|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
OP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.32
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: BCBS MAPPO |
$12.26
|
| Rate for Payer: BCBS Trust/PPO |
$40.30
|
| Rate for Payer: BCN Commercial |
$40.30
|
| Rate for Payer: BCN Medicare Advantage |
$12.26
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.26
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Mclaren Medicaid |
$8.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.87
|
| Rate for Payer: Meridian Medicaid |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$40.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PACE Senior Care Partners |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.26
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$12.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$12.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.14
|
| Rate for Payer: UHC Core |
$40.93
|
| Rate for Payer: UHC Exchange |
$12.26
|
| Rate for Payer: UHC Medicaid |
$8.64
|
| Rate for Payer: UHC Medicare Advantage |
$12.26
|
| Rate for Payer: UHCCP Medicaid |
$8.64
|
| Rate for Payer: VA VA |
$12.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
IP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: BCBS Trust/PPO |
$40.49
|
| Rate for Payer: BCN Commercial |
$40.49
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$40.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.14
|
| Rate for Payer: UHC Core |
$40.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OMMAYA
|
Facility
|
IP
|
$392.42
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$273.12 |
| Max. Negotiated Rate |
$353.18 |
| Rate for Payer: Aetna Commercial |
$333.56
|
| Rate for Payer: BCBS Trust/PPO |
$324.10
|
| Rate for Payer: BCN Commercial |
$324.10
|
| Rate for Payer: Cash Price |
$313.94
|
| Rate for Payer: Cofinity Commercial |
$337.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.94
|
| Rate for Payer: Healthscope Commercial |
$353.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.56
|
| Rate for Payer: Nomi Health Commercial |
$321.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.31
|
| Rate for Payer: PHP Commercial |
$333.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$341.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.33
|
| Rate for Payer: UHC Core |
$327.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.31
|
|
|
HC OMMAYA
|
Facility
|
OP
|
$392.42
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$69.18 |
| Max. Negotiated Rate |
$353.18 |
| Rate for Payer: Aetna Commercial |
$333.56
|
| Rate for Payer: Aetna Medicare |
$102.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.63
|
| Rate for Payer: BCBS Complete |
$72.64
|
| Rate for Payer: BCBS MAPPO |
$98.11
|
| Rate for Payer: BCBS Trust/PPO |
$322.61
|
| Rate for Payer: BCN Commercial |
$322.61
|
| Rate for Payer: BCN Medicare Advantage |
$98.11
|
| Rate for Payer: Cash Price |
$313.94
|
| Rate for Payer: Cofinity Commercial |
$337.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.11
|
| Rate for Payer: Healthscope Commercial |
$353.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.31
|
| Rate for Payer: Mclaren Medicaid |
$69.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.01
|
| Rate for Payer: Meridian Medicaid |
$72.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.56
|
| Rate for Payer: Nomi Health Commercial |
$321.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.31
|
| Rate for Payer: PACE Senior Care Partners |
$93.20
|
| Rate for Payer: PACE SWMI |
$98.11
|
| Rate for Payer: PHP Commercial |
$333.56
|
| Rate for Payer: PHP Medicare Advantage |
$98.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$341.41
|
| Rate for Payer: Priority Health Medicare |
$99.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.12
|
| Rate for Payer: Railroad Medicare Medicare |
$98.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.33
|
| Rate for Payer: UHC Core |
$327.67
|
| Rate for Payer: UHC Exchange |
$98.11
|
| Rate for Payer: UHC Medicaid |
$69.18
|
| Rate for Payer: UHC Medicare Advantage |
$98.11
|
| Rate for Payer: UHCCP Medicaid |
$69.18
|
| Rate for Payer: VA VA |
$98.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.31
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
IP
|
$1.85
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.29 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna Commercial |
$1.57
|
| Rate for Payer: BCBS Trust/PPO |
$1.53
|
| Rate for Payer: BCN Commercial |
$1.53
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cofinity Commercial |
$1.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.48
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.57
|
| Rate for Payer: Nomi Health Commercial |
$1.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.39
|
| Rate for Payer: PHP Commercial |
$1.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC Core |
$1.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.39
