|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
IP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$313.14 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: BCBS Trust/PPO |
$393.26
|
| Rate for Payer: BCN Commercial |
$372.30
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
OP
|
$481.76
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$433.58 |
| Rate for Payer: Aetna Commercial |
$409.50
|
| Rate for Payer: Aetna Medicare |
$125.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.55
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$120.44
|
| Rate for Payer: BCBS Trust/PPO |
$396.05
|
| Rate for Payer: BCN Commercial |
$374.57
|
| Rate for Payer: BCN Medicare Advantage |
$120.44
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cash Price |
$385.41
|
| Rate for Payer: Cofinity Commercial |
$414.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.44
|
| Rate for Payer: Healthscope Commercial |
$433.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.32
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.46
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.50
|
| Rate for Payer: Nomi Health Commercial |
$395.04
|
| Rate for Payer: PACE Senior Care Partners |
$114.42
|
| Rate for Payer: PACE SWMI |
$120.44
|
| Rate for Payer: PHP Commercial |
$409.50
|
| Rate for Payer: PHP Medicare Advantage |
$120.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.14
|
| Rate for Payer: Priority Health HMO/PPO |
$419.13
|
| Rate for Payer: Priority Health Medicare |
$121.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$322.78
|
| Rate for Payer: Railroad Medicare Medicare |
$120.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.95
|
| Rate for Payer: UHC Core |
$402.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.44
|
| Rate for Payer: UHC Exchange |
$120.44
|
| Rate for Payer: UHC Medicare Advantage |
$120.44
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$120.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.32
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: BCBS Trust/PPO |
$442.43
|
| Rate for Payer: BCN Commercial |
$418.85
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna Medicare |
$140.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.37
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$135.50
|
| Rate for Payer: BCBS Trust/PPO |
$445.57
|
| Rate for Payer: BCN Commercial |
$421.40
|
| Rate for Payer: BCN Medicare Advantage |
$135.50
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.50
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.27
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PACE Senior Care Partners |
$128.72
|
| Rate for Payer: PACE SWMI |
$135.50
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: PHP Medicare Advantage |
$135.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Medicare |
$136.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: Railroad Medicare Medicare |
$135.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.50
|
| Rate for Payer: UHC Exchange |
$135.50
|
| Rate for Payer: UHC Medicare Advantage |
$135.50
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$135.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.75 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: Aetna Medicare |
$39.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.04
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$37.64
|
| Rate for Payer: BCBS Trust/PPO |
$123.76
|
| Rate for Payer: BCN Commercial |
$117.04
|
| Rate for Payer: BCN Medicare Advantage |
$37.64
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.64
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.52
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PACE Senior Care Partners |
$35.75
|
| Rate for Payer: PACE SWMI |
$37.64
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Medicare |
$38.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: Railroad Medicare Medicare |
$37.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.64
|
| Rate for Payer: UHC Exchange |
$37.64
|
| Rate for Payer: UHC Medicare Advantage |
$37.64
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$37.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$150.54
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Aetna Commercial |
$127.96
|
| Rate for Payer: BCBS Trust/PPO |
$122.89
|
| Rate for Payer: BCN Commercial |
$116.34
|
| Rate for Payer: Cash Price |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$129.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.43
|
| Rate for Payer: Healthscope Commercial |
$135.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.96
|
| Rate for Payer: Nomi Health Commercial |
$123.44
|
| Rate for Payer: PHP Commercial |
$127.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.85
|
| Rate for Payer: Priority Health HMO/PPO |
$130.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.48
|
| Rate for Payer: UHC Core |
$125.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.90
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$270.99 |
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: Aetna Medicare |
$78.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.09
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$75.28
|
| Rate for Payer: BCBS Trust/PPO |
$247.53
|
| Rate for Payer: BCN Commercial |
$234.11
|
| Rate for Payer: BCN Medicare Advantage |
$75.28
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.28
|
| Rate for Payer: Healthscope Commercial |
$270.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.82
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.04
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: PACE Senior Care Partners |
$71.51
|
| Rate for Payer: PACE SWMI |
$75.28
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: PHP Medicare Advantage |
$75.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health HMO/PPO |
$261.96
|
| Rate for Payer: Priority Health Medicare |
$76.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.74
|
| Rate for Payer: Railroad Medicare Medicare |
$75.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.97
|
