|
HC MYCOPHENOLIC ACID
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 80180
|
| Hospital Charge Code |
30100062
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA AB IGG & IGM CMPT
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200311
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.41
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.48
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.63
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Medicare |
$5.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Exchange |
$5.92
|
| Rate for Payer: UHC Medicaid |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.92
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: VA VA |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA AB IGM
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200312
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.41
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.48
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.63
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Medicare |
$5.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Exchange |
$5.92
|
| Rate for Payer: UHC Medicaid |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.92
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: VA VA |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
IP
|
$111.95
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: BCBS Trust/PPO |
$92.46
|
| Rate for Payer: BCN Commercial |
$92.46
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC MYCOPLASMA CULTURE
|
Facility
|
OP
|
$111.95
|
|
|
Service Code
|
CPT 87109
|
| Hospital Charge Code |
30600086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.74 |
| Max. Negotiated Rate |
$100.75 |
| Rate for Payer: Aetna Commercial |
$95.16
|
| Rate for Payer: Aetna Medicare |
$29.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.98
|
| Rate for Payer: BCBS Complete |
$20.72
|
| Rate for Payer: BCBS MAPPO |
$27.99
|
| Rate for Payer: BCBS Trust/PPO |
$92.03
|
| Rate for Payer: BCN Commercial |
$92.03
|
| Rate for Payer: BCN Medicare Advantage |
$27.99
|
| Rate for Payer: Cash Price |
$89.56
|
| Rate for Payer: Cofinity Commercial |
$96.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.99
|
| Rate for Payer: Healthscope Commercial |
$100.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.96
|
| Rate for Payer: Mclaren Medicaid |
$19.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.39
|
| Rate for Payer: Meridian Medicaid |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.16
|
| Rate for Payer: Nomi Health Commercial |
$91.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.96
|
| Rate for Payer: PACE Senior Care Partners |
$26.59
|
| Rate for Payer: PACE SWMI |
$27.99
|
| Rate for Payer: PHP Commercial |
$95.16
|
| Rate for Payer: PHP Medicare Advantage |
$27.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.40
|
| Rate for Payer: Priority Health Medicare |
$28.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.92
|
| Rate for Payer: Railroad Medicare Medicare |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.52
|
| Rate for Payer: UHC Core |
$93.48
|
| Rate for Payer: UHC Exchange |
$27.99
|
| Rate for Payer: UHC Medicaid |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$27.99
|
| Rate for Payer: UHCCP Medicaid |
$19.74
|
| Rate for Payer: VA VA |
$27.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.96
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC MYCOPLASMA GENITALIUM
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600338
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
IP
|
$148.84
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.59 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: BCBS Trust/PPO |
$122.93
|
| Rate for Payer: BCN Commercial |
$122.93
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA GENITALIUM AMGEN
|
Facility
|
OP
|
$148.84
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600330
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.24 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: Aetna Medicare |
$38.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.51
|
| Rate for Payer: BCBS Complete |
$27.55
|
| Rate for Payer: BCBS MAPPO |
$37.21
|
| Rate for Payer: BCBS Trust/PPO |
$122.36
|
| Rate for Payer: BCN Commercial |
$122.36
|
| Rate for Payer: BCN Medicare Advantage |
$37.21
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.21
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Mclaren Medicaid |
$26.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.07
|
| Rate for Payer: Meridian Medicaid |
$27.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PACE Senior Care Partners |
$35.35
|
| Rate for Payer: PACE SWMI |
$37.21
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: PHP Medicare Advantage |
$37.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Medicare |
$37.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: Railroad Medicare Medicare |
$37.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: UHC Exchange |
$37.21
|
| Rate for Payer: UHC Medicaid |
$26.24
|
| Rate for Payer: UHC Medicare Advantage |
$37.21
|
| Rate for Payer: UHCCP Medicaid |
$26.24
|
| Rate for Payer: VA VA |
$37.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
IP
|
$148.84
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.59 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: BCBS Trust/PPO |
$122.93
|
| Rate for Payer: BCN Commercial |
$122.93
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA GENITALIUM PCR
|
Facility
|
OP
|
$148.84
|
|
|
Service Code
|
CPT 87563
|
| Hospital Charge Code |
30600303
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.24 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: Aetna Medicare |
$38.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.51
|
| Rate for Payer: BCBS Complete |
$27.55
|
| Rate for Payer: BCBS MAPPO |
$37.21
|
| Rate for Payer: BCBS Trust/PPO |
$122.36
|
| Rate for Payer: BCN Commercial |
$122.36
|
| Rate for Payer: BCN Medicare Advantage |
$37.21
