|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$98.36
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$98.82
|
| Rate for Payer: BCN Commercial |
$98.82
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.13
|
| Rate for Payer: BCBS Complete |
$17.85
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.31
|
| Rate for Payer: Meridian Medicaid |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Medicare |
$24.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$17.00
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.11 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: BCBS Trust/PPO |
$79.63
|
| Rate for Payer: BCN Commercial |
$79.63
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC METHADONE SCRN URN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$81.15
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.48 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: BCBS Trust/PPO |
$67.02
|
| Rate for Payer: BCN Commercial |
$67.02
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.86
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$81.15
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: Aetna Medicare |
$21.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.36
|
| Rate for Payer: BCBS Complete |
$15.02
|
| Rate for Payer: BCBS MAPPO |
$20.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.71
|
| Rate for Payer: BCN Commercial |
$66.71
|
| Rate for Payer: BCN Medicare Advantage |
$20.29
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.29
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Mclaren Medicaid |
$14.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.30
|
| Rate for Payer: Meridian Medicaid |
$15.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.86
|
| Rate for Payer: PACE Senior Care Partners |
$19.27
|
| Rate for Payer: PACE SWMI |
$20.29
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: PHP Medicare Advantage |
$20.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$20.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.48
|
| Rate for Payer: Railroad Medicare Medicare |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: UHC Exchange |
$20.29
|
| Rate for Payer: UHC Medicaid |
$14.31
|
| Rate for Payer: UHC Medicare Advantage |
$20.29
|
| Rate for Payer: UHCCP Medicaid |
$14.31
|
| Rate for Payer: VA VA |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$11.55
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$51.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicaid |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$11.00
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.44 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC METHANOL LVL
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.61 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: Aetna Medicare |
$42.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.72
|
| Rate for Payer: BCBS Complete |
$30.04
|
| Rate for Payer: BCBS MAPPO |
$40.58
|
| Rate for Payer: BCBS Trust/PPO |
$133.43
|
| Rate for Payer: BCN Commercial |
$133.43
|
| Rate for Payer: BCN Medicare Advantage |
$40.58
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.58
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Mclaren Medicaid |
$28.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.60
|
| Rate for Payer: Meridian Medicaid |
$30.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PACE Senior Care Partners |
$38.55
|
| Rate for Payer: PACE SWMI |
$40.58
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: PHP Medicare Advantage |
$40.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Medicare |
$40.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.96
|
| Rate for Payer: Railroad Medicare Medicare |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: UHC Exchange |
$40.58
|
| Rate for Payer: UHC Medicaid |
$28.61
|
| Rate for Payer: UHC Medicare Advantage |
$40.58
|
| Rate for Payer: UHCCP Medicaid |
$28.61
|
| Rate for Payer: VA VA |
$40.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.96 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: BCBS Trust/PPO |
$134.04
|
| Rate for Payer: BCN Commercial |
$134.04
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$47.96
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare |
$12.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.99
|
| Rate for Payer: BCBS Complete |
$8.88
|
| Rate for Payer: BCBS MAPPO |
$11.99
|
| Rate for Payer: BCBS Trust/PPO |
$39.43
|
| Rate for Payer: BCN Commercial |
$39.43
|
| Rate for Payer: BCN Medicare Advantage |
$11.99
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cofinity Commercial |
$41.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.99
|
| Rate for Payer: Healthscope Commercial |
$43.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.97
|
| Rate for Payer: Mclaren Medicaid |
$8.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.59
|
| Rate for Payer: Meridian Medicaid |
$8.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.77
|
| Rate for Payer: Nomi Health Commercial |
$39.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.97
|
| Rate for Payer: PACE Senior Care Partners |
$11.39
|
| Rate for Payer: PACE SWMI |
$11.99
|
| Rate for Payer: PHP Commercial |
$40.77
|
| Rate for Payer: PHP Medicare Advantage |
$11.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.73
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.38
|
| Rate for Payer: Railroad Medicare Medicare |
$11.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.20
|
| Rate for Payer: UHC Core |
$40.05
|
| Rate for Payer: UHC Exchange |
$11.99
|
| Rate for Payer: UHC Medicaid |
$8.46
|
| Rate for Payer: UHC Medicare Advantage |
$11.99
|
| Rate for Payer: UHCCP Medicaid |
$8.46
|
| Rate for Payer: VA VA |
$11.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.97
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$47.96
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.38 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: BCBS Trust/PPO |
$39.61
|
| Rate for Payer: BCN Commercial |
$39.61
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cofinity Commercial |
$41.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.37
|
| Rate for Payer: Healthscope Commercial |
$43.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.77
|
| Rate for Payer: Nomi Health Commercial |
$39.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.97
|
| Rate for Payer: PHP Commercial |
$40.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.20
|
| Rate for Payer: UHC Core |
$40.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.97
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$180.51
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$125.63 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: BCBS Trust/PPO |
$149.08
|
| Rate for Payer: BCN Commercial |
$149.08
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$148.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.85
|
| Rate for Payer: UHC Core |
$150.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
OP
|
$180.51
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna Medicare |
$46.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.41
