|
HC SYCAMORE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$24.58
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.14
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$24.44
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: BCBS Trust/PPO |
$61.82
|
| Rate for Payer: BCN Commercial |
$61.82
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: Aetna Medicare |
$20.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.00
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$62.20
|
| Rate for Payer: BCN Commercial |
$62.20
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.00
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$20.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.79
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.00
|
| Rate for Payer: UHC Medicare Advantage |
$20.60
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.50 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.64
|
| Rate for Payer: BCN Commercial |
$38.64
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.00
|
| Rate for Payer: UHC Core |
$41.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.88 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.88
|
| Rate for Payer: BCN Commercial |
$38.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.50
|
| Rate for Payer: PACE Senior Care Partners |
$11.88
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.50
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.00
|
| Rate for Payer: UHC Core |
$41.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.88
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$129.60
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.50 |
| Max. Negotiated Rate |
$116.64 |
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: Aetna Medicare |
$33.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.50
|
| Rate for Payer: BCBS Complete |
$13.13
|
| Rate for Payer: BCBS MAPPO |
$32.40
|
| Rate for Payer: BCBS Trust/PPO |
$100.76
|
| Rate for Payer: BCN Commercial |
$100.76
|
| Rate for Payer: BCN Medicare Advantage |
$32.40
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$111.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.40
|
| Rate for Payer: Healthscope Commercial |
$116.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.20
|
| Rate for Payer: Mclaren Medicaid |
$12.50
|
| Rate for Payer: Meridian Medicaid |
$13.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.16
|
| Rate for Payer: PACE Senior Care Partners |
$30.78
|
| Rate for Payer: PACE SWMI |
$32.40
|
| Rate for Payer: PHP Commercial |
$110.16
|
| Rate for Payer: PHP Medicare Advantage |
$32.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.75
|
| Rate for Payer: Priority Health Medicare |
$32.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.04
|
| Rate for Payer: Railroad Medicare Medicare |
$32.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.05
|
| Rate for Payer: UHC Core |
$108.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.40
|
| Rate for Payer: UHC Medicare Advantage |
$33.37
|
| Rate for Payer: VA VA |
$32.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.20
|
|
|
HC T3 FREE
|
Facility
|
IP
|
$129.60
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.04 |
| Max. Negotiated Rate |
$116.64 |
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.05
|
| Rate for Payer: UHC Core |
$108.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.20
|
| Rate for Payer: Aetna Commercial |
$110.16
|
| Rate for Payer: BCBS Trust/PPO |
$100.15
|
| Rate for Payer: BCN Commercial |
$100.15
|
| Rate for Payer: Cash Price |
$103.68
|
| Rate for Payer: Cofinity Commercial |
$111.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.68
|
| Rate for Payer: Healthscope Commercial |
$116.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.16
|
| Rate for Payer: PHP Commercial |
$110.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.04
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$44.05
|
| Rate for Payer: BCN Commercial |
$44.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$14.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.81
|
| Rate for Payer: BCBS Complete |
$12.21
|
| Rate for Payer: BCBS MAPPO |
$14.25
|
| Rate for Payer: BCBS Trust/PPO |
$44.32
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.25
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.25
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Mclaren Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$12.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Senior Care Partners |
$13.54
|
| Rate for Payer: PACE SWMI |
$14.25
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$14.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$14.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$14.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.16
|
| Rate for Payer: UHC Core |
$47.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.25
|
| Rate for Payer: UHC Medicare Advantage |
$14.68
|
| Rate for Payer: VA VA |
$14.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.73 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: BCBS Trust/PPO |
$103.56
|
| Rate for Payer: BCN Commercial |
$103.56
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC T3 UPTAKE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$34.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.88
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$33.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.18
|
| Rate for Payer: BCN Commercial |
$104.18
|
| Rate for Payer: BCN Medicare Advantage |
$33.50
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.50
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.82
|
| Rate for Payer: PACE SWMI |
$33.50
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: PHP Medicare Advantage |
$33.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.58
|
| Rate for Payer: Priority Health Medicare |
$33.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.73
|
| Rate for Payer: Railroad Medicare Medicare |
$33.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.92
|
| Rate for Payer: UHC Core |
$111.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.50
|
| Rate for Payer: VA VA |
$33.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC T4 TOTAL
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: BCBS Trust/PPO |
$35.55
|
| Rate for Payer: BCN Commercial |
$35.55
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.48
|
| Rate for Payer: UHC Core |
$38.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna Medicare |
$11.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.38
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$11.50
|
