|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$138.43 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$164.27
|
| Rate for Payer: BCN Commercial |
$164.27
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.07 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna Medicare |
$51.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.16
|
| Rate for Payer: BCBS Complete |
$36.82
|
| Rate for Payer: BCBS MAPPO |
$49.73
|
| Rate for Payer: BCBS Trust/PPO |
$163.52
|
| Rate for Payer: BCN Commercial |
$163.52
|
| Rate for Payer: BCN Medicare Advantage |
$49.73
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.73
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Mclaren Medicaid |
$35.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: Meridian Medicaid |
$36.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: PACE Senior Care Partners |
$47.24
|
| Rate for Payer: PACE SWMI |
$49.73
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: PHP Medicare Advantage |
$49.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.04
|
| Rate for Payer: Priority Health Medicare |
$50.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.43
|
| Rate for Payer: Railroad Medicare Medicare |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: UHC Exchange |
$49.73
|
| Rate for Payer: UHC Medicaid |
$35.07
|
| Rate for Payer: UHC Medicare Advantage |
$49.73
|
| Rate for Payer: UHCCP Medicaid |
$35.07
|
| Rate for Payer: VA VA |
$49.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$526.09 |
| Max. Negotiated Rate |
$2,685.64 |
| Rate for Payer: Aetna Commercial |
$2,536.43
|
| Rate for Payer: Aetna Medicare |
$775.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$932.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$932.51
|
| Rate for Payer: BCBS Complete |
$552.35
|
| Rate for Payer: BCBS MAPPO |
$746.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,453.18
|
| Rate for Payer: BCN Commercial |
$2,453.18
|
| Rate for Payer: BCN Medicare Advantage |
$746.01
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Commercial |
$2,566.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.01
|
| Rate for Payer: Healthscope Commercial |
$2,685.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,238.03
|
| Rate for Payer: Mclaren Medicaid |
$526.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$783.31
|
| Rate for Payer: Meridian Medicaid |
$552.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$857.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$820.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Nomi Health Commercial |
$2,446.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: PACE Senior Care Partners |
$708.71
|
| Rate for Payer: PACE SWMI |
$746.01
|
| Rate for Payer: PHP Commercial |
$2,536.43
|
| Rate for Payer: PHP Medicare Advantage |
$746.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,596.11
|
| Rate for Payer: Priority Health Medicare |
$753.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,076.89
|
| Rate for Payer: Railroad Medicare Medicare |
$746.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,625.96
|
| Rate for Payer: UHC Core |
$2,491.67
|
| Rate for Payer: UHC Exchange |
$746.01
|
| Rate for Payer: UHC Medicaid |
$526.09
|
| Rate for Payer: UHC Medicare Advantage |
$746.01
|
| Rate for Payer: UHCCP Medicaid |
$526.09
|
| Rate for Payer: VA VA |
$746.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,238.03
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,076.89 |
| Max. Negotiated Rate |
$2,685.64 |
| Rate for Payer: Aetna Commercial |
$2,536.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,464.52
|
| Rate for Payer: BCN Commercial |
$2,464.52
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Commercial |
$2,566.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Healthscope Commercial |
$2,685.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,238.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Nomi Health Commercial |
$2,446.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: PHP Commercial |
$2,536.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,596.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,076.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,625.96
|
| Rate for Payer: UHC Core |
$2,491.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,238.03
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,630.16 |
| Max. Negotiated Rate |
$3,401.07 |
| Rate for Payer: Aetna Commercial |
$3,212.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,121.05
|
| Rate for Payer: BCN Commercial |
$3,121.05
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Commercial |
$3,249.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Healthscope Commercial |
$3,401.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,834.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Nomi Health Commercial |
$3,098.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: PHP Commercial |
$3,212.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,287.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,630.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,325.49
|
| Rate for Payer: UHC Core |
$3,155.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,834.23
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$666.23 |
| Max. Negotiated Rate |
$3,401.07 |
| Rate for Payer: Aetna Commercial |
$3,212.12
|
| Rate for Payer: Aetna Medicare |
$982.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,180.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,180.93
|
| Rate for Payer: BCBS Complete |
$699.49
|
| Rate for Payer: BCBS MAPPO |
$944.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,106.69
|
| Rate for Payer: BCN Commercial |
$3,106.69
|
| Rate for Payer: BCN Medicare Advantage |
$944.74
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Commercial |
$3,249.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$944.74
|
