|
HC METANEB SUPPLY
|
Facility
|
OP
|
$259.27
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$61.58 |
| Max. Negotiated Rate |
$233.34 |
| Rate for Payer: Aetna Commercial |
$220.38
|
| Rate for Payer: Aetna Medicare |
$67.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.02
|
| Rate for Payer: BCBS Complete |
$103.71
|
| Rate for Payer: BCBS MAPPO |
$64.82
|
| Rate for Payer: BCBS Trust/PPO |
$213.15
|
| Rate for Payer: BCN Commercial |
$201.58
|
| Rate for Payer: BCN Medicare Advantage |
$64.82
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$222.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.82
|
| Rate for Payer: Healthscope Commercial |
$233.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.38
|
| Rate for Payer: Nomi Health Commercial |
$212.60
|
| Rate for Payer: PACE Senior Care Partners |
$61.58
|
| Rate for Payer: PACE SWMI |
$64.82
|
| Rate for Payer: PHP Commercial |
$220.38
|
| Rate for Payer: PHP Medicare Advantage |
$64.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.53
|
| Rate for Payer: Priority Health HMO/PPO |
$225.56
|
| Rate for Payer: Priority Health Medicare |
$65.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.71
|
| Rate for Payer: Railroad Medicare Medicare |
$64.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.16
|
| Rate for Payer: UHC Core |
$216.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.82
|
| Rate for Payer: UHC Exchange |
$64.82
|
| Rate for Payer: UHC Medicare Advantage |
$64.82
|
| Rate for Payer: VA VA |
$64.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.45
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.87 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$11.44
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$11.44
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.44
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.44
|
| Rate for Payer: UHC Exchange |
$11.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.44
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.37
|
| Rate for Payer: BCN Commercial |
$35.38
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$51.15
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Exchange |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$15.56
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.79
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC METANEPHRINES URINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Exchange |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC METANEPHRINES URINE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.49 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.31
|
| Rate for Payer: BCN Commercial |
$41.00
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
OP
|
$1,798.97
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$427.26 |
| Max. Negotiated Rate |
$3,147.90 |
| Rate for Payer: Aetna Commercial |
$1,529.12
|
| Rate for Payer: Aetna Medicare |
$467.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$562.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$562.18
|
| Rate for Payer: BCBS Complete |
$3,147.90
|
| Rate for Payer: BCBS MAPPO |
$449.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,478.93
|
| Rate for Payer: BCN Commercial |
$1,398.70
|
| Rate for Payer: BCN Medicare Advantage |
$449.74
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cofinity Commercial |
$1,547.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$449.74
|
| Rate for Payer: Healthscope Commercial |
$1,619.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.23
|
| Rate for Payer: Mclaren Medicaid |
$2,997.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$472.23
|
| Rate for Payer: Meridian Medicaid |
$3,147.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$517.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,529.12
|
| Rate for Payer: Nomi Health Commercial |
$1,475.16
|
| Rate for Payer: PACE Senior Care Partners |
$427.26
|
| Rate for Payer: PACE SWMI |
$449.74
|
| Rate for Payer: PHP Commercial |
$1,529.12
|
| Rate for Payer: PHP Medicare Advantage |
$449.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,997.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,565.10
|
| Rate for Payer: Priority Health Medicare |
$454.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,205.31
|
| Rate for Payer: Railroad Medicare Medicare |
$449.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,583.09
|
| Rate for Payer: UHC Core |
$1,502.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$449.74
|
| Rate for Payer: UHC Exchange |
$449.74
|
| Rate for Payer: UHC Medicare Advantage |
$449.74
|
| Rate for Payer: UHCCP Medicaid |
$2,997.80
|
| Rate for Payer: VA VA |
$449.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.23
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
IP
|
$1,798.97
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,169.33 |
| Max. Negotiated Rate |
$1,619.07 |
| Rate for Payer: Aetna Commercial |
$1,529.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,468.50
|
| Rate for Payer: BCN Commercial |
$1,390.24
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cofinity Commercial |
$1,547.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.18
|
| Rate for Payer: Healthscope Commercial |
$1,619.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,529.12
|
| Rate for Payer: Nomi Health Commercial |
$1,475.16
|
| Rate for Payer: PHP Commercial |
