|
HC HIV DNA BY PCR
|
Facility
|
OP
|
$91.26
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna Medicare |
$23.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.52
|
| Rate for Payer: BCBS Complete |
$16.89
|
| Rate for Payer: BCBS MAPPO |
$22.82
|
| Rate for Payer: BCBS Trust/PPO |
$75.02
|
| Rate for Payer: BCN Commercial |
$75.02
|
| Rate for Payer: BCN Medicare Advantage |
$22.82
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.82
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.44
|
| Rate for Payer: Mclaren Medicaid |
$16.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.96
|
| Rate for Payer: Meridian Medicaid |
$16.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Nomi Health Commercial |
$74.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PACE Senior Care Partners |
$21.67
|
| Rate for Payer: PACE SWMI |
$22.82
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: PHP Medicare Advantage |
$22.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.40
|
| Rate for Payer: Priority Health Medicare |
$23.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.52
|
| Rate for Payer: Railroad Medicare Medicare |
$22.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.31
|
| Rate for Payer: UHC Core |
$76.20
|
| Rate for Payer: UHC Exchange |
$22.82
|
| Rate for Payer: UHC Medicaid |
$16.09
|
| Rate for Payer: UHC Medicare Advantage |
$22.82
|
| Rate for Payer: UHCCP Medicaid |
$16.09
|
| Rate for Payer: VA VA |
$22.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.44
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: BCBS Trust/PPO |
$125.83
|
| Rate for Payer: BCN Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$124.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.07
|
| Rate for Payer: UHC Core |
$127.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.26
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.86 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna Medicare |
$39.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.61
|
| Rate for Payer: BCBS Complete |
$28.20
|
| Rate for Payer: BCBS MAPPO |
$38.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.25
|
| Rate for Payer: BCN Commercial |
$125.25
|
| Rate for Payer: BCN Medicare Advantage |
$38.09
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.09
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.26
|
| Rate for Payer: Mclaren Medicaid |
$26.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.99
|
| Rate for Payer: Meridian Medicaid |
$28.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$124.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PACE Senior Care Partners |
$36.18
|
| Rate for Payer: PACE SWMI |
$38.09
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: PHP Medicare Advantage |
$38.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.54
|
| Rate for Payer: Priority Health Medicare |
$38.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.04
|
| Rate for Payer: Railroad Medicare Medicare |
$38.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.07
|
| Rate for Payer: UHC Core |
$127.21
|
| Rate for Payer: UHC Exchange |
$38.09
|
| Rate for Payer: UHC Medicaid |
$26.86
|
| Rate for Payer: UHC Medicare Advantage |
$38.09
|
| Rate for Payer: UHCCP Medicaid |
$26.86
|
| Rate for Payer: VA VA |
$38.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.26
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$212.24
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.42 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: Aetna Medicare |
$55.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.33
|
| Rate for Payer: BCBS Complete |
$39.29
|
| Rate for Payer: BCBS MAPPO |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$174.48
|
| Rate for Payer: BCN Commercial |
$174.48
|
| Rate for Payer: BCN Medicare Advantage |
$53.06
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.06
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Mclaren Medicaid |
$37.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.71
|
| Rate for Payer: Meridian Medicaid |
$39.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PACE Senior Care Partners |
$50.41
|
| Rate for Payer: PACE SWMI |
$53.06
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: PHP Medicare Advantage |
$53.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Medicare |
$53.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: Railroad Medicare Medicare |
$53.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: UHC Exchange |
$53.06
|
| Rate for Payer: UHC Medicaid |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$53.06
|
| Rate for Payer: UHCCP Medicaid |
$37.42
|
| Rate for Payer: VA VA |
$53.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$212.24
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$147.72 |
| Max. Negotiated Rate |
$191.02 |
| Rate for Payer: Aetna Commercial |
$180.40
|
| Rate for Payer: BCBS Trust/PPO |
$175.29
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: Cash Price |
$169.79
|
| Rate for Payer: Cofinity Commercial |
$182.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.79
|
| Rate for Payer: Healthscope Commercial |
$191.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.40
|
| Rate for Payer: Nomi Health Commercial |
$174.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.18
|
| Rate for Payer: PHP Commercial |
$180.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$184.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.77
|