| Rate for Payer: UHC Core |
$251.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.28
|
| Rate for Payer: UHC Exchange |
$75.28
|
| Rate for Payer: UHC Medicare Advantage |
$75.28
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$75.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.82
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$301.10
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$195.72 |
| Max. Negotiated Rate |
$270.99 |
| Rate for Payer: Aetna Commercial |
$255.94
|
| Rate for Payer: BCBS Trust/PPO |
$245.79
|
| Rate for Payer: BCN Commercial |
$232.69
|
| Rate for Payer: Cash Price |
$240.88
|
| Rate for Payer: Cofinity Commercial |
$258.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.88
|
| Rate for Payer: Healthscope Commercial |
$270.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.94
|
| Rate for Payer: Nomi Health Commercial |
$246.90
|
| Rate for Payer: PHP Commercial |
$255.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.72
|
| Rate for Payer: Priority Health HMO/PPO |
$261.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.97
|
| Rate for Payer: UHC Core |
$251.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.82
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$391.43
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$254.43 |
| Max. Negotiated Rate |
$352.29 |
| Rate for Payer: Aetna Commercial |
$332.72
|
| Rate for Payer: BCBS Trust/PPO |
$319.52
|
| Rate for Payer: BCN Commercial |
$302.50
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$336.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Healthscope Commercial |
$352.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PHP Commercial |
$332.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO |
$340.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.46
|
| Rate for Payer: UHC Core |
$326.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.57
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$391.43
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$352.29 |
| Rate for Payer: Aetna Commercial |
$332.72
|
| Rate for Payer: Aetna Medicare |
$101.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.32
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$97.86
|
| Rate for Payer: BCBS Trust/PPO |
$321.79
|
| Rate for Payer: BCN Commercial |
$304.34
|
| Rate for Payer: BCN Medicare Advantage |
$97.86
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cash Price |
$313.14
|
| Rate for Payer: Cofinity Commercial |
$336.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.86
|
| Rate for Payer: Healthscope Commercial |
$352.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.57
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.75
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.72
|
| Rate for Payer: Nomi Health Commercial |
$320.97
|
| Rate for Payer: PACE Senior Care Partners |
$92.96
|
| Rate for Payer: PACE SWMI |
$97.86
|
| Rate for Payer: PHP Commercial |
$332.72
|
| Rate for Payer: PHP Medicare Advantage |
$97.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.43
|
| Rate for Payer: Priority Health HMO/PPO |
$340.54
|
| Rate for Payer: Priority Health Medicare |
$98.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: Railroad Medicare Medicare |
$97.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.46
|
| Rate for Payer: UHC Core |
$326.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.86
|
| Rate for Payer: UHC Exchange |
$97.86
|
| Rate for Payer: UHC Medicare Advantage |
$97.86
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$97.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.57
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,441.99
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$937.29 |
| Max. Negotiated Rate |
$1,297.79 |
| Rate for Payer: Aetna Commercial |
$1,225.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,177.10
|
| Rate for Payer: BCN Commercial |
$1,114.37
|
| Rate for Payer: Cash Price |
$1,153.59
|
| Rate for Payer: Cofinity Commercial |
$1,240.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.59
|
| Rate for Payer: Healthscope Commercial |
$1,297.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,081.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,225.69
|
| Rate for Payer: Nomi Health Commercial |
$1,182.43
|
| Rate for Payer: PHP Commercial |
$1,225.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.29
|
| Rate for Payer: Priority Health HMO/PPO |
$1,254.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$966.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.95
|
| Rate for Payer: UHC Core |
$1,204.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,081.49
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,441.99
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$342.47 |
| Max. Negotiated Rate |
$1,297.79 |
| Rate for Payer: Aetna Commercial |
$1,225.69
|
| Rate for Payer: Aetna Medicare |
$374.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$450.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$450.62
|
| Rate for Payer: BCBS Complete |
$576.80
|
| Rate for Payer: BCBS MAPPO |
$360.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,185.46
|
| Rate for Payer: BCN Commercial |
$1,121.15
|
| Rate for Payer: BCN Medicare Advantage |
$360.50
|
| Rate for Payer: Cash Price |
$1,153.59
|
| Rate for Payer: Cofinity Commercial |
$1,240.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.50
|
| Rate for Payer: Healthscope Commercial |
$1,297.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,081.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,225.69
|
| Rate for Payer: Nomi Health Commercial |
$1,182.43
|
| Rate for Payer: PACE Senior Care Partners |
$342.47
|
| Rate for Payer: PACE SWMI |
$360.50
|
| Rate for Payer: PHP Commercial |
$1,225.69
|
| Rate for Payer: PHP Medicare Advantage |
$360.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$937.29
|
| Rate for Payer: Priority Health HMO/PPO |
$1,254.53
|
| Rate for Payer: Priority Health Medicare |
$364.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$966.13
|
| Rate for Payer: Railroad Medicare Medicare |
