|
HC LYME CSF IGG AB INDEX
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Aetna Commercial |
$60.35
|
| Rate for Payer: Aetna Medicare |
$18.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.19
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$17.75
|
| Rate for Payer: BCBS Trust/PPO |
$55.20
|
| Rate for Payer: BCN Commercial |
$55.20
|
| Rate for Payer: BCN Medicare Advantage |
$17.75
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$61.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.75
|
| Rate for Payer: Healthscope Commercial |
$63.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.25
|
| Rate for Payer: Mclaren Medicaid |
$3.65
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.35
|
| Rate for Payer: PACE Senior Care Partners |
$16.86
|
| Rate for Payer: PACE SWMI |
$17.75
|
| Rate for Payer: PHP Commercial |
$60.35
|
| Rate for Payer: PHP Medicare Advantage |
$17.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.77
|
| Rate for Payer: Priority Health Medicare |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.48
|
| Rate for Payer: UHC Core |
$59.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.75
|
| Rate for Payer: UHC Medicare Advantage |
$18.28
|
| Rate for Payer: VA VA |
$17.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.25
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
IP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.30 |
| Max. Negotiated Rate |
$229.17 |
| Rate for Payer: Aetna Commercial |
$216.44
|
| Rate for Payer: BCBS Trust/PPO |
$196.78
|
| Rate for Payer: BCN Commercial |
$196.78
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$218.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Healthscope Commercial |
$229.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PHP Commercial |
$216.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.07
|
| Rate for Payer: UHC Core |
$212.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.97
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
OP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$229.17 |
| Rate for Payer: Aetna Commercial |
$216.44
|
| Rate for Payer: Aetna Medicare |
$66.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.57
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS MAPPO |
$63.66
|
| Rate for Payer: BCBS Trust/PPO |
$197.97
|
| Rate for Payer: BCN Commercial |
$197.97
|
| Rate for Payer: BCN Medicare Advantage |
$63.66
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$218.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.66
|
| Rate for Payer: Healthscope Commercial |
$229.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.97
|
| Rate for Payer: Mclaren Medicaid |
$36.18
|
| Rate for Payer: Meridian Medicaid |
$37.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PACE Senior Care Partners |
$60.47
|
| Rate for Payer: PACE SWMI |
$63.66
|
| Rate for Payer: PHP Commercial |
$216.44
|
| Rate for Payer: PHP Medicare Advantage |
$63.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Medicare |
$63.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.30
|
| Rate for Payer: Railroad Medicare Medicare |
$63.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.07
|
| Rate for Payer: UHC Core |
$212.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.66
|
| Rate for Payer: UHC Medicare Advantage |
$65.57
|
| Rate for Payer: VA VA |
$63.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.97
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
IP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$167.48 |
| Max. Negotiated Rate |
$247.14 |
| Rate for Payer: Aetna Commercial |
$233.41
|
| Rate for Payer: BCBS Trust/PPO |
$212.21
|
| Rate for Payer: BCN Commercial |
$212.21
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$247.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PHP Commercial |
$233.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.65
|
| Rate for Payer: UHC Core |
$229.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.95
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
OP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$247.14 |
| Rate for Payer: Aetna Commercial |
$233.41
|
| Rate for Payer: Aetna Medicare |
$71.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.81
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS MAPPO |
$68.65
|
| Rate for Payer: BCBS Trust/PPO |
$213.50
|
| Rate for Payer: BCN Commercial |
$213.50
|
| Rate for Payer: BCN Medicare Advantage |
$68.65
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.65
|
| Rate for Payer: Healthscope Commercial |
$247.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.95
|
| Rate for Payer: Mclaren Medicaid |
$36.18
|
| Rate for Payer: Meridian Medicaid |
$37.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PACE Senior Care Partners |
$65.22
|
| Rate for Payer: PACE SWMI |
$68.65
|
| Rate for Payer: PHP Commercial |
$233.41
|
| Rate for Payer: PHP Medicare Advantage |
$68.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.90
|
| Rate for Payer: Priority Health Medicare |
$68.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.48
|
| Rate for Payer: Railroad Medicare Medicare |
$68.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.65
|
| Rate for Payer: UHC Core |
$229.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.65
|
| Rate for Payer: UHC Medicare Advantage |
$70.71
|
| Rate for Payer: VA VA |
$68.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.95
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$207.90 |
| Rate for Payer: Aetna Commercial |
$196.35
|
| Rate for Payer: Aetna Medicare |
$60.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.19
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS MAPPO |
$57.75
|
| Rate for Payer: BCBS Trust/PPO |
$179.60
|
| Rate for Payer: BCN Commercial |
$179.60
|
| Rate for Payer: BCN Medicare Advantage |
$57.75
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$198.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.75
|