| Rate for Payer: UHC Core |
$177.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.18
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$106.04 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: BCBS Trust/PPO |
$125.83
|
| Rate for Payer: BCN Commercial |
$125.83
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$124.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.07
|
| Rate for Payer: UHC Core |
$127.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.26
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$152.35
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.86 |
| Max. Negotiated Rate |
$137.12 |
| Rate for Payer: Aetna Commercial |
$129.50
|
| Rate for Payer: Aetna Medicare |
$39.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.61
|
| Rate for Payer: BCBS Complete |
$28.20
|
| Rate for Payer: BCBS MAPPO |
$38.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.25
|
| Rate for Payer: BCN Commercial |
$125.25
|
| Rate for Payer: BCN Medicare Advantage |
$38.09
|
| Rate for Payer: Cash Price |
$121.88
|
| Rate for Payer: Cofinity Commercial |
$131.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.09
|
| Rate for Payer: Healthscope Commercial |
$137.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.26
|
| Rate for Payer: Mclaren Medicaid |
$26.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.99
|
| Rate for Payer: Meridian Medicaid |
$28.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.50
|
| Rate for Payer: Nomi Health Commercial |
$124.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.26
|
| Rate for Payer: PACE Senior Care Partners |
$36.18
|
| Rate for Payer: PACE SWMI |
$38.09
|
| Rate for Payer: PHP Commercial |
$129.50
|
| Rate for Payer: PHP Medicare Advantage |
$38.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.54
|
| Rate for Payer: Priority Health Medicare |
$38.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.04
|
| Rate for Payer: Railroad Medicare Medicare |
$38.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.07
|
| Rate for Payer: UHC Core |
$127.21
|
| Rate for Payer: UHC Exchange |
$38.09
|
| Rate for Payer: UHC Medicaid |
$26.86
|
| Rate for Payer: UHC Medicare Advantage |
$38.09
|
| Rate for Payer: UHCCP Medicaid |
$26.86
|
| Rate for Payer: VA VA |
$38.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.26
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.84
|
| Rate for Payer: BCBS Complete |
$19.45
|
| Rate for Payer: BCBS MAPPO |
$26.27
|
| Rate for Payer: BCBS Trust/PPO |
$86.39
|
| Rate for Payer: BCN Commercial |
$86.39
|
| Rate for Payer: BCN Medicare Advantage |
$26.27
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.27
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$18.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.58
|
| Rate for Payer: Meridian Medicaid |
$19.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.81
|
| Rate for Payer: PACE Senior Care Partners |
$24.96
|
| Rate for Payer: PACE SWMI |
$26.27
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$26.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Medicare |
$26.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.14
|
| Rate for Payer: Railroad Medicare Medicare |
$26.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: UHC Exchange |
$26.27
|
| Rate for Payer: UHC Medicaid |
$18.53
|
| Rate for Payer: UHC Medicare Advantage |
$26.27
|
| Rate for Payer: UHCCP Medicaid |
$18.53
|
| Rate for Payer: VA VA |
$26.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: BCBS Trust/PPO |
$86.79
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.81
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$20.22
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$89.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$19.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$20.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicaid |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$19.26
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$90.22
|
| Rate for Payer: BCN Commercial |
$90.22
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.01 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: BCBS Trust/PPO |
$56.97
|
| Rate for Payer: BCN Commercial |
$56.97
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.56
|
| Rate for Payer: BCBS Complete |
$12.77
|
| Rate for Payer: BCBS MAPPO |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.71
|
| Rate for Payer: BCN Commercial |
$56.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.25
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$12.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$12.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Senior Care Partners |
$16.38
|
| Rate for Payer: PACE SWMI |
$17.25
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Medicare |
$17.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: UHC Exchange |
$17.25
|
| Rate for Payer: UHC Medicaid |
$12.16
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$12.16
|
| Rate for Payer: VA VA |
$17.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| 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 |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$64.15
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicaid |
$13.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$13.76
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$64.44
|
| Rate for Payer: BCN Commercial |
$64.44
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$283.48
