|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: BCBS Trust/PPO |
$79.61
|
| Rate for Payer: BCN Commercial |
$79.61
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
IP
|
$399.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$243.86 |
| Max. Negotiated Rate |
$359.86 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: BCBS Trust/PPO |
$309.00
|
| Rate for Payer: BCN Commercial |
$309.00
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cofinity Commercial |
$343.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.87
|
| Rate for Payer: Healthscope Commercial |
$359.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$339.86
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$347.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.86
|
| Rate for Payer: UHC Core |
$333.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.88
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
OP
|
$399.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.56 |
| Max. Negotiated Rate |
$359.86 |
| Rate for Payer: Aetna Commercial |
$339.86
|
| Rate for Payer: Aetna Medicare |
$103.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.95
|
| Rate for Payer: BCBS Complete |
$14.23
|
| Rate for Payer: BCBS MAPPO |
$99.96
|
| Rate for Payer: BCBS Trust/PPO |
$310.88
|
| Rate for Payer: BCN Commercial |
$310.88
|
| Rate for Payer: BCN Medicare Advantage |
$99.96
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cash Price |
$319.87
|
| Rate for Payer: Cofinity Commercial |
$343.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$319.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.96
|
| Rate for Payer: Healthscope Commercial |
$359.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$299.88
|
| Rate for Payer: Mclaren Medicaid |
$13.56
|
| Rate for Payer: Meridian Medicaid |
$14.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$339.86
|
| Rate for Payer: PACE Senior Care Partners |
$94.96
|
| Rate for Payer: PACE SWMI |
$99.96
|
| Rate for Payer: PHP Commercial |
$339.86
|
| Rate for Payer: PHP Medicare Advantage |
$99.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$347.86
|
| Rate for Payer: Priority Health Medicare |
$99.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.86
|
| Rate for Payer: Railroad Medicare Medicare |
$99.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.86
|
| Rate for Payer: UHC Core |
$333.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: VA VA |
$99.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$299.88
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.72
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$18.98
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$59.01
|
| Rate for Payer: BCN Medicare Advantage |
$18.98
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.03
|
| Rate for Payer: PACE SWMI |
$18.98
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: PHP Medicare Advantage |
$18.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Medicare |
$18.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: Railroad Medicare Medicare |
$18.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: BCBS Trust/PPO |
$58.66
|
| Rate for Payer: BCN Commercial |
$58.66
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: BCBS Trust/PPO |
$58.66
|
| Rate for Payer: BCN Commercial |
$58.66
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.72
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$18.98
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$59.01
|
| Rate for Payer: BCN Medicare Advantage |
$18.98
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.03
|
| Rate for Payer: PACE SWMI |
$18.98
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: PHP Medicare Advantage |
$18.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Medicare |
$18.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: Railroad Medicare Medicare |
$18.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC SESAME SEED IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SETUP 1
|
Facility
|
OP
|
$32.88
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.28
|
| Rate for Payer: BCBS Complete |
$13.15
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$25.56
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$28.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.95
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.95
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.61
|
| Rate for Payer: Priority Health Medicare |
$8.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.05
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.93
|
| Rate for Payer: UHC Core |
$27.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.22
|
| Rate for Payer: UHC Medicare Advantage |
$8.47
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.66
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$32.88
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.05 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: BCBS Trust/PPO |
$25.41
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$28.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Healthscope Commercial |
$29.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.95
|
| Rate for Payer: PHP Commercial |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.93
|
| Rate for Payer: UHC Core |
$27.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.66
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna Medicare |
$15.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.49
|
| Rate for Payer: BCBS Complete |
$16.84
|
| Rate for Payer: BCBS MAPPO |
$14.79
|
| Rate for Payer: BCBS Trust/PPO |
$46.00
|
| Rate for Payer: BCN Commercial |
$46.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.79
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.79
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Mclaren Medicaid |
$16.04
|
| Rate for Payer: Meridian Medicaid |
$16.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PACE Senior Care Partners |
$14.05
|
| Rate for Payer: PACE SWMI |
$14.79
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Medicare |
$14.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.08
|
| Rate for Payer: Railroad Medicare Medicare |
$14.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.79
|
| Rate for Payer: UHC Medicare Advantage |
$15.23
|
| Rate for Payer: VA VA |
$14.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.08 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$45.72
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$83.46
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.90 |
| Max. Negotiated Rate |
$75.11 |
| Rate for Payer: Aetna Commercial |
$70.94
|
| Rate for Payer: BCBS Trust/PPO |
$64.50
|
| Rate for Payer: BCN Commercial |
$64.50
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.77
|
| Rate for Payer: Healthscope Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.94
|
| Rate for Payer: PHP Commercial |
$70.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.44
|
| Rate for Payer: UHC Core |
$69.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$83.46
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.04 |
| Max. Negotiated Rate |
$75.11 |
| Rate for Payer: Aetna Commercial |
$70.94
|
| Rate for Payer: Aetna Medicare |
$21.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.08
|
| Rate for Payer: BCBS Complete |
$16.84
|
| Rate for Payer: BCBS MAPPO |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$64.89
|
| Rate for Payer: BCN Commercial |
$64.89
|
| Rate for Payer: BCN Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cash Price |
$66.77
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$75.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Mclaren Medicaid |
$16.04
|
| Rate for Payer: Meridian Medicaid |
$16.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.94
|
| Rate for Payer: PACE Senior Care Partners |
$19.82
|
| Rate for Payer: PACE SWMI |
