|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
IP
|
$79.07
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: BCBS Trust/PPO |
$64.54
|
| Rate for Payer: BCN Commercial |
$61.11
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO |
$68.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.58
|
| Rate for Payer: UHC Core |
$66.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$74.74
|
| Rate for Payer: BCN Commercial |
$70.76
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna Medicare |
$23.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.61
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$71.19
|
| Rate for Payer: BCN Medicare Advantage |
$22.89
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.89
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.03
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PACE Senior Care Partners |
$21.75
|
| Rate for Payer: PACE SWMI |
$22.89
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Medicare |
$23.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.89
|
| Rate for Payer: UHC Exchange |
$22.89
|
| Rate for Payer: UHC Medicare Advantage |
$22.89
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$74.74
|
| Rate for Payer: BCN Commercial |
$70.76
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna Medicare |
$23.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.61
|
| Rate for Payer: BCBS Complete |
$16.96
|
| Rate for Payer: BCBS MAPPO |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$71.19
|
| Rate for Payer: BCN Medicare Advantage |
$22.89
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.89
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Mclaren Medicaid |
$16.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.03
|
| Rate for Payer: Meridian Medicaid |
$16.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: PACE Senior Care Partners |
$21.75
|
| Rate for Payer: PACE SWMI |
$22.89
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Medicare |
$23.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.89
|
| Rate for Payer: UHC Exchange |
$22.89
|
| Rate for Payer: UHC Medicare Advantage |
$22.89
|
| Rate for Payer: UHCCP Medicaid |
$16.15
|
| Rate for Payer: VA VA |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
OP
|
$169.12
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.15 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna Medicare |
$43.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.85
|
| Rate for Payer: BCBS Complete |
$16.96
|
| Rate for Payer: BCBS MAPPO |
$42.28
|
| Rate for Payer: BCBS Trust/PPO |
$139.03
|
| Rate for Payer: BCN Commercial |
$131.49
|
| Rate for Payer: BCN Medicare Advantage |
$42.28
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.28
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Mclaren Medicaid |
$16.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.39
|
| Rate for Payer: Meridian Medicaid |
$16.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: PACE Senior Care Partners |
$40.17
|
| Rate for Payer: PACE SWMI |
$42.28
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: PHP Medicare Advantage |
$42.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO |
$147.13
|
| Rate for Payer: Priority Health Medicare |
$42.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.31
|
| Rate for Payer: Railroad Medicare Medicare |
$42.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.83
|
| Rate for Payer: UHC Core |
$141.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.28
|
| Rate for Payer: UHC Exchange |
$42.28
|
| Rate for Payer: UHC Medicare Advantage |
$42.28
|
| Rate for Payer: UHCCP Medicaid |
$16.15
|
| Rate for Payer: VA VA |
$42.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
IP
|
$169.12
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.93 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$138.05
|
| Rate for Payer: BCN Commercial |
$130.70
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO |
$147.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.83
|
| Rate for Payer: UHC Core |
$141.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
OP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna Medicare |
$43.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.85
|
| Rate for Payer: BCBS Complete |
$22.28
|
| Rate for Payer: BCBS MAPPO |
$42.28
|
| Rate for Payer: BCBS Trust/PPO |
$139.03
|
| Rate for Payer: BCN Commercial |
$131.49
|
| Rate for Payer: BCN Medicare Advantage |
$42.28
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.28
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Mclaren Medicaid |
$21.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.39
|
| Rate for Payer: Meridian Medicaid |
$22.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: PACE Senior Care Partners |
$40.17
|
| Rate for Payer: PACE SWMI |
$42.28
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: PHP Medicare Advantage |
$42.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO |
$147.13
|
| Rate for Payer: Priority Health Medicare |
$42.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.31
|
| Rate for Payer: Railroad Medicare Medicare |
$42.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.83
|
| Rate for Payer: UHC Core |
$141.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.28
|
| Rate for Payer: UHC Exchange |
$42.28
|
| Rate for Payer: UHC Medicare Advantage |
$42.28
|
| Rate for Payer: UHCCP Medicaid |
$21.22
|
| Rate for Payer: VA VA |
$42.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
IP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.93 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$138.05
|
| Rate for Payer: BCN Commercial |
$130.70
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$138.68
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO |
$147.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.83
|
| Rate for Payer: UHC Core |
$141.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.47
|
| Rate for Payer: BCN Commercial |
$30.74
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: Nomi Health Commercial |
$32.62
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health HMO/PPO |
$34.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$10.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.43
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$9.94
|
| Rate for Payer: BCBS Trust/PPO |
$32.70
|
| Rate for Payer: BCN Commercial |