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$197.30 |
| Max. Negotiated Rate |
$255.13 |
| Rate for Payer: Aetna Commercial |
$240.96
|
| Rate for Payer: BCBS Trust/PPO |
$234.13
|
| Rate for Payer: BCN Commercial |
$234.13
|
| Rate for Payer: Cash Price |
$226.78
|
| Rate for Payer: Cofinity Commercial |
$243.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.78
|
| Rate for Payer: Healthscope Commercial |
$255.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.96
|
| Rate for Payer: Nomi Health Commercial |
$232.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.61
|
| Rate for Payer: PHP Commercial |
$240.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.46
|
| Rate for Payer: UHC Core |
$236.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.61
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$283.48
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$255.13 |
| Rate for Payer: Aetna Commercial |
$240.96
|
| Rate for Payer: Aetna Medicare |
$73.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.59
|
| Rate for Payer: BCBS Complete |
$52.47
|
| Rate for Payer: BCBS MAPPO |
$70.87
|
| Rate for Payer: BCBS Trust/PPO |
$233.05
|
| Rate for Payer: BCN Commercial |
$233.05
|
| Rate for Payer: BCN Medicare Advantage |
$70.87
|
| Rate for Payer: Cash Price |
$226.78
|
| Rate for Payer: Cofinity Commercial |
$243.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.87
|
| Rate for Payer: Healthscope Commercial |
$255.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.61
|
| Rate for Payer: Mclaren Medicaid |
$49.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.41
|
| Rate for Payer: Meridian Medicaid |
$52.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.96
|
| Rate for Payer: Nomi Health Commercial |
$232.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.61
|
| Rate for Payer: PACE Senior Care Partners |
$67.33
|
| Rate for Payer: PACE SWMI |
$70.87
|
| Rate for Payer: PHP Commercial |
$240.96
|
| Rate for Payer: PHP Medicare Advantage |
$70.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.63
|
| Rate for Payer: Priority Health Medicare |
$71.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.30
|
| Rate for Payer: Railroad Medicare Medicare |
$70.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.46
|
| Rate for Payer: UHC Core |
$236.71
|
| Rate for Payer: UHC Exchange |
$70.87
|
| Rate for Payer: UHC Medicaid |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$70.87
|
| Rate for Payer: UHCCP Medicaid |
$49.98
|
| Rate for Payer: VA VA |
$70.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.61
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,811.89
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$495.74 |
| Max. Negotiated Rate |
$2,530.70 |
| Rate for Payer: Aetna Commercial |
$2,390.11
|
| Rate for Payer: Aetna Medicare |
$731.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$878.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$878.72
|
| Rate for Payer: BCBS Complete |
$520.48
|
| Rate for Payer: BCBS MAPPO |
$702.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,311.65
|
| Rate for Payer: BCN Commercial |
$2,311.65
|
| Rate for Payer: BCN Medicare Advantage |
$702.97
|
| Rate for Payer: Cash Price |
$2,249.51
|
| Rate for Payer: Cofinity Commercial |
$2,418.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,249.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$702.97
|
| Rate for Payer: Healthscope Commercial |
$2,530.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,108.92
|
| Rate for Payer: Mclaren Medicaid |
$495.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.12
|
| Rate for Payer: Meridian Medicaid |
$520.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,390.11
|
| Rate for Payer: Nomi Health Commercial |
$2,305.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,108.92
|
| Rate for Payer: PACE Senior Care Partners |
$667.82
|
| Rate for Payer: PACE SWMI |
$702.97
|
| Rate for Payer: PHP Commercial |
$2,390.11
|
| Rate for Payer: PHP Medicare Advantage |
$702.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,446.34
|
| Rate for Payer: Priority Health Medicare |
$710.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,957.08
|
| Rate for Payer: Railroad Medicare Medicare |
$702.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,474.46
|
| Rate for Payer: UHC Core |
$2,347.93
|
| Rate for Payer: UHC Exchange |
$702.97
|
| Rate for Payer: UHC Medicaid |
$495.74
|
| Rate for Payer: UHC Medicare Advantage |
$702.97
|
| Rate for Payer: UHCCP Medicaid |
$495.74
|
| Rate for Payer: VA VA |
$702.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,108.92
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,811.89
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,957.08 |
| Max. Negotiated Rate |
$2,530.70 |
| Rate for Payer: Aetna Commercial |
$2,390.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,322.34
|
| Rate for Payer: BCN Commercial |
$2,322.34
|
| Rate for Payer: Cash Price |
$2,249.51
|
| Rate for Payer: Cofinity Commercial |
$2,418.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,249.51
|
| Rate for Payer: Healthscope Commercial |
$2,530.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,108.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,390.11
|
| Rate for Payer: Nomi Health Commercial |
$2,305.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,108.92
|
| Rate for Payer: PHP Commercial |
