|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
IP
|
$34.33
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.31 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.02
|
| Rate for Payer: BCN Commercial |
$26.53
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.46
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.18
|
| Rate for Payer: Nomi Health Commercial |
$28.15
|
| Rate for Payer: PHP Commercial |
$29.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.31
|
| Rate for Payer: Priority Health HMO/PPO |
$29.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.75
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
OP
|
$34.33
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.15 |
| Max. Negotiated Rate |
$30.90 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.73
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$8.58
|
| Rate for Payer: BCBS Trust/PPO |
$28.22
|
| Rate for Payer: BCN Commercial |
$26.69
|
| Rate for Payer: BCN Medicare Advantage |
$8.58
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cash Price |
$27.46
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.58
|
| Rate for Payer: Healthscope Commercial |
$30.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.75
|
| Rate for Payer: Mclaren Medicaid |
$11.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.01
|
| Rate for Payer: Meridian Medicaid |
$11.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.18
|
| Rate for Payer: Nomi Health Commercial |
$28.15
|
| Rate for Payer: PACE Senior Care Partners |
$8.15
|
| Rate for Payer: PACE SWMI |
$8.58
|
| Rate for Payer: PHP Commercial |
$29.18
|
| Rate for Payer: PHP Medicare Advantage |
$8.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.31
|
| Rate for Payer: Priority Health HMO/PPO |
$29.87
|
| Rate for Payer: Priority Health Medicare |
$8.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.00
|
| Rate for Payer: Railroad Medicare Medicare |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.58
|
| Rate for Payer: UHC Exchange |
$8.58
|
| Rate for Payer: UHC Medicare Advantage |
$8.58
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: VA VA |
$8.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.75
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
OP
|
$60.18
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$15.04
|
| Rate for Payer: BCBS Trust/PPO |
$49.47
|
| Rate for Payer: BCN Commercial |
$46.79
|
| Rate for Payer: BCN Medicare Advantage |
$15.04
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.04
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.13
|
| Rate for Payer: Mclaren Medicaid |
$5.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$5.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: PACE Senior Care Partners |
$14.29
|
| Rate for Payer: PACE SWMI |
$15.04
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: PHP Medicare Advantage |
$15.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: Priority Health HMO/PPO |
$52.36
|
| Rate for Payer: Priority Health Medicare |
$15.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.32
|
| Rate for Payer: Railroad Medicare Medicare |
$15.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.04
|
| Rate for Payer: UHC Exchange |
$15.04
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
| Rate for Payer: UHCCP Medicaid |
$5.62
|
| Rate for Payer: VA VA |
$15.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.13
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.12 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: BCBS Trust/PPO |
$49.12
|
| Rate for Payer: BCN Commercial |
$46.51
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.15
|
| Rate for Payer: Nomi Health Commercial |
$49.35
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.12
|
| Rate for Payer: Priority Health HMO/PPO |
$52.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.96
|
| Rate for Payer: UHC Core |
$50.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.13
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
IP
|
$162.18
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.42 |
| Max. Negotiated Rate |
$145.96 |
| Rate for Payer: Aetna Commercial |
$137.85
|
| Rate for Payer: BCBS Trust/PPO |
$132.39
|
| Rate for Payer: BCN Commercial |
$125.33
|
| Rate for Payer: Cash Price |
$129.74
|
| Rate for Payer: Cofinity Commercial |
$139.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.74
|
| Rate for Payer: Healthscope Commercial |
$145.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.85
|
| Rate for Payer: Nomi Health Commercial |
$132.99
|
| Rate for Payer: PHP Commercial |
$137.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.42
|
| Rate for Payer: Priority Health HMO/PPO |
$141.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.72
|
| Rate for Payer: UHC Core |
$135.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.64
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
