|
HC FRUCTOSAMINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
OP
|
$98.74
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.41 |
| Max. Negotiated Rate |
$88.87 |
| Rate for Payer: Aetna Commercial |
$83.93
|
| Rate for Payer: Aetna Medicare |
$25.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.86
|
| Rate for Payer: BCBS Complete |
$18.28
|
| Rate for Payer: BCBS MAPPO |
$24.68
|
| Rate for Payer: BCBS Trust/PPO |
$81.17
|
| Rate for Payer: BCN Commercial |
$81.17
|
| Rate for Payer: BCN Medicare Advantage |
$24.68
|
| Rate for Payer: Cash Price |
$78.99
|
| Rate for Payer: Cofinity Commercial |
$84.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.68
|
| Rate for Payer: Healthscope Commercial |
$88.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.06
|
| Rate for Payer: Mclaren Medicaid |
$17.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.92
|
| Rate for Payer: Meridian Medicaid |
$18.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.93
|
| Rate for Payer: Nomi Health Commercial |
$80.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.06
|
| Rate for Payer: PACE Senior Care Partners |
$23.45
|
| Rate for Payer: PACE SWMI |
$24.68
|
| Rate for Payer: PHP Commercial |
$83.93
|
| Rate for Payer: PHP Medicare Advantage |
$24.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.90
|
| Rate for Payer: Priority Health Medicare |
$24.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.72
|
| Rate for Payer: Railroad Medicare Medicare |
$24.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.89
|
| Rate for Payer: UHC Core |
$82.45
|
| Rate for Payer: UHC Exchange |
$24.68
|
| Rate for Payer: UHC Medicaid |
$17.41
|
| Rate for Payer: UHC Medicare Advantage |
$24.68
|
| Rate for Payer: UHCCP Medicaid |
$17.41
|
| Rate for Payer: VA VA |
$24.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.06
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
IP
|
$98.74
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.72 |
| Max. Negotiated Rate |
$88.87 |
| Rate for Payer: Aetna Commercial |
$83.93
|
| Rate for Payer: BCBS Trust/PPO |
$81.55
|
| Rate for Payer: BCN Commercial |
$81.55
|
| Rate for Payer: Cash Price |
$78.99
|
| Rate for Payer: Cofinity Commercial |
$84.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$88.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.93
|
| Rate for Payer: Nomi Health Commercial |
$80.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.06
|
| Rate for Payer: PHP Commercial |
$83.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.89
|
| Rate for Payer: UHC Core |
$82.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.06
|
|
|
HC FTH/GFT FREE W/DIR CLSR N/E/E/L EA ADDL 20 SQ CM
|
Facility
|
OP
|
$2,439.15
|
|
|
Service Code
|
CPT 15261
|
| Hospital Charge Code |
76100561
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.02 |
| Max. Negotiated Rate |
$2,195.24 |
| Rate for Payer: Aetna Commercial |
$2,073.28
|
| Rate for Payer: Aetna Medicare |
$634.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$762.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$762.23
|
| Rate for Payer: BCBS Complete |
$451.49
|
| Rate for Payer: BCBS MAPPO |
$609.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,005.23
|
| Rate for Payer: BCN Commercial |
$2,005.23
|
| Rate for Payer: BCN Medicare Advantage |
$609.79
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cofinity Commercial |
$2,097.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.79
|
| Rate for Payer: Healthscope Commercial |
$2,195.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.36
|
| Rate for Payer: Mclaren Medicaid |
$430.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$640.28
|
| Rate for Payer: Meridian Medicaid |
$451.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$701.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$670.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.28
|
| Rate for Payer: Nomi Health Commercial |
$2,000.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.36
|
| Rate for Payer: PACE Senior Care Partners |
$579.30
|
| Rate for Payer: PACE SWMI |
$609.79
|
| Rate for Payer: PHP Commercial |
$2,073.28
|
| Rate for Payer: PHP Medicare Advantage |
$609.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,122.06
|
| Rate for Payer: Priority Health Medicare |
$615.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.65
|
| Rate for Payer: Railroad Medicare Medicare |
$609.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,146.45
|
| Rate for Payer: UHC Core |
$2,036.69
|
| Rate for Payer: UHC Exchange |
$609.79
|
| Rate for Payer: UHC Medicaid |
$430.02
|
| Rate for Payer: UHC Medicare Advantage |
$609.79
|
| Rate for Payer: UHCCP Medicaid |
$430.02
|
| Rate for Payer: VA VA |
$609.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.36
|
|
|
HC FTH/GFT FREE W/DIR CLSR N/E/E/L EA ADDL 20 SQ CM
|
Facility
|
IP
|
$2,439.15
|
|
|
Service Code
|
CPT 15261
|
| Hospital Charge Code |