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
OP
|
$1.85
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna Commercial |
$1.57
|
| Rate for Payer: Aetna Medicare |
$0.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.58
|
| Rate for Payer: BCBS Complete |
$0.34
|
| Rate for Payer: BCBS MAPPO |
$0.46
|
| Rate for Payer: BCBS Trust/PPO |
$1.52
|
| Rate for Payer: BCN Commercial |
$1.52
|
| Rate for Payer: BCN Medicare Advantage |
$0.46
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cofinity Commercial |
$1.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.46
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.39
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.49
|
| Rate for Payer: Meridian Medicaid |
$0.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.57
|
| Rate for Payer: Nomi Health Commercial |
$1.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.39
|
| Rate for Payer: PACE Senior Care Partners |
$0.44
|
| Rate for Payer: PACE SWMI |
$0.46
|
| Rate for Payer: PHP Commercial |
$1.57
|
| Rate for Payer: PHP Medicare Advantage |
$0.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.61
|
| Rate for Payer: Priority Health Medicare |
$0.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.29
|
| Rate for Payer: Railroad Medicare Medicare |
$0.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.63
|
| Rate for Payer: UHC Core |
$1.54
|
| Rate for Payer: UHC Exchange |
$0.46
|
| Rate for Payer: UHC Medicaid |
$0.33
|
| Rate for Payer: UHC Medicare Advantage |
$0.46
|
| Rate for Payer: UHCCP Medicaid |
$0.33
|
| Rate for Payer: VA VA |
$0.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.39
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
IP
|
$5,919.88
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,120.24 |
| Max. Negotiated Rate |
$5,327.89 |
| Rate for Payer: Aetna Commercial |
$5,031.90
|
| Rate for Payer: BCBS Trust/PPO |
$4,889.23
|
| Rate for Payer: BCN Commercial |
$4,889.23
|
| Rate for Payer: Cash Price |
$4,735.90
|
| Rate for Payer: Cofinity Commercial |
$5,091.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,735.90
|
| Rate for Payer: Healthscope Commercial |
$5,327.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,439.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,031.90
|
| Rate for Payer: Nomi Health Commercial |
$4,854.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,439.91
|
| Rate for Payer: PHP Commercial |
$5,031.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,150.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,120.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,209.49
|
| Rate for Payer: UHC Core |
$4,943.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,439.91
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
OP
|
$5,919.88
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,043.67 |
| Max. Negotiated Rate |
$5,327.89 |
| Rate for Payer: Aetna Commercial |
$5,031.90
|
| Rate for Payer: Aetna Medicare |
$1,539.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,849.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,849.96
|
| Rate for Payer: BCBS Complete |
$1,095.77
|
| Rate for Payer: BCBS MAPPO |
$1,479.97
|
| Rate for Payer: BCBS Trust/PPO |
$4,866.73
|
| Rate for Payer: BCN Commercial |
$4,866.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,479.97
|
| Rate for Payer: Cash Price |
$4,735.90
|
| Rate for Payer: Cofinity Commercial |
$5,091.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,735.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,479.97
|
| Rate for Payer: Healthscope Commercial |
$5,327.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,439.91
|
| Rate for Payer: Mclaren Medicaid |
$1,043.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,553.97
|
| Rate for Payer: Meridian Medicaid |
$1,095.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,701.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,627.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,031.90
|
| Rate for Payer: Nomi Health Commercial |
$4,854.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,439.91
|
| Rate for Payer: PACE Senior Care Partners |
$1,405.97
|
| Rate for Payer: PACE SWMI |
$1,479.97
|
| Rate for Payer: PHP Commercial |
$5,031.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,479.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,043.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,150.30
|
| Rate for Payer: Priority Health Medicare |
$1,494.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,120.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,479.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,209.49
|
| Rate for Payer: UHC Core |
$4,943.10
|
| Rate for Payer: UHC Exchange |
$1,479.97
|
| Rate for Payer: UHC Medicaid |
$1,043.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,479.97
|
| Rate for Payer: UHCCP Medicaid |
$1,043.67
|
| Rate for Payer: VA VA |
$1,479.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,439.91