OP
|
$162.18
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$145.96 |
| Rate for Payer: Aetna Commercial |
$137.85
|
| Rate for Payer: Aetna Medicare |
$42.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.68
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$40.55
|
| Rate for Payer: BCBS Trust/PPO |
$133.33
|
| Rate for Payer: BCN Commercial |
$126.09
|
| Rate for Payer: BCN Medicare Advantage |
$40.55
|
| Rate for Payer: Cash Price |
$129.74
|
| Rate for Payer: Cash Price |
$129.74
|
| Rate for Payer: Cofinity Commercial |
$139.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.55
|
| Rate for Payer: Healthscope Commercial |
$145.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.64
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.57
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.85
|
| Rate for Payer: Nomi Health Commercial |
$132.99
|
| Rate for Payer: PACE Senior Care Partners |
$38.52
|
| Rate for Payer: PACE SWMI |
$40.55
|
| Rate for Payer: PHP Commercial |
$137.85
|
| Rate for Payer: PHP Medicare Advantage |
$40.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.42
|
| Rate for Payer: Priority Health HMO/PPO |
$141.10
|
| Rate for Payer: Priority Health Medicare |
$40.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.66
|
| Rate for Payer: Railroad Medicare Medicare |
$40.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.72
|
| Rate for Payer: UHC Core |
$135.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.55
|
| Rate for Payer: UHC Exchange |
$40.55
|
| Rate for Payer: UHC Medicare Advantage |
$40.55
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: VA VA |
$40.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.64
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.68 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: BCBS Trust/PPO |
$72.44
|
| Rate for Payer: BCN Commercial |
$68.58
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO |
$77.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.73
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$22.18
|
| Rate for Payer: BCBS Trust/PPO |
$72.95
|
| Rate for Payer: BCN Commercial |
$69.00
|
| Rate for Payer: BCN Medicare Advantage |
$22.18
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.18
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.29
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$72.77
|
| Rate for Payer: PACE Senior Care Partners |
$21.08
|
| Rate for Payer: PACE SWMI |
$22.18
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO |
$77.20
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.46
|
| Rate for Payer: Railroad Medicare Medicare |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.18
|
| Rate for Payer: UHC Exchange |
$22.18
|
| Rate for Payer: UHC Medicare Advantage |
$22.18
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$22.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
OP
|
$72.42
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Aetna Commercial |
$61.56
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.63
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$18.11
|
| Rate for Payer: BCBS Trust/PPO |
$59.54
|
| Rate for Payer: BCN Commercial |
$56.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.11
|
| Rate for Payer: Cash Price |
$57.94
|
| Rate for Payer: Cash Price |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.11
|
| Rate for Payer: Healthscope Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.31
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.56
|
| Rate for Payer: Nomi Health Commercial |
$59.38
|
| Rate for Payer: PACE Senior Care Partners |
$17.20
|
| Rate for Payer: PACE SWMI |
$18.11
|
| Rate for Payer: PHP Commercial |
$61.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.07
|
| Rate for Payer: Priority Health HMO/PPO |
$63.01
|
| Rate for Payer: Priority Health Medicare |
$18.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: Railroad Medicare Medicare |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$60.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.11
|
| Rate for Payer: UHC Exchange |
$18.11
|
| Rate for Payer: UHC Medicare Advantage |
$18.11
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: VA VA |
$18.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.31
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
IP
|
$72.42
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Aetna Commercial |
$61.56
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$55.97
|
| Rate for Payer: Cash Price |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$62.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.94
|
| Rate for Payer: Healthscope Commercial |
$65.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.56
|
| Rate for Payer: Nomi Health Commercial |
$59.38
|
| Rate for Payer: PHP Commercial |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.07
|
