|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,613.56
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,648.81 |
| Max. Negotiated Rate |
$5,052.20 |
| Rate for Payer: Aetna Commercial |
$4,771.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,582.35
|
| Rate for Payer: BCN Commercial |
$4,338.16
|
| Rate for Payer: Cash Price |
$4,490.85
|
| Rate for Payer: Cofinity Commercial |
$4,827.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,490.85
|
| Rate for Payer: Healthscope Commercial |
$5,052.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,210.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,771.53
|
| Rate for Payer: Nomi Health Commercial |
$4,603.12
|
| Rate for Payer: PHP Commercial |
$4,771.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,648.81
|
| Rate for Payer: Priority Health HMO/PPO |
$4,883.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,761.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,939.93
|
| Rate for Payer: UHC Core |
$4,687.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,210.17
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$125.65
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$113.08 |
| Rate for Payer: Aetna Commercial |
$106.80
|
| Rate for Payer: Aetna Medicare |
$32.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.27
|
| Rate for Payer: BCBS Complete |
$50.26
|
| Rate for Payer: BCBS MAPPO |
$31.41
|
| Rate for Payer: BCBS Trust/PPO |
$103.30
|
| Rate for Payer: BCN Commercial |
$97.69
|
| Rate for Payer: BCN Medicare Advantage |
$31.41
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$108.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$113.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.80
|
| Rate for Payer: Nomi Health Commercial |
$103.03
|
| Rate for Payer: PACE Senior Care Partners |
$29.84
|
| Rate for Payer: PACE SWMI |
$31.41
|
| Rate for Payer: PHP Commercial |
$106.80
|
| Rate for Payer: PHP Medicare Advantage |
$31.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.67
|
| Rate for Payer: Priority Health HMO/PPO |
$109.32
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.19
|
| Rate for Payer: Railroad Medicare Medicare |
$31.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.57
|
| Rate for Payer: UHC Core |
$104.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.41
|
| Rate for Payer: UHC Exchange |
$31.41
|
| Rate for Payer: UHC Medicare Advantage |
$31.41
|
| Rate for Payer: VA VA |
$31.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.24
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$125.65
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$81.67 |
| Max. Negotiated Rate |
$113.08 |
| Rate for Payer: Aetna Commercial |
$106.80
|
| Rate for Payer: BCBS Trust/PPO |
$102.57
|
| Rate for Payer: BCN Commercial |
$97.10
|
| Rate for Payer: Cash Price |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$108.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.52
|
| Rate for Payer: Healthscope Commercial |
$113.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.80
|
| Rate for Payer: Nomi Health Commercial |
$103.03
|
| Rate for Payer: PHP Commercial |
$106.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.67
|
| Rate for Payer: Priority Health HMO/PPO |
$109.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.57
|
| Rate for Payer: UHC Core |
$104.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.24
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$67.42
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.82 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$57.31
|
| Rate for Payer: BCBS Trust/PPO |
$55.03
|
| Rate for Payer: BCN Commercial |
$52.10
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$57.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Healthscope Commercial |
$60.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$57.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO |
$58.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.33
|
| Rate for Payer: UHC Core |
$56.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.56
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$67.42
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$57.31
|
| Rate for Payer: Aetna Medicare |
$17.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.07
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$16.86
|
| Rate for Payer: BCBS Trust/PPO |
$55.43
|
| Rate for Payer: BCN Commercial |
$52.42
|
| Rate for Payer: BCN Medicare Advantage |
$16.86
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$57.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.86
|
| Rate for Payer: Healthscope Commercial |
$60.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.56
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.70
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PACE Senior Care Partners |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.86
|
| Rate for Payer: PHP Commercial |
$57.31
|
| Rate for Payer: PHP Medicare Advantage |
$16.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO |
$58.66
|
| Rate for Payer: Priority Health Medicare |
$17.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.17
|
| Rate for Payer: Railroad Medicare Medicare |
$16.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.33
|
| Rate for Payer: UHC Core |
$56.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.86
|
| Rate for Payer: UHC Exchange |
$16.86
|
| Rate for Payer: UHC Medicare Advantage |
$16.86
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$16.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.56
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$67.42
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.82 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$57.31
|
| Rate for Payer: BCBS Trust/PPO |
$55.03
|
| Rate for Payer: BCN Commercial |
$52.10
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$57.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Healthscope Commercial |
$60.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PHP Commercial |
$57.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO |
$58.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.33
|
| Rate for Payer: UHC Core |
$56.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.56
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$67.42
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$57.31
|
| Rate for Payer: Aetna Medicare |
$17.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.07
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$16.86
|
| Rate for Payer: BCBS Trust/PPO |
$55.43
|
| Rate for Payer: BCN Commercial |
$52.42
|
| Rate for Payer: BCN Medicare Advantage |
$16.86
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cash Price |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$57.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.86
|
| Rate for Payer: Healthscope Commercial |
$60.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.56
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.70
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.31
|
| Rate for Payer: Nomi Health Commercial |
$55.28
|
| Rate for Payer: PACE Senior Care Partners |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.86
|
