|
HC H PYLORI CLARITHRO RESIST PCR, FECES
|
Facility
|
OP
|
$66.75
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600325
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$60.08 |
| Rate for Payer: Aetna Commercial |
$56.74
|
| Rate for Payer: Aetna Medicare |
$17.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.86
|
| Rate for Payer: BCBS Complete |
$12.36
|
| Rate for Payer: BCBS MAPPO |
$16.69
|
| Rate for Payer: BCBS Trust/PPO |
$54.88
|
| Rate for Payer: BCN Commercial |
$54.88
|
| Rate for Payer: BCN Medicare Advantage |
$16.69
|
| Rate for Payer: Cash Price |
$53.40
|
| Rate for Payer: Cofinity Commercial |
$57.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.69
|
| Rate for Payer: Healthscope Commercial |
$60.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.06
|
| Rate for Payer: Mclaren Medicaid |
$11.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.52
|
| Rate for Payer: Meridian Medicaid |
$12.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.74
|
| Rate for Payer: Nomi Health Commercial |
$54.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.06
|
| Rate for Payer: PACE Senior Care Partners |
$15.85
|
| Rate for Payer: PACE SWMI |
$16.69
|
| Rate for Payer: PHP Commercial |
$56.74
|
| Rate for Payer: PHP Medicare Advantage |
$16.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.07
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.46
|
| Rate for Payer: Railroad Medicare Medicare |
$16.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.74
|
| Rate for Payer: UHC Core |
$55.74
|
| Rate for Payer: UHC Exchange |
$16.69
|
| Rate for Payer: UHC Medicaid |
$11.77
|
| Rate for Payer: UHC Medicare Advantage |
$16.69
|
| Rate for Payer: UHCCP Medicaid |
$11.77
|
| Rate for Payer: VA VA |
$16.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.06
|
|
|
HC H PYLORI CLARITHRO RESIST PCR, FECES
|
Facility
|
IP
|
$66.75
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600325
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.46 |
| Max. Negotiated Rate |
$60.08 |
| Rate for Payer: Aetna Commercial |
$56.74
|
| Rate for Payer: BCBS Trust/PPO |
$55.13
|
| Rate for Payer: BCN Commercial |
$55.13
|
| Rate for Payer: Cash Price |
$53.40
|
| Rate for Payer: Cofinity Commercial |
$57.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.40
|
| Rate for Payer: Healthscope Commercial |
$60.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.74
|
| Rate for Payer: Nomi Health Commercial |
$54.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.06
|
| Rate for Payer: PHP Commercial |
$56.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.74
|
| Rate for Payer: UHC Core |
$55.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.06
|
|
|
HC H PYLORI W SUSCEPTIBILITIES
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600333
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.46 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: BCBS Trust/PPO |
$77.68
|
| Rate for Payer: BCN Commercial |
$77.68
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC H PYLORI W SUSCEPTIBILITIES
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600333
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.39
|
| Rate for Payer: BCBS Complete |
$17.41
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$77.32
|
| Rate for Payer: BCN Commercial |
$77.32
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$16.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Meridian Medicaid |
$17.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Senior Care Partners |
$22.34
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: Railroad Medicare Medicare |
$23.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicaid |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$16.58
|
| Rate for Payer: VA VA |
$23.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC HSV 1/2/VZV DETECTION BY NUCLEIC ACID AMP
|
Facility
|
OP
|
$207.06
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600352
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.50 |
| Max. Negotiated Rate |
$186.35 |
| Rate for Payer: Aetna Commercial |
$176.00
|
| Rate for Payer: Aetna Medicare |
$53.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.71
|
| Rate for Payer: BCBS Complete |
$38.33
|
| Rate for Payer: BCBS MAPPO |
$51.77
|
| Rate for Payer: BCBS Trust/PPO |
$170.22
|
| Rate for Payer: BCN Commercial |
$170.22
|
| Rate for Payer: BCN Medicare Advantage |
$51.77
|
| Rate for Payer: Cash Price |
$165.65
|
| Rate for Payer: Cofinity Commercial |
$178.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.77
|
| Rate for Payer: Healthscope Commercial |
$186.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.29
|
| Rate for Payer: Mclaren Medicaid |
$36.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.35
|
| Rate for Payer: Meridian Medicaid |
$38.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.00
|
| Rate for Payer: Nomi Health Commercial |
$169.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.29
|
| Rate for Payer: PACE Senior Care Partners |
$49.18
|
| Rate for Payer: PACE SWMI |
$51.77
|
| Rate for Payer: PHP Commercial |
$176.00
|
| Rate for Payer: PHP Medicare Advantage |
$51.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$180.14
|
| Rate for Payer: Priority Health Medicare |
