|
HC POC HEMOGLOBIN; METHEMOGLOBIN, QUANT
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100725
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.84 |
| 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 |
$6.35
|
| 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 |
$6.05
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| 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 |
$6.05
|
| 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 POC IONIZED CALCIUM
|
Facility
|
OP
|
$105.40
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$94.86 |
| Rate for Payer: Aetna Commercial |
$89.59
|
| Rate for Payer: Aetna Medicare |
$27.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.94
|
| Rate for Payer: BCBS Complete |
$10.60
|
| Rate for Payer: BCBS MAPPO |
$26.35
|
| Rate for Payer: BCBS Trust/PPO |
$81.95
|
| Rate for Payer: BCN Commercial |
$81.95
|
| Rate for Payer: BCN Medicare Advantage |
$26.35
|
| Rate for Payer: Cash Price |
$84.32
|
| Rate for Payer: Cash Price |
$84.32
|
| Rate for Payer: Cofinity Commercial |
$90.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.35
|
| Rate for Payer: Healthscope Commercial |
$94.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.05
|
| Rate for Payer: Mclaren Medicaid |
$10.10
|
| Rate for Payer: Meridian Medicaid |
$10.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.59
|
| Rate for Payer: PACE Senior Care Partners |
$25.03
|
| Rate for Payer: PACE SWMI |
$26.35
|
| Rate for Payer: PHP Commercial |
$89.59
|
| Rate for Payer: PHP Medicare Advantage |
$26.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.70
|
| Rate for Payer: Priority Health Medicare |
$26.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.28
|
| Rate for Payer: Railroad Medicare Medicare |
$26.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.75
|
| Rate for Payer: UHC Core |
$88.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.35
|
| Rate for Payer: UHC Medicare Advantage |
$27.14
|
| Rate for Payer: VA VA |
$26.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.05
|
|
|
HC POC IONIZED CALCIUM
|
Facility
|
IP
|
$105.40
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.28 |
| Max. Negotiated Rate |
$94.86 |
| Rate for Payer: Aetna Commercial |
$89.59
|
| Rate for Payer: BCBS Trust/PPO |
$81.45
|
| Rate for Payer: BCN Commercial |
$81.45
|
| Rate for Payer: Cash Price |
$84.32
|
| Rate for Payer: Cofinity Commercial |
$90.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.32
|
| Rate for Payer: Healthscope Commercial |
$94.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$89.59
|
| Rate for Payer: PHP Commercial |
$89.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.75
|
| Rate for Payer: UHC Core |
$88.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.05
|
|
|
HC POC LACTIC ACID
|
Facility
|
IP
|
$53.59
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100697
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.68 |
| Max. Negotiated Rate |
$48.23 |
| Rate for Payer: Aetna Commercial |
$45.55
|
| Rate for Payer: BCBS Trust/PPO |
$41.41
|
| Rate for Payer: BCN Commercial |
$41.41
|
| Rate for Payer: Cash Price |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$46.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.87
|
| Rate for Payer: Healthscope Commercial |
$48.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.55
|
| Rate for Payer: PHP Commercial |
$45.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.16
|
| Rate for Payer: UHC Core |
$44.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.19
|
|
|
HC POC LACTIC ACID
|
Facility
|
OP
|
$53.59
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100697
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$48.23 |
| Rate for Payer: Aetna Commercial |
$45.55
|
| Rate for Payer: Aetna Medicare |
$13.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.75
|
| Rate for Payer: BCBS Complete |
$8.97
|
| Rate for Payer: BCBS MAPPO |
$13.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.67
|
| Rate for Payer: BCN Commercial |
$41.67
|
| Rate for Payer: BCN Medicare Advantage |
$13.40
|
| Rate for Payer: Cash Price |
$42.87
|
| Rate for Payer: Cash Price |
$42.87
|
| Rate for Payer: Cofinity Commercial |
$46.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$48.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.19
|
| Rate for Payer: Mclaren Medicaid |
$8.54
|
| Rate for Payer: Meridian Medicaid |
$8.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.55
|
| Rate for Payer: PACE Senior Care Partners |
$12.73
|
| Rate for Payer: PACE SWMI |
$13.40
|
| Rate for Payer: PHP Commercial |
$45.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.62
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.68
|
| Rate for Payer: Railroad Medicare Medicare |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.16
|
| Rate for Payer: UHC Core |
$44.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.40
|
| Rate for Payer: UHC Medicare Advantage |
$13.80
|
| Rate for Payer: VA VA |
