|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$3.33
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Meridian Medicaid |
$3.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: UHCCP Medicaid |
$3.17
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC FECAL OCCULT BLOOD PEROXIDASE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
30100121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC FECAL PH
|
Facility
|
OP
|
$23.93
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna Medicare |
$6.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.48
|
| Rate for Payer: BCBS Complete |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$5.98
|
| Rate for Payer: BCBS Trust/PPO |
$19.67
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: BCN Medicare Advantage |
$5.98
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.98
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Mclaren Medicaid |
$2.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.28
|
| Rate for Payer: Meridian Medicaid |
$2.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.68
|
| Rate for Payer: PACE SWMI |
$5.98
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.98
|
| Rate for Payer: UHC Exchange |
$5.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.98
|
| Rate for Payer: UHCCP Medicaid |
$2.59
|
| Rate for Payer: VA VA |
$5.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC FECAL PH
|
Facility
|
IP
|
$23.93
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100491
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: BCBS Trust/PPO |
$19.53
|
| Rate for Payer: BCN Commercial |
$18.49
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$13.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.03
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS MAPPO |
$12.83
|
| Rate for Payer: BCBS Trust/PPO |
$42.18
|
| Rate for Payer: BCN Commercial |
$39.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.83
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.83
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$3.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.47
|
| Rate for Payer: Meridian Medicaid |
$4.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PACE Senior Care Partners |
$12.19
|
| Rate for Payer: PACE SWMI |
$12.83
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Medicare |
$12.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: Railroad Medicare Medicare |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.83
|
| Rate for Payer: UHC Exchange |
$12.83
|
| Rate for Payer: UHC Medicare Advantage |
$12.83
|
| Rate for Payer: UHCCP Medicaid |
$3.98
|
| Rate for Payer: VA VA |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.35 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
IP
|
$75.33
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.96 |
| Max. Negotiated Rate |
$67.80 |
| Rate for Payer: Aetna Commercial |
$64.03
|
| Rate for Payer: BCBS Trust/PPO |
$61.49
|
| Rate for Payer: BCN Commercial |
$58.22
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cofinity Commercial |
$64.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.26
|
| Rate for Payer: Healthscope Commercial |
$67.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.03
|
| Rate for Payer: Nomi Health Commercial |
$61.77
|
| Rate for Payer: PHP Commercial |
$64.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.96
|
| Rate for Payer: Priority Health HMO/PPO |
$65.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.29
|
| Rate for Payer: UHC Core |
$62.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.50
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
OP
|
$75.33
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.24 |
| Max. Negotiated Rate |
$67.80 |
| Rate for Payer: Aetna Commercial |
$64.03
|
| Rate for Payer: Aetna Medicare |
$19.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.54
|
| Rate for Payer: BCBS Complete |
$14.96
|
| Rate for Payer: BCBS MAPPO |
$18.83
|
| Rate for Payer: BCBS Trust/PPO |
$61.93
|
| Rate for Payer: BCN Commercial |
$58.57
|
| Rate for Payer: BCN Medicare Advantage |
$18.83
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cofinity Commercial |
$64.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.83
|
| Rate for Payer: Healthscope Commercial |
$67.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.50
|
| Rate for Payer: Mclaren Medicaid |
$14.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.77
|
| Rate for Payer: Meridian Medicaid |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.03
|
| Rate for Payer: Nomi Health Commercial |
$61.77
|
| Rate for Payer: PACE Senior Care Partners |
$17.89
|
| Rate for Payer: PACE SWMI |
$18.83
|
| Rate for Payer: PHP Commercial |
$64.03
|
| Rate for Payer: PHP Medicare Advantage |
$18.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.96
|
| Rate for Payer: Priority Health HMO/PPO |
$65.54
|
| Rate for Payer: Priority Health Medicare |
$19.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.47
|
| Rate for Payer: Railroad Medicare Medicare |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.29
|
| Rate for Payer: UHC Core |
$62.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.83
|
| Rate for Payer: UHC Exchange |
$18.83
|
| Rate for Payer: UHC Medicare Advantage |
$18.83
|
| Rate for Payer: UHCCP Medicaid |
$14.24
|
| Rate for Payer: VA VA |
