|
HC LEVETIRACETAM LEVEL
|
Facility
|
IP
|
$78.33
|
|
|
Service Code
|
CPT 80177
|
| Hospital Charge Code |
30100057
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.52 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Aetna Commercial |
$66.58
|
| Rate for Payer: BCBS Trust/PPO |
$64.69
|
| Rate for Payer: BCN Commercial |
$64.69
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Cofinity Commercial |
$67.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.66
|
| Rate for Payer: Healthscope Commercial |
$70.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.58
|
| Rate for Payer: Nomi Health Commercial |
$64.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.75
|
| Rate for Payer: PHP Commercial |
$66.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.93
|
| Rate for Payer: UHC Core |
$65.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.75
|
|
|
HC LEVONORGESTREL-RELEASING ICS, 52MG, 5 YR
|
Facility
|
IP
|
$3,923.65
|
|
|
Service Code
|
CPT J7298
|
| Hospital Charge Code |
63600106
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,730.86 |
| Max. Negotiated Rate |
$3,531.28 |
| Rate for Payer: Aetna Commercial |
$3,335.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,240.54
|
| Rate for Payer: BCN Commercial |
$3,240.54
|
| Rate for Payer: Cash Price |
$3,138.92
|
| Rate for Payer: Cofinity Commercial |
$3,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,138.92
|
| Rate for Payer: Healthscope Commercial |
$3,531.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,942.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,335.10
|
| Rate for Payer: Nomi Health Commercial |
$3,217.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,942.74
|
| Rate for Payer: PHP Commercial |
$3,335.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,413.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,730.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,452.81
|
| Rate for Payer: UHC Core |
$3,276.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,942.74
|
|
|
HC LEVONORGESTREL-RELEASING ICS, 52MG, 5 YR
|
Facility
|
OP
|
$3,923.65
|
|
|
Service Code
|
CPT J7298
|
| Hospital Charge Code |
63600106
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$691.74 |
| Max. Negotiated Rate |
$3,531.28 |
| Rate for Payer: Aetna Commercial |
$3,335.10
|
| Rate for Payer: Aetna Medicare |
$1,020.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,226.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,226.14
|
| Rate for Payer: BCBS Complete |
$726.27
|
| Rate for Payer: BCBS MAPPO |
$980.91
|
| Rate for Payer: BCBS Trust/PPO |
$3,225.63
|
| Rate for Payer: BCN Commercial |
$3,225.63
|
| Rate for Payer: BCN Medicare Advantage |
$980.91
|
| Rate for Payer: Cash Price |
$3,138.92
|
| Rate for Payer: Cofinity Commercial |
$3,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,138.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.91
|
| Rate for Payer: Healthscope Commercial |
$3,531.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,942.74
|
| Rate for Payer: Mclaren Medicaid |
$691.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,029.96
|
| Rate for Payer: Meridian Medicaid |
$726.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,128.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,079.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,335.10
|
| Rate for Payer: Nomi Health Commercial |
$3,217.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,942.74
|
| Rate for Payer: PACE Senior Care Partners |
$931.87
|
| Rate for Payer: PACE SWMI |
$980.91
|
| Rate for Payer: PHP Commercial |
$3,335.10
|
| Rate for Payer: PHP Medicare Advantage |
$980.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,413.58
|
| Rate for Payer: Priority Health Medicare |
$990.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,730.86
|
| Rate for Payer: Railroad Medicare Medicare |
$980.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,452.81
|
| Rate for Payer: UHC Core |
$3,276.25
|
| Rate for Payer: UHC Exchange |
$980.91
|
| Rate for Payer: UHC Medicaid |
$691.74
|
| Rate for Payer: UHC Medicare Advantage |
$980.91
|
| Rate for Payer: UHCCP Medicaid |
$691.74
|
| Rate for Payer: VA VA |
$980.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,942.74
|
|
|
HC LH (LUTEINIZING HORMONE)
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC LH (LUTEINIZING HORMONE)
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC LH PEDS, S
|
Facility
|
IP
|
$187.27
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100738
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$130.34 |
| Max. Negotiated Rate |
$168.54 |
| Rate for Payer: Aetna Commercial |
$159.18
|
| Rate for Payer: BCBS Trust/PPO |
$154.67
|
| Rate for Payer: BCN Commercial |
$154.67
|
| Rate for Payer: Cash Price |
$149.82
|
| Rate for Payer: Cofinity Commercial |
$161.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.82
|
| Rate for Payer: Healthscope Commercial |
$168.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.18
|
| Rate for Payer: Nomi Health Commercial |
$153.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.45
|
