|
HC PH BODY FLUID
|
Facility
|
IP
|
$24.68
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna Commercial |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$19.07
|
| Rate for Payer: BCN Commercial |
$19.07
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$21.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
| Rate for Payer: Healthscope Commercial |
$22.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.98
|
| Rate for Payer: PHP Commercial |
$20.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.72
|
| Rate for Payer: UHC Core |
$20.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.51
|
|
|
HC PHENOBARB LVL
|
Facility
|
OP
|
$98.60
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.29 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$83.81
|
| Rate for Payer: Aetna Medicare |
$25.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.81
|
| Rate for Payer: BCBS Complete |
$11.86
|
| Rate for Payer: BCBS MAPPO |
$24.65
|
| Rate for Payer: BCBS Trust/PPO |
$76.66
|
| Rate for Payer: BCN Commercial |
$76.66
|
| Rate for Payer: BCN Medicare Advantage |
$24.65
|
| Rate for Payer: Cash Price |
$78.88
|
| Rate for Payer: Cash Price |
$78.88
|
| Rate for Payer: Cofinity Commercial |
$84.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.65
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.95
|
| Rate for Payer: Mclaren Medicaid |
$11.29
|
| Rate for Payer: Meridian Medicaid |
$11.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.81
|
| Rate for Payer: PACE Senior Care Partners |
$23.42
|
| Rate for Payer: PACE SWMI |
$24.65
|
| Rate for Payer: PHP Commercial |
$83.81
|
| Rate for Payer: PHP Medicare Advantage |
$24.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.78
|
| Rate for Payer: Priority Health Medicare |
$24.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: Railroad Medicare Medicare |
$24.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.77
|
| Rate for Payer: UHC Core |
$82.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.65
|
| Rate for Payer: UHC Medicare Advantage |
$25.39
|
| Rate for Payer: VA VA |
$24.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.95
|
|
|
HC PHENOBARB LVL
|
Facility
|
IP
|
$98.60
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.14 |
| Max. Negotiated Rate |
$88.74 |
| Rate for Payer: Aetna Commercial |
$83.81
|
| Rate for Payer: BCBS Trust/PPO |
$76.20
|
| Rate for Payer: BCN Commercial |
$76.20
|
| Rate for Payer: Cash Price |
$78.88
|
| Rate for Payer: Cofinity Commercial |
$84.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.88
|
| Rate for Payer: Healthscope Commercial |
$88.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.81
|
| Rate for Payer: PHP Commercial |
$83.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.77
|
| Rate for Payer: UHC Core |
$82.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.95
|
|
|
HC PH GASTRIC
|
Facility
|
OP
|
$24.20
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$21.78 |
| Rate for Payer: Aetna Commercial |
$20.57
|
| Rate for Payer: Aetna Medicare |
$6.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.56
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$6.05
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$18.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.05
|
| Rate for Payer: Cash Price |
$19.36
|
| Rate for Payer: Cash Price |
$19.36
|
| Rate for Payer: Cofinity Commercial |
$20.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.05
|
| Rate for Payer: Healthscope Commercial |
$21.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.15
|
| Rate for Payer: Mclaren Medicaid |
$4.95
|
| Rate for Payer: Meridian Medicaid |
$5.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.57
|
| Rate for Payer: PACE Senior Care Partners |
$5.75
|
| Rate for Payer: PACE SWMI |
$6.05
|
| Rate for Payer: PHP Commercial |
$20.57
|
| Rate for Payer: PHP Medicare Advantage |
$6.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.05
|
| Rate for Payer: Priority Health Medicare |
$6.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.30
|
| Rate for Payer: UHC Core |
$20.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.05
|
| Rate for Payer: UHC Medicare Advantage |
$6.23
|
| Rate for Payer: VA VA |
$6.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.15
|
|
|
HC PH GASTRIC
|
Facility
|
IP
|
$24.20
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$21.78 |
| Rate for Payer: Aetna Commercial |
$20.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.70
|
| Rate for Payer: BCN Commercial |
$18.70
|
| Rate for Payer: Cash Price |
$19.36
|
| Rate for Payer: Cofinity Commercial |
$20.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.36
|
| Rate for Payer: Healthscope Commercial |
$21.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.57
|
| Rate for Payer: PHP Commercial |
$20.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.30
|
| Rate for Payer: UHC Core |
$20.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.15
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: BCBS Trust/PPO |
$73.42
|
| Rate for Payer: BCN Commercial |
$73.42
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.60
|
| Rate for Payer: UHC Core |
$79.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: Aetna Medicare |
