|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,807.00
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,931.79 |
| Max. Negotiated Rate |
$4,326.30 |
| Rate for Payer: Aetna Commercial |
$4,085.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,714.85
|
| Rate for Payer: BCN Commercial |
$3,714.85
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cofinity Commercial |
$4,134.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,845.60
|
| Rate for Payer: Healthscope Commercial |
$4,326.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,605.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,085.95
|
| Rate for Payer: PHP Commercial |
$4,085.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,364.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,182.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,931.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,230.16
|
| Rate for Payer: UHC Core |
$4,013.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,605.25
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,160.11
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$988.03 |
| Max. Negotiated Rate |
$3,744.10 |
| Rate for Payer: Aetna Commercial |
$3,536.09
|
| Rate for Payer: Aetna Medicare |
$1,081.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,300.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,300.03
|
| Rate for Payer: BCBS Complete |
$1,107.03
|
| Rate for Payer: BCBS MAPPO |
$1,040.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,234.49
|
| Rate for Payer: BCN Commercial |
$3,234.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,040.03
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cofinity Commercial |
$3,577.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,040.03
|
| Rate for Payer: Healthscope Commercial |
$3,744.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,120.08
|
| Rate for Payer: Mclaren Medicaid |
$1,054.31
|
| Rate for Payer: Meridian Medicaid |
$1,107.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,092.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,196.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,536.09
|
| Rate for Payer: PACE Senior Care Partners |
$988.03
|
| Rate for Payer: PACE SWMI |
$1,040.03
|
| Rate for Payer: PHP Commercial |
$3,536.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,040.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,054.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,912.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,619.30
|
| Rate for Payer: Priority Health Medicare |
$1,040.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,537.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,040.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,660.90
|
| Rate for Payer: UHC Core |
$3,473.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,040.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,071.23
|
| Rate for Payer: VA VA |
$1,040.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,120.08
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,160.11
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,537.25 |
| Max. Negotiated Rate |
$3,744.10 |
| Rate for Payer: Aetna Commercial |
$3,536.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,214.93
|
| Rate for Payer: BCN Commercial |
$3,214.93
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cofinity Commercial |
$3,577.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.09
|
| Rate for Payer: Healthscope Commercial |
$3,744.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,120.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,536.09
|
| Rate for Payer: PHP Commercial |
$3,536.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,912.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,619.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,537.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,660.90
|
| Rate for Payer: UHC Core |
$3,473.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,120.08
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$24.28 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.81
|
| Rate for Payer: BCBS Complete |
$24.28
|
| Rate for Payer: BCBS MAPPO |
$6.25
|
| Rate for Payer: BCBS Trust/PPO |
$19.44
|
| Rate for Payer: BCN Commercial |
$19.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.25
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$23.12
|
| Rate for Payer: Meridian Medicaid |
$24.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PACE Senior Care Partners |
$5.94
|
| Rate for Payer: PACE SWMI |
$6.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$6.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.75
|
| Rate for Payer: Priority Health Medicare |
$6.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.25
|
| Rate for Payer: Railroad Medicare Medicare |
$6.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.25
|
| Rate for Payer: UHC Medicare Advantage |
$6.44
|
| Rate for Payer: VA VA |
$6.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$19.32
|
| Rate for Payer: BCN Commercial |
$19.32
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.00
|
| Rate for Payer: UHC Core |
$20.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$18.55
|
| Rate for Payer: BCN Commercial |
$18.55
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
| Rate for Payer: UHC Core |
$20.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.50
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$18.66
|
| Rate for Payer: BCN Commercial |
$18.66
|
| Rate for Payer: BCN Medicare Advantage |
$6.00
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PACE Senior Care Partners |
$5.70
|
| Rate for Payer: PACE SWMI |
$6.00
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
| Rate for Payer: Priority Health Medicare |
$6.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
