|
HC PROTEGE RX STENT
|
Facility
|
IP
|
$4,482.37
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,733.80 |
| Max. Negotiated Rate |
$4,034.13 |
| Rate for Payer: Aetna Commercial |
$3,810.01
|
| Rate for Payer: BCBS Trust/PPO |
$3,463.98
|
| Rate for Payer: BCN Commercial |
$3,463.98
|
| Rate for Payer: Cash Price |
$3,585.90
|
| Rate for Payer: Cofinity Commercial |
$3,854.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,585.90
|
| Rate for Payer: Healthscope Commercial |
$4,034.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,361.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,810.01
|
| Rate for Payer: PHP Commercial |
$3,810.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,137.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,899.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,733.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,944.49
|
| Rate for Payer: UHC Core |
$3,742.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,361.78
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
IP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.86
|
| Rate for Payer: BCN Commercial |
$22.86
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
OP
|
$29.58
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: Aetna Medicare |
$7.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.24
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$23.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.40
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.40
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Mclaren Medicaid |
$8.51
|
| Rate for Payer: Meridian Medicaid |
$8.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PACE Senior Care Partners |
$7.03
|
| Rate for Payer: PACE SWMI |
$7.40
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Medicare |
$7.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.40
|
| Rate for Payer: UHC Medicare Advantage |
$7.62
|
| Rate for Payer: VA VA |
$7.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$10.72
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$10.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: Aetna Medicare |
$14.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.19
|
| Rate for Payer: BCBS Complete |
$9.31
|
| Rate for Payer: BCBS MAPPO |
$13.75
|
| Rate for Payer: BCBS Trust/PPO |
$42.76
|
| Rate for Payer: BCN Commercial |
$42.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.75
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$47.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.75
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.25
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$9.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PACE Senior Care Partners |
$13.06
|
| Rate for Payer: PACE SWMI |
$13.75
|
| Rate for Payer: PHP Commercial |
$46.75
|
| Rate for Payer: PHP Medicare Advantage |
$13.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.85
|
| Rate for Payer: Priority Health Medicare |
$13.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.54
|
| Rate for Payer: Railroad Medicare Medicare |
$13.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.40
|
| Rate for Payer: UHC Core |
$45.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.75
|
| Rate for Payer: UHC Medicare Advantage |
$14.16
|
| Rate for Payer: VA VA |
$13.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.25
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.54 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: BCBS Trust/PPO |
$42.50
|
| Rate for Payer: BCN Commercial |
$42.50
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$47.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.00
|
| Rate for Payer: Healthscope Commercial |
$49.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.75
|
| Rate for Payer: PHP Commercial |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.40
|
| Rate for Payer: UHC Core |
$45.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.25
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$7.93
|
| Rate for Payer: Meridian Medicaid |
$8.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
IP
|
$103.60
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$93.24 |
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: BCBS Trust/PPO |
$80.06
|
| Rate for Payer: BCN Commercial |
$80.06
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$93.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: PHP Commercial |
$88.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.17
|
| Rate for Payer: UHC Core |
$86.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.70
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$103.60
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$93.24 |
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: Aetna Medicare |
$26.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.38
|
| Rate for Payer: BCBS Complete |
$13.82
|
| Rate for Payer: BCBS MAPPO |
$25.90
|
| Rate for Payer: BCBS Trust/PPO |
$80.55
|
| Rate for Payer: BCN Commercial |
$80.55
|
| Rate for Payer: BCN Medicare Advantage |
$25.90
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.90
|
| Rate for Payer: Healthscope Commercial |
$93.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.70
|
| Rate for Payer: Mclaren Medicaid |
$13.16
|
| Rate for Payer: Meridian Medicaid |
$13.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: PACE Senior Care Partners |
$24.60
|
| Rate for Payer: PACE SWMI |
$25.90
|
| Rate for Payer: PHP Commercial |
$88.06
|
| Rate for Payer: PHP Medicare Advantage |
$25.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.13
|
| Rate for Payer: Priority Health Medicare |
$25.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.19
|
| Rate for Payer: Railroad Medicare Medicare |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.17
|
| Rate for Payer: UHC Core |
$86.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.90
|
| Rate for Payer: UHC Medicare Advantage |
$26.68
|
| Rate for Payer: VA VA |
$25.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.70
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna Medicare |
$15.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.06
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$15.25
|
| Rate for Payer: BCBS Trust/PPO |
$47.43
|
| Rate for Payer: BCN Commercial |
$47.43
|
| Rate for Payer: BCN Medicare Advantage |
$15.25
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.25
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Mclaren Medicaid |
$11.31
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Senior Care Partners |
$14.49
|
| Rate for Payer: PACE SWMI |
$15.25
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: PHP Medicare Advantage |