$24.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.69
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$73.86
|
| Rate for Payer: BCN Medicare Advantage |
$23.75
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.75
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: PACE Senior Care Partners |
$22.56
|
| Rate for Payer: PACE SWMI |
$23.75
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: PHP Medicare Advantage |
$23.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.65
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.94
|
| Rate for Payer: Railroad Medicare Medicare |
$23.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.60
|
| Rate for Payer: UHC Core |
$79.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.75
|
| Rate for Payer: UHC Medicare Advantage |
$24.46
|
| Rate for Payer: VA VA |
$23.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$66.60 |
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: Aetna Medicare |
$19.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.12
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$18.50
|
| Rate for Payer: BCBS Trust/PPO |
$57.54
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: BCN Medicare Advantage |
$18.50
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$63.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.50
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.50
|
| Rate for Payer: Mclaren Medicaid |
$12.19
|
| Rate for Payer: Meridian Medicaid |
$12.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.90
|
| Rate for Payer: PACE Senior Care Partners |
$17.58
|
| Rate for Payer: PACE SWMI |
$18.50
|
| Rate for Payer: PHP Commercial |
$62.90
|
| Rate for Payer: PHP Medicare Advantage |
$18.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.38
|
| Rate for Payer: Priority Health Medicare |
$18.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.12
|
| Rate for Payer: UHC Core |
$61.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.50
|
| Rate for Payer: UHC Medicare Advantage |
$19.06
|
| Rate for Payer: VA VA |
$18.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.50
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.13 |
| Max. Negotiated Rate |
$66.60 |
| Rate for Payer: Aetna Commercial |
$62.90
|
| Rate for Payer: BCBS Trust/PPO |
$57.19
|
| Rate for Payer: BCN Commercial |
$57.19
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$63.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.20
|
| Rate for Payer: Healthscope Commercial |
$66.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.90
|
| Rate for Payer: PHP Commercial |
$62.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.12
|
| Rate for Payer: UHC Core |
$61.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.50
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: BCBS Trust/PPO |
$64.14
|
| Rate for Payer: BCN Commercial |
$64.14
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: Aetna Medicare |
$21.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.94
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$20.75
|
| Rate for Payer: BCBS Trust/PPO |
$64.53
|
| Rate for Payer: BCN Commercial |
$64.53
|
| Rate for Payer: BCN Medicare Advantage |
$20.75
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Mclaren Medicaid |
$12.19
|
| Rate for Payer: Meridian Medicaid |
$12.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PACE Senior Care Partners |
$19.71
|
| Rate for Payer: PACE SWMI |
$20.75
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: PHP Medicare Advantage |
$20.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: Railroad Medicare Medicare |
$20.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.75
|
| Rate for Payer: UHC Medicare Advantage |
$21.37
|
| Rate for Payer: VA VA |
$20.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.97 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: BCBS Trust/PPO |
$41.78
|
| Rate for Payer: BCN Commercial |
$41.78
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.35 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: BCBS Trust/PPO |
$40.99
|
| Rate for Payer: BCN Commercial |
$40.99
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$41.24
|
| Rate for Payer: BCN Commercial |
$41.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
| Rate for Payer: Priority Health Medicare |
$13.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.66
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
IP
|
$276.60
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$248.94 |
| Rate for Payer: Aetna Commercial |
$235.11
|
| Rate for Payer: BCBS Trust/PPO |
$213.76
|
| Rate for Payer: BCN Commercial |
$213.76
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cofinity Commercial |
$237.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.28
|
| Rate for Payer: Healthscope Commercial |
$248.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.11
|
| Rate for Payer: PHP Commercial |
$235.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.41
|
| Rate for Payer: UHC Core |
$230.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.45
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
OP
|
$276.60
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$248.94 |
| Rate for Payer: Aetna Commercial |
$235.11
|
| Rate for Payer: Aetna Medicare |
