|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$42.32
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.45 |
| Max. Negotiated Rate |
$38.09 |
| Rate for Payer: Aetna Commercial |
$35.97
|
| Rate for Payer: BCBS Trust/PPO |
$34.95
|
| Rate for Payer: BCN Commercial |
$34.95
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cofinity Commercial |
$36.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.86
|
| Rate for Payer: Healthscope Commercial |
$38.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.74
|
| Rate for Payer: PHP Commercial |
$35.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.24
|
| Rate for Payer: UHC Core |
$35.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.74
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$42.32
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$38.09 |
| Rate for Payer: Aetna Commercial |
$35.97
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.22
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$10.58
|
| Rate for Payer: BCBS Trust/PPO |
$34.79
|
| Rate for Payer: BCN Commercial |
$34.79
|
| Rate for Payer: BCN Medicare Advantage |
$10.58
|
| Rate for Payer: Cash Price |
$33.86
|
| Rate for Payer: Cofinity Commercial |
$36.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.58
|
| Rate for Payer: Healthscope Commercial |
$38.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.74
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.97
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.74
|
| Rate for Payer: PACE Senior Care Partners |
$10.05
|
| Rate for Payer: PACE SWMI |
$10.58
|
| Rate for Payer: PHP Commercial |
$35.97
|
| Rate for Payer: PHP Medicare Advantage |
$10.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.82
|
| Rate for Payer: Priority Health Medicare |
$10.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.45
|
| Rate for Payer: Railroad Medicare Medicare |
$10.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.24
|
| Rate for Payer: UHC Core |
$35.34
|
| Rate for Payer: UHC Exchange |
$10.58
|
| Rate for Payer: UHC Medicaid |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.58
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$10.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.74
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: BCBS Trust/PPO |
$17.90
|
| Rate for Payer: BCN Commercial |
$17.90
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Nomi Health Commercial |
$17.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.07
|
| Rate for Payer: UHC Core |
$18.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$21.67
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Commercial |
$18.42
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.77
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$5.42
|
| Rate for Payer: BCBS Trust/PPO |
$17.81
|
| Rate for Payer: BCN Commercial |
$17.81
|
| Rate for Payer: BCN Medicare Advantage |
$5.42
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cofinity Commercial |
$18.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.42
|
| Rate for Payer: Healthscope Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.25
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.69
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.42
|
| Rate for Payer: Nomi Health Commercial |
$17.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.25
|
| Rate for Payer: PACE Senior Care Partners |
$5.15
|
| Rate for Payer: PACE SWMI |
$5.42
|
| Rate for Payer: PHP Commercial |
$18.42
|
| Rate for Payer: PHP Medicare Advantage |
$5.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$5.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.08
|
| Rate for Payer: Railroad Medicare Medicare |
$5.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.07
|
| Rate for Payer: UHC Core |
$18.09
|
| Rate for Payer: UHC Exchange |
$5.42
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.42
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: VA VA |
$5.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.25
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: BCBS Trust/PPO |
$28.05
|
| Rate for Payer: BCN Commercial |
$28.05
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.88
|
| Rate for Payer: UHC Core |
$28.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna Medicare |
$8.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.61
|
| Rate for Payer: BCBS Complete |
$6.29
|
| Rate for Payer: BCBS MAPPO |
$8.49
|
| Rate for Payer: BCBS Trust/PPO |
$27.92
|
| Rate for Payer: BCN Commercial |
$27.92
|
| Rate for Payer: BCN Medicare Advantage |
$8.49
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.49
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: Mclaren Medicaid |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.91
|
| Rate for Payer: Meridian Medicaid |
$6.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$27.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Senior Care Partners |
$8.07
|
| Rate for Payer: PACE SWMI |
$8.49
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: PHP Medicare Advantage |