| Rate for Payer: Priority Health HMO/PPO |
$63.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.73
|
| Rate for Payer: UHC Core |
$60.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.31
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.71
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
IP
|
$259.72
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: Aetna Commercial |
$220.76
|
| Rate for Payer: BCBS Trust/PPO |
$212.01
|
| Rate for Payer: BCN Commercial |
$200.71
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cofinity Commercial |
$223.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.78
|
| Rate for Payer: Healthscope Commercial |
$233.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.76
|
| Rate for Payer: Nomi Health Commercial |
$212.97
|
| Rate for Payer: PHP Commercial |
$220.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.82
|
| Rate for Payer: Priority Health HMO/PPO |
$225.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.55
|
| Rate for Payer: UHC Core |
$216.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.79
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
OP
|
$259.72
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: Aetna Commercial |
$220.76
|
| Rate for Payer: Aetna Medicare |
$67.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.16
|
| Rate for Payer: BCBS Complete |
$37.22
|
| Rate for Payer: BCBS MAPPO |
$64.93
|
| Rate for Payer: BCBS Trust/PPO |
$213.52
|
| Rate for Payer: BCN Commercial |
$201.93
|
| Rate for Payer: BCN Medicare Advantage |
$64.93
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cofinity Commercial |
$223.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.93
|
| Rate for Payer: Healthscope Commercial |
$233.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.79
|
| Rate for Payer: Mclaren Medicaid |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.18
|
| Rate for Payer: Meridian Medicaid |
$37.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.76
|
| Rate for Payer: Nomi Health Commercial |
$212.97
|
| Rate for Payer: PACE Senior Care Partners |
$61.68
|
| Rate for Payer: PACE SWMI |
$64.93
|
| Rate for Payer: PHP Commercial |
$220.76
|
| Rate for Payer: PHP Medicare Advantage |
$64.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.82
|
| Rate for Payer: Priority Health HMO/PPO |
$225.96
|
| Rate for Payer: Priority Health Medicare |
$65.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.01
|
| Rate for Payer: Railroad Medicare Medicare |
$64.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.55
|
| Rate for Payer: UHC Core |
$216.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.93
|
| Rate for Payer: UHC Exchange |
$64.93
|
| Rate for Payer: UHC Medicare Advantage |
$64.93
|
| Rate for Payer: UHCCP Medicaid |
$35.45
|
| Rate for Payer: VA VA |
$64.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.79
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
IP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$182.06 |
| Max. Negotiated Rate |
$252.08 |
| Rate for Payer: Aetna Commercial |
$238.08
|
| Rate for Payer: BCBS Trust/PPO |
$228.64
|
| Rate for Payer: BCN Commercial |
$216.45
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$240.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Healthscope Commercial |
$252.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: PHP Commercial |
$238.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: Priority Health HMO/PPO |
$243.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.48
|
| Rate for Payer: UHC Core |
$233.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.07
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
OP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$252.08 |
| Rate for Payer: Aetna Commercial |
$238.08
|
| Rate for Payer: Aetna Medicare |
$72.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.53
|
| Rate for Payer: BCBS Complete |
$37.22
|
| Rate for Payer: BCBS MAPPO |
$70.02
|
| Rate for Payer: BCBS Trust/PPO |
$230.26
|
| Rate for Payer: BCN Commercial |
$217.77
|
| Rate for Payer: BCN Medicare Advantage |
$70.02
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$240.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.02
|
| Rate for Payer: Healthscope Commercial |
$252.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.07
|
| Rate for Payer: Mclaren Medicaid |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.52
|
| Rate for Payer: Meridian Medicaid |
$37.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: PACE Senior Care Partners |
$66.52
|
| Rate for Payer: PACE SWMI |
$70.02
|
| Rate for Payer: PHP Commercial |
$238.08
|
| Rate for Payer: PHP Medicare Advantage |
$70.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: Priority Health HMO/PPO |
$243.68
|
| Rate for Payer: Priority Health Medicare |
$70.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.66
|
| Rate for Payer: Railroad Medicare Medicare |