76100561
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,697.65 |
| Max. Negotiated Rate |
$2,195.24 |
| Rate for Payer: Aetna Commercial |
$2,073.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,014.49
|
| Rate for Payer: BCN Commercial |
$2,014.49
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cofinity Commercial |
$2,097.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.32
|
| Rate for Payer: Healthscope Commercial |
$2,195.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.28
|
| Rate for Payer: Nomi Health Commercial |
$2,000.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.36
|
| Rate for Payer: PHP Commercial |
$2,073.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,122.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,146.45
|
| Rate for Payer: UHC Core |
$2,036.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.36
|
|
|
HC FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<
|
Facility
|
IP
|
$3,515.06
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
76100560
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,446.48 |
| Max. Negotiated Rate |
$3,163.55 |
| Rate for Payer: Aetna Commercial |
$2,987.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,903.09
|
| Rate for Payer: BCN Commercial |
$2,903.09
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cofinity Commercial |
$3,022.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.05
|
| Rate for Payer: Healthscope Commercial |
$3,163.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,987.80
|
| Rate for Payer: Nomi Health Commercial |
$2,882.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.30
|
| Rate for Payer: PHP Commercial |
$2,987.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,058.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,446.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,093.25
|
| Rate for Payer: UHC Core |
$2,935.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.30
|
|
|
HC FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<
|
Facility
|
OP
|
$3,515.06
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
76100560
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$619.71 |
| Max. Negotiated Rate |
$3,163.55 |
| Rate for Payer: Aetna Commercial |
$2,987.80
|
| Rate for Payer: Aetna Medicare |
$913.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,098.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,098.46
|
| Rate for Payer: BCBS Complete |
$650.64
|
| Rate for Payer: BCBS MAPPO |
$878.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.73
|
| Rate for Payer: BCN Commercial |
$2,889.73
|
| Rate for Payer: BCN Medicare Advantage |
$878.76
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cofinity Commercial |
$3,022.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$878.76
|
| Rate for Payer: Healthscope Commercial |
$3,163.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.30
|
| Rate for Payer: Mclaren Medicaid |
$619.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$922.70
|
| Rate for Payer: Meridian Medicaid |
$650.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,010.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$966.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,987.80
|
| Rate for Payer: Nomi Health Commercial |
$2,882.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.30
|
| Rate for Payer: PACE Senior Care Partners |
$834.83
|
| Rate for Payer: PACE SWMI |
$878.76
|
| Rate for Payer: PHP Commercial |
$2,987.80
|
| Rate for Payer: PHP Medicare Advantage |
$878.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,058.10
|
| Rate for Payer: Priority Health Medicare |
$887.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,446.48
|
| Rate for Payer: Railroad Medicare Medicare |
$878.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,093.25
|
| Rate for Payer: UHC Core |
$2,935.08
|
| Rate for Payer: UHC Exchange |
$878.76
|
| Rate for Payer: UHC Medicaid |
$619.71
|
| Rate for Payer: UHC Medicare Advantage |
$878.76
|
| Rate for Payer: UHCCP Medicaid |
$619.71
|
| Rate for Payer: VA VA |
$878.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.30
|
|
|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,725.83
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,985.18 |
| Max. Negotiated Rate |
$5,153.25 |
| Rate for Payer: Aetna Commercial |
$4,866.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,728.96
|
| Rate for Payer: BCN Commercial |
$4,728.96
|
| Rate for Payer: Cash Price |
$4,580.66
|
| Rate for Payer: Cofinity Commercial |
$4,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,580.66
|
| Rate for Payer: Healthscope Commercial |
$5,153.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,294.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,866.96
|
| Rate for Payer: Nomi Health Commercial |
$4,695.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,294.37
|
| Rate for Payer: PHP Commercial |