$13.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.19
|
|
|
HC POC POTASSIUM
|
Facility
|
IP
|
$31.60
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.27 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: BCBS Trust/PPO |
$24.42
|
| Rate for Payer: BCN Commercial |
$24.42
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.86
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.81
|
| Rate for Payer: UHC Core |
$26.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC POC POTASSIUM
|
Facility
|
OP
|
$31.60
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$3.69
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$24.57
|
| Rate for Payer: BCN Commercial |
$24.57
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: Mclaren Medicaid |
$3.51
|
| Rate for Payer: Meridian Medicaid |
$3.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.86
|
| Rate for Payer: PACE Senior Care Partners |
$7.50
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.49
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.27
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.81
|
| Rate for Payer: UHC Core |
$26.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.14
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC POC SODIUM
|
Facility
|
IP
|
$32.23
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.66 |
| Max. Negotiated Rate |
$29.01 |
| Rate for Payer: Aetna Commercial |
$27.40
|
| Rate for Payer: BCBS Trust/PPO |
$24.91
|
| Rate for Payer: BCN Commercial |
$24.91
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cofinity Commercial |
$27.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.78
|
| Rate for Payer: Healthscope Commercial |
$29.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.40
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.36
|
| Rate for Payer: UHC Core |
$26.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.17
|
|
|
HC POC SODIUM
|
Facility
|
OP
|
$32.23
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$29.01 |
| Rate for Payer: Aetna Commercial |
$27.40
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.07
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$25.06
|
| Rate for Payer: BCN Commercial |
$25.06
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cofinity Commercial |
$27.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.17
|
| Rate for Payer: Mclaren Medicaid |
$3.55
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.40
|
| Rate for Payer: PACE Senior Care Partners |
$7.65
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.04
|
| Rate for Payer: Priority Health Medicare |
$8.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.36
|
| Rate for Payer: UHC Core |
$26.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.06
|
| Rate for Payer: UHC Medicare Advantage |
$8.30
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.17
|
|
|
HC POC TOTAL CO2
|
Facility
|
IP
|
$17.82
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$16.04 |
| Rate for Payer: Aetna Commercial |
$15.15
|
| Rate for Payer: BCBS Trust/PPO |
$13.77
|
| Rate for Payer: BCN Commercial |
$13.77
|
| Rate for Payer: Cash Price |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$15.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.26
|
| Rate for Payer: Healthscope Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.15
|
| Rate for Payer: PHP Commercial |
$15.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.68
|
| Rate for Payer: UHC Core |
$14.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.36
|
|
|
HC POC TOTAL CO2
|
Facility
|
OP
|
$17.82
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.04 |
| Rate for Payer: Aetna Commercial |
$15.15
|
| Rate for Payer: Aetna Medicare |
$4.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.57
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$4.46
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$4.46
|
| Rate for Payer: Cash Price |
$14.26
|
| Rate for Payer: Cash Price |
$14.26
|
| Rate for Payer: Cofinity Commercial |
$15.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.46
|
| Rate for Payer: Healthscope Commercial |
$16.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.36
|
| Rate for Payer: Mclaren Medicaid |
$3.60
|
| Rate for Payer: Meridian Medicaid |
$3.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.15
|
| Rate for Payer: PACE Senior Care Partners |
$4.23
|
| Rate for Payer: PACE SWMI |
$4.46
|
| Rate for Payer: PHP Commercial |
$15.15
|
| Rate for Payer: PHP Medicare Advantage |
$4.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.50
|
| Rate for Payer: Priority Health Medicare |
$4.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.87
|
| Rate for Payer: Railroad Medicare Medicare |
$4.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.68
|
| Rate for Payer: UHC Core |
$14.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.46
|
| Rate for Payer: UHC Medicare Advantage |
$4.59
|
| Rate for Payer: VA VA |
$4.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.36
|
|
|
HC POC UREA NITROGEN
|
