|
HC HIV 1 ANTIGEN
|
Facility
|
IP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Aetna Commercial |
$36.17
|
| Rate for Payer: BCBS Trust/PPO |
$34.73
|
| Rate for Payer: BCN Commercial |
$32.88
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Healthscope Commercial |
$38.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PHP Commercial |
$36.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO |
$37.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.44
|
| Rate for Payer: UHC Core |
$35.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.91
|
|
|
HC HIV 1 ANTIGEN
|
Facility
|
OP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600214
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.11 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Aetna Commercial |
$36.17
|
| Rate for Payer: Aetna Medicare |
$11.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.30
|
| Rate for Payer: BCBS Complete |
$12.20
|
| Rate for Payer: BCBS MAPPO |
$10.64
|
| Rate for Payer: BCBS Trust/PPO |
$34.98
|
| Rate for Payer: BCN Commercial |
$33.08
|
| Rate for Payer: BCN Medicare Advantage |
$10.64
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.64
|
| Rate for Payer: Healthscope Commercial |
$38.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.91
|
| Rate for Payer: Mclaren Medicaid |
$11.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.17
|
| Rate for Payer: Meridian Medicaid |
$12.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PACE Senior Care Partners |
$10.11
|
| Rate for Payer: PACE SWMI |
$10.64
|
| Rate for Payer: PHP Commercial |
$36.17
|
| Rate for Payer: PHP Medicare Advantage |
$10.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO |
$37.02
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.51
|
| Rate for Payer: Railroad Medicare Medicare |
$10.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.44
|
| Rate for Payer: UHC Core |
$35.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.64
|
| Rate for Payer: UHC Exchange |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$10.64
|
| Rate for Payer: UHCCP Medicaid |
$11.62
|
| Rate for Payer: VA VA |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.91
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
OP
|
$436.97
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.78 |
| Max. Negotiated Rate |
$393.27 |
| Rate for Payer: Aetna Commercial |
$371.42
|
| Rate for Payer: Aetna Medicare |
$113.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.55
|
| Rate for Payer: BCBS Complete |
$195.46
|
| Rate for Payer: BCBS MAPPO |
$109.24
|
| Rate for Payer: BCBS Trust/PPO |
$359.23
|
| Rate for Payer: BCN Commercial |
$339.74
|
| Rate for Payer: BCN Medicare Advantage |
$109.24
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$375.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.24
|
| Rate for Payer: Healthscope Commercial |
$393.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.73
|
| Rate for Payer: Mclaren Medicaid |
$186.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.70
|
| Rate for Payer: Meridian Medicaid |
$195.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PACE Senior Care Partners |
$103.78
|
| Rate for Payer: PACE SWMI |
$109.24
|
| Rate for Payer: PHP Commercial |
$371.42
|
| Rate for Payer: PHP Medicare Advantage |
$109.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO |
$380.16
|
| Rate for Payer: Priority Health Medicare |
$110.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.77
|
| Rate for Payer: Railroad Medicare Medicare |
$109.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.53
|
| Rate for Payer: UHC Core |
$364.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.24
|
| Rate for Payer: UHC Exchange |
$109.24
|
| Rate for Payer: UHC Medicare Advantage |
$109.24
|
| Rate for Payer: UHCCP Medicaid |
$186.14
|
| Rate for Payer: VA VA |
$109.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.73
|
|
|
HC HIV 1 GENOTYPE
|
Facility
|
IP
|
$436.97
|
|
|
Service Code
|
CPT 87901
|
| Hospital Charge Code |
30600178
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$284.03 |
| Max. Negotiated Rate |
$393.27 |
| Rate for Payer: Aetna Commercial |
$371.42
|
| Rate for Payer: BCBS Trust/PPO |
$356.70
|
| Rate for Payer: BCN Commercial |
$337.69
|
| Rate for Payer: Cash Price |
$349.58
|
| Rate for Payer: Cofinity Commercial |
$375.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.58
|
| Rate for Payer: Healthscope Commercial |
$393.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.42
|
| Rate for Payer: Nomi Health Commercial |
$358.32
|
| Rate for Payer: PHP Commercial |
$371.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.03
|
| Rate for Payer: Priority Health HMO/PPO |
$380.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.53
|
| Rate for Payer: UHC Core |
$364.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.73
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.09
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$71.28
|
| Rate for Payer: BCN Commercial |
$67.41
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Mclaren Medicaid |
$13.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PACE Senior Care Partners |
$20.59
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.68
|
| Rate for Payer: UHC Exchange |
$21.68
|
| Rate for Payer: UHC Medicare Advantage |
$21.68
|
| Rate for Payer: UHCCP Medicaid |
$13.99
|
| Rate for Payer: VA VA |
$21.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC HIV 2 AB CONFIRMATION
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: BCBS Trust/PPO |
$70.77
|
| Rate for Payer: BCN Commercial |
$67.00
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC HIV ANTIBODY
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$39.97
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC HIV ANTIBODY
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
30200292
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$40.25
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$9.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Exchange |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.24
|
| Rate for Payer: UHCCP Medicaid |
$9.91