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$962.88
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$169.76 |
| Max. Negotiated Rate |
$866.59 |
| Rate for Payer: Aetna Commercial |
$818.45
|
| Rate for Payer: Aetna Medicare |
$250.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$300.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$300.90
|
| Rate for Payer: BCBS Complete |
$178.23
|
| Rate for Payer: BCBS MAPPO |
$240.72
|
| Rate for Payer: BCBS Trust/PPO |
$791.58
|
| Rate for Payer: BCN Commercial |
$791.58
|
| Rate for Payer: BCN Medicare Advantage |
$240.72
|
| Rate for Payer: Cash Price |
$770.30
|
| Rate for Payer: Cofinity Commercial |
$828.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.72
|
| Rate for Payer: Healthscope Commercial |
$866.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.16
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.76
|
| Rate for Payer: Meridian Medicaid |
$178.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$264.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.45
|
| Rate for Payer: Nomi Health Commercial |
$789.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.16
|
| Rate for Payer: PACE Senior Care Partners |
$228.68
|
| Rate for Payer: PACE SWMI |
$240.72
|
| Rate for Payer: PHP Commercial |
$818.45
|
| Rate for Payer: PHP Medicare Advantage |
$240.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$837.71
|
| Rate for Payer: Priority Health Medicare |
$243.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$670.16
|
| Rate for Payer: Railroad Medicare Medicare |
$240.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$847.33
|
| Rate for Payer: UHC Core |
$804.00
|
| Rate for Payer: UHC Exchange |
$240.72
|
| Rate for Payer: UHC Medicaid |
$169.76
|
| Rate for Payer: UHC Medicare Advantage |
$240.72
|
| Rate for Payer: UHCCP Medicaid |
$169.76
|
| Rate for Payer: VA VA |
$240.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.16
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$962.88
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$670.16 |
| Max. Negotiated Rate |
$866.59 |
| Rate for Payer: Aetna Commercial |
$818.45
|
| Rate for Payer: BCBS Trust/PPO |
$795.24
|
| Rate for Payer: BCN Commercial |
$795.24
|
| Rate for Payer: Cash Price |
$770.30
|
| Rate for Payer: Cofinity Commercial |
$828.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.30
|
| Rate for Payer: Healthscope Commercial |
$866.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.45
|
| Rate for Payer: Nomi Health Commercial |
$789.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.16
|
| Rate for Payer: PHP Commercial |
$818.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$837.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$670.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$847.33
|
| Rate for Payer: UHC Core |
$804.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.16
|
|
|
HC OPEN HEART TEG
|
Facility
|
OP
|
$563.42
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.33 |
| Max. Negotiated Rate |
$507.08 |
| Rate for Payer: Aetna Commercial |
$478.91
|
| Rate for Payer: Aetna Medicare |
$146.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.07
|
| Rate for Payer: BCBS Complete |
$104.29
|
| Rate for Payer: BCBS MAPPO |
$140.85
|
| Rate for Payer: BCBS Trust/PPO |
$463.19
|
| Rate for Payer: BCN Commercial |
$463.19
|
| Rate for Payer: BCN Medicare Advantage |
$140.85
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cofinity Commercial |
$484.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.85
|
| Rate for Payer: Healthscope Commercial |
$507.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.56
|
| Rate for Payer: Mclaren Medicaid |
$99.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.90
|
| Rate for Payer: Meridian Medicaid |
$104.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.91
|
| Rate for Payer: Nomi Health Commercial |
$462.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.56
|
| Rate for Payer: PACE Senior Care Partners |
$133.81
|
| Rate for Payer: PACE SWMI |
$140.85
|
| Rate for Payer: PHP Commercial |
$478.91
|
| Rate for Payer: PHP Medicare Advantage |
$140.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$490.18
|
| Rate for Payer: Priority Health Medicare |
$142.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.14
|
| Rate for Payer: Railroad Medicare Medicare |
$140.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.81
|
| Rate for Payer: UHC Core |
$470.46
|
| Rate for Payer: UHC Exchange |
$140.85
|
| Rate for Payer: UHC Medicaid |
$99.33
|
| Rate for Payer: UHC Medicare Advantage |
$140.85
|
| Rate for Payer: UHCCP Medicaid |
$99.33
|
| Rate for Payer: VA VA |
$140.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.56
|
|
|
HC OPEN HEART TEG
|
Facility
|
IP
|
$563.42
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$392.14 |
| Max. Negotiated Rate |
$507.08 |
| Rate for Payer: Aetna Commercial |
$478.91
|