| Rate for Payer: Healthscope Commercial |
$3,401.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,834.23
|
| Rate for Payer: Mclaren Medicaid |
$666.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$991.98
|
| Rate for Payer: Meridian Medicaid |
$699.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,086.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,039.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Nomi Health Commercial |
$3,098.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: PACE Senior Care Partners |
$897.51
|
| Rate for Payer: PACE SWMI |
$944.74
|
| Rate for Payer: PHP Commercial |
$3,212.12
|
| Rate for Payer: PHP Medicare Advantage |
$944.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$666.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,287.70
|
| Rate for Payer: Priority Health Medicare |
$954.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,630.16
|
| Rate for Payer: Railroad Medicare Medicare |
$944.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,325.49
|
| Rate for Payer: UHC Core |
$3,155.44
|
| Rate for Payer: UHC Exchange |
$944.74
|
| Rate for Payer: UHC Medicaid |
$666.23
|
| Rate for Payer: UHC Medicare Advantage |
$944.74
|
| Rate for Payer: UHCCP Medicaid |
$666.23
|
| Rate for Payer: VA VA |
$944.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,834.23
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,939.33 |
| Max. Negotiated Rate |
$27,076.72 |
| Rate for Payer: Aetna Commercial |
$25,572.46
|
| Rate for Payer: BCBS Trust/PPO |
$24,847.41
|
| Rate for Payer: BCN Commercial |
$24,847.41
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Commercial |
$25,873.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Healthscope Commercial |
$27,076.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,563.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Nomi Health Commercial |
$24,669.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: PHP Commercial |
$25,572.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,174.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,939.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,475.02
|
| Rate for Payer: UHC Core |
$25,121.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,563.94
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,304.03 |
| Max. Negotiated Rate |
$27,076.72 |
| Rate for Payer: Aetna Commercial |
$25,572.46
|
| Rate for Payer: Aetna Medicare |
$7,822.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,401.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,401.64
|
| Rate for Payer: BCBS Complete |
$5,568.78
|
| Rate for Payer: BCBS MAPPO |
$7,521.31
|
| Rate for Payer: BCBS Trust/PPO |
$24,733.08
|
| Rate for Payer: BCN Commercial |
$24,733.08
|
| Rate for Payer: BCN Medicare Advantage |
$7,521.31
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Commercial |
$25,873.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,521.31
|
| Rate for Payer: Healthscope Commercial |
$27,076.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,563.94
|
| Rate for Payer: Mclaren Medicaid |
$5,304.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,897.38
|
| Rate for Payer: Meridian Medicaid |
$5,568.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,649.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,273.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Nomi Health Commercial |
$24,669.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: PACE Senior Care Partners |
$7,145.25
|
| Rate for Payer: PACE SWMI |
$7,521.31
|
| Rate for Payer: PHP Commercial |
$25,572.46
|
| Rate for Payer: PHP Medicare Advantage |
$7,521.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,304.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,174.17
|
| Rate for Payer: Priority Health Medicare |
$7,596.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,939.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7,521.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,475.02
|
| Rate for Payer: UHC Core |
$25,121.18
|
| Rate for Payer: UHC Exchange |
$7,521.31
|
| Rate for Payer: UHC Medicaid |
$5,304.03
|
| Rate for Payer: UHC Medicare Advantage |
$7,521.31
|
| Rate for Payer: UHCCP Medicaid |
$5,304.03
|
| Rate for Payer: VA VA |
$7,521.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,563.94
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,772.01 |
| Max. Negotiated Rate |
$9,045.99 |
| Rate for Payer: Aetna Commercial |
$8,543.43
|
| Rate for Payer: Aetna Medicare |
$2,613.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,140.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,140.97
|
| Rate for Payer: BCBS Complete |
$1,860.46
|
| Rate for Payer: BCBS MAPPO |
$2,512.78
|
| Rate for Payer: BCBS Trust/PPO |
$8,263.01
|
| Rate for Payer: BCN Commercial |
$8,263.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,512.78
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Commercial |
$8,643.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,512.78
|
| Rate for Payer: Healthscope Commercial |
$9,045.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.32
|
| Rate for Payer: Mclaren Medicaid |
$1,772.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,638.41
|
| Rate for Payer: Meridian Medicaid |
$1,860.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,889.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,764.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Nomi Health Commercial |
$8,241.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: PACE Senior Care Partners |
$2,387.14
|
| Rate for Payer: PACE SWMI |
$2,512.78
|
| Rate for Payer: PHP Commercial |
$8,543.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,512.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,772.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,744.46
|
| Rate for Payer: Priority Health Medicare |
$2,537.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,995.57
|