$18.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.50
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC FEMOSTOP
|
Facility
|
OP
|
$479.81
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$113.95 |
| Max. Negotiated Rate |
$431.83 |
| Rate for Payer: Aetna Commercial |
$407.84
|
| Rate for Payer: Aetna Medicare |
$124.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.94
|
| Rate for Payer: BCBS Complete |
$191.92
|
| Rate for Payer: BCBS MAPPO |
$119.95
|
| Rate for Payer: BCBS Trust/PPO |
$394.45
|
| Rate for Payer: BCN Commercial |
$373.05
|
| Rate for Payer: BCN Medicare Advantage |
$119.95
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cofinity Commercial |
$412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.95
|
| Rate for Payer: Healthscope Commercial |
$431.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.84
|
| Rate for Payer: Nomi Health Commercial |
$393.44
|
| Rate for Payer: PACE Senior Care Partners |
$113.95
|
| Rate for Payer: PACE SWMI |
$119.95
|
| Rate for Payer: PHP Commercial |
$407.84
|
| Rate for Payer: PHP Medicare Advantage |
$119.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.88
|
| Rate for Payer: Priority Health HMO/PPO |
$417.43
|
| Rate for Payer: Priority Health Medicare |
$121.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.47
|
| Rate for Payer: Railroad Medicare Medicare |
$119.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.23
|
| Rate for Payer: UHC Core |
$400.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.95
|
| Rate for Payer: UHC Exchange |
$119.95
|
| Rate for Payer: UHC Medicare Advantage |
$119.95
|
| Rate for Payer: VA VA |
$119.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.86
|
|
|
HC FEMOSTOP
|
Facility
|
IP
|
$479.81
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$311.88 |
| Max. Negotiated Rate |
$431.83 |
| Rate for Payer: Aetna Commercial |
$407.84
|
| Rate for Payer: BCBS Trust/PPO |
$391.67
|
| Rate for Payer: BCN Commercial |
$370.80
|
| Rate for Payer: Cash Price |
$383.85
|
| Rate for Payer: Cofinity Commercial |
$412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.85
|
| Rate for Payer: Healthscope Commercial |
$431.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$407.84
|
| Rate for Payer: Nomi Health Commercial |
$393.44
|
| Rate for Payer: PHP Commercial |
$407.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$311.88
|
| Rate for Payer: Priority Health HMO/PPO |
$417.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.23
|
| Rate for Payer: UHC Core |
$400.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.86
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
IP
|
$356.50
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.72 |
| Max. Negotiated Rate |
$320.85 |
| Rate for Payer: Aetna Commercial |
$303.02
|
| Rate for Payer: BCBS Trust/PPO |
$291.01
|
| Rate for Payer: BCN Commercial |
$275.50
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cofinity Commercial |
$306.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.20
|
| Rate for Payer: Healthscope Commercial |
$320.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.02
|
| Rate for Payer: Nomi Health Commercial |
$292.33
|
| Rate for Payer: PHP Commercial |
$303.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.72
|
| Rate for Payer: Priority Health HMO/PPO |
$310.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.72
|
| Rate for Payer: UHC Core |
$297.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.38
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
OP
|
$356.50
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$320.85 |
| Rate for Payer: Aetna Commercial |
$303.02
|
| Rate for Payer: Aetna Medicare |
$92.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.41
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$89.12
|
| Rate for Payer: BCBS Trust/PPO |
$293.08
|
| Rate for Payer: BCN Commercial |
$277.18
|
| Rate for Payer: BCN Medicare Advantage |
$89.12
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cofinity Commercial |
$306.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.12
|
| Rate for Payer: Healthscope Commercial |
$320.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.38
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.58
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.02
|
| Rate for Payer: Nomi Health Commercial |
$292.33
|
| Rate for Payer: PACE Senior Care Partners |
$84.67
|
| Rate for Payer: PACE SWMI |
$89.12
|
| Rate for Payer: PHP Commercial |
$303.02
|
| Rate for Payer: PHP Medicare Advantage |
$89.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.72
|
| Rate for Payer: Priority Health HMO/PPO |
$310.15
|
| Rate for Payer: Priority Health Medicare |
$90.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.85
|
| Rate for Payer: Railroad Medicare Medicare |
$89.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.72
|
| Rate for Payer: UHC Core |
$297.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.12
|
| Rate for Payer: UHC Exchange |
$89.12
|
| Rate for Payer: UHC Medicare Advantage |
$89.12
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$89.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.38
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
OP
|
$356.50
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$320.85 |
| Rate for Payer: Aetna Commercial |
$303.02
|
| Rate for Payer: Aetna Medicare |