| Rate for Payer: BCBS Trust/PPO |
$35.76
|
| Rate for Payer: BCN Commercial |
$35.76
|
| Rate for Payer: BCN Medicare Advantage |
$11.50
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.50
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: PACE Senior Care Partners |
$10.92
|
| Rate for Payer: PACE SWMI |
$11.50
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: PHP Medicare Advantage |
$11.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.02
|
| Rate for Payer: Priority Health Medicare |
$11.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.06
|
| Rate for Payer: Railroad Medicare Medicare |
$11.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.48
|
| Rate for Payer: UHC Core |
$38.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.50
|
| Rate for Payer: UHC Medicare Advantage |
$11.84
|
| Rate for Payer: VA VA |
$11.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: BCBS Trust/PPO |
$49.66
|
| Rate for Payer: BCN Commercial |
$49.66
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.55
|
| Rate for Payer: UHC Core |
$53.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.08
|
| Rate for Payer: BCBS Complete |
$10.64
|
| Rate for Payer: BCBS MAPPO |
$16.06
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$49.96
|
| Rate for Payer: BCN Medicare Advantage |
$16.06
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Mclaren Medicaid |
$10.13
|
| Rate for Payer: Meridian Medicaid |
$10.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$15.26
|
| Rate for Payer: PACE SWMI |
$16.06
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: PHP Medicare Advantage |
$16.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.91
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.19
|
| Rate for Payer: Railroad Medicare Medicare |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.55
|
| Rate for Payer: UHC Core |
$53.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.06
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: VA VA |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.80
|
| Rate for Payer: BCN Commercial |
$44.80
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$15.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.12
|
| Rate for Payer: BCBS Complete |
$29.24
|
| Rate for Payer: BCBS MAPPO |
$14.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.07
|
| Rate for Payer: BCN Commercial |
$45.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.49
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.49
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$27.84
|
| Rate for Payer: Meridian Medicaid |
$29.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Senior Care Partners |
$13.77
|
| Rate for Payer: PACE SWMI |
$14.49
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$14.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: Railroad Medicare Medicare |
$14.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$14.93
|
| Rate for Payer: VA VA |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.03 |
| Max. Negotiated Rate |
$64.98 |
| Rate for Payer: Aetna Commercial |
$61.37
|
| Rate for Payer: BCBS Trust/PPO |
$55.80
|
| Rate for Payer: BCN Commercial |
$55.80
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$62.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Healthscope Commercial |
$64.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: PHP Commercial |
$61.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.54
|
| Rate for Payer: UHC Core |
$60.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.15
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.15 |
| Max. Negotiated Rate |
$64.98 |
| Rate for Payer: Aetna Commercial |
$61.37
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$56.14
|
| Rate for Payer: BCN Commercial |
$56.14
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$62.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$64.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.15
|
| Rate for Payer: Mclaren Medicaid |
$34.67
|
| Rate for Payer: Meridian Medicaid |
$36.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: PACE Senior Care Partners |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$61.37
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.81
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.03
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.54
|
| Rate for Payer: UHC Core |
$60.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: VA VA |
$18.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.15
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$15.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.12
|
| Rate for Payer: BCBS Complete |
$29.24
|
| Rate for Payer: BCBS MAPPO |
$14.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.07
|
| Rate for Payer: BCN Commercial |
$45.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.49
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.49
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$27.84
|
| Rate for Payer: Meridian Medicaid |
$29.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Senior Care Partners |
$13.77
|
| Rate for Payer: PACE SWMI |
$14.49
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$14.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: Railroad Medicare Medicare |
$14.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$14.93
|
| Rate for Payer: VA VA |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.80
|
| Rate for Payer: BCN Commercial |
$44.80
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.80
|
| Rate for Payer: BCN Commercial |
$44.80
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$15.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.12
|
| Rate for Payer: BCBS Complete |
$29.24
|
| Rate for Payer: BCBS MAPPO |
$14.49
|
| Rate for Payer: BCBS Trust/PPO |
$45.07
|
| Rate for Payer: BCN Commercial |
$45.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.49
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.49
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$27.84
|
| Rate for Payer: Meridian Medicaid |
$29.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Senior Care Partners |
$13.77
|
| Rate for Payer: PACE SWMI |
$14.49
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$14.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.43
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.36
|
| Rate for Payer: Railroad Medicare Medicare |
$14.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.01
|
| Rate for Payer: UHC Core |
$48.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$14.93
|
| Rate for Payer: VA VA |
$14.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