| Rate for Payer: Railroad Medicare Medicare |
$2,512.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,844.97
|
| Rate for Payer: UHC Core |
$8,392.67
|
| Rate for Payer: UHC Exchange |
$2,512.78
|
| Rate for Payer: UHC Medicaid |
$1,772.01
|
| Rate for Payer: UHC Medicare Advantage |
$2,512.78
|
| Rate for Payer: UHCCP Medicaid |
$1,772.01
|
| Rate for Payer: VA VA |
$2,512.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.32
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,995.57 |
| Max. Negotiated Rate |
$9,045.99 |
| Rate for Payer: Aetna Commercial |
$8,543.43
|
| Rate for Payer: BCBS Trust/PPO |
$8,301.20
|
| Rate for Payer: BCN Commercial |
$8,301.20
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Commercial |
$8,643.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Healthscope Commercial |
$9,045.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Nomi Health Commercial |
$8,241.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: PHP Commercial |
$8,543.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,744.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,995.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,844.97
|
| Rate for Payer: UHC Core |
$8,392.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.32
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.63 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.25
|
| Rate for Payer: BCBS Complete |
$18.51
|
| Rate for Payer: BCBS MAPPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.21
|
| Rate for Payer: BCN Commercial |
$82.21
|
| Rate for Payer: BCN Medicare Advantage |
$25.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Mclaren Medicaid |
$17.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.25
|
| Rate for Payer: Meridian Medicaid |
$18.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.75
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE Senior Care Partners |
$23.75
|
| Rate for Payer: PACE SWMI |
$25.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$25.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.60
|
| Rate for Payer: Railroad Medicare Medicare |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: UHC Exchange |
$25.00
|
| Rate for Payer: UHC Medicaid |
$17.63
|
| Rate for Payer: UHC Medicare Advantage |
$25.00
|
| Rate for Payer: UHCCP Medicaid |
$17.63
|
| Rate for Payer: VA VA |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.59
|
| Rate for Payer: BCN Commercial |
$82.59
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGIONELLA
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.19 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$42.95
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.19 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$42.95
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.19 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$42.95
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: BCBS Trust/PPO |
$92.46
|
| Rate for Payer: BCN Commercial |
$92.46
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.74 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.98
|
| Rate for Payer: BCBS Complete |
$20.72
|
| Rate for Payer: BCBS MAPPO |
$27.99
|
| Rate for Payer: BCBS Trust/PPO |
$92.03
|
| Rate for Payer: BCN Commercial |
$92.03
|
| Rate for Payer: BCN Medicare Advantage |
$27.99
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.99
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Mclaren Medicaid |
$19.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.39
|
| Rate for Payer: Meridian Medicaid |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PACE Senior Care Partners |
$26.59
|
| Rate for Payer: PACE SWMI |
$27.99
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$27.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Medicare |
$28.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: Railroad Medicare Medicare |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: UHC Exchange |
$27.99
|
| Rate for Payer: UHC Medicaid |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$27.99
|
| Rate for Payer: UHCCP Medicaid |
$19.74
|
| Rate for Payer: VA VA |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
OP
|
$127.35
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna Medicare |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.80
|
| Rate for Payer: BCBS Complete |
$23.57
|
| Rate for Payer: BCBS MAPPO |
$31.84
|
| Rate for Payer: BCBS Trust/PPO |
$104.69
|
| Rate for Payer: BCN Commercial |
$104.69
|
| Rate for Payer: BCN Medicare Advantage |
$31.84
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$22.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.43
|
| Rate for Payer: Meridian Medicaid |
$23.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$104.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PACE Senior Care Partners |
$30.25
|
| Rate for Payer: PACE SWMI |
$31.84
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.79
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.64
|
| Rate for Payer: Railroad Medicare Medicare |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.07
|
| Rate for Payer: UHC Core |
$106.34
|
| Rate for Payer: UHC Exchange |
$31.84
|
| Rate for Payer: UHC Medicaid |
$22.45
|
| Rate for Payer: UHC Medicare Advantage |
$31.84
|
| Rate for Payer: UHCCP Medicaid |
$22.45
|
| Rate for Payer: VA VA |
$31.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
IP
|
$127.35
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$88.64 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: BCBS Trust/PPO |
$105.18
|
| Rate for Payer: BCN Commercial |
$105.18
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$104.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.07
|
| Rate for Payer: UHC Core |
$106.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC LEGIONELLA PNEUMOPHILA AB
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200301
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
