|
HC METANEB SUPPLY
|
Facility
|
OP
|
$254.19
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.37 |
| Max. Negotiated Rate |
$228.77 |
| Rate for Payer: Aetna Commercial |
$216.06
|
| Rate for Payer: Aetna Medicare |
$66.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.43
|
| Rate for Payer: BCBS Complete |
$101.68
|
| Rate for Payer: BCBS MAPPO |
$63.55
|
| Rate for Payer: BCBS Trust/PPO |
$197.63
|
| Rate for Payer: BCN Commercial |
$197.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.55
|
| Rate for Payer: Cash Price |
$203.35
|
| Rate for Payer: Cofinity Commercial |
$218.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.55
|
| Rate for Payer: Healthscope Commercial |
$228.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.06
|
| Rate for Payer: PACE Senior Care Partners |
$60.37
|
| Rate for Payer: PACE SWMI |
$63.55
|
| Rate for Payer: PHP Commercial |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$63.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.15
|
| Rate for Payer: Priority Health Medicare |
$63.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.03
|
| Rate for Payer: Railroad Medicare Medicare |
$63.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.69
|
| Rate for Payer: UHC Core |
$212.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.55
|
| Rate for Payer: UHC Medicare Advantage |
$65.45
|
| Rate for Payer: VA VA |
$63.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.64
|
|
|
HC METANEB SUPPLY
|
Facility
|
IP
|
$254.19
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$155.03 |
| Max. Negotiated Rate |
$228.77 |
| Rate for Payer: Aetna Commercial |
$216.06
|
| Rate for Payer: BCBS Trust/PPO |
$196.44
|
| Rate for Payer: BCN Commercial |
$196.44
|
| Rate for Payer: Cash Price |
$203.35
|
| Rate for Payer: Cofinity Commercial |
$218.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.35
|
| Rate for Payer: Healthscope Commercial |
$228.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.06
|
| Rate for Payer: PHP Commercial |
$216.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$221.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.69
|
| Rate for Payer: UHC Core |
$212.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.64
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.66 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$13.13
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$12.50
|
| Rate for Payer: Meridian Medicaid |
$13.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.50 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna Medicare |
$15.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.06
|
| Rate for Payer: BCBS Complete |
$13.13
|
| Rate for Payer: BCBS MAPPO |
$15.25
|
| Rate for Payer: BCBS Trust/PPO |
$47.43
|
| Rate for Payer: BCN Commercial |
$47.43
|
| Rate for Payer: BCN Medicare Advantage |
$15.25
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.25
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Mclaren Medicaid |
$12.50
|
| Rate for Payer: Meridian Medicaid |
$13.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Senior Care Partners |
$14.49
|
| Rate for Payer: PACE SWMI |
$15.25
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: PHP Medicare Advantage |
$15.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.07
|
| Rate for Payer: Priority Health Medicare |
$15.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.68
|
| Rate for Payer: UHC Core |
$50.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.25
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: VA VA |
$15.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: BCBS Trust/PPO |
$47.14
|
| Rate for Payer: BCN Commercial |
$47.14
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.68
|
| Rate for Payer: UHC Core |
$50.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC METANEPHRINES URINE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.73 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC METANEPHRINES URINE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$13.13
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$40.45
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$12.50
|
| Rate for Payer: Meridian Medicaid |
$13.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.40
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
OP
|
$1,763.70
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$418.88 |
| Max. Negotiated Rate |
$3,220.93 |
| Rate for Payer: Aetna Commercial |
$1,499.14
|
| Rate for Payer: Aetna Medicare |
$458.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$551.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$551.16
|
| Rate for Payer: BCBS Complete |
$3,220.93
|
| Rate for Payer: BCBS MAPPO |
$440.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,371.28
|
| Rate for Payer: BCN Commercial |
$1,371.28
|
| Rate for Payer: BCN Medicare Advantage |
$440.92
|
| Rate for Payer: Cash Price |
$1,410.96
|
| Rate for Payer: Cash Price |
$1,410.96
|
| Rate for Payer: Cofinity Commercial |
$1,516.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,410.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.92
|
| Rate for Payer: Healthscope Commercial |
$1,587.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,322.78
|
| Rate for Payer: Mclaren Medicaid |
$3,067.55
|
| Rate for Payer: Meridian Medicaid |
$3,220.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$507.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,499.14
|
| Rate for Payer: PACE Senior Care Partners |
$418.88
|
| Rate for Payer: PACE SWMI |
$440.92
|
| Rate for Payer: PHP Commercial |
$1,499.14
|
| Rate for Payer: PHP Medicare Advantage |
$440.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,067.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,534.42
|
| Rate for Payer: Priority Health Medicare |
$440.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.68
|
| Rate for Payer: Railroad Medicare Medicare |
$440.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,552.06
|
| Rate for Payer: UHC Core |
$1,472.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.92
|
| Rate for Payer: UHC Medicare Advantage |
$454.15
|
| Rate for Payer: VA VA |
$440.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,322.78
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
IP
|
$1,763.70
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,075.68 |
| Max. Negotiated Rate |
$1,587.33 |
| Rate for Payer: Aetna Commercial |
$1,499.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,362.99
|
| Rate for Payer: BCN Commercial |
$1,362.99
|
| Rate for Payer: Cash Price |
$1,410.96
|
| Rate for Payer: Cofinity Commercial |
$1,516.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,410.96
|
| Rate for Payer: Healthscope Commercial |
$1,587.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,322.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,499.14
|
| Rate for Payer: PHP Commercial |
