|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
OP
|
$1,226.51
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$291.30 |
| Max. Negotiated Rate |
$1,103.86 |
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna Medicare |
$318.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$383.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$383.28
|
| Rate for Payer: BCBS Complete |
$697.40
|
| Rate for Payer: BCBS MAPPO |
$306.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.31
|
| Rate for Payer: BCN Commercial |
$953.61
|
| Rate for Payer: BCN Medicare Advantage |
$306.63
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.63
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Mclaren Medicaid |
$664.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.96
|
| Rate for Payer: Meridian Medicaid |
$697.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: Nomi Health Commercial |
$1,005.74
|
| Rate for Payer: PACE Senior Care Partners |
$291.30
|
| Rate for Payer: PACE SWMI |
$306.63
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: PHP Medicare Advantage |
$306.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,067.06
|
| Rate for Payer: Priority Health Medicare |
$309.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.76
|
| Rate for Payer: Railroad Medicare Medicare |
$306.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,079.33
|
| Rate for Payer: UHC Core |
$1,024.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.63
|
| Rate for Payer: UHC Exchange |
$306.63
|
| Rate for Payer: UHC Medicare Advantage |
$306.63
|
| Rate for Payer: UHCCP Medicaid |
$664.15
|
| Rate for Payer: VA VA |
$306.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
IP
|
$1,226.51
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$797.23 |
| Max. Negotiated Rate |
$1,103.86 |
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,001.20
|
| Rate for Payer: BCN Commercial |
$947.85
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: Nomi Health Commercial |
$1,005.74
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,067.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,079.33
|
| Rate for Payer: UHC Core |
$1,024.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$29.72
|
| Rate for Payer: BCN Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$28.31
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.39
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.10
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.10
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE SWMI |
$7.10
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.10
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.10
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: BCBS Trust/PPO |
$23.19
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$41.09
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: Nomi Health Commercial |
$40.98
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: Priority Health HMO/PPO |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Exchange |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.50
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$40.80
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: Nomi Health Commercial |
$40.98
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: Priority Health HMO/PPO |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
OP
|
$309.24
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.44 |
| Max. Negotiated Rate |
$278.32 |
| Rate for Payer: Aetna Commercial |
$262.85
|
| Rate for Payer: Aetna Medicare |
$80.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.64
|
| Rate for Payer: BCBS Complete |
$123.70
|
| Rate for Payer: BCBS MAPPO |
$77.31
|
| Rate for Payer: BCBS Trust/PPO |
$254.23
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: BCN Medicare Advantage |
$77.31
|
| Rate for Payer: Cash Price |
$247.39
|
| Rate for Payer: Cofinity Commercial |
$265.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.31
|
| Rate for Payer: Healthscope Commercial |
$278.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.85
|
| Rate for Payer: Nomi Health Commercial |
$253.58
|
| Rate for Payer: PACE Senior Care Partners |
$73.44
|
| Rate for Payer: PACE SWMI |
$77.31
|
| Rate for Payer: PHP Commercial |
$262.85
|
| Rate for Payer: PHP Medicare Advantage |
$77.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.01
|
| Rate for Payer: Priority Health HMO/PPO |
$269.04
|
| Rate for Payer: Priority Health Medicare |
$78.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: Railroad Medicare Medicare |
$77.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.13
|
| Rate for Payer: UHC Core |
$258.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.31
|
| Rate for Payer: UHC Exchange |
$77.31
|
| Rate for Payer: UHC Medicare Advantage |
$77.31
|
| Rate for Payer: VA VA |
$77.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.93
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
IP
|
$309.24
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.01 |
| Max. Negotiated Rate |
$278.32 |
| Rate for Payer: Aetna Commercial |
$262.85
|
| Rate for Payer: BCBS Trust/PPO |
$252.43
|
| Rate for Payer: BCN Commercial |
$238.98
|
| Rate for Payer: Cash Price |
$247.39
|
| Rate for Payer: Cofinity Commercial |
$265.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.39
|
| Rate for Payer: Healthscope Commercial |
$278.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.85
|
| Rate for Payer: Nomi Health Commercial |
$253.58
|
| Rate for Payer: PHP Commercial |
$262.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.01
|
| Rate for Payer: Priority Health HMO/PPO |
$269.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.13
|
| Rate for Payer: UHC Core |
$258.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.93
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: BCBS Complete |
$7.36
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$7.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: Meridian Medicaid |
$7.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Medicare |
$13.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.22
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$7.01
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: BCBS Trust/PPO |
$44.13
|
| Rate for Payer: BCN Commercial |