$52.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.11
|
| Rate for Payer: Railroad Medicare Medicare |
$51.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.21
|
| Rate for Payer: UHC Core |
$172.90
|
| Rate for Payer: UHC Exchange |
$51.77
|
| Rate for Payer: UHC Medicaid |
$36.50
|
| Rate for Payer: UHC Medicare Advantage |
$51.77
|
| Rate for Payer: UHCCP Medicaid |
$36.50
|
| Rate for Payer: VA VA |
$51.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.29
|
|
|
HC HSV 1/2/VZV DETECTION BY NUCLEIC ACID AMP
|
Facility
|
IP
|
$207.06
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600352
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$144.11 |
| Max. Negotiated Rate |
$186.35 |
| Rate for Payer: Aetna Commercial |
$176.00
|
| Rate for Payer: BCBS Trust/PPO |
$171.01
|
| Rate for Payer: BCN Commercial |
$171.01
|
| Rate for Payer: Cash Price |
$165.65
|
| Rate for Payer: Cofinity Commercial |
$178.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.65
|
| Rate for Payer: Healthscope Commercial |
$186.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.00
|
| Rate for Payer: Nomi Health Commercial |
$169.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.29
|
| Rate for Payer: PHP Commercial |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$180.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.21
|
| Rate for Payer: UHC Core |
$172.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.29
|
|
|
HC HSV 1 IGM TITER
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200384
|
|
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 HSV 1 IGM TITER
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200384
|
|
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 HSV 2 IGM TITER
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200385
|
|
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 HSV 2 IGM TITER
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200385
|
|
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 HSV AB IGM BY IFA
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200279
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Senior Care Partners |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Medicare |
$12.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: UHC Exchange |
$12.47
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$12.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC HSV AB IGM BY IFA
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200279
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$41.20
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC HSV CULTURE, NEONATE
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600296
|
|
Hospital Revenue Code
|
306
|
| 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 HSV CULTURE, NEONATE
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600296
|
|
Hospital Revenue Code
|
306
|
| 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 HSV CULTURE, NEONATE CMPT
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600297
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC HSV CULTURE, NEONATE CMPT
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600297
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC HTLV I II ANTIBODY SCREEN,S
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200427
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HTLV I II ANTIBODY SCREEN,S
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200427
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HTLV I II CONFIRMATION
|
Facility
|
OP
|
$164.38
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200276
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.98 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: Aetna Medicare |
$42.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.37
|
| Rate for Payer: BCBS Complete |
$30.43
|
| Rate for Payer: BCBS MAPPO |
$41.09
|
| Rate for Payer: BCBS Trust/PPO |
$135.14
|
| Rate for Payer: BCN Commercial |
$135.14
|
| Rate for Payer: BCN Medicare Advantage |
$41.09
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.09
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Mclaren Medicaid |
$28.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.15
|
| Rate for Payer: Meridian Medicaid |
$30.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.28
|
| Rate for Payer: PACE Senior Care Partners |
$39.04
|
| Rate for Payer: PACE SWMI |
$41.09
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$41.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.01
|
| Rate for Payer: Priority Health Medicare |
$41.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.41
|
| Rate for Payer: Railroad Medicare Medicare |
$41.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.65
|
| Rate for Payer: UHC Core |
$137.26
|
| Rate for Payer: UHC Exchange |
$41.09
|
| Rate for Payer: UHC Medicaid |
$28.98
|
| Rate for Payer: UHC Medicare Advantage |
$41.09
|
| Rate for Payer: UHCCP Medicaid |
$28.98
|
| Rate for Payer: VA VA |
$41.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC HTLV I II CONFIRMATION
|
Facility
|
IP
|
$164.38
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200276
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$114.41 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: BCBS Trust/PPO |
$135.76
|
| Rate for Payer: BCN Commercial |