$70.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.48
|
| Rate for Payer: UHC Core |
$233.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.02
|
| Rate for Payer: UHC Exchange |
$70.02
|
| Rate for Payer: UHC Medicare Advantage |
$70.02
|
| Rate for Payer: UHCCP Medicaid |
$35.45
|
| Rate for Payer: VA VA |
$70.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.07
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
OP
|
$235.62
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$212.06 |
| Rate for Payer: Aetna Commercial |
$200.28
|
| Rate for Payer: Aetna Medicare |
$61.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.63
|
| Rate for Payer: BCBS Complete |
$37.22
|
| Rate for Payer: BCBS MAPPO |
$58.91
|
| Rate for Payer: BCBS Trust/PPO |
$193.70
|
| Rate for Payer: BCN Commercial |
$183.19
|
| Rate for Payer: BCN Medicare Advantage |
$58.91
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$202.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.91
|
| Rate for Payer: Healthscope Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.72
|
| Rate for Payer: Mclaren Medicaid |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.85
|
| Rate for Payer: Meridian Medicaid |
$37.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.28
|
| Rate for Payer: Nomi Health Commercial |
$193.21
|
| Rate for Payer: PACE Senior Care Partners |
$55.96
|
| Rate for Payer: PACE SWMI |
$58.91
|
| Rate for Payer: PHP Commercial |
$200.28
|
| Rate for Payer: PHP Medicare Advantage |
$58.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.15
|
| Rate for Payer: Priority Health HMO/PPO |
$204.99
|
| Rate for Payer: Priority Health Medicare |
$59.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.87
|
| Rate for Payer: Railroad Medicare Medicare |
$58.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.35
|
| Rate for Payer: UHC Core |
$196.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.91
|
| Rate for Payer: UHC Exchange |
$58.91
|
| Rate for Payer: UHC Medicare Advantage |
$58.91
|
| Rate for Payer: UHCCP Medicaid |
$35.45
|
| Rate for Payer: VA VA |
$58.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.72
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
IP
|
$235.62
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$212.06 |
| Rate for Payer: Aetna Commercial |
$200.28
|
| Rate for Payer: BCBS Trust/PPO |
$192.34
|
| Rate for Payer: BCN Commercial |
$182.09
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$202.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Healthscope Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.28
|
| Rate for Payer: Nomi Health Commercial |
$193.21
|
| Rate for Payer: PHP Commercial |
$200.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.15
|
| Rate for Payer: Priority Health HMO/PPO |
$204.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.35
|
| Rate for Payer: UHC Core |
$196.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.72
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
IP
|
$259.72
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$168.82 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: Aetna Commercial |
$220.76
|
| Rate for Payer: BCBS Trust/PPO |
$212.01
|
| Rate for Payer: BCN Commercial |
$200.71
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cofinity Commercial |
$223.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.78
|
| Rate for Payer: Healthscope Commercial |
$233.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.76
|
| Rate for Payer: Nomi Health Commercial |
$212.97
|
| Rate for Payer: PHP Commercial |
$220.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.82
|
| Rate for Payer: Priority Health HMO/PPO |
$225.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.55
|
| Rate for Payer: UHC Core |
$216.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.79
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
OP
|
$259.72
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$233.75 |
| Rate for Payer: Aetna Commercial |
$220.76
|
| Rate for Payer: Aetna Medicare |
$67.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.16
|
| Rate for Payer: BCBS Complete |
$37.22
|
| Rate for Payer: BCBS MAPPO |
$64.93
|
| Rate for Payer: BCBS Trust/PPO |
$213.52
|
| Rate for Payer: BCN Commercial |
$201.93
|
| Rate for Payer: BCN Medicare Advantage |
$64.93
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cash Price |
$207.78
|
| Rate for Payer: Cofinity Commercial |
$223.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.93
|
| Rate for Payer: Healthscope Commercial |
$233.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.79
|
| Rate for Payer: Mclaren Medicaid |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.18
|
| Rate for Payer: Meridian Medicaid |
$37.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.76
|
| Rate for Payer: Nomi Health Commercial |
$212.97
|
| Rate for Payer: PACE Senior Care Partners |