$8.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.55
|
| Rate for Payer: Priority Health Medicare |
$8.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.64
|
| Rate for Payer: Railroad Medicare Medicare |
$8.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.88
|
| Rate for Payer: UHC Core |
$28.36
|
| Rate for Payer: UHC Exchange |
$8.49
|
| Rate for Payer: UHC Medicaid |
$5.99
|
| Rate for Payer: UHC Medicare Advantage |
$8.49
|
| Rate for Payer: UHCCP Medicaid |
$5.99
|
| Rate for Payer: VA VA |
$8.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.84 |
| Max. Negotiated Rate |
$25.66 |
| Rate for Payer: Aetna Commercial |
$24.23
|
| Rate for Payer: BCBS Trust/PPO |
$23.55
|
| Rate for Payer: BCN Commercial |
$23.55
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$25.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$23.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: PHP Commercial |
$24.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.09
|
| Rate for Payer: UHC Core |
$23.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$28.51
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$25.66 |
| Rate for Payer: Aetna Commercial |
$24.23
|
| Rate for Payer: Aetna Medicare |
$7.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.91
|
| Rate for Payer: BCBS Complete |
$5.28
|
| Rate for Payer: BCBS MAPPO |
$7.13
|
| Rate for Payer: BCBS Trust/PPO |
$23.44
|
| Rate for Payer: BCN Commercial |
$23.44
|
| Rate for Payer: BCN Medicare Advantage |
$7.13
|
| Rate for Payer: Cash Price |
$22.81
|
| Rate for Payer: Cofinity Commercial |
$24.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.13
|
| Rate for Payer: Healthscope Commercial |
$25.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.38
|
| Rate for Payer: Mclaren Medicaid |
$5.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.48
|
| Rate for Payer: Meridian Medicaid |
$5.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.23
|
| Rate for Payer: Nomi Health Commercial |
$23.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.38
|
| Rate for Payer: PACE Senior Care Partners |
$6.77
|
| Rate for Payer: PACE SWMI |
$7.13
|
| Rate for Payer: PHP Commercial |
$24.23
|
| Rate for Payer: PHP Medicare Advantage |
$7.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.80
|
| Rate for Payer: Priority Health Medicare |
$7.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.09
|
| Rate for Payer: UHC Core |
$23.81
|
| Rate for Payer: UHC Exchange |
$7.13
|
| Rate for Payer: UHC Medicaid |
$5.03
|
| Rate for Payer: UHC Medicare Advantage |
$7.13
|
| Rate for Payer: UHCCP Medicaid |
$5.03
|
| Rate for Payer: VA VA |
$7.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.38
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.74 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.98
|
| Rate for Payer: BCBS Complete |
$20.72
|
| Rate for Payer: BCBS MAPPO |
$27.99
|
| Rate for Payer: BCBS Trust/PPO |
$92.03
|
| Rate for Payer: BCN Commercial |
$92.03
|
| Rate for Payer: BCN Medicare Advantage |
$27.99
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.99
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Mclaren Medicaid |
$19.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.39
|
| Rate for Payer: Meridian Medicaid |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PACE Senior Care Partners |
$26.59
|
| Rate for Payer: PACE SWMI |
$27.99
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$27.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Medicare |
$28.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: Railroad Medicare Medicare |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: UHC Exchange |
$27.99
|
| Rate for Payer: UHC Medicaid |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$27.99
|
| Rate for Payer: UHCCP Medicaid |
$19.74
|
| Rate for Payer: VA VA |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: BCBS Trust/PPO |
$92.46
|
| Rate for Payer: BCN Commercial |
$92.46
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
OP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$143.26 |
| Rate for Payer: Aetna Commercial |
$135.30
|
| Rate for Payer: Aetna Medicare |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.74
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$130.86
|
| Rate for Payer: BCN Commercial |
$130.86
|
| Rate for Payer: BCN Medicare Advantage |
$39.80
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Commercial |
$136.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.80
|
| Rate for Payer: Healthscope Commercial |
$143.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.39
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.78
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Nomi Health Commercial |
$130.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: PACE Senior Care Partners |
$37.81
|
| Rate for Payer: PACE SWMI |
$39.80
|
| Rate for Payer: PHP Commercial |
$135.30
|
| Rate for Payer: PHP Medicare Advantage |
$39.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$138.49
|