$30.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.94
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.94
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.44
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: Nomi Health Commercial |
$32.62
|
| Rate for Payer: PACE Senior Care Partners |
$9.45
|
| Rate for Payer: PACE SWMI |
$9.94
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: PHP Medicare Advantage |
$9.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health HMO/PPO |
$34.61
|
| Rate for Payer: Priority Health Medicare |
$10.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.65
|
| Rate for Payer: Railroad Medicare Medicare |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.94
|
| Rate for Payer: UHC Exchange |
$9.94
|
| Rate for Payer: UHC Medicare Advantage |
$9.94
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$9.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
IP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.12 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$48.89
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health HMO/PPO |
$55.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.67
|
| Rate for Payer: UHC Core |
$52.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
OP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: Aetna Medicare |
$16.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.77
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS MAPPO |
$15.82
|
| Rate for Payer: BCBS Trust/PPO |
$52.01
|
| Rate for Payer: BCN Commercial |
$49.18
|
| Rate for Payer: BCN Medicare Advantage |
$15.82
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Mclaren Medicaid |
$11.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.61
|
| Rate for Payer: Meridian Medicaid |
$12.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.82
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: PHP Medicare Advantage |
$15.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health HMO/PPO |
$55.04
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.38
|
| Rate for Payer: Railroad Medicare Medicare |
$15.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.67
|
| Rate for Payer: UHC Core |
$52.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.82
|
| Rate for Payer: UHC Exchange |
$15.82
|
| Rate for Payer: UHC Medicare Advantage |
$15.82
|
| Rate for Payer: UHCCP Medicaid |
$11.90
|
| Rate for Payer: VA VA |
$15.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.15
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Exchange |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$18.69
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.97 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: Aetna Medicare |
$43.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.59
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS MAPPO |
$42.08
|
| Rate for Payer: BCBS Trust/PPO |
$138.36
|
| Rate for Payer: BCCCP Commercial |
$89.57
|
| Rate for Payer: BCN Commercial |
$130.85
|
| Rate for Payer: BCN Medicare Advantage |
$42.08
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.08
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: Nomi Health Commercial |
$138.01
|
| Rate for Payer: PACE Senior Care Partners |
$39.97
|
| Rate for Payer: PACE SWMI |
$42.08
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: PHP Medicare Advantage |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.40
|
| Rate for Payer: Priority Health HMO/PPO |
$146.42
|
| Rate for Payer: Priority Health Medicare |
$42.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.76
|
| Rate for Payer: Railroad Medicare Medicare |
$42.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.10
|
| Rate for Payer: UHC Core |
$140.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.08
|
| Rate for Payer: UHC Exchange |
$42.08
|
| Rate for Payer: UHC Medicare Advantage |
$42.08
|
| Rate for Payer: VA VA |
$42.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
IP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.40 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: BCBS Trust/PPO |
$137.38
|
| Rate for Payer: BCN Commercial |
$130.06
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: Nomi Health Commercial |
$138.01
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.40
|
| Rate for Payer: Priority Health HMO/PPO |
$146.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.10
|
| Rate for Payer: UHC Core |
$140.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$123.77 |
| Max. Negotiated Rate |
$171.38 |
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: BCBS Trust/PPO |
$155.44
|
| Rate for Payer: BCN Commercial |
$147.16
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: Nomi Health Commercial |
$156.14
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health HMO/PPO |
$165.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.57
|
| Rate for Payer: UHC Core |
$159.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.82
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.22 |
| Max. Negotiated Rate |
$171.38 |
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: Aetna Medicare |
$49.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.51
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$47.60
|
| Rate for Payer: BCBS Trust/PPO |
$156.54
|
| Rate for Payer: BCCCP Commercial |
$104.63
|
| Rate for Payer: BCN Commercial |
$148.05
|
| Rate for Payer: BCN Medicare Advantage |
$47.60
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.60
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.82
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.99
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: Nomi Health Commercial |
$156.14
|
| Rate for Payer: PACE Senior Care Partners |
$45.22
|
| Rate for Payer: PACE SWMI |
$47.60
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: PHP Medicare Advantage |
$47.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health HMO/PPO |
$165.67
|
| Rate for Payer: Priority Health Medicare |
$48.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.58
|
| Rate for Payer: Railroad Medicare Medicare |
$47.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.57
|
| Rate for Payer: UHC Core |
$159.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.60
|
| Rate for Payer: UHC Exchange |
$47.60
|
| Rate for Payer: UHC Medicare Advantage |
$47.60
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.82
|
|