$1,529.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,565.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,205.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,583.09
|
| Rate for Payer: UHC Core |
$1,502.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.23
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC METHADONE SCRN URN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.86
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCBS Trust/PPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$61.86
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Medicare |
$20.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.89
|
| Rate for Payer: UHC Exchange |
$19.89
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
| Rate for Payer: VA VA |
$19.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: BCBS Trust/PPO |
$64.94
|
| Rate for Payer: BCN Commercial |
$61.48
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC METHANOL LVL
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna Medicare |
$41.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.72
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: BCBS MAPPO |
$39.78
|
| Rate for Payer: BCBS Trust/PPO |
$130.81
|
| Rate for Payer: BCN Commercial |
$123.72
|
| Rate for Payer: BCN Medicare Advantage |
$39.78
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.78
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: PACE Senior Care Partners |
$37.79
|
| Rate for Payer: PACE SWMI |
$39.78
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: PHP Medicare Advantage |
$39.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health HMO/PPO |
$138.43
|
| Rate for Payer: Priority Health Medicare |
$40.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.61
|
| Rate for Payer: Railroad Medicare Medicare |
$39.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.03
|
| Rate for Payer: UHC Core |
$132.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.78
|
| Rate for Payer: UHC Exchange |
$39.78
|
| Rate for Payer: UHC Medicare Advantage |
$39.78
|
| Rate for Payer: VA VA |
$39.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.43 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: BCBS Trust/PPO |
$129.89
|
| Rate for Payer: BCN Commercial |
$122.97
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health HMO/PPO |
$138.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.03
|
| Rate for Payer: UHC Core |
$132.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.93 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: Aetna Medicare |
$12.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$6.23
|
| Rate for Payer: BCBS MAPPO |
$11.76
|
| Rate for Payer: BCBS Trust/PPO |
$38.66
|
| Rate for Payer: BCN Commercial |
$36.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.76
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.76
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.26
|
| Rate for Payer: Mclaren Medicaid |
$5.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: Meridian Medicaid |
$6.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: Nomi Health Commercial |
$38.56
|
| Rate for Payer: PACE Senior Care Partners |
$11.17
|
| Rate for Payer: PACE SWMI |
$11.76
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: PHP Medicare Advantage |
$11.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health HMO/PPO |
$40.91
|
| Rate for Payer: Priority Health Medicare |
$11.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.38
|
| Rate for Payer: UHC Core |
$39.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.76
|
| Rate for Payer: UHC Exchange |
$11.76
|
| Rate for Payer: UHC Medicare Advantage |
$11.76
|
| Rate for Payer: UHCCP Medicaid |
$5.93
|
| Rate for Payer: VA VA |
$11.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.26
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.56 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: BCBS Trust/PPO |
$38.38
|
| Rate for Payer: BCN Commercial |
$36.34
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: Nomi Health Commercial |
$38.56
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health HMO/PPO |
$40.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.38
|
| Rate for Payer: UHC Core |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.26
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: Aetna Medicare |
$46.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.30
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$44.24
|
| Rate for Payer: BCBS Trust/PPO |
$145.49
|
| Rate for Payer: BCN Commercial |
$137.59
|
| Rate for Payer: BCN Medicare Advantage |
$44.24
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.24
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.45
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PACE Senior Care Partners |
$42.03
|
| Rate for Payer: PACE SWMI |
$44.24
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: PHP Medicare Advantage |
$44.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Medicare |
$44.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: Railroad Medicare Medicare |
$44.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.24
|
| Rate for Payer: UHC Exchange |
$44.24
|
| Rate for Payer: UHC Medicare Advantage |
$44.24
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$44.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.03 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: BCBS Trust/PPO |
$144.46
|
| Rate for Payer: BCN Commercial |
$136.76
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