$135.76
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.28
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.65
|
| Rate for Payer: UHC Core |
$137.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC HUM/AEROSOL CONTINUOUS
|
Facility
|
IP
|
$386.77
|
|
| Hospital Charge Code |
27000115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$269.19 |
| Max. Negotiated Rate |
$348.09 |
| Rate for Payer: Aetna Commercial |
$328.75
|
| Rate for Payer: BCBS Trust/PPO |
$319.43
|
| Rate for Payer: BCN Commercial |
$319.43
|
| Rate for Payer: Cash Price |
$309.42
|
| Rate for Payer: Cofinity Commercial |
$332.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.42
|
| Rate for Payer: Healthscope Commercial |
$348.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.75
|
| Rate for Payer: Nomi Health Commercial |
$317.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.08
|
| Rate for Payer: PHP Commercial |
$328.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$336.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.36
|
| Rate for Payer: UHC Core |
$322.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.08
|
|
|
HC HUM/AEROSOL CONTINUOUS
|
Facility
|
OP
|
$386.77
|
|
| Hospital Charge Code |
27000115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$68.19 |
| Max. Negotiated Rate |
$348.09 |
| Rate for Payer: Aetna Commercial |
$328.75
|
| Rate for Payer: Aetna Medicare |
$100.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.87
|
| Rate for Payer: BCBS Complete |
$71.59
|
| Rate for Payer: BCBS MAPPO |
$96.69
|
| Rate for Payer: BCBS Trust/PPO |
$317.96
|
| Rate for Payer: BCN Commercial |
$317.96
|
| Rate for Payer: BCN Medicare Advantage |
$96.69
|
| Rate for Payer: Cash Price |
$309.42
|
| Rate for Payer: Cofinity Commercial |
$332.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.69
|
| Rate for Payer: Healthscope Commercial |
$348.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.08
|
| Rate for Payer: Mclaren Medicaid |
$68.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.53
|
| Rate for Payer: Meridian Medicaid |
$71.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.75
|
| Rate for Payer: Nomi Health Commercial |
$317.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.08
|
| Rate for Payer: PACE Senior Care Partners |
$91.86
|
| Rate for Payer: PACE SWMI |
$96.69
|
| Rate for Payer: PHP Commercial |
$328.75
|
| Rate for Payer: PHP Medicare Advantage |
$96.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$336.49
|
| Rate for Payer: Priority Health Medicare |
$97.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.19
|
| Rate for Payer: Railroad Medicare Medicare |
$96.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.36
|
| Rate for Payer: UHC Core |
$322.95
|
| Rate for Payer: UHC Exchange |
$96.69
|
| Rate for Payer: UHC Medicaid |
$68.19
|
| Rate for Payer: UHC Medicare Advantage |
$96.69
|
| Rate for Payer: UHCCP Medicaid |
$68.19
|
| Rate for Payer: VA VA |
$96.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.08
|
|
|
HC HUMAN HERPESVIRUS 6 (HHV-6)
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
30600272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HUMAN HERPESVIRUS 6 (HHV-6)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
30600272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HUMAN PAPILLOMAVIRUS HIGH RISK
|
Facility
|
OP
|
$101.05
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
30600221
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.82 |
| Max. Negotiated Rate |
$90.94 |
| Rate for Payer: Aetna Commercial |
$85.89
|
| Rate for Payer: Aetna Medicare |
$26.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.58
|
| Rate for Payer: BCBS Complete |
$18.70
|
| Rate for Payer: BCBS MAPPO |
$25.26
|
| Rate for Payer: BCBS Trust/PPO |
$83.07
|
| Rate for Payer: BCCCP Commercial |
$35.09
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: BCN Medicare Advantage |
$25.26
|
| Rate for Payer: Cash Price |
$80.84
|
| Rate for Payer: Cash Price |
$80.84
|
| Rate for Payer: Cofinity Commercial |
$86.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.26
|
| Rate for Payer: Healthscope Commercial |
$90.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.79
|
| Rate for Payer: Mclaren Medicaid |
$17.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.53
|
| Rate for Payer: Meridian Medicaid |
$18.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.89
|
| Rate for Payer: Nomi Health Commercial |
$82.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.79
|
| Rate for Payer: PACE Senior Care Partners |
$24.00
|
| Rate for Payer: PACE SWMI |
$25.26
|
| Rate for Payer: PHP Commercial |
$85.89
|
| Rate for Payer: PHP Medicare Advantage |
$25.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.91
|
| Rate for Payer: Priority Health Medicare |
$25.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.33
|
| Rate for Payer: Railroad Medicare Medicare |
$25.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.92
|
| Rate for Payer: UHC Core |
$84.38
|
| Rate for Payer: UHC Exchange |
$25.26
|
| Rate for Payer: UHC Medicaid |
$17.82
|
| Rate for Payer: UHC Medicare Advantage |
$25.26
|
| Rate for Payer: UHCCP Medicaid |
$17.82
|
| Rate for Payer: VA VA |
$25.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.79
|
|