$1,499.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,234.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,534.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,075.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,552.06
|
| Rate for Payer: UHC Core |
$1,472.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,322.78
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC METHADONE SCRN URN
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Aetna Commercial |
$66.30
|
| Rate for Payer: Aetna Medicare |
$20.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: BCBS MAPPO |
$19.50
|
| Rate for Payer: BCBS Trust/PPO |
$60.64
|
| Rate for Payer: BCN Commercial |
$60.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.50
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$67.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.50
|
| Rate for Payer: Healthscope Commercial |
$70.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.30
|
| Rate for Payer: PACE Senior Care Partners |
$18.52
|
| Rate for Payer: PACE SWMI |
$19.50
|
| Rate for Payer: PHP Commercial |
$66.30
|
| Rate for Payer: PHP Medicare Advantage |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.86
|
| Rate for Payer: Priority Health Medicare |
$19.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.57
|
| Rate for Payer: Railroad Medicare Medicare |
$19.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.64
|
| Rate for Payer: UHC Core |
$65.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.50
|
| Rate for Payer: UHC Medicare Advantage |
$20.08
|
| Rate for Payer: VA VA |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.50
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$78.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.57 |
| Max. Negotiated Rate |
$70.20 |
| Rate for Payer: Aetna Commercial |
$66.30
|
| Rate for Payer: BCBS Trust/PPO |
$60.28
|
| Rate for Payer: BCN Commercial |
$60.28
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$67.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.40
|
| Rate for Payer: Healthscope Commercial |
$70.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.30
|
| Rate for Payer: PHP Commercial |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.64
|
| Rate for Payer: UHC Core |
$65.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.50
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.59 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.75
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$15.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.65
|
| Rate for Payer: BCN Commercial |
$46.65
|
| Rate for Payer: BCN Medicare Advantage |
$15.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE SWMI |
$15.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$15.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$15.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.45
|
| Rate for Payer: VA VA |
$15.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.14 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: BCBS Trust/PPO |
$120.56
|
| Rate for Payer: BCN Commercial |
$120.56
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$132.60
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC METHANOL LVL
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.05 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna Medicare |
$40.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.75
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$39.00
|
| Rate for Payer: BCBS Trust/PPO |
$121.29
|
| Rate for Payer: BCN Commercial |
$121.29
|
| Rate for Payer: BCN Medicare Advantage |
$39.00
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.00
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$132.60
|
| Rate for Payer: PACE Senior Care Partners |
$37.05
|
| Rate for Payer: PACE SWMI |
$39.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: PHP Medicare Advantage |
$39.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$39.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.14
|
| Rate for Payer: Railroad Medicare Medicare |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.28
|
| Rate for Payer: UHC Core |
$130.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.00
|
| Rate for Payer: UHC Medicare Advantage |
$40.17
|
| Rate for Payer: VA VA |
$39.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$46.10
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$41.49 |
| Rate for Payer: Aetna Commercial |
$39.18
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$11.52
|
| Rate for Payer: BCBS Trust/PPO |
$35.84
|
| Rate for Payer: BCN Commercial |
$35.84
|
| Rate for Payer: BCN Medicare Advantage |
$11.52
|
| Rate for Payer: Cash Price |
$36.88
|
| Rate for Payer: Cash Price |
$36.88
|
| Rate for Payer: Cofinity Commercial |
$39.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.52
|
| Rate for Payer: Healthscope Commercial |
$41.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.58
|
| Rate for Payer: Mclaren Medicaid |
$6.05
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.18
|
| Rate for Payer: PACE Senior Care Partners |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.52
|
| Rate for Payer: PHP Commercial |
$39.18
|
| Rate for Payer: PHP Medicare Advantage |
$11.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.12
|
| Rate for Payer: Railroad Medicare Medicare |
$11.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.57
|
| Rate for Payer: UHC Core |
$38.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.52
|
| Rate for Payer: UHC Medicare Advantage |
$11.87
|
| Rate for Payer: VA VA |
$11.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.58
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$46.10
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$41.49 |
| Rate for Payer: Aetna Commercial |
$39.18
|
| Rate for Payer: BCBS Trust/PPO |
$35.63
|
| Rate for Payer: BCN Commercial |
$35.63
|
| Rate for Payer: Cash Price |
$36.88
|
| Rate for Payer: Cofinity Commercial |
$39.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.88
|
| Rate for Payer: Healthscope Commercial |
$41.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.18
|
| Rate for Payer: PHP Commercial |
$39.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.57
|
| Rate for Payer: UHC Core |
$38.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.58
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$173.50
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.82 |
| Max. Negotiated Rate |
$156.15 |
| Rate for Payer: Aetna Commercial |
$147.48
|
| Rate for Payer: BCBS Trust/PPO |
$134.08
|
| Rate for Payer: BCN Commercial |
$134.08
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$149.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Healthscope Commercial |
$156.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PHP Commercial |
$147.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.68
|
| Rate for Payer: UHC Core |
$144.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.12
|
|