$15.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.07
|
| Rate for Payer: Priority Health Medicare |
$15.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.68
|
| Rate for Payer: UHC Core |
$50.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.25
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: VA VA |
$15.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: BCBS Trust/PPO |
$47.14
|
| Rate for Payer: BCN Commercial |
$47.14
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.68
|
| Rate for Payer: UHC Core |
$50.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: Aetna Medicare |
$22.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.56
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$66.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.25
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Mclaren Medicaid |
$11.31
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PACE Senior Care Partners |
$20.19
|
| Rate for Payer: PACE SWMI |
$21.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: PHP Medicare Advantage |
$21.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Medicare |
$21.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.25
|
| Rate for Payer: UHC Medicare Advantage |
$21.89
|
| Rate for Payer: VA VA |
$21.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$51.84 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: BCBS Trust/PPO |
$65.69
|
| Rate for Payer: BCN Commercial |
$65.69
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$37.32
|
| Rate for Payer: BCN Commercial |
$37.32
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Meridian Medicaid |
$3.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PACE Senior Care Partners |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
| Rate for Payer: UHC Core |
$40.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.36
|
| Rate for Payer: VA VA |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.28 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: BCBS Trust/PPO |
$37.09
|
| Rate for Payer: BCN Commercial |
$37.09
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.24
|
| Rate for Payer: UHC Core |
$40.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC PROTIME WITH INR
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$22.07
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC PROTIME WITH INR
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.92
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.21
|
| Rate for Payer: BCN Commercial |
$22.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Meridian Medicaid |
$3.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Senior Care Partners |
$6.78
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Medicare |
$7.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$7.35
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: Aetna Medicare |
$21.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.94
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$20.75
|
| Rate for Payer: BCBS Trust/PPO |
$64.53
|
| Rate for Payer: BCN Commercial |
$64.53
|
| Rate for Payer: BCN Medicare Advantage |
$20.75
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PACE Senior Care Partners |
$19.71
|
| Rate for Payer: PACE SWMI |
$20.75
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: PHP Medicare Advantage |
$20.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: Railroad Medicare Medicare |
$20.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.75
|
| Rate for Payer: UHC Medicare Advantage |
$21.37
|
| Rate for Payer: VA VA |
$20.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: BCBS Trust/PPO |
$64.14
|
| Rate for Payer: BCN Commercial |
$64.14
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.78 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$22.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.46
|
| Rate for Payer: BCBS Complete |
$18.67
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$65.82
|
| Rate for Payer: BCN Commercial |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$18.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Senior Care Partners |
$20.11
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.65
|
| Rate for Payer: Priority Health Medicare |
$21.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.63
|
| Rate for Payer: Railroad Medicare Medicare |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.16
|
| Rate for Payer: UHC Medicare Advantage |
$21.80
|
| Rate for Payer: VA VA |
$21.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.63 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
IP
|
$68.31
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$61.48 |
| Rate for Payer: Aetna Commercial |
$58.06
|
| Rate for Payer: BCBS Trust/PPO |
$52.79
|
| Rate for Payer: BCN Commercial |
$52.79
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.65
|
| Rate for Payer: Healthscope Commercial |
$61.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.06
|
| Rate for Payer: PHP Commercial |
$58.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.11
|
| Rate for Payer: UHC Core |
$57.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.23
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
OP
|
$68.31
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$61.48 |
| Rate for Payer: Aetna Commercial |
$58.06
|
| Rate for Payer: Aetna Medicare |
$17.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.35
|
| Rate for Payer: BCBS Complete |
$14.96
|
| Rate for Payer: BCBS MAPPO |
$17.08
|
| Rate for Payer: BCBS Trust/PPO |
$53.11
|
| Rate for Payer: BCN Commercial |
$53.11
|
| Rate for Payer: BCN Medicare Advantage |
$17.08
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cash Price |
$54.65
|
| Rate for Payer: Cofinity Commercial |
$58.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.08
|
| Rate for Payer: Healthscope Commercial |
$61.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.23
|
| Rate for Payer: Mclaren Medicaid |
$14.25
|
| Rate for Payer: Meridian Medicaid |
$14.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.22
|
| Rate for Payer: PACE SWMI |
$17.08
|
| Rate for Payer: PHP Commercial |
$58.06
|
| Rate for Payer: PHP Medicare Advantage |
$17.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.43
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.66
|
| Rate for Payer: Railroad Medicare Medicare |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.11
|
| Rate for Payer: UHC Core |
$57.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.08
|
| Rate for Payer: UHC Medicare Advantage |
$17.59
|
| Rate for Payer: VA VA |
$17.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.23
|
|