| Rate for Payer: Priority Health Medicare |
$40.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.79
|
| Rate for Payer: Railroad Medicare Medicare |
$39.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.08
|
| Rate for Payer: UHC Core |
$132.92
|
| Rate for Payer: UHC Exchange |
$39.80
|
| Rate for Payer: UHC Medicaid |
$28.06
|
| Rate for Payer: UHC Medicare Advantage |
$39.80
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: VA VA |
$39.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.39
|
|
|
HC HELICO PYL BREATH TST NON RADIOACTIVE ISOTOPE
|
Facility
|
IP
|
$159.18
|
|
|
Service Code
|
CPT 83013
|
| Hospital Charge Code |
30600223
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$110.79 |
| Max. Negotiated Rate |
$143.26 |
| Rate for Payer: Aetna Commercial |
$135.30
|
| Rate for Payer: BCBS Trust/PPO |
$131.47
|
| Rate for Payer: BCN Commercial |
$131.47
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cofinity Commercial |
$136.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.34
|
| Rate for Payer: Healthscope Commercial |
$143.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.30
|
| Rate for Payer: Nomi Health Commercial |
$130.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.39
|
| Rate for Payer: PHP Commercial |
$135.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$138.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.08
|
| Rate for Payer: UHC Core |
$132.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.39
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC HELMINTHO SETOMELANO IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200088
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC HEMATOCRIT
|
Facility
|
IP
|
$24.35
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$21.91 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: BCBS Trust/PPO |
$20.11
|
| Rate for Payer: BCN Commercial |
$20.11
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$20.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Healthscope Commercial |
$21.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.70
|
| Rate for Payer: Nomi Health Commercial |
$19.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: PHP Commercial |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.43
|
| Rate for Payer: UHC Core |
$20.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.26
|
|
|
HC HEMATOCRIT
|
Facility
|
OP
|
$24.35
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
30500005
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$21.91 |
| Rate for Payer: Aetna Commercial |
$20.70
|
| Rate for Payer: Aetna Medicare |
$6.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.61
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$6.09
|
| Rate for Payer: BCBS Trust/PPO |
$20.02
|
| Rate for Payer: BCN Commercial |
$20.02
|
| Rate for Payer: BCN Medicare Advantage |
$6.09
|
| Rate for Payer: Cash Price |
$19.48
|
| Rate for Payer: Cofinity Commercial |
$20.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.09
|
| Rate for Payer: Healthscope Commercial |
$21.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.26
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.39
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.70
|
| Rate for Payer: Nomi Health Commercial |
$19.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.26
|
| Rate for Payer: PACE Senior Care Partners |
$5.78
|
| Rate for Payer: PACE SWMI |
$6.09
|
| Rate for Payer: PHP Commercial |
$20.70
|
| Rate for Payer: PHP Medicare Advantage |
$6.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.18
|
| Rate for Payer: Priority Health Medicare |
$6.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.95
|
| Rate for Payer: Railroad Medicare Medicare |
$6.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.43
|
| Rate for Payer: UHC Core |
$20.33
|
| Rate for Payer: UHC Exchange |
$6.09
|
| Rate for Payer: UHC Medicaid |
$4.29
|
| Rate for Payer: UHC Medicare Advantage |
$6.09
|
| Rate for Payer: UHCCP Medicaid |
$4.29
|
| Rate for Payer: VA VA |
$6.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.26
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
IP
|
$270.61
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$188.34 |
| Max. Negotiated Rate |
$243.55 |
| Rate for Payer: Aetna Commercial |
$230.02
|
| Rate for Payer: BCBS Trust/PPO |
$223.50
|
| Rate for Payer: BCN Commercial |
$223.50
|
| Rate for Payer: Cash Price |
$216.49
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.49
|
| Rate for Payer: Healthscope Commercial |
$243.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.02
|
| Rate for Payer: Nomi Health Commercial |
$221.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.96
|
| Rate for Payer: PHP Commercial |
$230.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.14
|
| Rate for Payer: UHC Core |
$225.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.96
|
|
|
HC HEMOCHROMATOSIS GENE ANALYSIS
|
Facility
|
OP
|
$270.61
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
31000100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$243.55 |