| Rate for Payer: Healthscope Commercial |
$207.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.25
|
| Rate for Payer: Mclaren Medicaid |
$36.18
|
| Rate for Payer: Meridian Medicaid |
$37.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.35
|
| Rate for Payer: PACE Senior Care Partners |
$54.86
|
| Rate for Payer: PACE SWMI |
$57.75
|
| Rate for Payer: PHP Commercial |
$196.35
|
| Rate for Payer: PHP Medicare Advantage |
$57.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.97
|
| Rate for Payer: Priority Health Medicare |
$57.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.89
|
| Rate for Payer: Railroad Medicare Medicare |
$57.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.28
|
| Rate for Payer: UHC Core |
$192.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.75
|
| Rate for Payer: UHC Medicare Advantage |
$59.48
|
| Rate for Payer: VA VA |
$57.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.25
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$207.90 |
| Rate for Payer: Aetna Commercial |
$196.35
|
| Rate for Payer: BCBS Trust/PPO |
$178.52
|
| Rate for Payer: BCN Commercial |
$178.52
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$198.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.80
|
| Rate for Payer: Healthscope Commercial |
$207.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.35
|
| Rate for Payer: PHP Commercial |
$196.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.28
|
| Rate for Payer: UHC Core |
$192.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.25
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
IP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$155.30 |
| Max. Negotiated Rate |
$229.17 |
| Rate for Payer: Aetna Commercial |
$216.44
|
| Rate for Payer: BCBS Trust/PPO |
$196.78
|
| Rate for Payer: BCN Commercial |
$196.78
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$218.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Healthscope Commercial |
$229.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PHP Commercial |
$216.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.07
|
| Rate for Payer: UHC Core |
$212.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.97
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
OP
|
$254.63
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$229.17 |
| Rate for Payer: Aetna Commercial |
$216.44
|
| Rate for Payer: Aetna Medicare |
$66.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.57
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS MAPPO |
$63.66
|
| Rate for Payer: BCBS Trust/PPO |
$197.97
|
| Rate for Payer: BCN Commercial |
$197.97
|
| Rate for Payer: BCN Medicare Advantage |
$63.66
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cash Price |
$203.70
|
| Rate for Payer: Cofinity Commercial |
$218.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.66
|
| Rate for Payer: Healthscope Commercial |
$229.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.97
|
| Rate for Payer: Mclaren Medicaid |
$36.18
|
| Rate for Payer: Meridian Medicaid |
$37.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.44
|
| Rate for Payer: PACE Senior Care Partners |
$60.47
|
| Rate for Payer: PACE SWMI |
$63.66
|
| Rate for Payer: PHP Commercial |
$216.44
|
| Rate for Payer: PHP Medicare Advantage |
$63.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.53
|
| Rate for Payer: Priority Health Medicare |
$63.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.30
|
| Rate for Payer: Railroad Medicare Medicare |
$63.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.07
|
| Rate for Payer: UHC Core |
$212.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.66
|
| Rate for Payer: UHC Medicare Advantage |
$65.57
|
| Rate for Payer: VA VA |
$63.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.97
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$247.14 |
| Rate for Payer: Aetna Commercial |
$233.41
|
| Rate for Payer: Aetna Medicare |
$71.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.81
|
| Rate for Payer: BCBS Complete |
$37.99
|
| Rate for Payer: BCBS MAPPO |
$68.65
|
| Rate for Payer: BCBS Trust/PPO |
$213.50
|
| Rate for Payer: BCN Commercial |
$213.50
|
| Rate for Payer: BCN Medicare Advantage |
$68.65
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.65
|
| Rate for Payer: Healthscope Commercial |
$247.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.95
|
| Rate for Payer: Mclaren Medicaid |
$36.18
|
| Rate for Payer: Meridian Medicaid |
$37.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PACE Senior Care Partners |
$65.22
|
| Rate for Payer: PACE SWMI |
$68.65
|
| Rate for Payer: PHP Commercial |
$233.41
|
| Rate for Payer: PHP Medicare Advantage |
$68.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.90
|
| Rate for Payer: Priority Health Medicare |
$68.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.48
|
| Rate for Payer: Railroad Medicare Medicare |
$68.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.65
|
| Rate for Payer: UHC Core |
$229.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.65
|
| Rate for Payer: UHC Medicare Advantage |
$70.71
|
| Rate for Payer: VA VA |
$68.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.95
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$274.60
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$167.48 |
| Max. Negotiated Rate |
$247.14 |
| Rate for Payer: Aetna Commercial |
$233.41
|
| Rate for Payer: BCBS Trust/PPO |
$212.21
|
| Rate for Payer: BCN Commercial |
$212.21
|
| Rate for Payer: Cash Price |
$219.68
|
| Rate for Payer: Cofinity Commercial |
$236.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$247.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.41
|
| Rate for Payer: PHP Commercial |
$233.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.65
|
| Rate for Payer: UHC Core |
$229.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.95
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.82