| Rate for Payer: PHP Commercial |
$159.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$162.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.80
|
| Rate for Payer: UHC Core |
$156.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.45
|
|
|
HC LH PEDS, S
|
Facility
|
OP
|
$187.27
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100738
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.02 |
| Max. Negotiated Rate |
$168.54 |
| Rate for Payer: Aetna Commercial |
$159.18
|
| Rate for Payer: Aetna Medicare |
$48.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.52
|
| Rate for Payer: BCBS Complete |
$34.66
|
| Rate for Payer: BCBS MAPPO |
$46.82
|
| Rate for Payer: BCBS Trust/PPO |
$153.95
|
| Rate for Payer: BCN Commercial |
$153.95
|
| Rate for Payer: BCN Medicare Advantage |
$46.82
|
| Rate for Payer: Cash Price |
$149.82
|
| Rate for Payer: Cofinity Commercial |
$161.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.82
|
| Rate for Payer: Healthscope Commercial |
$168.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.45
|
| Rate for Payer: Mclaren Medicaid |
$33.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.16
|
| Rate for Payer: Meridian Medicaid |
$34.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.18
|
| Rate for Payer: Nomi Health Commercial |
$153.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.45
|
| Rate for Payer: PACE Senior Care Partners |
$44.48
|
| Rate for Payer: PACE SWMI |
$46.82
|
| Rate for Payer: PHP Commercial |
$159.18
|
| Rate for Payer: PHP Medicare Advantage |
$46.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$162.92
|
| Rate for Payer: Priority Health Medicare |
$47.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.34
|
| Rate for Payer: Railroad Medicare Medicare |
$46.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.80
|
| Rate for Payer: UHC Core |
$156.37
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UHC Medicaid |
$33.02
|
| Rate for Payer: UHC Medicare Advantage |
$46.82
|
| Rate for Payer: UHCCP Medicaid |
$33.02
|
| Rate for Payer: VA VA |
$46.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.45
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
OP
|
$80.65
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.22 |
| Max. Negotiated Rate |
$72.58 |
| Rate for Payer: Aetna Commercial |
$68.55
|
| Rate for Payer: Aetna Medicare |
$20.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.20
|
| Rate for Payer: BCBS Complete |
$14.93
|
| Rate for Payer: BCBS MAPPO |
$20.16
|
| Rate for Payer: BCBS Trust/PPO |
$66.30
|
| Rate for Payer: BCN Commercial |
$66.30
|
| Rate for Payer: BCN Medicare Advantage |
$20.16
|
| Rate for Payer: Cash Price |
$64.52
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.16
|
| Rate for Payer: Healthscope Commercial |
$72.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.49
|
| Rate for Payer: Mclaren Medicaid |
$14.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.17
|
| Rate for Payer: Meridian Medicaid |
$14.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.55
|
| Rate for Payer: Nomi Health Commercial |
$66.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.49
|
| Rate for Payer: PACE Senior Care Partners |
$19.15
|
| Rate for Payer: PACE SWMI |
$20.16
|
| Rate for Payer: PHP Commercial |
$68.55
|
| Rate for Payer: PHP Medicare Advantage |
$20.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.17
|
| Rate for Payer: Priority Health Medicare |
$20.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.13
|
| Rate for Payer: Railroad Medicare Medicare |
$20.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$67.34
|
| Rate for Payer: UHC Exchange |
$20.16
|
| Rate for Payer: UHC Medicaid |
$14.22
|
| Rate for Payer: UHC Medicare Advantage |
$20.16
|
| Rate for Payer: UHCCP Medicaid |
$14.22
|
| Rate for Payer: VA VA |
$20.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.49
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
IP
|
$80.65
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$72.58 |
| Rate for Payer: Aetna Commercial |
$68.55
|
| Rate for Payer: BCBS Trust/PPO |
$66.61
|
| Rate for Payer: BCN Commercial |
$66.61
|
| Rate for Payer: Cash Price |
$64.52
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.52
|
| Rate for Payer: Healthscope Commercial |
$72.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.55
|
| Rate for Payer: Nomi Health Commercial |
$66.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.49
|
| Rate for Payer: PHP Commercial |
$68.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$67.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.49
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.86
|
| Rate for Payer: BCN Commercial |
$55.86
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$11.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$12.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicaid |
$11.92
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$11.92
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
OP
|
$383.29
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$67.57 |
| Max. Negotiated Rate |
$344.96 |