|
| Rate for Payer: BCBS Complete |
$33.41
|
| Rate for Payer: BCBS MAPPO |
$45.13
|
| Rate for Payer: BCBS Trust/PPO |
$148.40
|
| Rate for Payer: BCN Commercial |
$148.40
|
| Rate for Payer: BCN Medicare Advantage |
$45.13
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.13
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Mclaren Medicaid |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.38
|
| Rate for Payer: Meridian Medicaid |
$33.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$148.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PACE Senior Care Partners |
$42.87
|
| Rate for Payer: PACE SWMI |
$45.13
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: PHP Medicare Advantage |
$45.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.04
|
| Rate for Payer: Priority Health Medicare |
$45.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.63
|
| Rate for Payer: Railroad Medicare Medicare |
$45.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.85
|
| Rate for Payer: UHC Core |
$150.73
|
| Rate for Payer: UHC Exchange |
$45.13
|
| Rate for Payer: UHC Medicaid |
$31.82
|
| Rate for Payer: UHC Medicare Advantage |
$45.13
|
| Rate for Payer: UHCCP Medicaid |
$31.82
|
| Rate for Payer: VA VA |
$45.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: BCBS Trust/PPO |
$52.51
|
| Rate for Payer: BCN Commercial |
$52.51
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: PHP Commercial |
$54.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.95
|
| Rate for Payer: UHC Core |
$53.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.69
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.21 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.87
|
| Rate for Payer: BCBS Complete |
$11.77
|
| Rate for Payer: BCBS MAPPO |
$15.89
|
| Rate for Payer: BCBS Trust/PPO |
$52.27
|
| Rate for Payer: BCN Commercial |
$52.27
|
| Rate for Payer: BCN Medicare Advantage |
$15.89
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.89
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.69
|
| Rate for Payer: Mclaren Medicaid |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.69
|
| Rate for Payer: Meridian Medicaid |
$11.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Nomi Health Commercial |
$52.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: PACE Senior Care Partners |
$15.10
|
| Rate for Payer: PACE SWMI |
$15.89
|
| Rate for Payer: PHP Commercial |
$54.04
|
| Rate for Payer: PHP Medicare Advantage |
$15.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.31
|
| Rate for Payer: Priority Health Medicare |
$16.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.25
|
| Rate for Payer: Railroad Medicare Medicare |
$15.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.95
|
| Rate for Payer: UHC Core |
$53.09
|
| Rate for Payer: UHC Exchange |
$15.89
|
| Rate for Payer: UHC Medicaid |
$11.21
|
| Rate for Payer: UHC Medicare Advantage |
$15.89
|
| Rate for Payer: UHCCP Medicaid |
$11.21
|
| Rate for Payer: VA VA |
$15.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.69
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.26 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: BCBS Trust/PPO |
$70.32
|
| Rate for Payer: BCN Commercial |
$70.32
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Commercial |
$73.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Healthscope Commercial |
$76.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: PHP Commercial |
$72.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.92
|
| Rate for Payer: UHC Core |
$71.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.61
|
| Rate for Payer: BCBS Complete |
$15.76
|
| Rate for Payer: BCBS MAPPO |
$21.29
|
| Rate for Payer: BCBS Trust/PPO |
$69.99
|
| Rate for Payer: BCN Commercial |
$69.99
|
| Rate for Payer: BCN Medicare Advantage |
$21.29
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Commercial |
$73.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.29
|
| Rate for Payer: Healthscope Commercial |
$76.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Mclaren Medicaid |
$15.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.35
|
| Rate for Payer: Meridian Medicaid |
$15.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Nomi Health Commercial |
$69.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: PACE Senior Care Partners |
$20.22
|
| Rate for Payer: PACE SWMI |
$21.29
|
| Rate for Payer: PHP Commercial |
$72.37
|
| Rate for Payer: PHP Medicare Advantage |
$21.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.07
|
| Rate for Payer: Priority Health Medicare |
$21.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.26
|
| Rate for Payer: Railroad Medicare Medicare |
$21.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.92
|
| Rate for Payer: UHC Core |
$71.09
|
| Rate for Payer: UHC Exchange |
$21.29
|
| Rate for Payer: UHC Medicaid |
$15.01
|
| Rate for Payer: UHC Medicare Advantage |
$21.29
|
| Rate for Payer: UHCCP Medicaid |
$15.01
|
| Rate for Payer: VA VA |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$74.49 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare |
$21.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.87
|
| Rate for Payer: BCBS Complete |
$15.32
|
| Rate for Payer: BCBS MAPPO |
$20.69
|
| Rate for Payer: BCBS Trust/PPO |
$68.05
|
| Rate for Payer: BCN Commercial |
$68.05
|
| Rate for Payer: BCN Medicare Advantage |
$20.69
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.69
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$14.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.73
|
| Rate for Payer: Meridian Medicaid |
$15.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PACE Senior Care Partners |
$19.66
|
| Rate for Payer: PACE SWMI |
$20.69
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Medicare Advantage |
$20.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.01
|
| Rate for Payer: Priority Health Medicare |
$20.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.61
|
| Rate for Payer: Railroad Medicare Medicare |
$20.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.84
|
| Rate for Payer: UHC Core |
$69.11
|
| Rate for Payer: UHC Exchange |
$20.69
|
| Rate for Payer: UHC Medicaid |
$14.59
|
| Rate for Payer: UHC Medicare Advantage |
$20.69
|
| Rate for Payer: UHCCP Medicaid |
$14.59
|
| Rate for Payer: VA VA |
$20.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.61 |
| Max. Negotiated Rate |
$74.49 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: BCBS Trust/PPO |
$68.36
|
| Rate for Payer: BCN Commercial |
$68.36
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$67.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.84
|
| Rate for Payer: UHC Core |
$69.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.86 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$48.14
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$213.83
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$48.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicaid |
$45.86
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$45.86
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