$61.68
|
| Rate for Payer: PACE SWMI |
$64.93
|
| Rate for Payer: PHP Commercial |
$220.76
|
| Rate for Payer: PHP Medicare Advantage |
$64.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.82
|
| Rate for Payer: Priority Health HMO/PPO |
$225.96
|
| Rate for Payer: Priority Health Medicare |
$65.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.01
|
| Rate for Payer: Railroad Medicare Medicare |
$64.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.55
|
| Rate for Payer: UHC Core |
$216.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.93
|
| Rate for Payer: UHC Exchange |
$64.93
|
| Rate for Payer: UHC Medicare Advantage |
$64.93
|
| Rate for Payer: UHCCP Medicaid |
$35.45
|
| Rate for Payer: VA VA |
$64.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.79
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$252.08 |
| Rate for Payer: Aetna Commercial |
$238.08
|
| Rate for Payer: Aetna Medicare |
$72.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.53
|
| Rate for Payer: BCBS Complete |
$37.22
|
| Rate for Payer: BCBS MAPPO |
$70.02
|
| Rate for Payer: BCBS Trust/PPO |
$230.26
|
| Rate for Payer: BCN Commercial |
$217.77
|
| Rate for Payer: BCN Medicare Advantage |
$70.02
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$240.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.02
|
| Rate for Payer: Healthscope Commercial |
$252.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.07
|
| Rate for Payer: Mclaren Medicaid |
$35.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.52
|
| Rate for Payer: Meridian Medicaid |
$37.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: PACE Senior Care Partners |
$66.52
|
| Rate for Payer: PACE SWMI |
$70.02
|
| Rate for Payer: PHP Commercial |
$238.08
|
| Rate for Payer: PHP Medicare Advantage |
$70.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: Priority Health HMO/PPO |
$243.68
|
| Rate for Payer: Priority Health Medicare |
$70.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.66
|
| Rate for Payer: Railroad Medicare Medicare |
$70.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.48
|
| Rate for Payer: UHC Core |
$233.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.02
|
| Rate for Payer: UHC Exchange |
$70.02
|
| Rate for Payer: UHC Medicare Advantage |
$70.02
|
| Rate for Payer: UHCCP Medicaid |
$35.45
|
| Rate for Payer: VA VA |
$70.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.07
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$280.09
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$182.06 |
| Max. Negotiated Rate |
$252.08 |
| Rate for Payer: Aetna Commercial |
$238.08
|
| Rate for Payer: BCBS Trust/PPO |
$228.64
|
| Rate for Payer: BCN Commercial |
$216.45
|
| Rate for Payer: Cash Price |
$224.07
|
| Rate for Payer: Cofinity Commercial |
$240.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.07
|
| Rate for Payer: Healthscope Commercial |
$252.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.08
|
| Rate for Payer: Nomi Health Commercial |
$229.67
|
| Rate for Payer: PHP Commercial |
$238.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.06
|
| Rate for Payer: Priority Health HMO/PPO |
$243.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.48
|
| Rate for Payer: UHC Core |
$233.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.07
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$4.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.88
|
| Rate for Payer: BCBS Complete |
$6.24
|
| Rate for Payer: BCBS MAPPO |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.83
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$3.90
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.90
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PACE Senior Care Partners |
$3.71
|
| Rate for Payer: PACE SWMI |
$3.90
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Medicare |
$3.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.90
|
| Rate for Payer: UHC Exchange |
$3.90
|
| Rate for Payer: UHC Medicare Advantage |
$3.90
|
| Rate for Payer: VA VA |
$3.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$12.74
|
| Rate for Payer: BCN Commercial |
$12.06
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$12.80
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health HMO/PPO |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.74
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$437.58 |
| Max. Negotiated Rate |
$605.88 |
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: BCBS Trust/PPO |
$549.53
|
| Rate for Payer: BCN Commercial |
$520.25
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$552.02
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO |
$585.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$451.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$592.42
|
| Rate for Payer: UHC Core |
$562.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