Facility
|
IP
|
$15.46
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.43 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: Aetna Commercial |
$13.14
|
| Rate for Payer: BCBS Trust/PPO |
$11.95
|
| Rate for Payer: BCN Commercial |
$11.95
|
| Rate for Payer: Cash Price |
$12.37
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.37
|
| Rate for Payer: Healthscope Commercial |
$13.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.14
|
| Rate for Payer: PHP Commercial |
$13.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.60
|
| Rate for Payer: UHC Core |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
|
|
HC POC UREA NITROGEN
|
Facility
|
OP
|
$15.46
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: Aetna Commercial |
$13.14
|
| Rate for Payer: Aetna Medicare |
$4.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.83
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS MAPPO |
$3.86
|
| Rate for Payer: BCBS Trust/PPO |
$12.02
|
| Rate for Payer: BCN Commercial |
$12.02
|
| Rate for Payer: BCN Medicare Advantage |
$3.86
|
| Rate for Payer: Cash Price |
$12.37
|
| Rate for Payer: Cash Price |
$12.37
|
| Rate for Payer: Cofinity Commercial |
$13.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.86
|
| Rate for Payer: Healthscope Commercial |
$13.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.60
|
| Rate for Payer: Mclaren Medicaid |
$2.92
|
| Rate for Payer: Meridian Medicaid |
$3.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.67
|
| Rate for Payer: PACE SWMI |
$3.86
|
| Rate for Payer: PHP Commercial |
$13.14
|
| Rate for Payer: PHP Medicare Advantage |
$3.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.45
|
| Rate for Payer: Priority Health Medicare |
$3.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.60
|
| Rate for Payer: UHC Core |
$12.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.86
|
| Rate for Payer: UHC Medicare Advantage |
$3.98
|
| Rate for Payer: VA VA |
$3.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.60
|
|
|
HC POLARCATH
|
Facility
|
OP
|
$6,937.70
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,647.70 |
| Max. Negotiated Rate |
$6,243.93 |
| Rate for Payer: Aetna Commercial |
$5,897.04
|
| Rate for Payer: Aetna Medicare |
$1,803.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,168.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,168.03
|
| Rate for Payer: BCBS Complete |
$2,775.08
|
| Rate for Payer: BCBS MAPPO |
$1,734.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,394.06
|
| Rate for Payer: BCN Commercial |
$5,394.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,734.42
|
| Rate for Payer: Cash Price |
$5,550.16
|
| Rate for Payer: Cofinity Commercial |
$5,966.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,550.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,734.42
|
| Rate for Payer: Healthscope Commercial |
$6,243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,203.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,821.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,994.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,897.04
|
| Rate for Payer: PACE Senior Care Partners |
$1,647.70
|
| Rate for Payer: PACE SWMI |
$1,734.42
|
| Rate for Payer: PHP Commercial |
$5,897.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,734.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,856.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,035.80
|
| Rate for Payer: Priority Health Medicare |
$1,734.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,231.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,734.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,105.18
|
| Rate for Payer: UHC Core |
$5,792.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,734.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,786.46
|
| Rate for Payer: VA VA |
$1,734.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,203.28
|
|
|
HC POLARCATH
|
Facility
|
IP
|
$6,937.70
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200064
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,231.30 |
| Max. Negotiated Rate |
$6,243.93 |
| Rate for Payer: Aetna Commercial |
$5,897.04
|
| Rate for Payer: BCBS Trust/PPO |
$5,361.45
|
| Rate for Payer: BCN Commercial |
$5,361.45
|
| Rate for Payer: Cash Price |
$5,550.16
|
| Rate for Payer: Cofinity Commercial |
$5,966.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,550.16
|
| Rate for Payer: Healthscope Commercial |
$6,243.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,203.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,897.04
|
| Rate for Payer: PHP Commercial |
$5,897.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,856.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,035.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,231.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,105.18
|
| Rate for Payer: UHC Core |
$5,792.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,203.28
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