$92.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.41
|
| Rate for Payer: BCBS Complete |
$66.85
|
| Rate for Payer: BCBS MAPPO |
$89.12
|
| Rate for Payer: BCBS Trust/PPO |
$293.08
|
| Rate for Payer: BCN Commercial |
$277.18
|
| Rate for Payer: BCN Medicare Advantage |
$89.12
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cofinity Commercial |
$306.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.12
|
| Rate for Payer: Healthscope Commercial |
$320.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.38
|
| Rate for Payer: Mclaren Medicaid |
$63.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.58
|
| Rate for Payer: Meridian Medicaid |
$66.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.02
|
| Rate for Payer: Nomi Health Commercial |
$292.33
|
| Rate for Payer: PACE Senior Care Partners |
$84.67
|
| Rate for Payer: PACE SWMI |
$89.12
|
| Rate for Payer: PHP Commercial |
$303.02
|
| Rate for Payer: PHP Medicare Advantage |
$89.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.72
|
| Rate for Payer: Priority Health HMO/PPO |
$310.15
|
| Rate for Payer: Priority Health Medicare |
$90.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.85
|
| Rate for Payer: Railroad Medicare Medicare |
$89.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.72
|
| Rate for Payer: UHC Core |
$297.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.12
|
| Rate for Payer: UHC Exchange |
$89.12
|
| Rate for Payer: UHC Medicare Advantage |
$89.12
|
| Rate for Payer: UHCCP Medicaid |
$63.66
|
| Rate for Payer: VA VA |
$89.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.38
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
IP
|
$356.50
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.72 |
| Max. Negotiated Rate |
$320.85 |
| Rate for Payer: Aetna Commercial |
$303.02
|
| Rate for Payer: BCBS Trust/PPO |
$291.01
|
| Rate for Payer: BCN Commercial |
$275.50
|
| Rate for Payer: Cash Price |
$285.20
|
| Rate for Payer: Cofinity Commercial |
$306.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.20
|
| Rate for Payer: Healthscope Commercial |
$320.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.02
|
| Rate for Payer: Nomi Health Commercial |
$292.33
|
| Rate for Payer: PHP Commercial |
$303.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.72
|
| Rate for Payer: Priority Health HMO/PPO |
$310.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.72
|
| Rate for Payer: UHC Core |
$297.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.38
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
IP
|
$202.98
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$131.94 |
| Max. Negotiated Rate |
$182.68 |
| Rate for Payer: Aetna Commercial |
$172.53
|
| Rate for Payer: BCBS Trust/PPO |
$165.69
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$174.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Healthscope Commercial |
$182.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.53
|
| Rate for Payer: Nomi Health Commercial |
$166.44
|
| Rate for Payer: PHP Commercial |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.94
|
| Rate for Payer: Priority Health HMO/PPO |
$176.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.62
|
| Rate for Payer: UHC Core |
$169.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.24
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
OP
|
$202.98
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.21 |
| Max. Negotiated Rate |
$182.68 |
| Rate for Payer: Aetna Commercial |
$172.53
|
| Rate for Payer: Aetna Medicare |
$52.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.43
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$50.74
|
| Rate for Payer: BCBS Trust/PPO |
$166.87
|
| Rate for Payer: BCN Commercial |
$157.82
|
| Rate for Payer: BCN Medicare Advantage |
$50.74
|
| Rate for Payer: Cash Price |
$162.38
|
| Rate for Payer: Cofinity Commercial |
$174.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.74
|
| Rate for Payer: Healthscope Commercial |
$182.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.53
|
| Rate for Payer: Nomi Health Commercial |
$166.44
|
| Rate for Payer: PACE Senior Care Partners |
$48.21
|
| Rate for Payer: PACE SWMI |
$50.74
|
| Rate for Payer: PHP Commercial |
$172.53
|
| Rate for Payer: PHP Medicare Advantage |
$50.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.94
|
| Rate for Payer: Priority Health HMO/PPO |
$176.59
|
| Rate for Payer: Priority Health Medicare |
$51.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.00
|
| Rate for Payer: Railroad Medicare Medicare |
$50.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.62
|
| Rate for Payer: UHC Core |
$169.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.74
|
| Rate for Payer: UHC Exchange |
$50.74
|
| Rate for Payer: UHC Medicare Advantage |
$50.74
|
| Rate for Payer: VA VA |
$50.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.24
|
|
|
HC FENTANYL UR
|
Facility
|
OP
|
$234.60
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.72 |
| Max. Negotiated Rate |
$211.14 |
| Rate for Payer: Aetna Commercial |
$199.41
|
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.31
|
| Rate for Payer: BCBS Complete |
$93.84
|
| Rate for Payer: BCBS MAPPO |
$58.65
|
| Rate for Payer: BCBS Trust/PPO |
$192.86
|
| Rate for Payer: BCN Commercial |
$182.40
|
| Rate for Payer: BCN Medicare Advantage |
$58.65