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$156.75 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$561.00
|
| Rate for Payer: Aetna Medicare |
$171.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$206.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$206.25
|
| Rate for Payer: BCBS Complete |
$264.00
|
| Rate for Payer: BCBS MAPPO |
$165.00
|
| Rate for Payer: BCBS Trust/PPO |
$513.15
|
| Rate for Payer: BCN Commercial |
$513.15
|
| Rate for Payer: BCN Medicare Advantage |
$165.00
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$567.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.00
|
| Rate for Payer: Healthscope Commercial |
$594.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: PACE Senior Care Partners |
$156.75
|
| Rate for Payer: PACE SWMI |
$165.00
|
| Rate for Payer: PHP Commercial |
$561.00
|
| Rate for Payer: PHP Medicare Advantage |
$165.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.20
|
| Rate for Payer: Priority Health Medicare |
$165.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.53
|
| Rate for Payer: Railroad Medicare Medicare |
$165.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.80
|
| Rate for Payer: UHC Core |
$551.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.00
|
| Rate for Payer: UHC Medicare Advantage |
$169.95
|
| Rate for Payer: VA VA |
$165.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.00
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$402.53 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Aetna Commercial |
$561.00
|
| Rate for Payer: BCBS Trust/PPO |
$510.05
|
| Rate for Payer: BCN Commercial |
$510.05
|
| Rate for Payer: Cash Price |
$528.00
|
| Rate for Payer: Cofinity Commercial |
$567.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.00
|
| Rate for Payer: Healthscope Commercial |
$594.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.00
|
| Rate for Payer: PHP Commercial |
$561.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$574.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.80
|
| Rate for Payer: UHC Core |
$551.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.00
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
IP
|
$3,657.70
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,230.83 |
| Max. Negotiated Rate |
$3,291.93 |
| Rate for Payer: Aetna Commercial |
$3,109.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,826.67
|
| Rate for Payer: BCN Commercial |
$2,826.67
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cofinity Commercial |
$3,145.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,926.16
|
| Rate for Payer: Healthscope Commercial |
$3,291.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,743.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,109.04
|
| Rate for Payer: PHP Commercial |
$3,109.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,560.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,182.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,230.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,218.78
|
| Rate for Payer: UHC Core |
$3,054.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,743.28
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
OP
|
$3,657.70
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$868.70 |
| Max. Negotiated Rate |
$3,291.93 |
| Rate for Payer: Aetna Commercial |
$3,109.04
|
| Rate for Payer: Aetna Medicare |
$951.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,143.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,143.03
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$914.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.86
|
| Rate for Payer: BCN Commercial |
$2,843.86
|
| Rate for Payer: BCN Medicare Advantage |
$914.42
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cash Price |
$2,926.16
|
| Rate for Payer: Cofinity Commercial |
$3,145.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,926.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.42
|
| Rate for Payer: Healthscope Commercial |
$3,291.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,743.28
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$960.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,109.04
|
| Rate for Payer: PACE Senior Care Partners |
$868.70
|
| Rate for Payer: PACE SWMI |
$914.42
|
| Rate for Payer: PHP Commercial |
$3,109.04
|
| Rate for Payer: PHP Medicare Advantage |
$914.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,560.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,182.20
|
| Rate for Payer: Priority Health Medicare |
$914.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,230.83
|
| Rate for Payer: Railroad Medicare Medicare |
$914.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,218.78
|
| Rate for Payer: UHC Core |
$3,054.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.42
|
| Rate for Payer: UHC Medicare Advantage |
$941.86
|
| Rate for Payer: VA VA |
$914.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,743.28
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$823.36 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.28
|
| Rate for Payer: BCN Commercial |
$1,043.28
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,161.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Healthscope Commercial |
$1,215.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PHP Commercial |
$1,147.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,174.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.00
|
| Rate for Payer: UHC Core |
$1,127.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.50
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$320.62 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: Aetna Medicare |
$351.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$421.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$421.88
|
| Rate for Payer: BCBS Complete |
$378.97
|
| Rate for Payer: BCBS MAPPO |
$337.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.62
|