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.21
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Mclaren Medicaid |
$26.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.07
|
| Rate for Payer: Meridian Medicaid |
$27.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PACE Senior Care Partners |
$35.35
|
| Rate for Payer: PACE SWMI |
$37.21
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: PHP Medicare Advantage |
$37.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Medicare |
$37.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: Railroad Medicare Medicare |
$37.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: UHC Exchange |
$37.21
|
| Rate for Payer: UHC Medicaid |
$26.24
|
| Rate for Payer: UHC Medicare Advantage |
$37.21
|
| Rate for Payer: UHCCP Medicaid |
$26.24
|
| Rate for Payer: VA VA |
$37.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
IP
|
$148.84
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$103.59 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: BCBS Trust/PPO |
$122.93
|
| Rate for Payer: BCN Commercial |
$122.93
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA HOMINIS PCR
|
Facility
|
OP
|
$148.84
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600304
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.24 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: Aetna Medicare |
$38.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.51
|
| Rate for Payer: BCBS Complete |
$27.55
|
| Rate for Payer: BCBS MAPPO |
$37.21
|
| Rate for Payer: BCBS Trust/PPO |
$122.36
|
| Rate for Payer: BCN Commercial |
$122.36
|
| Rate for Payer: BCN Medicare Advantage |
$37.21
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.21
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Mclaren Medicaid |
$26.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.07
|
| Rate for Payer: Meridian Medicaid |
$27.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Nomi Health Commercial |
$122.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PACE Senior Care Partners |
$35.35
|
| Rate for Payer: PACE SWMI |
$37.21
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: PHP Medicare Advantage |
$37.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.49
|
| Rate for Payer: Priority Health Medicare |
$37.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.59
|
| Rate for Payer: Railroad Medicare Medicare |
$37.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.98
|
| Rate for Payer: UHC Core |
$124.28
|
| Rate for Payer: UHC Exchange |
$37.21
|
| Rate for Payer: UHC Medicaid |
$26.24
|
| Rate for Payer: UHC Medicare Advantage |
$37.21
|
| Rate for Payer: UHCCP Medicaid |
$26.24
|
| Rate for Payer: VA VA |
$37.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: Aetna Medicare |
$6.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.41
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$5.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.48
|
| Rate for Payer: BCN Medicare Advantage |
$5.92
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.92
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.22
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.63
|
| Rate for Payer: PACE SWMI |
$5.92
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: PHP Medicare Advantage |
$5.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Medicare |
$5.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Exchange |
$5.92
|
| Rate for Payer: UHC Medicaid |
$4.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.92
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: VA VA |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA PNEUMO AB IGG & IGM
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Aetna Commercial |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.57
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: Cash Price |
$18.96
|
| Rate for Payer: Cofinity Commercial |
$20.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$21.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.14
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.77
|
| Rate for Payer: PHP Commercial |
$20.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.77
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
OP
|
$224.73
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$202.26 |
| Rate for Payer: Aetna Commercial |
$191.02
|
| Rate for Payer: Aetna Medicare |
$58.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.23
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$56.18
|
| Rate for Payer: BCBS Trust/PPO |
$184.75
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$56.18
|
| Rate for Payer: Cash Price |
$179.78
|
| Rate for Payer: Cofinity Commercial |
$193.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.18
|
| Rate for Payer: Healthscope Commercial |
$202.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.55
|
| Rate for Payer: Mclaren Medicaid |
$39.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.99
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.02
|
| Rate for Payer: Nomi Health Commercial |
$184.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.55
|
| Rate for Payer: PACE Senior Care Partners |
$53.37
|
| Rate for Payer: PACE SWMI |
$56.18
|
| Rate for Payer: PHP Commercial |
$191.02
|
| Rate for Payer: PHP Medicare Advantage |
$56.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.52
|
| Rate for Payer: Priority Health Medicare |
$56.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.41
|
| Rate for Payer: Railroad Medicare Medicare |
$56.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.76
|
| Rate for Payer: UHC Core |
$187.65
|
| Rate for Payer: UHC Exchange |
$56.18
|
| Rate for Payer: UHC Medicaid |
$39.62
|
| Rate for Payer: UHC Medicare Advantage |
$56.18
|
| Rate for Payer: UHCCP Medicaid |
$39.62
|
| Rate for Payer: VA VA |
$56.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.55
|
|
|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$224.73
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$156.41 |
| Max. Negotiated Rate |
$202.26 |
| Rate for Payer: Aetna Commercial |