| Rate for Payer: Railroad Medicare Medicare |
$6.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
| Rate for Payer: UHC Core |
$20.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.00
|
| Rate for Payer: UHC Medicare Advantage |
$6.18
|
| Rate for Payer: VA VA |
$6.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: Aetna Medicare |
$17.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.56
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$53.65
|
| Rate for Payer: BCN Commercial |
$53.65
|
| Rate for Payer: BCN Medicare Advantage |
$17.25
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Mclaren Medicaid |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$10.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PACE Senior Care Partners |
$16.39
|
| Rate for Payer: PACE SWMI |
$17.25
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: PHP Medicare Advantage |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.03
|
| Rate for Payer: Priority Health Medicare |
$17.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.08
|
| Rate for Payer: Railroad Medicare Medicare |
$17.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.72
|
| Rate for Payer: UHC Core |
$57.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.25
|
| Rate for Payer: UHC Medicare Advantage |
$17.77
|
| Rate for Payer: VA VA |
$17.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: BCBS Trust/PPO |
$53.32
|
| Rate for Payer: BCN Commercial |
$53.32
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.72
|
| Rate for Payer: UHC Core |
$57.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.16
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.56 |
| Max. Negotiated Rate |
$24.44 |
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: BCBS Trust/PPO |
$20.99
|
| Rate for Payer: BCN Commercial |
$20.99
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$23.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$24.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: PHP Commercial |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.90
|
| Rate for Payer: UHC Core |
$22.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.37
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.16
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$24.44 |
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: Aetna Medicare |
$7.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.49
|
| Rate for Payer: BCBS Complete |
$10.86
|
| Rate for Payer: BCBS MAPPO |
$6.79
|
| Rate for Payer: BCBS Trust/PPO |
$21.12
|
| Rate for Payer: BCN Commercial |
$21.12
|
| Rate for Payer: BCN Medicare Advantage |
$6.79
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$23.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.79
|
| Rate for Payer: Healthscope Commercial |
$24.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: PACE Senior Care Partners |
$6.45
|
| Rate for Payer: PACE SWMI |
$6.79
|
| Rate for Payer: PHP Commercial |
$23.09
|
| Rate for Payer: PHP Medicare Advantage |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.63
|
| Rate for Payer: Priority Health Medicare |
$6.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.56
|
| Rate for Payer: Railroad Medicare Medicare |
$6.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.90
|
| Rate for Payer: UHC Core |
$22.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.79
|
| Rate for Payer: UHC Medicare Advantage |
$6.99
|
| Rate for Payer: VA VA |
$6.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.37
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
30600222
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.36
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
IP
|
$438.58
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$267.49 |
| Max. Negotiated Rate |
$394.72 |
| Rate for Payer: Aetna Commercial |
$372.79
|
| Rate for Payer: BCBS Trust/PPO |
$338.93
|
| Rate for Payer: BCN Commercial |
$338.93
|
| Rate for Payer: Cash Price |
$350.86
|
| Rate for Payer: Cofinity Commercial |
$377.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.86
|
| Rate for Payer: Healthscope Commercial |
$394.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$372.79
|
| Rate for Payer: PHP Commercial |
$372.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$381.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.95
|
| Rate for Payer: UHC Core |
$366.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.94
|
|
|
HC TRIGGER POINT INJ
|
Facility
|
OP
|
$438.58
|
|
| Hospital Charge Code |
45000088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$394.72 |
| Rate for Payer: Aetna Commercial |
$372.79
|
| Rate for Payer: Aetna Medicare |
$114.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.06
|
| Rate for Payer: BCBS Complete |
$175.43
|
| Rate for Payer: BCBS MAPPO |
$109.64
|
| Rate for Payer: BCBS Trust/PPO |
$341.00
|
| Rate for Payer: BCN Commercial |
$341.00
|
| Rate for Payer: BCN Medicare Advantage |
$109.64
|
| Rate for Payer: Cash Price |
$350.86
|
| Rate for Payer: Cofinity Commercial |
$377.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.64
|
| Rate for Payer: Healthscope Commercial |
$394.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$115.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$372.79
|
| Rate for Payer: PACE Senior Care Partners |
$104.16
|
| Rate for Payer: PACE SWMI |
$109.64
|
| Rate for Payer: PHP Commercial |
$372.79
|
| Rate for Payer: PHP Medicare Advantage |
$109.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$381.56
|
| Rate for Payer: Priority Health Medicare |
$109.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.49
|
| Rate for Payer: Railroad Medicare Medicare |
$109.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.95
|
| Rate for Payer: UHC Core |
$366.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.64
|