$20.86
|
| Rate for Payer: PHP Commercial |
$70.94
|
| Rate for Payer: PHP Medicare Advantage |
$20.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.61
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.90
|
| Rate for Payer: Railroad Medicare Medicare |
$20.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.44
|
| Rate for Payer: UHC Core |
$69.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.86
|
| Rate for Payer: UHC Medicare Advantage |
$21.49
|
| Rate for Payer: VA VA |
$20.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.08
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$17.17 |
| Rate for Payer: Aetna Commercial |
$16.22
|
| Rate for Payer: Aetna Medicare |
$4.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.96
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$4.77
|
| Rate for Payer: BCBS Trust/PPO |
$14.83
|
| Rate for Payer: BCN Commercial |
$14.83
|
| Rate for Payer: BCN Medicare Advantage |
$4.77
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cofinity Commercial |
$16.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.77
|
| Rate for Payer: Healthscope Commercial |
$17.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.31
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.22
|
| Rate for Payer: PACE Senior Care Partners |
$4.53
|
| Rate for Payer: PACE SWMI |
$4.77
|
| Rate for Payer: PHP Commercial |
$16.22
|
| Rate for Payer: PHP Medicare Advantage |
$4.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.60
|
| Rate for Payer: Priority Health Medicare |
$4.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.64
|
| Rate for Payer: Railroad Medicare Medicare |
$4.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.79
|
| Rate for Payer: UHC Core |
$15.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.77
|
| Rate for Payer: UHC Medicare Advantage |
$4.91
|
| Rate for Payer: VA VA |
$4.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.31
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.08
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$17.17 |
| Rate for Payer: Aetna Commercial |
$16.22
|
| Rate for Payer: BCBS Trust/PPO |
$14.75
|
| Rate for Payer: BCN Commercial |
$14.75
|
| Rate for Payer: Cash Price |
$15.26
|
| Rate for Payer: Cofinity Commercial |
$16.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.26
|
| Rate for Payer: Healthscope Commercial |
$17.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.22
|
| Rate for Payer: PHP Commercial |
$16.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.79
|
| Rate for Payer: UHC Core |
$15.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.31
|
|
|
HC SGPT ALT
|
Facility
|
OP
|
$19.24
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$17.32 |
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.01
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS MAPPO |
$4.81
|
| Rate for Payer: BCBS Trust/PPO |
$14.96
|
| Rate for Payer: BCN Commercial |
$14.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.81
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$16.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.81
|
| Rate for Payer: Healthscope Commercial |
$17.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.43
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.35
|
| Rate for Payer: PACE Senior Care Partners |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.81
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.74
|
| Rate for Payer: Priority Health Medicare |
$4.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.73
|
| Rate for Payer: Railroad Medicare Medicare |
$4.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.93
|
| Rate for Payer: UHC Core |
$16.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.81
|
| Rate for Payer: UHC Medicare Advantage |
$4.95
|
| Rate for Payer: VA VA |
$4.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.43
|
|
|
HC SGPT ALT
|
Facility
|
IP
|
$19.24
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.73 |
| Max. Negotiated Rate |
$17.32 |
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Commercial |
$14.87
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cofinity Commercial |
$16.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.39
|
| Rate for Payer: Healthscope Commercial |
$17.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.35
|
| Rate for Payer: PHP Commercial |
$16.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.93
|
| Rate for Payer: UHC Core |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.43
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$77.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.39
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$74.72
|
| Rate for Payer: BCBS Trust/PPO |
$232.36
|
| Rate for Payer: BCN Commercial |
$232.36
|
| Rate for Payer: BCN Medicare Advantage |
$74.72
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.72
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Senior Care Partners |
$70.98
|
| Rate for Payer: PACE SWMI |
$74.72
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Medicare |
$74.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: Railroad Medicare Medicare |
$74.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.72
|
| Rate for Payer: UHC Medicare Advantage |
$76.96
|
| Rate for Payer: VA VA |
$74.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.27 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: BCBS Trust/PPO |
$230.96
|
| Rate for Payer: BCN Commercial |
$230.96
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$274.65 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$77.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.39
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$74.72
|
| Rate for Payer: BCBS Trust/PPO |
$232.36
|
| Rate for Payer: BCN Commercial |
$232.36
|
| Rate for Payer: BCN Medicare Advantage |
$74.72
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.72
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Senior Care Partners |
$70.98
|
| Rate for Payer: PACE SWMI |
$74.72
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Medicare |
$74.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: Railroad Medicare Medicare |
$74.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.72
|
| Rate for Payer: UHC Medicare Advantage |
$76.96
|
| Rate for Payer: VA VA |
$74.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.27 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: BCBS Trust/PPO |
$230.96
|
| Rate for Payer: BCN Commercial |
$230.96
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.00
|
| Rate for Payer: UHC Core |
$249.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.38 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: BCBS Trust/PPO |
$213.35
|
| Rate for Payer: BCN Commercial |
$213.35
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.57 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$71.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.27
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$69.02
|
| Rate for Payer: BCBS Trust/PPO |
$214.64
|
| Rate for Payer: BCN Commercial |
$214.64
|
| Rate for Payer: BCN Medicare Advantage |
$69.02
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.02
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Senior Care Partners |
$65.57
|
| Rate for Payer: PACE SWMI |
$69.02
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$69.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.18
|
| Rate for Payer: Priority Health Medicare |
$69.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$168.38
|
| Rate for Payer: Railroad Medicare Medicare |
$69.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.94
|
| Rate for Payer: UHC Core |
$230.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.02
|
| Rate for Payer: UHC Medicare Advantage |
$71.09
|
| Rate for Payer: VA VA |
$69.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