$191.02
|
| Rate for Payer: BCBS Trust/PPO |
$185.60
|
| Rate for Payer: BCN Commercial |
$185.60
|
| Rate for Payer: Cash Price |
$179.78
|
| Rate for Payer: Cofinity Commercial |
$193.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.78
|
| Rate for Payer: Healthscope Commercial |
$202.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.02
|
| Rate for Payer: Nomi Health Commercial |
$184.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.55
|
| Rate for Payer: PHP Commercial |
$191.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.76
|
| Rate for Payer: UHC Core |
$187.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.55
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$657.95
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$592.15 |
| Rate for Payer: Aetna Commercial |
$559.26
|
| Rate for Payer: Aetna Medicare |
$171.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$205.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$205.61
|
| Rate for Payer: BCBS Complete |
$121.79
|
| Rate for Payer: BCBS MAPPO |
$164.49
|
| Rate for Payer: BCBS Trust/PPO |
$540.90
|
| Rate for Payer: BCN Commercial |
$540.90
|
| Rate for Payer: BCN Medicare Advantage |
$164.49
|
| Rate for Payer: Cash Price |
$526.36
|
| Rate for Payer: Cofinity Commercial |
$565.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.49
|
| Rate for Payer: Healthscope Commercial |
$592.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.46
|
| Rate for Payer: Mclaren Medicaid |
$116.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.71
|
| Rate for Payer: Meridian Medicaid |
$121.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.26
|
| Rate for Payer: Nomi Health Commercial |
$539.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.46
|
| Rate for Payer: PACE Senior Care Partners |
$156.26
|
| Rate for Payer: PACE SWMI |
$164.49
|
| Rate for Payer: PHP Commercial |
$559.26
|
| Rate for Payer: PHP Medicare Advantage |
$164.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$572.42
|
| Rate for Payer: Priority Health Medicare |
$166.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.93
|
| Rate for Payer: Railroad Medicare Medicare |
$164.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.00
|
| Rate for Payer: UHC Core |
$549.39
|
| Rate for Payer: UHC Exchange |
$164.49
|
| Rate for Payer: UHC Medicaid |
$116.00
|
| Rate for Payer: UHC Medicare Advantage |
$164.49
|
| Rate for Payer: UHCCP Medicaid |
$116.00
|
| Rate for Payer: VA VA |
$164.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.46
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$657.95
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$457.93 |
| Max. Negotiated Rate |
$592.15 |
| Rate for Payer: Aetna Commercial |
$559.26
|
| Rate for Payer: BCBS Trust/PPO |
$543.40
|
| Rate for Payer: BCN Commercial |
$543.40
|
| Rate for Payer: Cash Price |
$526.36
|
| Rate for Payer: Cofinity Commercial |
$565.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.36
|
| Rate for Payer: Healthscope Commercial |
$592.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.26
|
| Rate for Payer: Nomi Health Commercial |
$539.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.46
|
| Rate for Payer: PHP Commercial |
$559.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$572.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$579.00
|
| Rate for Payer: UHC Core |
$549.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.46
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$127.35
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.64 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: BCBS Trust/PPO |
$105.18
|
| Rate for Payer: BCN Commercial |
$105.18
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$104.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.07
|
| Rate for Payer: UHC Core |
$106.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$127.35
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna Medicare |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.80
|
| Rate for Payer: BCBS Complete |
$23.57
|
| Rate for Payer: BCBS MAPPO |
$31.84
|
| Rate for Payer: BCBS Trust/PPO |
$104.69
|
| Rate for Payer: BCN Commercial |
$104.69
|
| Rate for Payer: BCN Medicare Advantage |
$31.84
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$22.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.43
|
| Rate for Payer: Meridian Medicaid |
$23.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$104.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PACE Senior Care Partners |
$30.25
|
| Rate for Payer: PACE SWMI |
$31.84
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.79
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.64
|
| Rate for Payer: Railroad Medicare Medicare |
$31.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.07
|
| Rate for Payer: UHC Core |
$106.34
|
| Rate for Payer: UHC Exchange |
$31.84
|
| Rate for Payer: UHC Medicaid |
$22.45
|
| Rate for Payer: UHC Medicare Advantage |
$31.84
|
| Rate for Payer: UHCCP Medicaid |
$22.45
|
| Rate for Payer: VA VA |
$31.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.17 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: BCBS Trust/PPO |
$83.27
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$26.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.51
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$82.88
|
| Rate for Payer: BCN Commercial |
$82.88
|
| Rate for Payer: BCN Medicare Advantage |
$25.20
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Mclaren Medicaid |
$17.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$18.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$23.94
|
| Rate for Payer: PACE SWMI |
$25.20
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Medicare |
$25.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: Railroad Medicare Medicare |
$25.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$25.20
|
| Rate for Payer: UHCCP Medicaid |
$17.77
|
| Rate for Payer: VA VA |
$25.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