$4,866.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,981.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,985.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,038.73
|
| Rate for Payer: UHC Core |
$4,781.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,294.37
|
|
|
HC F/U EP STUDY
|
Facility
|
OP
|
$5,725.83
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,009.46 |
| Max. Negotiated Rate |
$5,153.25 |
| Rate for Payer: Aetna Commercial |
$4,866.96
|
| Rate for Payer: Aetna Medicare |
$1,488.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,789.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,789.32
|
| Rate for Payer: BCBS Complete |
$1,059.85
|
| Rate for Payer: BCBS MAPPO |
$1,431.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,707.20
|
| Rate for Payer: BCN Commercial |
$4,707.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,431.46
|
| Rate for Payer: Cash Price |
$4,580.66
|
| Rate for Payer: Cofinity Commercial |
$4,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,580.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,431.46
|
| Rate for Payer: Healthscope Commercial |
$5,153.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,294.37
|
| Rate for Payer: Mclaren Medicaid |
$1,009.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,503.03
|
| Rate for Payer: Meridian Medicaid |
$1,059.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,646.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,574.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,866.96
|
| Rate for Payer: Nomi Health Commercial |
$4,695.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,294.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,359.88
|
| Rate for Payer: PACE SWMI |
$1,431.46
|
| Rate for Payer: PHP Commercial |
$4,866.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,431.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,009.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,981.47
|
| Rate for Payer: Priority Health Medicare |
$1,445.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,985.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,431.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,038.73
|
| Rate for Payer: UHC Core |
$4,781.07
|
| Rate for Payer: UHC Exchange |
$1,431.46
|
| Rate for Payer: UHC Medicaid |
$1,009.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,431.46
|
| Rate for Payer: UHCCP Medicaid |
$1,009.46
|
| Rate for Payer: VA VA |
$1,431.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,294.37
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$128.16
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$89.20 |
| Max. Negotiated Rate |
$115.34 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: BCBS Trust/PPO |
$105.85
|
| Rate for Payer: BCN Commercial |
$105.85
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: Nomi Health Commercial |
$105.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.12
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.78
|
| Rate for Payer: UHC Core |
$107.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$128.16
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$115.34 |
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna Medicare |
$33.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.05
|
| Rate for Payer: BCBS Complete |
$23.72
|
| Rate for Payer: BCBS MAPPO |
$32.04
|
| Rate for Payer: BCBS Trust/PPO |
$105.36
|
| Rate for Payer: BCN Commercial |
$105.36
|
| Rate for Payer: BCN Medicare Advantage |
$32.04
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.04
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: Mclaren Medicaid |
$22.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.64
|
| Rate for Payer: Meridian Medicaid |
$23.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: Nomi Health Commercial |
$105.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.12
|
| Rate for Payer: PACE Senior Care Partners |
$30.44
|
| Rate for Payer: PACE SWMI |
$32.04
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: PHP Medicare Advantage |
$32.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.50
|
| Rate for Payer: Priority Health Medicare |
$32.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.20
|
| Rate for Payer: Railroad Medicare Medicare |
$32.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.78
|
| Rate for Payer: UHC Core |
$107.01
|
| Rate for Payer: UHC Exchange |
$32.04
|
| Rate for Payer: UHC Medicaid |
$22.59
|
| Rate for Payer: UHC Medicare Advantage |
$32.04
|
| Rate for Payer: UHCCP Medicaid |
$22.59
|
| Rate for Payer: VA VA |
$32.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$68.77
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.86 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$56.80
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$56.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.52
|
| Rate for Payer: UHC Core |
$57.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$68.77