$360.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.95
|
| Rate for Payer: UHC Core |
$1,204.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$360.50
|
| Rate for Payer: UHC Exchange |
$360.50
|
| Rate for Payer: UHC Medicare Advantage |
$360.50
|
| Rate for Payer: VA VA |
$360.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,081.49
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HISTOPLASMA AB
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.12 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: BCBS Trust/PPO |
$49.12
|
| Rate for Payer: BCN Commercial |
$46.51
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: Priority Health HMO/PPO |
$52.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC HISTOPLASMA AB
|
Facility
|
OP
|
$60.18
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200286
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$10.47
|
| Rate for Payer: BCBS MAPPO |
$15.04
|
| Rate for Payer: BCBS Trust/PPO |
$49.47
|
| Rate for Payer: BCN Commercial |
$46.79
|
| Rate for Payer: BCN Medicare Advantage |
$15.04
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.04
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Mclaren Medicaid |
$9.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$10.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: PACE Senior Care Partners |
$14.29
|
| Rate for Payer: PACE SWMI |
$15.04
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: PHP Medicare Advantage |
$15.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: Priority Health HMO/PPO |
$52.36
|
| Rate for Payer: Priority Health Medicare |
$15.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.32
|
| Rate for Payer: Railroad Medicare Medicare |
$15.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.04
|
| Rate for Payer: UHC Exchange |
$15.04
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
| Rate for Payer: UHCCP Medicaid |
$9.97
|
| Rate for Payer: VA VA |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.82
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HISTOPLASMA AB CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.47
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$20.96
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$10.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Exchange |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$9.97
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.47
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$20.96
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: Meridian Medicaid |
$10.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Exchange |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.38
|
| Rate for Payer: UHCCP Medicaid |
$9.97
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HISTOPLASMA AB CONFIRMATION
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200288
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$20.82
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$20.91
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
OP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: Aetna Medicare |
$35.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.71
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$34.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.36
|
| Rate for Payer: BCN Commercial |
$106.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.17
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.17
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.88
|
| Rate for Payer: Meridian Medicaid |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PACE Senior Care Partners |
$32.46
|
| Rate for Payer: PACE SWMI |
$34.17
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: PHP Medicare Advantage |
$34.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Medicare |
$34.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.17
|
| Rate for Payer: UHC Exchange |
$34.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.17
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: VA VA |
$34.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC HISTOPLASMA AG CONFIRM
|
Facility
|
IP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600257
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$88.84 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: BCBS Trust/PPO |
$111.57
|
| Rate for Payer: BCN Commercial |
$105.63
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
OP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: Aetna Medicare |
$35.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.71
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$34.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.36
|
| Rate for Payer: BCN Commercial |
$106.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.17
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.17
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.88
|
| Rate for Payer: Meridian Medicaid |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PACE Senior Care Partners |
$32.46
|
| Rate for Payer: PACE SWMI |
$34.17
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: PHP Medicare Advantage |
$34.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Medicare |
$34.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.17
|
| Rate for Payer: UHC Exchange |
$34.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.17
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: VA VA |
$34.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC HISTOPLASMA ANTIGEN BLOOD
|
Facility
|
IP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600143
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$88.84 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: BCBS Trust/PPO |
$111.57
|
| Rate for Payer: BCN Commercial |
$105.63
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC HISTOPLASMA ANTIGEN URINE
|
Facility
|
IP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$88.84 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: BCBS Trust/PPO |
$111.57
|
| Rate for Payer: BCN Commercial |
$105.63
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