OP
|
$268.79
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.84 |
| Max. Negotiated Rate |
$241.91 |
| Rate for Payer: Aetna Commercial |
$228.47
|
| Rate for Payer: Aetna Medicare |
$69.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.00
|
| Rate for Payer: BCBS Complete |
$107.52
|
| Rate for Payer: BCBS MAPPO |
$67.20
|
| Rate for Payer: BCBS Trust/PPO |
$208.98
|
| Rate for Payer: BCN Commercial |
$208.98
|
| Rate for Payer: BCN Medicare Advantage |
$67.20
|
| Rate for Payer: Cash Price |
$215.03
|
| Rate for Payer: Cofinity Commercial |
$231.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.20
|
| Rate for Payer: Healthscope Commercial |
$241.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.47
|
| Rate for Payer: PACE Senior Care Partners |
$63.84
|
| Rate for Payer: PACE SWMI |
$67.20
|
| Rate for Payer: PHP Commercial |
$228.47
|
| Rate for Payer: PHP Medicare Advantage |
$67.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.85
|
| Rate for Payer: Priority Health Medicare |
$67.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.94
|
| Rate for Payer: Railroad Medicare Medicare |
$67.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.54
|
| Rate for Payer: UHC Core |
$224.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.20
|
| Rate for Payer: UHC Medicare Advantage |
$69.21
|
| Rate for Payer: VA VA |
$67.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.59
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
IP
|
$268.79
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.94 |
| Max. Negotiated Rate |
$241.91 |
| Rate for Payer: Aetna Commercial |
$228.47
|
| Rate for Payer: BCBS Trust/PPO |
$207.72
|
| Rate for Payer: BCN Commercial |
$207.72
|
| Rate for Payer: Cash Price |
$215.03
|
| Rate for Payer: Cofinity Commercial |
$231.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.03
|
| Rate for Payer: Healthscope Commercial |
$241.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$228.47
|
| Rate for Payer: PHP Commercial |
$228.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$233.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.54
|
| Rate for Payer: UHC Core |
$224.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.59
|
|
|
HC POLIOVIRUS VACCINE, INACTIVATED (IPV) SUBQ/IM
|
Facility
|
IP
|
$42.64
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
63600082
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.01 |
| Max. Negotiated Rate |
$38.38 |
| Rate for Payer: Aetna Commercial |
$36.24
|
| Rate for Payer: BCBS Trust/PPO |
$32.95
|
| Rate for Payer: BCN Commercial |
$32.95
|
| Rate for Payer: Cash Price |
$34.11
|
| Rate for Payer: Cofinity Commercial |
$36.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.11
|
| Rate for Payer: Healthscope Commercial |
$38.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.24
|
| Rate for Payer: PHP Commercial |
$36.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.52
|
| Rate for Payer: UHC Core |
$35.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.98
|
|
|
HC POLIOVIRUS VACCINE, INACTIVATED (IPV) SUBQ/IM
|
Facility
|
OP
|
$42.64
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
63600082
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$38.38 |
| Rate for Payer: Aetna Commercial |
$36.24
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.32
|
| Rate for Payer: BCBS Complete |
$17.06
|
| Rate for Payer: BCBS MAPPO |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$33.15
|
| Rate for Payer: BCN Commercial |
$33.15
|
| Rate for Payer: BCN Medicare Advantage |
$10.66
|
| Rate for Payer: Cash Price |
$34.11
|
| Rate for Payer: Cofinity Commercial |
$36.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$38.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.24
|
| Rate for Payer: PACE Senior Care Partners |
$10.13
|
| Rate for Payer: PACE SWMI |
$10.66
|
| Rate for Payer: PHP Commercial |
$36.24
|
| Rate for Payer: PHP Medicare Advantage |
$10.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.10
|
| Rate for Payer: Priority Health Medicare |
$10.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.01
|
| Rate for Payer: Railroad Medicare Medicare |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.52
|
| Rate for Payer: UHC Core |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.66
|
| Rate for Payer: UHC Medicare Advantage |
$10.98
|
| Rate for Payer: VA VA |
$10.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.98
|
|
|
HC POLYPECTOMY
|
Facility
|
IP
|
$482.14
|
|
| Hospital Charge Code |
36000080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$294.06 |
| Max. Negotiated Rate |
$433.93 |
| Rate for Payer: Aetna Commercial |
$409.82
|
| Rate for Payer: BCBS Trust/PPO |
$372.60
|
| Rate for Payer: BCN Commercial |
$372.60
|
| Rate for Payer: Cash Price |
$385.71
|
| Rate for Payer: Cofinity Commercial |
$414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.71
|
| Rate for Payer: Healthscope Commercial |
$433.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.82
|