$71.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.44
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$69.15
|
| Rate for Payer: BCBS Trust/PPO |
$215.06
|
| Rate for Payer: BCN Commercial |
$215.06
|
| Rate for Payer: BCN Medicare Advantage |
$69.15
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cofinity Commercial |
$237.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.15
|
| Rate for Payer: Healthscope Commercial |
$248.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.45
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.11
|
| Rate for Payer: PACE Senior Care Partners |
$65.69
|
| Rate for Payer: PACE SWMI |
$69.15
|
| Rate for Payer: PHP Commercial |
$235.11
|
| Rate for Payer: PHP Medicare Advantage |
$69.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.64
|
| Rate for Payer: Priority Health Medicare |
$69.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.70
|
| Rate for Payer: Railroad Medicare Medicare |
$69.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.41
|
| Rate for Payer: UHC Core |
$230.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.15
|
| Rate for Payer: UHC Medicare Advantage |
$71.22
|
| Rate for Payer: VA VA |
$69.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.45
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$53.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.38
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$51.50
|
| Rate for Payer: BCBS Trust/PPO |
$160.16
|
| Rate for Payer: BCN Commercial |
$160.16
|
| Rate for Payer: BCN Medicare Advantage |
$51.50
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.50
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PACE Senior Care Partners |
$48.92
|
| Rate for Payer: PACE SWMI |
$51.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.22
|
| Rate for Payer: Priority Health Medicare |
$51.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.64
|
| Rate for Payer: Railroad Medicare Medicare |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.50
|
| Rate for Payer: UHC Medicare Advantage |
$53.04
|
| Rate for Payer: VA VA |
$51.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: BCBS Trust/PPO |
$159.20
|
| Rate for Payer: BCN Commercial |
$159.20
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$53.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.38
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$51.50
|
| Rate for Payer: BCBS Trust/PPO |
$160.16
|
| Rate for Payer: BCN Commercial |
$160.16
|
| Rate for Payer: BCN Medicare Advantage |
$51.50
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.50
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PACE Senior Care Partners |
$48.92
|
| Rate for Payer: PACE SWMI |
$51.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.22
|
| Rate for Payer: Priority Health Medicare |
$51.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.64
|
| Rate for Payer: Railroad Medicare Medicare |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.50
|
| Rate for Payer: UHC Medicare Advantage |
$53.04
|
| Rate for Payer: VA VA |
$51.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: BCBS Trust/PPO |
$159.20
|
| Rate for Payer: BCN Commercial |
$159.20
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.50
|
| Rate for Payer: Meridian Medicaid |
$3.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
OP
|
$51.90
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$46.71 |
| Rate for Payer: Aetna Commercial |
$44.12
|
| Rate for Payer: Aetna Medicare |
$13.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.22
|
| Rate for Payer: BCBS Complete |
$4.48
|
| Rate for Payer: BCBS MAPPO |
$12.98
|
| Rate for Payer: BCBS Trust/PPO |
$40.35
|
| Rate for Payer: BCN Commercial |
$40.35
|
| Rate for Payer: BCN Medicare Advantage |
$12.98
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.98
|
| Rate for Payer: Healthscope Commercial |
$46.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.92
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.12
|
| Rate for Payer: PACE Senior Care Partners |
$12.33
|
| Rate for Payer: PACE SWMI |
$12.98
|
| Rate for Payer: PHP Commercial |
$44.12
|
| Rate for Payer: PHP Medicare Advantage |
$12.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Medicare |
$12.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.65
|
| Rate for Payer: Railroad Medicare Medicare |
$12.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.67
|
| Rate for Payer: UHC Core |
$43.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.98
|
| Rate for Payer: UHC Medicare Advantage |
$13.36
|
| Rate for Payer: VA VA |
$12.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.92
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
IP
|
$51.90
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.65 |
| Max. Negotiated Rate |
$46.71 |
| Rate for Payer: Aetna Commercial |
$44.12
|
| Rate for Payer: BCBS Trust/PPO |
$40.11
|
| Rate for Payer: BCN Commercial |
$40.11
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.52
|
| Rate for Payer: Healthscope Commercial |
$46.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.12
|
| Rate for Payer: PHP Commercial |
$44.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.67
|
| Rate for Payer: UHC Core |
$43.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.92
|
|