| Rate for Payer: UHC Medicare Advantage |
$112.93
|
| Rate for Payer: VA VA |
$109.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.94
|
|
|
HC TRIGLYCERIDES
|
Facility
|
IP
|
$21.24
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.41
|
| Rate for Payer: BCN Commercial |
$16.41
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.05
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
HC TRIGLYCERIDES
|
Facility
|
OP
|
$21.24
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100444
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.24 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.64
|
| Rate for Payer: BCBS Complete |
$4.45
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$16.51
|
| Rate for Payer: BCN Commercial |
$16.51
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cash Price |
$16.99
|
| Rate for Payer: Cofinity Commercial |
$18.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.93
|
| Rate for Payer: Mclaren Medicaid |
$4.24
|
| Rate for Payer: Meridian Medicaid |
$4.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.05
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.48
|
| Rate for Payer: Priority Health Medicare |
$5.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$17.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.31
|
| Rate for Payer: UHC Medicare Advantage |
$5.47
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.93
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$4.45
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$4.24
|
| Rate for Payer: Meridian Medicaid |
$4.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC TRIGLYCERIDES LMPP
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
30100689
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.82
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$144.50
|
| Rate for Payer: Aetna Medicare |
$44.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.12
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$132.18
|
| Rate for Payer: BCN Commercial |
$132.18
|
| Rate for Payer: BCN Medicare Advantage |
$42.50
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$146.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.50
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.50
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.50
|
| Rate for Payer: PACE Senior Care Partners |
$40.38
|
| Rate for Payer: PACE SWMI |
$42.50
|
| Rate for Payer: PHP Commercial |
$144.50
|
| Rate for Payer: PHP Medicare Advantage |
$42.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.90
|
| Rate for Payer: Priority Health Medicare |
$42.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.68
|
| Rate for Payer: Railroad Medicare Medicare |
$42.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.60
|
| Rate for Payer: UHC Core |
$141.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.50
|
| Rate for Payer: UHC Medicare Advantage |
$43.78
|
| Rate for Payer: VA VA |
$42.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.50
|
|
|
HC TRIM DYSTROPHIC NAIL(S)
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
76100513
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.68 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Aetna Commercial |
$144.50
|
| Rate for Payer: BCBS Trust/PPO |
$131.38
|
| Rate for Payer: BCN Commercial |
$131.38
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$146.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.00
|
| Rate for Payer: Healthscope Commercial |
$153.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.50
|
| Rate for Payer: PHP Commercial |
$144.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.60
|
| Rate for Payer: UHC Core |
$141.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.50
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$75.32
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$67.79 |
| Rate for Payer: Aetna Commercial |
$64.02
|
| Rate for Payer: Aetna Medicare |
$19.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.54
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$18.83
|
| Rate for Payer: BCBS Trust/PPO |
$58.56
|
| Rate for Payer: BCN Commercial |
$58.56
|
| Rate for Payer: BCN Medicare Advantage |
$18.83
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cofinity Commercial |
$64.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.83
|
| Rate for Payer: Healthscope Commercial |
$67.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.49
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.02
|
| Rate for Payer: PACE Senior Care Partners |
$17.89
|
| Rate for Payer: PACE SWMI |
$18.83
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: PHP Medicare Advantage |
$18.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.53
|
| Rate for Payer: Priority Health Medicare |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.28
|
| Rate for Payer: UHC Core |
$62.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.83
|
| Rate for Payer: UHC Medicare Advantage |
$19.39
|
| Rate for Payer: VA VA |
$18.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.49
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$75.32
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
76100042
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$45.94 |
| Max. Negotiated Rate |
$67.79 |
| Rate for Payer: Aetna Commercial |
$64.02
|
| Rate for Payer: BCBS Trust/PPO |
$58.21
|
| Rate for Payer: BCN Commercial |
$58.21
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Cofinity Commercial |
$64.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.26
|
| Rate for Payer: Healthscope Commercial |
$67.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.02
|
| Rate for Payer: PHP Commercial |
$64.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.28
|
| Rate for Payer: UHC Core |
$62.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.49
|
|
