|
HC MENENCEPH CMPT 9
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
OP
|
$163.42
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.81 |
| Max. Negotiated Rate |
$147.08 |
| Rate for Payer: Aetna Commercial |
$138.91
|
| Rate for Payer: Aetna Medicare |
$42.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.07
|
| Rate for Payer: BCBS Complete |
$30.25
|
| Rate for Payer: BCBS MAPPO |
$40.85
|
| Rate for Payer: BCBS Trust/PPO |
$134.35
|
| Rate for Payer: BCN Commercial |
$134.35
|
| Rate for Payer: BCN Medicare Advantage |
$40.85
|
| Rate for Payer: Cash Price |
$130.74
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.85
|
| Rate for Payer: Healthscope Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.56
|
| Rate for Payer: Mclaren Medicaid |
$28.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.90
|
| Rate for Payer: Meridian Medicaid |
$30.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.91
|
| Rate for Payer: Nomi Health Commercial |
$134.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.56
|
| Rate for Payer: PACE Senior Care Partners |
$38.81
|
| Rate for Payer: PACE SWMI |
$40.85
|
| Rate for Payer: PHP Commercial |
$138.91
|
| Rate for Payer: PHP Medicare Advantage |
$40.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.18
|
| Rate for Payer: Priority Health Medicare |
$41.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.74
|
| Rate for Payer: Railroad Medicare Medicare |
$40.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.81
|
| Rate for Payer: UHC Core |
$136.46
|
| Rate for Payer: UHC Exchange |
$40.85
|
| Rate for Payer: UHC Medicaid |
$28.81
|
| Rate for Payer: UHC Medicare Advantage |
$40.85
|
| Rate for Payer: UHCCP Medicaid |
$28.81
|
| Rate for Payer: VA VA |
$40.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.56
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
IP
|
$163.42
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$113.74 |
| Max. Negotiated Rate |
$147.08 |
| Rate for Payer: Aetna Commercial |
$138.91
|
| Rate for Payer: BCBS Trust/PPO |
$134.97
|
| Rate for Payer: BCN Commercial |
$134.97
|
| Rate for Payer: Cash Price |
$130.74
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.74
|
| Rate for Payer: Healthscope Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.91
|
| Rate for Payer: Nomi Health Commercial |
$134.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.56
|
| Rate for Payer: PHP Commercial |
$138.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.81
|
| Rate for Payer: UHC Core |
$136.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.56
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
OP
|
$746.09
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$131.54 |
| Max. Negotiated Rate |
$671.48 |
| Rate for Payer: Aetna Commercial |
$634.18
|
| Rate for Payer: Aetna Medicare |
$193.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$233.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$233.15
|
| Rate for Payer: BCBS Complete |
$138.10
|
| Rate for Payer: BCBS MAPPO |
$186.52
|
| Rate for Payer: BCBS Trust/PPO |
$613.36
|
| Rate for Payer: BCN Commercial |
$613.36
|
| Rate for Payer: BCN Medicare Advantage |
$186.52
|
| Rate for Payer: Cash Price |
$596.87
|
| Rate for Payer: Cofinity Commercial |
$641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.52
|
| Rate for Payer: Healthscope Commercial |
$671.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.57
|
| Rate for Payer: Mclaren Medicaid |
$131.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.85
|
| Rate for Payer: Meridian Medicaid |
$138.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$205.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.18
|
| Rate for Payer: Nomi Health Commercial |
$611.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$559.57
|
| Rate for Payer: PACE Senior Care Partners |
$177.20
|
| Rate for Payer: PACE SWMI |
$186.52
|
| Rate for Payer: PHP Commercial |
$634.18
|
| Rate for Payer: PHP Medicare Advantage |
$186.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$649.10
|
| Rate for Payer: Priority Health Medicare |
$188.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.28
|
| Rate for Payer: Railroad Medicare Medicare |
$186.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.56
|
| Rate for Payer: UHC Core |
$622.99
|
| Rate for Payer: UHC Exchange |
$186.52
|
| Rate for Payer: UHC Medicaid |
$131.54
|
| Rate for Payer: UHC Medicare Advantage |
$186.52
|
| Rate for Payer: UHCCP Medicaid |
$131.54
|
| Rate for Payer: VA VA |
$186.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.57
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
IP
|
$746.09
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$519.28 |
| Max. Negotiated Rate |
$671.48 |
| Rate for Payer: Aetna Commercial |
$634.18
|
| Rate for Payer: BCBS Trust/PPO |
$616.20
|
| Rate for Payer: BCN Commercial |
$616.20
|
| Rate for Payer: Cash Price |
$596.87
|
| Rate for Payer: Cofinity Commercial |
$641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.87
|
| Rate for Payer: Healthscope Commercial |
$671.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.18
|
| Rate for Payer: Nomi Health Commercial |
$611.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$559.57
|
| Rate for Payer: PHP Commercial |
$634.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$649.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.56
|
| Rate for Payer: UHC Core |
$622.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.57
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$9.55
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna Medicare |
$2.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.98
|
| Rate for Payer: BCBS Complete |
$1.77
|
| Rate for Payer: BCBS MAPPO |
$2.39
|
| Rate for Payer: BCBS Trust/PPO |
$7.85
|
| Rate for Payer: BCN Commercial |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$2.39
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.39
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Mclaren Medicaid |
$1.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.51