| Rate for Payer: PHP Commercial |
$409.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.28
|
| Rate for Payer: UHC Core |
$402.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.60
|
|
|
HC POLYPECTOMY
|
Facility
|
OP
|
$482.14
|
|
| Hospital Charge Code |
36000080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$114.51 |
| Max. Negotiated Rate |
$433.93 |
| Rate for Payer: Aetna Commercial |
$409.82
|
| Rate for Payer: Aetna Medicare |
$125.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.67
|
| Rate for Payer: BCBS Complete |
$192.86
|
| Rate for Payer: BCBS MAPPO |
$120.54
|
| Rate for Payer: BCBS Trust/PPO |
$374.86
|
| Rate for Payer: BCN Commercial |
$374.86
|
| Rate for Payer: BCN Medicare Advantage |
$120.54
|
| Rate for Payer: Cash Price |
$385.71
|
| Rate for Payer: Cofinity Commercial |
$414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.54
|
| Rate for Payer: Healthscope Commercial |
$433.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$409.82
|
| Rate for Payer: PACE Senior Care Partners |
$114.51
|
| Rate for Payer: PACE SWMI |
$120.54
|
| Rate for Payer: PHP Commercial |
$409.82
|
| Rate for Payer: PHP Medicare Advantage |
$120.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$419.46
|
| Rate for Payer: Priority Health Medicare |
$120.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.06
|
| Rate for Payer: Railroad Medicare Medicare |
$120.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.28
|
| Rate for Payer: UHC Core |
$402.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.54
|
| Rate for Payer: UHC Medicare Advantage |
$124.15
|
| Rate for Payer: VA VA |
$120.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.60
|
|
|
HC POLYPECTOMY ADDL 45 MIN OR MORE
|
Facility
|
OP
|
$179.15
|
|
| Hospital Charge Code |
36000004
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$161.24 |
| Rate for Payer: Aetna Commercial |
$152.28
|
| Rate for Payer: Aetna Medicare |
$46.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.98
|
| Rate for Payer: BCBS Complete |
$71.66
|
| Rate for Payer: BCBS MAPPO |
$44.79
|
| Rate for Payer: BCBS Trust/PPO |
$139.29
|
| Rate for Payer: BCN Commercial |
$139.29
|
| Rate for Payer: BCN Medicare Advantage |
$44.79
|
| Rate for Payer: Cash Price |
$143.32
|
| Rate for Payer: Cofinity Commercial |
$154.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.79
|
| Rate for Payer: Healthscope Commercial |
$161.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.28
|
| Rate for Payer: PACE Senior Care Partners |
$42.55
|
| Rate for Payer: PACE SWMI |
$44.79
|
| Rate for Payer: PHP Commercial |
$152.28
|
| Rate for Payer: PHP Medicare Advantage |
$44.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.86
|
| Rate for Payer: Priority Health Medicare |
$44.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.26
|
| Rate for Payer: Railroad Medicare Medicare |
$44.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.65
|
| Rate for Payer: UHC Core |
$149.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.79
|
| Rate for Payer: UHC Medicare Advantage |
$46.13
|
| Rate for Payer: VA VA |
$44.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.36
|
|
|
HC POLYPECTOMY ADDL 45 MIN OR MORE
|
Facility
|
IP
|
$179.15
|
|
| Hospital Charge Code |
36000004
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$109.26 |
| Max. Negotiated Rate |
$161.24 |
| Rate for Payer: Aetna Commercial |
$152.28
|
| Rate for Payer: BCBS Trust/PPO |
$138.45
|
| Rate for Payer: BCN Commercial |
$138.45
|
| Rate for Payer: Cash Price |
$143.32
|
| Rate for Payer: Cofinity Commercial |
$154.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.32
|
| Rate for Payer: Healthscope Commercial |
$161.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$152.28
|
| Rate for Payer: PHP Commercial |
$152.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.65
|
| Rate for Payer: UHC Core |
$149.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.36
|
|
|
HC PORPHYRIN URINE QUANTITATIVE
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 84120
|
| Hospital Charge Code |
30100395
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.20
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$25.38
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: BCN Medicare Advantage |
$8.16
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Mclaren Medicaid |
$10.86
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.75
|
| Rate for Payer: PACE SWMI |
$8.16
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$8.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: Railroad Medicare Medicare |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$8.40
|
| Rate for Payer: VA VA |
$8.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC PORPHYRIN URINE QUANTITATIVE
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 84120
|
| Hospital Charge Code |
30100395
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$25.22
|
| Rate for Payer: BCN Commercial |
$25.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