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC HIV DNA BY PCR
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.16 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.03
|
| Rate for Payer: BCN Commercial |
$69.14
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC HIV DNA BY PCR
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 87535
|
| Hospital Charge Code |
30600159
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.25 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$69.56
|
| Rate for Payer: BCN Medicare Advantage |
$22.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.49
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: PACE Senior Care Partners |
$21.25
|
| Rate for Payer: PACE SWMI |
$22.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$22.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Medicare |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.94
|
| Rate for Payer: Railroad Medicare Medicare |
$22.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.37
|
| Rate for Payer: UHC Exchange |
$22.37
|
| Rate for Payer: UHC Medicare Advantage |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$22.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
OP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$129.26 |
| Rate for Payer: Aetna Commercial |
$122.08
|
| Rate for Payer: Aetna Medicare |
$37.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.88
|
| Rate for Payer: BCBS Complete |
$64.61
|
| Rate for Payer: BCBS MAPPO |
$35.91
|
| Rate for Payer: BCBS Trust/PPO |
$118.07
|
| Rate for Payer: BCN Commercial |
$111.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.91
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.91
|
| Rate for Payer: Healthscope Commercial |
$129.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.72
|
| Rate for Payer: Mclaren Medicaid |
$61.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.70
|
| Rate for Payer: Meridian Medicaid |
$64.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: Nomi Health Commercial |
$117.77
|
| Rate for Payer: PACE Senior Care Partners |
$34.11
|
| Rate for Payer: PACE SWMI |
$35.91
|
| Rate for Payer: PHP Commercial |
$122.08
|
| Rate for Payer: PHP Medicare Advantage |
$35.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: Priority Health HMO/PPO |
$124.95
|
| Rate for Payer: Priority Health Medicare |
$36.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.23
|
| Rate for Payer: Railroad Medicare Medicare |
$35.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.39
|
| Rate for Payer: UHC Core |
$119.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.91
|
| Rate for Payer: UHC Exchange |
$35.91
|
| Rate for Payer: UHC Medicare Advantage |
$35.91
|
| Rate for Payer: UHCCP Medicaid |
$61.53
|
| Rate for Payer: VA VA |
$35.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.72
|
|
|
HC HIV QUANTITATIVE
|
Facility
|
IP
|
$143.62
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600299
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$129.26 |
| Rate for Payer: Aetna Commercial |
$122.08
|
| Rate for Payer: BCBS Trust/PPO |
$117.24
|
| Rate for Payer: BCN Commercial |
$110.99
|
| Rate for Payer: Cash Price |
$114.90
|
| Rate for Payer: Cofinity Commercial |
$123.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.90
|
| Rate for Payer: Healthscope Commercial |
$129.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.08
|
| Rate for Payer: Nomi Health Commercial |
$117.77
|
| Rate for Payer: PHP Commercial |
$122.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.35
|
| Rate for Payer: Priority Health HMO/PPO |
$124.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.39
|
| Rate for Payer: UHC Core |
$119.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.72
|
|
|
HC HIV RNA BY PCR
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.03
|
| Rate for Payer: BCBS Complete |
$64.61
|
| Rate for Payer: BCBS MAPPO |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$171.06
|
| Rate for Payer: BCN Commercial |
$161.78
|
| Rate for Payer: BCN Medicare Advantage |
$52.02
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$61.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.62
|
| Rate for Payer: Meridian Medicaid |
$64.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PACE Senior Care Partners |
$49.42
|
| Rate for Payer: PACE SWMI |
$52.02
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$52.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Medicare |
$52.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: Railroad Medicare Medicare |
$52.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.02
|
| Rate for Payer: UHC Exchange |
$52.02
|
| Rate for Payer: UHC Medicare Advantage |
$52.02
|
| Rate for Payer: UHCCP Medicaid |
$61.53
|
| Rate for Payer: VA VA |
$52.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC HIV RNA BY PCR
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600160
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$135.25 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$169.86
|
| Rate for Payer: BCN Commercial |
$160.80
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
OP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.06 |
| Max. Negotiated Rate |
$125.29 |
| Rate for Payer: Aetna Commercial |
$118.33
|
| Rate for Payer: Aetna Medicare |
$36.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.50
|
| Rate for Payer: BCBS Complete |
$64.61
|
| Rate for Payer: BCBS MAPPO |
$34.80
|
| Rate for Payer: BCBS Trust/PPO |
$114.44
|
| Rate for Payer: BCN Commercial |
$108.24
|
| Rate for Payer: BCN Medicare Advantage |
$34.80
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$119.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.80
|
| Rate for Payer: Healthscope Commercial |
$125.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.41
|
| Rate for Payer: Mclaren Medicaid |
$61.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.54
|
| Rate for Payer: Meridian Medicaid |
$64.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: Nomi Health Commercial |
$114.15
|
| Rate for Payer: PACE Senior Care Partners |
$33.06
|
| Rate for Payer: PACE SWMI |