|
| Rate for Payer: Meridian Medicaid |
$1.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PACE Senior Care Partners |
$2.27
|
| Rate for Payer: PACE SWMI |
$2.39
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: PHP Medicare Advantage |
$2.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.31
|
| Rate for Payer: Priority Health Medicare |
$2.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.40
|
| Rate for Payer: UHC Core |
$7.97
|
| Rate for Payer: UHC Exchange |
$2.39
|
| Rate for Payer: UHC Medicaid |
$1.68
|
| Rate for Payer: UHC Medicare Advantage |
$2.39
|
| Rate for Payer: UHCCP Medicaid |
$1.68
|
| Rate for Payer: VA VA |
$2.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$9.55
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: BCBS Trust/PPO |
$7.89
|
| Rate for Payer: BCN Commercial |
$7.89
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.40
|
| Rate for Payer: UHC Core |
$7.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
OP
|
$14.86
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS Trust/PPO |
$12.22
|
| Rate for Payer: BCN Commercial |
$12.22
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.90
|
| Rate for Payer: Meridian Medicaid |
$2.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.53
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC MERCURY
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC MERCURY
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC MESH
|
Facility
|
OP
|
$4,739.23
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$835.53 |
| Max. Negotiated Rate |
$4,265.31 |
| Rate for Payer: Aetna Commercial |
$4,028.35
|
| Rate for Payer: Aetna Medicare |
$1,232.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,481.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,481.01
|
| Rate for Payer: BCBS Complete |
$877.23
|
| Rate for Payer: BCBS MAPPO |
$1,184.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,896.12
|
| Rate for Payer: BCN Commercial |
$3,896.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.81
|
| Rate for Payer: Cash Price |
$3,791.38
|
| Rate for Payer: Cofinity Commercial |
$4,075.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,791.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.81
|
| Rate for Payer: Healthscope Commercial |
$4,265.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,554.42
|
| Rate for Payer: Mclaren Medicaid |
$835.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,244.05
|
| Rate for Payer: Meridian Medicaid |
$877.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,362.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,303.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,028.35
|
| Rate for Payer: Nomi Health Commercial |
$3,886.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,554.42
|
| Rate for Payer: PACE Senior Care Partners |
$1,125.57
|
| Rate for Payer: PACE SWMI |
$1,184.81
|
| Rate for Payer: PHP Commercial |
$4,028.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,123.13
|
| Rate for Payer: Priority Health Medicare |
$1,196.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,184.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,170.52
|
| Rate for Payer: UHC Core |
$3,957.26
|
| Rate for Payer: UHC Exchange |
$1,184.81
|
| Rate for Payer: UHC Medicaid |
$835.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,184.81
|
| Rate for Payer: UHCCP Medicaid |
$835.53
|
| Rate for Payer: VA VA |
$1,184.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,554.42
|
|
|
HC MESH
|
Facility
|
IP
|
$4,739.23
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,298.50 |
| Max. Negotiated Rate |
$4,265.31 |
| Rate for Payer: Aetna Commercial |
$4,028.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,914.13
|
| Rate for Payer: BCN Commercial |
$3,914.13
|
| Rate for Payer: Cash Price |
$3,791.38
|
| Rate for Payer: Cofinity Commercial |
$4,075.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,791.38
|
| Rate for Payer: Healthscope Commercial |
$4,265.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,554.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,028.35
|
| Rate for Payer: Nomi Health Commercial |
$3,886.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,554.42
|
| Rate for Payer: PHP Commercial |
$4,028.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,123.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,298.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,170.52
|
| Rate for Payer: UHC Core |
$3,957.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,554.42
|
|
|
HC METANEB SUPPLY
|
Facility
|
IP
|
$264.46
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$184.06 |
| Max. Negotiated Rate |
$238.01 |
| Rate for Payer: Aetna Commercial |
$224.79
|
| Rate for Payer: BCBS Trust/PPO |
$218.42
|
| Rate for Payer: BCN Commercial |
$218.42
|
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Cofinity Commercial |
$227.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.57
|
| Rate for Payer: Healthscope Commercial |
$238.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.79
|
| Rate for Payer: Nomi Health Commercial |
$216.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.34
|
| Rate for Payer: PHP Commercial |
$224.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.72
|
| Rate for Payer: UHC Core |
$220.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.34
|
|
|
HC METANEB SUPPLY
|
Facility
|
OP
|
$264.46
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.62 |
| Max. Negotiated Rate |
$238.01 |
| Rate for Payer: Aetna Commercial |
$224.79
|
| Rate for Payer: Aetna Medicare |
$68.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.64
|
| Rate for Payer: BCBS Complete |
$48.95
|
| Rate for Payer: BCBS MAPPO |
$66.11
|
| Rate for Payer: BCBS Trust/PPO |
$217.41
|
| Rate for Payer: BCN Commercial |
$217.41
|
| Rate for Payer: BCN Medicare Advantage |
$66.11
|
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Cofinity Commercial |
$227.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.11
|
| Rate for Payer: Healthscope Commercial |
