|
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 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 |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| 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 |
$13.01
|
| 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 |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| 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 |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
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 |
$45.13
|
| 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 |
$45.13
|
|
|
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 |
$45.13
|
| 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 |
$45.13
|
|
|
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 |
$16.57
|
| 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 |
$17.09
|
| 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 CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86698
|
| Hospital Charge Code |
30200289
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.57 |
| 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 |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.09
|
| 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 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 |
$16.57
|
| 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 |
$17.09
|
| 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 |
$16.57 |
| 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 |
$16.57
|
| Rate for Payer: Priority Health HMO/PPO |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.09
|
| 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
|
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 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 URINE
|
Facility
|
OP
|
$136.68
|
|
|
Service Code
|
CPT 87385
|
| Hospital Charge Code |
30600144
|
|
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 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
|
|
|
HC HIT ASSAY
|
Facility
|
OP
|
$176.87
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: Aetna Medicare |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.27
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$145.40
|
| Rate for Payer: BCN Commercial |
$137.52
|
| Rate for Payer: BCN Medicare Advantage |
$44.22
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.22
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: PACE Senior Care Partners |
$42.01
|
| Rate for Payer: PACE SWMI |
$44.22
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: PHP Medicare Advantage |
$44.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.97
|
| Rate for Payer: Priority Health HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Medicare |
$44.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.50
|
| Rate for Payer: Railroad Medicare Medicare |
$44.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.22
|
| Rate for Payer: UHC Exchange |
$44.22
|
| Rate for Payer: UHC Medicare Advantage |
$44.22
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$44.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC HIT ASSAY
|
Facility
|
IP
|
$176.87
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$114.97 |
| Max. Negotiated Rate |
$159.18 |
| Rate for Payer: Aetna Commercial |
$150.34
|
| Rate for Payer: BCBS Trust/PPO |
$144.38
|
| Rate for Payer: BCN Commercial |
$136.69
|
| Rate for Payer: Cash Price |
$141.50
|
| Rate for Payer: Cofinity Commercial |
$152.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.50
|
| Rate for Payer: Healthscope Commercial |
$159.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.34
|
| Rate for Payer: Nomi Health Commercial |
$145.03
|
| Rate for Payer: PHP Commercial |
$150.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.97
|
| Rate for Payer: Priority Health HMO/PPO |
$153.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.65
|
| Rate for Payer: UHC Core |
$147.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.65
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.61
|
| Rate for Payer: BCBS Complete |
$18.28
|
| Rate for Payer: BCBS MAPPO |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$38.83
|
| Rate for Payer: BCN Medicare Advantage |
$12.48
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.48
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$17.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.11
|
| Rate for Payer: Meridian Medicaid |
$18.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.86
|
| Rate for Payer: PACE SWMI |
$12.48
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Medicare |
$12.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.46
|
| Rate for Payer: Railroad Medicare Medicare |
$12.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.48
|
| Rate for Payer: UHC Exchange |
$12.48
|
| Rate for Payer: UHC Medicare Advantage |
$12.48
|
| Rate for Payer: UHCCP Medicaid |
$17.41
|
| Rate for Payer: VA VA |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC HIV 1,2 AB AND AG COMBO
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 87389
|
| Hospital Charge Code |
30600261
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$40.77
|
| Rate for Payer: BCN Commercial |
$38.59
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$6.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$6.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HIV 1/2 AB DIFF HIV1
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200381
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HIV 1/2 AB DIFF HIV2
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200382
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$9.77
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