| Rate for Payer: Aetna Commercial |
$325.80
|
| Rate for Payer: Aetna Medicare |
$99.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.78
|
| Rate for Payer: BCBS Complete |
$70.95
|
| Rate for Payer: BCBS MAPPO |
$95.82
|
| Rate for Payer: BCBS Trust/PPO |
$315.10
|
| Rate for Payer: BCN Commercial |
$315.10
|
| Rate for Payer: BCN Medicare Advantage |
$95.82
|
| Rate for Payer: Cash Price |
$306.63
|
| Rate for Payer: Cofinity Commercial |
$329.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.82
|
| Rate for Payer: Healthscope Commercial |
$344.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.47
|
| Rate for Payer: Mclaren Medicaid |
$67.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.61
|
| Rate for Payer: Meridian Medicaid |
$70.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.80
|
| Rate for Payer: Nomi Health Commercial |
$314.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.47
|
| Rate for Payer: PACE Senior Care Partners |
$91.03
|
| Rate for Payer: PACE SWMI |
$95.82
|
| Rate for Payer: PHP Commercial |
$325.80
|
| Rate for Payer: PHP Medicare Advantage |
$95.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.46
|
| Rate for Payer: Priority Health Medicare |
$96.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.77
|
| Rate for Payer: Railroad Medicare Medicare |
$95.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.30
|
| Rate for Payer: UHC Core |
$320.05
|
| Rate for Payer: UHC Exchange |
$95.82
|
| Rate for Payer: UHC Medicaid |
$67.57
|
| Rate for Payer: UHC Medicare Advantage |
$95.82
|
| Rate for Payer: UHCCP Medicaid |
$67.57
|
| Rate for Payer: VA VA |
$95.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.47
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
IP
|
$383.29
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$266.77 |
| Max. Negotiated Rate |
$344.96 |
| Rate for Payer: Aetna Commercial |
$325.80
|
| Rate for Payer: BCBS Trust/PPO |
$316.56
|
| Rate for Payer: BCN Commercial |
$316.56
|
| Rate for Payer: Cash Price |
$306.63
|
| Rate for Payer: Cofinity Commercial |
$329.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.63
|
| Rate for Payer: Healthscope Commercial |
$344.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.80
|
| Rate for Payer: Nomi Health Commercial |
$314.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.47
|
| Rate for Payer: PHP Commercial |
$325.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.30
|
| Rate for Payer: UHC Core |
$320.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.47
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
IP
|
$128.75
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.61 |
| Max. Negotiated Rate |
$115.88 |
| Rate for Payer: Aetna Commercial |
$109.44
|
| Rate for Payer: BCBS Trust/PPO |
$106.33
|
| Rate for Payer: BCN Commercial |
$106.33
|
| Rate for Payer: Cash Price |
$103.00
|
| Rate for Payer: Cofinity Commercial |
$110.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.00
|
| Rate for Payer: Healthscope Commercial |
$115.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.44
|
| Rate for Payer: Nomi Health Commercial |
$105.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.56
|
| Rate for Payer: PHP Commercial |
$109.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.30
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.56
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
OP
|
$128.75
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.70 |
| Max. Negotiated Rate |
$115.88 |
| Rate for Payer: Aetna Commercial |
$109.44
|
| Rate for Payer: Aetna Medicare |
$33.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.23
|
| Rate for Payer: BCBS Complete |
$23.83
|
| Rate for Payer: BCBS MAPPO |
$32.19
|
| Rate for Payer: BCBS Trust/PPO |
$105.85
|
| Rate for Payer: BCN Commercial |
$105.85
|
| Rate for Payer: BCN Medicare Advantage |
$32.19
|
| Rate for Payer: Cash Price |
$103.00
|
| Rate for Payer: Cofinity Commercial |
$110.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.19
|
| Rate for Payer: Healthscope Commercial |
$115.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.56
|
| Rate for Payer: Mclaren Medicaid |
$22.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.80
|
| Rate for Payer: Meridian Medicaid |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.44
|
| Rate for Payer: Nomi Health Commercial |
$105.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.56
|
| Rate for Payer: PACE Senior Care Partners |
$30.58
|
| Rate for Payer: PACE SWMI |
$32.19
|
| Rate for Payer: PHP Commercial |
$109.44
|
| Rate for Payer: PHP Medicare Advantage |
$32.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.01
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.61
|
| Rate for Payer: Railroad Medicare Medicare |
$32.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.30
|
| Rate for Payer: UHC Core |
$107.51
|
| Rate for Payer: UHC Exchange |
$32.19
|
| Rate for Payer: UHC Medicaid |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$32.19
|
| Rate for Payer: UHCCP Medicaid |
$22.70
|
| Rate for Payer: VA VA |
$32.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.56