| Rate for Payer: BCBS Trust/PPO |
$465.33
|
| Rate for Payer: BCN Commercial |
$465.33
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cofinity Commercial |
$484.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.74
|
| Rate for Payer: Healthscope Commercial |
$507.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.91
|
| Rate for Payer: Nomi Health Commercial |
$462.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.56
|
| Rate for Payer: PHP Commercial |
$478.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$490.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$495.81
|
| Rate for Payer: UHC Core |
$470.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.56
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
OP
|
$356.21
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$320.59 |
| Rate for Payer: Aetna Commercial |
$302.78
|
| Rate for Payer: Aetna Medicare |
$92.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.32
|
| Rate for Payer: BCBS Complete |
$65.93
|
| Rate for Payer: BCBS MAPPO |
$89.05
|
| Rate for Payer: BCBS Trust/PPO |
$292.84
|
| Rate for Payer: BCN Commercial |
$292.84
|
| Rate for Payer: BCN Medicare Advantage |
$89.05
|
| Rate for Payer: Cash Price |
$284.97
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.05
|
| Rate for Payer: Healthscope Commercial |
$320.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.16
|
| Rate for Payer: Mclaren Medicaid |
$62.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.51
|
| Rate for Payer: Meridian Medicaid |
$65.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.78
|
| Rate for Payer: Nomi Health Commercial |
$292.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.16
|
| Rate for Payer: PACE Senior Care Partners |
$84.60
|
| Rate for Payer: PACE SWMI |
$89.05
|
| Rate for Payer: PHP Commercial |
$302.78
|
| Rate for Payer: PHP Medicare Advantage |
$89.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$309.90
|
| Rate for Payer: Priority Health Medicare |
$89.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.92
|
| Rate for Payer: Railroad Medicare Medicare |
$89.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.46
|
| Rate for Payer: UHC Core |
$297.44
|
| Rate for Payer: UHC Exchange |
$89.05
|
| Rate for Payer: UHC Medicaid |
$62.80
|
| Rate for Payer: UHC Medicare Advantage |
$89.05
|
| Rate for Payer: UHCCP Medicaid |
$62.80
|
| Rate for Payer: VA VA |
$89.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.16
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
IP
|
$356.21
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$247.92 |
| Max. Negotiated Rate |
$320.59 |
| Rate for Payer: Aetna Commercial |
$302.78
|
| Rate for Payer: BCBS Trust/PPO |
$294.19
|
| Rate for Payer: BCN Commercial |
$294.19
|
| Rate for Payer: Cash Price |
$284.97
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.97
|
| Rate for Payer: Healthscope Commercial |
$320.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.78
|
| Rate for Payer: Nomi Health Commercial |
$292.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.16
|
| Rate for Payer: PHP Commercial |
$302.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$309.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.46
|
| Rate for Payer: UHC Core |
$297.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.16
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
OP
|
$197.13
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$177.42 |
| Rate for Payer: Aetna Commercial |
$167.56
|
| Rate for Payer: Aetna Medicare |
$51.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.60
|
| Rate for Payer: BCBS Complete |
$36.49
|
| Rate for Payer: BCBS MAPPO |
$49.28
|
| Rate for Payer: BCBS Trust/PPO |
$162.06
|
| Rate for Payer: BCN Commercial |
$162.06
|
| Rate for Payer: BCN Medicare Advantage |
$49.28
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.28
|
| Rate for Payer: Healthscope Commercial |
$177.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.85
|
| Rate for Payer: Mclaren Medicaid |
$34.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.75
|
| Rate for Payer: Meridian Medicaid |
$36.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.56
|
| Rate for Payer: Nomi Health Commercial |
$161.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.85
|
| Rate for Payer: PACE Senior Care Partners |
$46.82
|
| Rate for Payer: PACE SWMI |
$49.28
|
| Rate for Payer: PHP Commercial |
$167.56
|
| Rate for Payer: PHP Medicare Advantage |
$49.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.50
|
| Rate for Payer: Priority Health Medicare |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.20
|
| Rate for Payer: Railroad Medicare Medicare |
$49.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.47
|
| Rate for Payer: UHC Core |
$164.60
|
| Rate for Payer: UHC Exchange |
$49.28
|
| Rate for Payer: UHC Medicaid |
$34.75
|
| Rate for Payer: UHC Medicare Advantage |
$49.28
|
| Rate for Payer: UHCCP Medicaid |
$34.75
|