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.12 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna Medicare |
$17.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.49
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS MAPPO |
$17.19
|
| Rate for Payer: BCBS Trust/PPO |
$56.54
|
| Rate for Payer: BCN Commercial |
$56.54
|
| Rate for Payer: BCN Medicare Advantage |
$17.19
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Mclaren Medicaid |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$12.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$56.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PACE Senior Care Partners |
$16.33
|
| Rate for Payer: PACE SWMI |
$17.19
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.83
|
| Rate for Payer: Priority Health Medicare |
$17.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.52
|
| Rate for Payer: UHC Core |
$57.42
|
| Rate for Payer: UHC Exchange |
$17.19
|
| Rate for Payer: UHC Medicaid |
$12.12
|
| Rate for Payer: UHC Medicare Advantage |
$17.19
|
| Rate for Payer: UHCCP Medicaid |
$12.12
|
| Rate for Payer: VA VA |
$17.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$68.77
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.86 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: BCBS Trust/PPO |
$56.80
|
| Rate for Payer: BCN Commercial |
$56.80
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$56.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.52
|
| Rate for Payer: UHC Core |
$57.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$68.77
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.12 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna Medicare |
$17.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.49
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS MAPPO |
$17.19
|
| Rate for Payer: BCBS Trust/PPO |
$56.54
|
| Rate for Payer: BCN Commercial |
$56.54
|
| Rate for Payer: BCN Medicare Advantage |
$17.19
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.19
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Mclaren Medicaid |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$12.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$56.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PACE Senior Care Partners |
$16.33
|
| Rate for Payer: PACE SWMI |
$17.19
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.83
|
| Rate for Payer: Priority Health Medicare |
$17.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.86
|
| Rate for Payer: Railroad Medicare Medicare |
$17.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.52
|
| Rate for Payer: UHC Core |
$57.42
|
| Rate for Payer: UHC Exchange |
$17.19
|
| Rate for Payer: UHC Medicaid |
$12.12
|
| Rate for Payer: UHC Medicare Advantage |
$17.19
|
| Rate for Payer: UHCCP Medicaid |
$12.12
|
| Rate for Payer: VA VA |
$17.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$34.37
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$34.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 2
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$34.37
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 2
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$34.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 3
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 3
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGITELL ASSAY
|
Facility
|
IP
|
$161.26
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$112.24 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: BCBS Trust/PPO |
$133.18
|
| Rate for Payer: BCN Commercial |
$133.18
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC FUNGITELL ASSAY
|
Facility
|
OP
|
$161.26
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: Aetna Medicare |
$41.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.39
|
| Rate for Payer: BCBS Complete |
$29.85
|
| Rate for Payer: BCBS MAPPO |
$40.31
|
| Rate for Payer: BCBS Trust/PPO |
$132.57
|
| Rate for Payer: BCN Commercial |
$132.57
|
| Rate for Payer: BCN Medicare Advantage |
$40.31
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.31
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Mclaren Medicaid |
$28.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.33
|
| Rate for Payer: Meridian Medicaid |
$29.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PACE Senior Care Partners |
$38.30
|
| Rate for Payer: PACE SWMI |
$40.31
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: PHP Medicare Advantage |
$40.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Medicare |
$40.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: Railroad Medicare Medicare |
$40.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: UHC Exchange |
$40.31
|
| Rate for Payer: UHC Medicaid |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$40.31
|
| Rate for Payer: UHCCP Medicaid |
$28.43
|
| Rate for Payer: VA VA |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