$238.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.34
|
| Rate for Payer: Mclaren Medicaid |
$46.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.42
|
| Rate for Payer: Meridian Medicaid |
$48.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.79
|
| Rate for Payer: Nomi Health Commercial |
$216.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.34
|
| Rate for Payer: PACE Senior Care Partners |
$62.81
|
| Rate for Payer: PACE SWMI |
$66.11
|
| Rate for Payer: PHP Commercial |
$224.79
|
| Rate for Payer: PHP Medicare Advantage |
$66.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.08
|
| Rate for Payer: Priority Health Medicare |
$66.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.06
|
| Rate for Payer: Railroad Medicare Medicare |
$66.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.72
|
| Rate for Payer: UHC Core |
$220.82
|
| Rate for Payer: UHC Exchange |
$66.11
|
| Rate for Payer: UHC Medicaid |
$46.62
|
| Rate for Payer: UHC Medicare Advantage |
$66.11
|
| Rate for Payer: UHCCP Medicaid |
$46.62
|
| Rate for Payer: VA VA |
$66.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.34
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$38.39
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.68
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.68
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.68
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: UHC Exchange |
$11.68
|
| Rate for Payer: UHC Medicaid |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$11.68
|
| Rate for Payer: UHCCP Medicaid |
$8.23
|
| Rate for Payer: VA VA |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$52.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Exchange |
$15.87
|
| Rate for Payer: UHC Medicaid |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC METANEPHRINES URINE
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.02
|
| Rate for Payer: BCBS MAPPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.49
|
| Rate for Payer: BCN Commercial |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.21
|
| Rate for Payer: Meridian Medicaid |
$10.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.53
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.08
|
| Rate for Payer: Priority Health Medicare |
$13.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.67
|
| Rate for Payer: Railroad Medicare Medicare |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.63
|
| Rate for Payer: UHC Core |
$45.19
|
| Rate for Payer: UHC Exchange |
$13.53
|
| Rate for Payer: UHC Medicaid |
$9.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.53
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$13.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC METANEPHRINES URINE
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: BCBS Trust/PPO |
$44.70
|
| Rate for Payer: BCN Commercial |
$44.70
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.63
|
| Rate for Payer: UHC Core |
$45.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
OP
|
$1,834.95
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$323.50 |
| Max. Negotiated Rate |
$1,651.45 |
| Rate for Payer: Aetna Commercial |
$1,559.71
|
| Rate for Payer: Aetna Medicare |
$477.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$573.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$573.42
|
| Rate for Payer: BCBS Complete |
$339.65
|
| Rate for Payer: BCBS MAPPO |
$458.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,508.51
|
| Rate for Payer: BCN Commercial |
$1,508.51
|
| Rate for Payer: BCN Medicare Advantage |
$458.74
|
| Rate for Payer: Cash Price |
$1,467.96
|
| Rate for Payer: Cofinity Commercial |
$1,578.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.74
|
| Rate for Payer: Healthscope Commercial |
$1,651.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.21
|
| Rate for Payer: Mclaren Medicaid |
$323.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.67
|
| Rate for Payer: Meridian Medicaid |
$339.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$527.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$504.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.71
|
| Rate for Payer: Nomi Health Commercial |
$1,504.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.21
|
| Rate for Payer: PACE Senior Care Partners |
$435.80
|
| Rate for Payer: PACE SWMI |
$458.74
|
| Rate for Payer: PHP Commercial |
$1,559.71
|
| Rate for Payer: PHP Medicare Advantage |
$458.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,596.41
|
| Rate for Payer: Priority Health Medicare |
$463.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,277.13
|
| Rate for Payer: Railroad Medicare Medicare |
$458.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.76
|
| Rate for Payer: UHC Core |
$1,532.18
|
| Rate for Payer: UHC Exchange |
$458.74
|
| Rate for Payer: UHC Medicaid |
$323.50
|
| Rate for Payer: UHC Medicare Advantage |
$458.74
|
| Rate for Payer: UHCCP Medicaid |
$323.50
|
| Rate for Payer: VA VA |
$458.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.21
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
IP
|
$1,834.95
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,277.13 |
| Max. Negotiated Rate |
$1,651.45 |
| Rate for Payer: Aetna Commercial |
$1,559.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,515.49
|
| Rate for Payer: BCN Commercial |
$1,515.49
|
| Rate for Payer: Cash Price |
$1,467.96
|
| Rate for Payer: Cofinity Commercial |
$1,578.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.96
|
| Rate for Payer: Healthscope Commercial |
$1,651.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.71
|
| Rate for Payer: Nomi Health Commercial |
$1,504.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.21
|
| Rate for Payer: PHP Commercial |
$1,559.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,596.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,277.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,614.76
|
| Rate for Payer: UHC Core |
$1,532.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.21
|
|