$2,390.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,446.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,957.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,474.46
|
| Rate for Payer: UHC Core |
$2,347.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,108.92
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$679.03
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$119.71 |
| Max. Negotiated Rate |
$611.13 |
| Rate for Payer: Aetna Commercial |
$577.18
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$125.69
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$558.23
|
| Rate for Payer: BCN Commercial |
$558.23
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$543.22
|
| Rate for Payer: Cofinity Commercial |
$583.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$611.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.27
|
| Rate for Payer: Mclaren Medicaid |
$119.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$125.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577.18
|
| Rate for Payer: Nomi Health Commercial |
$556.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$509.27
|
| Rate for Payer: PACE Senior Care Partners |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$577.18
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.76
|
| Rate for Payer: Priority Health Medicare |
$171.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.60
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.55
|
| Rate for Payer: UHC Core |
$566.99
|
| Rate for Payer: UHC Exchange |
$169.76
|
| Rate for Payer: UHC Medicaid |
$119.71
|
| Rate for Payer: UHC Medicare Advantage |
$169.76
|
| Rate for Payer: UHCCP Medicaid |
$119.71
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.27
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$679.03
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$472.60 |
| Max. Negotiated Rate |
$611.13 |
| Rate for Payer: Aetna Commercial |
$577.18
|
| Rate for Payer: BCBS Trust/PPO |
$560.81
|
| Rate for Payer: BCN Commercial |
$560.81
|
| Rate for Payer: Cash Price |
$543.22
|
| Rate for Payer: Cofinity Commercial |
$583.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.22
|
| Rate for Payer: Healthscope Commercial |
$611.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$577.18
|
| Rate for Payer: Nomi Health Commercial |
$556.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$509.27
|
| Rate for Payer: PHP Commercial |
$577.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$590.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$472.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.55
|
| Rate for Payer: UHC Core |
$566.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.27
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,074.74
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$748.02 |
| Max. Negotiated Rate |
$967.27 |
| Rate for Payer: Aetna Commercial |
$913.53
|
| Rate for Payer: BCBS Trust/PPO |
$887.63
|
| Rate for Payer: BCN Commercial |
$887.63
|
| Rate for Payer: Cash Price |
$859.79
|
| Rate for Payer: Cofinity Commercial |
$924.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.79
|
| Rate for Payer: Healthscope Commercial |
$967.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.53
|
| Rate for Payer: Nomi Health Commercial |
$881.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.05
|
| Rate for Payer: PHP Commercial |
$913.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$935.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.77
|
| Rate for Payer: UHC Core |
$897.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.05
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,074.74
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$189.48 |
| Max. Negotiated Rate |
$967.27 |
| Rate for Payer: Aetna Commercial |
$913.53
|
| Rate for Payer: Aetna Medicare |
$279.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.86
|
| Rate for Payer: BCBS Complete |
$198.93
|
| Rate for Payer: BCBS MAPPO |
$268.69
|
| Rate for Payer: BCBS Trust/PPO |
$883.54
|
| Rate for Payer: BCN Commercial |
$883.54
|
| Rate for Payer: BCN Medicare Advantage |
$268.69
|
| Rate for Payer: Cash Price |
$859.79
|
| Rate for Payer: Cofinity Commercial |
$924.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$859.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.69
|
| Rate for Payer: Healthscope Commercial |
$967.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.05
|
| Rate for Payer: Mclaren Medicaid |
$189.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.12
|
| Rate for Payer: Meridian Medicaid |
$198.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$913.53
|
| Rate for Payer: Nomi Health Commercial |
$881.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.05
|
| Rate for Payer: PACE Senior Care Partners |
$255.25
|
| Rate for Payer: PACE SWMI |
$268.69
|
| Rate for Payer: PHP Commercial |
$913.53
|
| Rate for Payer: PHP Medicare Advantage |
$268.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$935.02
|
| Rate for Payer: Priority Health Medicare |
$271.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$748.02
|
| Rate for Payer: Railroad Medicare Medicare |
$268.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$945.77
|
| Rate for Payer: UHC Core |
$897.41
|
| Rate for Payer: UHC Exchange |
$268.69
|
| Rate for Payer: UHC Medicaid |
$189.48
|
| Rate for Payer: UHC Medicare Advantage |
$268.69
|
| Rate for Payer: UHCCP Medicaid |
$189.48
|
| Rate for Payer: VA VA |
$268.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.05
|
|