| Rate for Payer: VA VA |
$49.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.85
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
IP
|
$197.13
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$137.20 |
| Max. Negotiated Rate |
$177.42 |
| Rate for Payer: Aetna Commercial |
$167.56
|
| Rate for Payer: BCBS Trust/PPO |
$162.81
|
| Rate for Payer: BCN Commercial |
$162.81
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.70
|
| Rate for Payer: Healthscope Commercial |
$177.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.56
|
| Rate for Payer: Nomi Health Commercial |
$161.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.85
|
| Rate for Payer: PHP Commercial |
$167.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.47
|
| Rate for Payer: UHC Core |
$164.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.85
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
OP
|
$988.38
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$174.25 |
| Max. Negotiated Rate |
$889.54 |
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: Aetna Medicare |
$256.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$308.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$308.87
|
| Rate for Payer: BCBS Complete |
$182.95
|
| Rate for Payer: BCBS MAPPO |
$247.09
|
| Rate for Payer: BCBS Trust/PPO |
$812.55
|
| Rate for Payer: BCN Commercial |
$812.55
|
| Rate for Payer: BCN Medicare Advantage |
$247.09
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.09
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Mclaren Medicaid |
$174.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.45
|
| Rate for Payer: Meridian Medicaid |
$182.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Nomi Health Commercial |
$810.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PACE Senior Care Partners |
$234.74
|
| Rate for Payer: PACE SWMI |
$247.09
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: PHP Medicare Advantage |
$247.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$859.89
|
| Rate for Payer: Priority Health Medicare |
$249.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.91
|
| Rate for Payer: Railroad Medicare Medicare |
$247.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.77
|
| Rate for Payer: UHC Core |
$825.30
|
| Rate for Payer: UHC Exchange |
$247.09
|
| Rate for Payer: UHC Medicaid |
$174.25
|
| Rate for Payer: UHC Medicare Advantage |
$247.09
|
| Rate for Payer: UHCCP Medicaid |
$174.25
|
| Rate for Payer: VA VA |
$247.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
IP
|
$988.38
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$687.91 |
| Max. Negotiated Rate |
$889.54 |
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: BCBS Trust/PPO |
$816.30
|
| Rate for Payer: BCN Commercial |
$816.30
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Nomi Health Commercial |
$810.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$859.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.77
|
| Rate for Payer: UHC Core |
$825.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
|
HC OPIATE URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000129
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC OPIATE URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000129
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC OPIATE URINE CONFIRM
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100579
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.89 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: BCBS Trust/PPO |
$53.27
|
| Rate for Payer: BCN Commercial |
$53.27
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC OPIATE URINE CONFIRM
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100579
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.16
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$16.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.03
|
| Rate for Payer: BCN Commercial |
$53.03
|
| Rate for Payer: BCN Medicare Advantage |
$16.12
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Mclaren Medicaid |
$11.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PACE Senior Care Partners |
$15.32
|
| Rate for Payer: PACE SWMI |
$16.12
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: Railroad Medicare Medicare |
$16.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: UHC Exchange |
$16.12
|
| Rate for Payer: UHC Medicaid |
$11.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.12
|
| Rate for Payer: UHCCP Medicaid |
$11.37
|
| Rate for Payer: VA VA |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC OPIOID DRUG PANEL URIN
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100645
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC OPIOID DRUG PANEL URIN
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100645
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC OPIOID DRUG PANEL URN.
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100644
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