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$201.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.65
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.41
|
| Rate for Payer: Nomi Health Commercial |
$192.37
|
| Rate for Payer: PACE Senior Care Partners |
$55.72
|
| Rate for Payer: PACE SWMI |
$58.65
|
| Rate for Payer: PHP Commercial |
$199.41
|
| Rate for Payer: PHP Medicare Advantage |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.49
|
| Rate for Payer: Priority Health HMO/PPO |
$204.10
|
| Rate for Payer: Priority Health Medicare |
$59.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.18
|
| Rate for Payer: Railroad Medicare Medicare |
$58.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.45
|
| Rate for Payer: UHC Core |
$195.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.65
|
| Rate for Payer: UHC Exchange |
$58.65
|
| Rate for Payer: UHC Medicare Advantage |
$58.65
|
| Rate for Payer: VA VA |
$58.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.95
|
|
|
HC FENTANYL UR
|
Facility
|
IP
|
$234.60
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$152.49 |
| Max. Negotiated Rate |
$211.14 |
| Rate for Payer: Aetna Commercial |
$199.41
|
| Rate for Payer: BCBS Trust/PPO |
$191.50
|
| Rate for Payer: BCN Commercial |
$181.30
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$201.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.41
|
| Rate for Payer: Nomi Health Commercial |
$192.37
|
| Rate for Payer: PHP Commercial |
$199.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.49
|
| Rate for Payer: Priority Health HMO/PPO |
$204.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.45
|
| Rate for Payer: UHC Core |
$195.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.95
|
|
|
HC FENTANYL URINE.
|
Facility
|
IP
|
$97.31
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.25 |
| Max. Negotiated Rate |
$87.58 |
| Rate for Payer: Aetna Commercial |
$82.71
|
| Rate for Payer: BCBS Trust/PPO |
$79.43
|
| Rate for Payer: BCN Commercial |
$75.20
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cofinity Commercial |
$83.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.85
|
| Rate for Payer: Healthscope Commercial |
$87.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.71
|
| Rate for Payer: Nomi Health Commercial |
$79.79
|
| Rate for Payer: PHP Commercial |
$82.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.25
|
| Rate for Payer: Priority Health HMO/PPO |
$84.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.63
|
| Rate for Payer: UHC Core |
$81.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.98
|
|
|
HC FENTANYL URINE.
|
Facility
|
OP
|
$97.31
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.11 |
| Max. Negotiated Rate |
$87.58 |
| Rate for Payer: Aetna Commercial |
$82.71
|
| Rate for Payer: Aetna Medicare |
$25.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.41
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$24.33
|
| Rate for Payer: BCBS Trust/PPO |
$80.00
|
| Rate for Payer: BCN Commercial |
$75.66
|
| Rate for Payer: BCN Medicare Advantage |
$24.33
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cofinity Commercial |
$83.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.33
|
| Rate for Payer: Healthscope Commercial |
$87.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.98
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.54
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.71
|
| Rate for Payer: Nomi Health Commercial |
$79.79
|
| Rate for Payer: PACE Senior Care Partners |
$23.11
|
| Rate for Payer: PACE SWMI |
$24.33
|
| Rate for Payer: PHP Commercial |
$82.71
|
| Rate for Payer: PHP Medicare Advantage |
$24.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.25
|
| Rate for Payer: Priority Health HMO/PPO |
$84.66
|
| Rate for Payer: Priority Health Medicare |
$24.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.20
|
| Rate for Payer: Railroad Medicare Medicare |
$24.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.63
|
| Rate for Payer: UHC Core |
$81.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.33
|
| Rate for Payer: UHC Exchange |
$24.33
|
| Rate for Payer: UHC Medicare Advantage |
$24.33
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$24.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.98
|
|
|
HC FERRITIN LEVEL
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC FERRITIN LEVEL
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC FETAL BIOPHYSICAL PROFILE
|
Facility
|
IP
|
$341.25
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
40200080
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$221.81 |
| Max. Negotiated Rate |
$307.12 |
| Rate for Payer: Aetna Commercial |
$290.06
|
| Rate for Payer: BCBS Trust/PPO |
$278.56
|
| Rate for Payer: BCN Commercial |
$263.72
|
| Rate for Payer: Cash Price |
$273.00
|
| Rate for Payer: Cofinity Commercial |
$293.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$273.00
|
| Rate for Payer: Healthscope Commercial |
$307.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$290.06
|
| Rate for Payer: Nomi Health Commercial |
$279.82
|
| Rate for Payer: PHP Commercial |
$290.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.81
|
| Rate for Payer: Priority Health HMO/PPO |
$296.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$300.30
|
| Rate for Payer: UHC Core |
$284.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.94
|
|