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
OP
|
$93.64
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$17.33
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$76.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$16.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicaid |
$16.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$16.51
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
IP
|
$93.64
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.34
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC LINE VACUUM
|
Facility
|
IP
|
$14.05
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.78 |
| Max. Negotiated Rate |
$12.64 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$11.60
|
| Rate for Payer: BCN Commercial |
$11.60
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.24
|
| Rate for Payer: Healthscope Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.94
|
| Rate for Payer: Nomi Health Commercial |
$11.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.54
|
| Rate for Payer: PHP Commercial |
$11.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.36
|
| Rate for Payer: UHC Core |
$11.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.54
|
|
|
HC LINE VACUUM
|
Facility
|
OP
|
$14.05
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$12.64 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna Medicare |
$3.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.39
|
| Rate for Payer: BCBS Complete |
$2.60
|
| Rate for Payer: BCBS MAPPO |
$3.51
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$3.51
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.51
|
| Rate for Payer: Healthscope Commercial |
$12.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.54
|
| Rate for Payer: Mclaren Medicaid |
$2.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$2.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.94
|
| Rate for Payer: Nomi Health Commercial |
$11.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.54
|
| Rate for Payer: PACE Senior Care Partners |
$3.34
|
| Rate for Payer: PACE SWMI |
$3.51
|
| Rate for Payer: PHP Commercial |
$11.94
|
| Rate for Payer: PHP Medicare Advantage |
$3.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.22
|
| Rate for Payer: Priority Health Medicare |
$3.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.36
|
| Rate for Payer: UHC Core |
$11.73
|
| Rate for Payer: UHC Exchange |
$3.51
|
| Rate for Payer: UHC Medicaid |
$2.48
|
| Rate for Payer: UHC Medicare Advantage |
$3.51
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$3.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.54
|
|
|
HC LIPASE
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC LIPASE
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC LIPASE BF
|
Facility
|
OP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$52.60 |
| Rate for Payer: Aetna Commercial |
$49.68
|
| Rate for Payer: Aetna Medicare |
$15.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.27
|
| Rate for Payer: BCBS Complete |
$10.82
|
| Rate for Payer: BCBS MAPPO |
$14.61
|
| Rate for Payer: BCBS Trust/PPO |
$48.05
|
| Rate for Payer: BCN Commercial |
$48.05
|
| Rate for Payer: BCN Medicare Advantage |
$14.61
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.61
|
| Rate for Payer: Healthscope Commercial |
$52.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.84
|
| Rate for Payer: Mclaren Medicaid |
$10.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.34
|
| Rate for Payer: Meridian Medicaid |
$10.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Nomi Health Commercial |
$47.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: PACE Senior Care Partners |
$13.88
|
| Rate for Payer: PACE SWMI |
$14.61
|
| Rate for Payer: PHP Commercial |
$49.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.85
|
| Rate for Payer: Priority Health Medicare |
$14.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.68
|
| Rate for Payer: Railroad Medicare Medicare |
$14.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.44
|
| Rate for Payer: UHC Core |
$48.81
|
| Rate for Payer: UHC Exchange |
$14.61
|
| Rate for Payer: UHC Medicaid |
$10.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: UHCCP Medicaid |
$10.30
|
| Rate for Payer: VA VA |
$14.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.84
|
|
|
HC LIPASE BF
|
Facility
|
IP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$52.60 |
| Rate for Payer: Aetna Commercial |
$49.68
|
| Rate for Payer: BCBS Trust/PPO |
$48.27
|
| Rate for Payer: BCN Commercial |
$48.27
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Healthscope Commercial |
$52.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Nomi Health Commercial |
$47.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: PHP Commercial |
$49.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.44
|
| Rate for Payer: UHC Core |
$48.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.84
|
|
|
HC LIPID PANEL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LIPID PANEL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