$41.78
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
IP
|
$82.62
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.70 |
| Max. Negotiated Rate |
$74.36 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: BCBS Trust/PPO |
$67.44
|
| Rate for Payer: BCN Commercial |
$63.85
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Nomi Health Commercial |
$67.75
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.70
|
| Rate for Payer: Priority Health HMO/PPO |
$71.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.71
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.96
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
OP
|
$82.62
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$74.36 |
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$21.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.82
|
| Rate for Payer: BCBS Complete |
$10.85
|
| Rate for Payer: BCBS MAPPO |
$20.66
|
| Rate for Payer: BCBS Trust/PPO |
$67.92
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.66
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.66
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.96
|
| Rate for Payer: Mclaren Medicaid |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.69
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: Nomi Health Commercial |
$67.75
|
| Rate for Payer: PACE Senior Care Partners |
$19.62
|
| Rate for Payer: PACE SWMI |
$20.66
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: PHP Medicare Advantage |
$20.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.70
|
| Rate for Payer: Priority Health HMO/PPO |
$71.88
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.36
|
| Rate for Payer: Railroad Medicare Medicare |
$20.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.71
|
| Rate for Payer: UHC Core |
$68.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.66
|
| Rate for Payer: UHC Exchange |
$20.66
|
| Rate for Payer: UHC Medicare Advantage |
$20.66
|
| Rate for Payer: UHCCP Medicaid |
$10.33
|
| Rate for Payer: VA VA |
$20.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.96
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
OP
|
$135.98
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$32.30 |
| Max. Negotiated Rate |
$122.38 |
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: Aetna Medicare |
$35.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.49
|
| Rate for Payer: BCBS Complete |
$54.39
|
| Rate for Payer: BCBS MAPPO |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$111.79
|
| Rate for Payer: BCN Commercial |
$105.72
|
| Rate for Payer: BCN Medicare Advantage |
$34.00
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.00
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: Nomi Health Commercial |
$111.50
|
| Rate for Payer: PACE Senior Care Partners |
$32.30
|
| Rate for Payer: PACE SWMI |
$34.00
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: PHP Medicare Advantage |
$34.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health HMO/PPO |
$118.30
|
| Rate for Payer: Priority Health Medicare |
$34.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.11
|
| Rate for Payer: Railroad Medicare Medicare |
$34.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.66
|
| Rate for Payer: UHC Core |
$113.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.00
|
| Rate for Payer: UHC Exchange |
$34.00
|
| Rate for Payer: UHC Medicare Advantage |
$34.00
|
| Rate for Payer: VA VA |
$34.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
IP
|
$135.98
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$88.39 |
| Max. Negotiated Rate |
$122.38 |
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: BCBS Trust/PPO |
$111.00
|
| Rate for Payer: BCN Commercial |
$105.09
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: Nomi Health Commercial |
$111.50
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health HMO/PPO |
$118.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.66
|
| Rate for Payer: UHC Core |
$113.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$2.83
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC GLUCOSE BODY FLUID NOT BLOOD
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
30100222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$2.84
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC GLUCOSE BODY FLUID NOT BLOOD
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
30100222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC GLUCOSE LEVEL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC GLUCOSE LEVEL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100223
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$2.84
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
30100224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$37.80
|
| Rate for Payer: BCN Commercial |
$35.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO |
$40.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
30100224
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$12.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.47
|
| Rate for Payer: BCBS Complete |
$3.61
|
| Rate for Payer: BCBS MAPPO |
$11.58
|
| Rate for Payer: BCBS Trust/PPO |
$38.07
|
| Rate for Payer: BCN Commercial |
$36.01
|
| Rate for Payer: BCN Medicare Advantage |
$11.58
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.58
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$3.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.16
|
| Rate for Payer: Meridian Medicaid |
$3.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$37.97
|
| Rate for Payer: PACE Senior Care Partners |
$11.00
|
| Rate for Payer: PACE SWMI |
$11.58
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$11.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO |
$40.29
|
| Rate for Payer: Priority Health Medicare |
$11.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.58
|
| Rate for Payer: UHC Exchange |
$11.58
|
| Rate for Payer: UHC Medicare Advantage |
$11.58
|
| Rate for Payer: UHCCP Medicaid |
$3.43
|
| Rate for Payer: VA VA |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC GLUCOSE QUANT BLOOD EXCPT REAGENT STRIP
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
30100753
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$2.84
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