| Rate for Payer: PHP Commercial |
$57.31
|
| Rate for Payer: PHP Medicare Advantage |
$16.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.82
|
| Rate for Payer: Priority Health HMO/PPO |
$58.66
|
| Rate for Payer: Priority Health Medicare |
$17.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.17
|
| Rate for Payer: Railroad Medicare Medicare |
$16.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.33
|
| Rate for Payer: UHC Core |
$56.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.86
|
| Rate for Payer: UHC Exchange |
$16.86
|
| Rate for Payer: UHC Medicare Advantage |
$16.86
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$16.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.56
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.70
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.54
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$9.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$9.33
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 2
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$8.71
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.54
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$8.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$8.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$8.29
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 2
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$33.46
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 3
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.47
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.97
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT 3
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200287
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC FUNGITELL ASSAY
|
Facility
|
OP
|
$158.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$142.29 |
| Rate for Payer: Aetna Commercial |
$134.38
|
| Rate for Payer: Aetna Medicare |
$41.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.41
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$39.52
|
| Rate for Payer: BCBS Trust/PPO |
$129.97
|
| Rate for Payer: BCN Commercial |
$122.92
|
| Rate for Payer: BCN Medicare Advantage |
$39.52
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$135.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.52
|
| Rate for Payer: Healthscope Commercial |
$142.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.58
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.50
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: PACE Senior Care Partners |
$37.55
|
| Rate for Payer: PACE SWMI |
$39.52
|
| Rate for Payer: PHP Commercial |
$134.38
|
| Rate for Payer: PHP Medicare Advantage |
$39.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.77
|
| Rate for Payer: Priority Health HMO/PPO |
$137.55
|
| Rate for Payer: Priority Health Medicare |
$39.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.93
|
| Rate for Payer: Railroad Medicare Medicare |
$39.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.13
|
| Rate for Payer: UHC Core |
$132.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.52
|
| Rate for Payer: UHC Exchange |
$39.52
|
| Rate for Payer: UHC Medicare Advantage |
$39.52
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$39.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.58
|
|
|
HC FUNGITELL ASSAY
|
Facility
|
IP
|
$158.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$102.77 |
| Max. Negotiated Rate |
$142.29 |
| Rate for Payer: Aetna Commercial |
$134.38
|
| Rate for Payer: BCBS Trust/PPO |
$129.06
|
| Rate for Payer: BCN Commercial |
$122.18
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$135.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Healthscope Commercial |
$142.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: PHP Commercial |
$134.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.77
|
| Rate for Payer: Priority Health HMO/PPO |
$137.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.13
|
| Rate for Payer: UHC Core |
$132.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.58
|
|
|
HC FUSARIUM PROLIFERATUM IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200085
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC FUSARIUM PROLIFERATUM IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200085
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC GABA-B-R AB CBA, SERUM
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200418
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$331.50 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: BCBS Trust/PPO |
$416.31
|
| Rate for Payer: BCN Commercial |
$394.13
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.50
|
| Rate for Payer: Nomi Health Commercial |
$418.20
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO |
$443.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC GABA-B-R AB CBA, SERUM
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200418
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: Aetna Medicare |
$132.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.38
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$419.27
|
| Rate for Payer: BCN Commercial |
$396.52
|
| Rate for Payer: BCN Medicare Advantage |
$127.50
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.50
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.88
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.50
|
| Rate for Payer: Nomi Health Commercial |
$418.20
|
| Rate for Payer: PACE Senior Care Partners |
$121.12
|
| Rate for Payer: PACE SWMI |
$127.50
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: PHP Medicare Advantage |
$127.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
| Rate for Payer: Priority Health HMO/PPO |
$443.70
|
| Rate for Payer: Priority Health Medicare |
$128.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$341.70
|
| Rate for Payer: Railroad Medicare Medicare |
$127.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.80
|
| Rate for Payer: UHC Core |
$425.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.50
|
| Rate for Payer: UHC Exchange |
$127.50
|
| Rate for Payer: UHC Medicare Advantage |
$127.50
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$127.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC GABA-B-R AB IF TITER ASSAY, S
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200419
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC GABA-B-R AB IF TITER ASSAY, S
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200419
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC GABAPENTIN LEVEL NEURONTIN
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 80171
|
| Hospital Charge Code |
30100160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$16.45
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$15.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$16.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.22
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$15.67
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC GABAPENTIN LEVEL NEURONTIN
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 80171
|
| Hospital Charge Code |
30100160
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$37.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
