
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$10.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$10.28
|
| Rate for Payer: PHP Commercial |
$10.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO |
$10.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.04
|
| Rate for Payer: UHC Core |
$10.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.40
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$11.29 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: Aetna Medicare |
$3.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.92
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$3.13
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$9.75
|
| Rate for Payer: BCN Medicare Advantage |
$3.13
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$10.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.13
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$10.28
|
| Rate for Payer: PACE Senior Care Partners |
$2.98
|
| Rate for Payer: PACE SWMI |
$3.13
|
| Rate for Payer: PHP Commercial |
$10.66
|
| Rate for Payer: PHP Medicare Advantage |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO |
$10.91
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.04
|
| Rate for Payer: UHC Core |
$10.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.13
|
| Rate for Payer: UHC Exchange |
$3.13
|
| Rate for Payer: UHC Medicare Advantage |
$3.13
|
| Rate for Payer: VA VA |
$3.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.40
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$29.68
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$24.23
|
| Rate for Payer: BCN Commercial |
$22.94
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cofinity Commercial |
$25.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.74
|
| Rate for Payer: Healthscope Commercial |
$26.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.23
|
| Rate for Payer: Nomi Health Commercial |
$24.34
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.29
|
| Rate for Payer: Priority Health HMO/PPO |
$25.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.12
|
| Rate for Payer: UHC Core |
$24.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.26
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
OP
|
$29.68
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Aetna Commercial |
$25.23
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$13.77
|
| Rate for Payer: BCBS MAPPO |
$7.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.40
|
| Rate for Payer: BCN Commercial |
$23.08
|
| Rate for Payer: BCN Medicare Advantage |
$7.42
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cash Price |
$23.74
|
| Rate for Payer: Cofinity Commercial |
$25.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.42
|
| Rate for Payer: Healthscope Commercial |
$26.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.26
|
| Rate for Payer: Mclaren Medicaid |
$13.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.79
|
| Rate for Payer: Meridian Medicaid |
$13.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.23
|
| Rate for Payer: Nomi Health Commercial |
$24.34
|
| Rate for Payer: PACE Senior Care Partners |
$7.05
|
| Rate for Payer: PACE SWMI |
$7.42
|
| Rate for Payer: PHP Commercial |
$25.23
|
| Rate for Payer: PHP Medicare Advantage |
$7.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.29
|
| Rate for Payer: Priority Health HMO/PPO |
$25.82
|
| Rate for Payer: Priority Health Medicare |
$7.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.89
|
| Rate for Payer: Railroad Medicare Medicare |
$7.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.12
|
| Rate for Payer: UHC Core |
$24.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.42
|
| Rate for Payer: UHC Exchange |
$7.42
|
| Rate for Payer: UHC Medicare Advantage |
$7.42
|
| Rate for Payer: UHCCP Medicaid |
$13.12
|
| Rate for Payer: VA VA |
$7.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.26
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$37.02
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$33.32 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare |
$9.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.57
|
| Rate for Payer: BCBS Complete |
$11.61
|
| Rate for Payer: BCBS MAPPO |
$9.26
|
| Rate for Payer: BCBS Trust/PPO |
$30.43
|
| Rate for Payer: BCN Commercial |
$28.78
|
| Rate for Payer: BCN Medicare Advantage |
$9.26
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$31.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.26
|
| Rate for Payer: Healthscope Commercial |
$33.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.77
|
| Rate for Payer: Mclaren Medicaid |
$11.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.72
|
| Rate for Payer: Meridian Medicaid |
$11.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.47
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: PACE Senior Care Partners |
$8.79
|
| Rate for Payer: PACE SWMI |
$9.26
|
| Rate for Payer: PHP Commercial |
$31.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.06
|
| Rate for Payer: Priority Health HMO/PPO |
$32.21
|
| Rate for Payer: Priority Health Medicare |
$9.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.80
|
| Rate for Payer: Railroad Medicare Medicare |
$9.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.58
|
| Rate for Payer: UHC Core |
$30.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.26
|
| Rate for Payer: UHC Exchange |
$9.26
|
| Rate for Payer: UHC Medicare Advantage |
$9.26
|
| Rate for Payer: UHCCP Medicaid |
$11.05
|
| Rate for Payer: VA VA |
$9.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.77
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
IP
|
$37.02
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.06 |
| Max. Negotiated Rate |
$33.32 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$30.22
|
| Rate for Payer: BCN Commercial |
$28.61
|
| Rate for Payer: Cash Price |
$29.62
|
| Rate for Payer: Cofinity Commercial |
$31.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.62
|
| Rate for Payer: Healthscope Commercial |
$33.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.47
|
| Rate for Payer: Nomi Health Commercial |
$30.36
|
| Rate for Payer: PHP Commercial |
$31.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.06
|
| Rate for Payer: Priority Health HMO/PPO |
$32.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.58
|
| Rate for Payer: UHC Core |
$30.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.77
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.70
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$30.79
|
| Rate for Payer: BCN Commercial |
$29.12
|
| Rate for Payer: BCN Medicare Advantage |
$9.36
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.83
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PACE Senior Care Partners |
$8.89
|
| Rate for Payer: PACE SWMI |
$9.36
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: Railroad Medicare Medicare |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.36
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$9.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.57
|
| Rate for Payer: BCN Commercial |
$28.94
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