| Rate for Payer: Aetna Commercial |
$230.02
|
| Rate for Payer: Aetna Medicare |
$70.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.57
|
| Rate for Payer: BCBS Complete |
$50.09
|
| Rate for Payer: BCBS MAPPO |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$222.47
|
| Rate for Payer: BCN Commercial |
$222.47
|
| Rate for Payer: BCN Medicare Advantage |
$67.65
|
| Rate for Payer: Cash Price |
$216.49
|
| Rate for Payer: Cofinity Commercial |
$232.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.65
|
| Rate for Payer: Healthscope Commercial |
$243.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.96
|
| Rate for Payer: Mclaren Medicaid |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.04
|
| Rate for Payer: Meridian Medicaid |
$50.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.02
|
| Rate for Payer: Nomi Health Commercial |
$221.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.96
|
| Rate for Payer: PACE Senior Care Partners |
$64.27
|
| Rate for Payer: PACE SWMI |
$67.65
|
| Rate for Payer: PHP Commercial |
$230.02
|
| Rate for Payer: PHP Medicare Advantage |
$67.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.43
|
| Rate for Payer: Priority Health Medicare |
$68.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.34
|
| Rate for Payer: Railroad Medicare Medicare |
$67.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.14
|
| Rate for Payer: UHC Core |
$225.96
|
| Rate for Payer: UHC Exchange |
$67.65
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHC Medicare Advantage |
$67.65
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
| Rate for Payer: VA VA |
$67.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.96
|
|
|
HC HEMO CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$247.77
|
| Rate for Payer: BCN Commercial |
$247.77
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC HEMO CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500002
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$52.89 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$55.53
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$246.63
|
| Rate for Payer: BCN Commercial |
$246.63
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Mclaren Medicaid |
$52.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: Meridian Medicaid |
$55.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.80
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Exchange |
$75.00
|
| Rate for Payer: UHC Medicaid |
$52.89
|
| Rate for Payer: UHC Medicare Advantage |
$75.00
|
| Rate for Payer: UHCCP Medicaid |
$52.89
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC HEMO CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$103.24
|
| Rate for Payer: BCN Commercial |
$103.24
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC HEMO CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500003
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.06
|
| Rate for Payer: BCBS Complete |
$23.14
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$102.76
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$102.76
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Mclaren Medicaid |
$22.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.81
|
| Rate for Payer: Meridian Medicaid |
$23.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.75
|
| Rate for Payer: Priority Health Medicare |
$31.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.00
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Exchange |
$31.25
|
| Rate for Payer: UHC Medicaid |
$22.04
|
| Rate for Payer: UHC Medicare Advantage |
$31.25
|
| Rate for Payer: UHCCP Medicaid |
$22.04
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC HEMO CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$79.33 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.62
|
| Rate for Payer: BCBS Complete |
$83.30
|
| Rate for Payer: BCBS MAPPO |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$369.94
|
| Rate for Payer: BCN Commercial |
$369.94
|
| Rate for Payer: BCN Medicare Advantage |
$112.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.50
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Mclaren Medicaid |
$79.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.12
|
| Rate for Payer: Meridian Medicaid |
$83.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.50
|
| Rate for Payer: PACE Senior Care Partners |
$106.88
|
| Rate for Payer: PACE SWMI |
$112.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: PHP Medicare Advantage |
$112.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$391.50
|
| Rate for Payer: Priority Health Medicare |
$113.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.20
|
| Rate for Payer: Railroad Medicare Medicare |
$112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: UHC Exchange |
$112.50
|
| Rate for Payer: UHC Medicaid |
$79.33
|
| Rate for Payer: UHC Medicare Advantage |
$112.50
|
| Rate for Payer: UHCCP Medicaid |
$79.33
|
| Rate for Payer: VA VA |
$112.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