$34.80
|
| Rate for Payer: PHP Commercial |
$118.33
|
| Rate for Payer: PHP Medicare Advantage |
$34.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: Priority Health HMO/PPO |
$121.11
|
| Rate for Payer: Priority Health Medicare |
$35.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.27
|
| Rate for Payer: Railroad Medicare Medicare |
$34.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.50
|
| Rate for Payer: UHC Core |
$116.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.80
|
| Rate for Payer: UHC Exchange |
$34.80
|
| Rate for Payer: UHC Medicare Advantage |
$34.80
|
| Rate for Payer: UHCCP Medicaid |
$61.53
|
| Rate for Payer: VA VA |
$34.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.41
|
|
|
HC HIV RNA QUANT REFLEX GENOTYPE
|
Facility
|
IP
|
$139.21
|
|
|
Service Code
|
CPT 87536
|
| Hospital Charge Code |
30600161
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$90.49 |
| Max. Negotiated Rate |
$125.29 |
| Rate for Payer: Aetna Commercial |
$118.33
|
| Rate for Payer: BCBS Trust/PPO |
$113.64
|
| Rate for Payer: BCN Commercial |
$107.58
|
| Rate for Payer: Cash Price |
$111.37
|
| Rate for Payer: Cofinity Commercial |
$119.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.37
|
| Rate for Payer: Healthscope Commercial |
$125.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.33
|
| Rate for Payer: Nomi Health Commercial |
$114.15
|
| Rate for Payer: PHP Commercial |
$118.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.49
|
| Rate for Payer: Priority Health HMO/PPO |
$121.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.50
|
| Rate for Payer: UHC Core |
$116.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.41
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.96 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: BCBS Trust/PPO |
$84.10
|
| Rate for Payer: BCN Commercial |
$79.61
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health HMO/PPO |
$89.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.27
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.19
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$25.75
|
| Rate for Payer: BCBS Trust/PPO |
$84.69
|
| Rate for Payer: BCN Commercial |
$80.10
|
| Rate for Payer: BCN Medicare Advantage |
$25.75
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.75
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.27
|
| Rate for Payer: Mclaren Medicaid |
$13.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.04
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: PACE Senior Care Partners |
$24.47
|
| Rate for Payer: PACE SWMI |
$25.75
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health HMO/PPO |
$89.63
|
| Rate for Payer: Priority Health Medicare |
$26.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.02
|
| Rate for Payer: Railroad Medicare Medicare |
$25.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.75
|
| Rate for Payer: UHC Exchange |
$25.75
|
| Rate for Payer: UHC Medicare Advantage |
$25.75
|
| Rate for Payer: UHCCP Medicaid |
$13.99
|
| Rate for Payer: VA VA |
$25.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.27
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$27.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.47
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$13.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.11
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Senior Care Partners |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.77
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$26.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Medicare |
$27.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: Railroad Medicare Medicare |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.77
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$13.99
|
| Rate for Payer: VA VA |
$26.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: BCBS Trust/PPO |
$87.43
|
| Rate for Payer: BCN Commercial |
$82.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$9.77
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
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 WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.99 |
| 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 |
$14.69
|
| 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 |
$13.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$14.69
|
| 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 |
$13.99
|
| 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 |
$13.99
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.01 |
| Max. Negotiated Rate |
$250.13 |
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna Medicare |
$72.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.85
|
| Rate for Payer: BCBS Complete |
$128.99
|
| Rate for Payer: BCBS MAPPO |
$69.48
|
| Rate for Payer: BCBS Trust/PPO |
$228.48
|
| Rate for Payer: BCN Commercial |
$216.08
|
| Rate for Payer: BCN Medicare Advantage |
$69.48
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$239.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.48
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.44
|
| Rate for Payer: Mclaren Medicaid |
$122.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.95
|
| Rate for Payer: Meridian Medicaid |
$128.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: Nomi Health Commercial |
$227.89
|
| Rate for Payer: PACE Senior Care Partners |
$66.01
|
| Rate for Payer: PACE SWMI |
$69.48
|
| Rate for Payer: PHP Commercial |
$236.23
|
| Rate for Payer: PHP Medicare Advantage |
$69.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health HMO/PPO |
$241.79
|
| Rate for Payer: Priority Health Medicare |
$70.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.21
|
| Rate for Payer: Railroad Medicare Medicare |
$69.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.57
|
| Rate for Payer: UHC Core |
$232.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.48
|
| Rate for Payer: UHC Exchange |
$69.48
|
| Rate for Payer: UHC Medicare Advantage |
$69.48
|
| Rate for Payer: UHCCP Medicaid |
$122.84
|
| Rate for Payer: VA VA |
$69.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.44
|
|