| Rate for Payer: BCN Commercial |
$1,049.62
|
| Rate for Payer: BCN Medicare Advantage |
$337.50
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,161.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.50
|
| Rate for Payer: Healthscope Commercial |
$1,215.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.50
|
| Rate for Payer: Mclaren Medicaid |
$360.93
|
| Rate for Payer: Meridian Medicaid |
$378.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$354.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$388.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PACE Senior Care Partners |
$320.62
|
| Rate for Payer: PACE SWMI |
$337.50
|
| Rate for Payer: PHP Commercial |
$1,147.50
|
| Rate for Payer: PHP Medicare Advantage |
$337.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,174.50
|
| Rate for Payer: Priority Health Medicare |
$337.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.36
|
| Rate for Payer: Railroad Medicare Medicare |
$337.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,188.00
|
| Rate for Payer: UHC Core |
$1,127.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.50
|
| Rate for Payer: UHC Medicare Advantage |
$347.62
|
| Rate for Payer: VA VA |
$337.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.50
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,632.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,812.60 |
| Max. Negotiated Rate |
$6,868.80 |
| Rate for Payer: Aetna Commercial |
$6,487.20
|
| Rate for Payer: Aetna Medicare |
$1,984.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,385.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,385.00
|
| Rate for Payer: BCBS Complete |
$2,153.41
|
| Rate for Payer: BCBS MAPPO |
$1,908.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,933.88
|
| Rate for Payer: BCN Commercial |
$5,933.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,908.00
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cofinity Commercial |
$6,563.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,105.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,908.00
|
| Rate for Payer: Healthscope Commercial |
$6,868.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,724.00
|
| Rate for Payer: Mclaren Medicaid |
$2,050.87
|
| Rate for Payer: Meridian Medicaid |
$2,153.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,003.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,194.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,487.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,812.60
|
| Rate for Payer: PACE SWMI |
$1,908.00
|
| Rate for Payer: PHP Commercial |
$6,487.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,908.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,050.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,342.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,639.84
|
| Rate for Payer: Priority Health Medicare |
$1,908.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,654.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,908.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,716.16
|
| Rate for Payer: UHC Core |
$6,372.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,908.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,965.24
|
| Rate for Payer: VA VA |
$1,908.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,724.00
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,632.00
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,654.76 |
| Max. Negotiated Rate |
$6,868.80 |
| Rate for Payer: Aetna Commercial |
$6,487.20
|
| Rate for Payer: BCBS Trust/PPO |
$5,898.01
|
| Rate for Payer: BCN Commercial |
$5,898.01
|
| Rate for Payer: Cash Price |
$6,105.60
|
| Rate for Payer: Cofinity Commercial |
$6,563.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,105.60
|
| Rate for Payer: Healthscope Commercial |
$6,868.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,724.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,487.20
|
| Rate for Payer: PHP Commercial |
$6,487.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,342.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,639.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,654.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,716.16
|
| Rate for Payer: UHC Core |
$6,372.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,724.00
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$44.06
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.87 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: BCBS Trust/PPO |
$34.05
|
| Rate for Payer: BCN Commercial |
$34.05
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.77
|
| Rate for Payer: UHC Core |
$36.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$44.06
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Commercial |
$37.45
|
| Rate for Payer: Aetna Medicare |
$11.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.77
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$11.02
|
| Rate for Payer: BCBS Trust/PPO |
$34.26
|
| Rate for Payer: BCN Commercial |
$34.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.02
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: Cofinity Commercial |
$37.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$39.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.04
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.45
|
| Rate for Payer: PACE Senior Care Partners |
$10.46
|
| Rate for Payer: PACE SWMI |
$11.02
|
| Rate for Payer: PHP Commercial |
$37.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.33
|
| Rate for Payer: Priority Health Medicare |
$11.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.87
|
| Rate for Payer: Railroad Medicare Medicare |
$11.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.77
|
| Rate for Payer: UHC Core |
$36.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.02
|
| Rate for Payer: UHC Medicare Advantage |
$11.35
|
| Rate for Payer: VA VA |
$11.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.04
|
|
