|
HC PH BODY FLUID
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Aetna Commercial |
$21.82
|
| Rate for Payer: Aetna Medicare |
$6.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.02
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$6.42
|
| Rate for Payer: BCBS Trust/PPO |
$21.10
|
| Rate for Payer: BCN Commercial |
$21.10
|
| Rate for Payer: BCN Medicare Advantage |
$6.42
|
| Rate for Payer: Cash Price |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$22.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$23.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| Rate for Payer: Mclaren Medicaid |
$4.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.74
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.82
|
| Rate for Payer: Nomi Health Commercial |
$21.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.25
|
| Rate for Payer: PACE Senior Care Partners |
$6.10
|
| Rate for Payer: PACE SWMI |
$6.42
|
| Rate for Payer: PHP Commercial |
$21.82
|
| Rate for Payer: PHP Medicare Advantage |
$6.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.33
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.59
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: UHC Exchange |
$6.42
|
| Rate for Payer: UHC Medicaid |
$4.53
|
| Rate for Payer: UHC Medicare Advantage |
$6.42
|
| Rate for Payer: UHCCP Medicaid |
$4.53
|
| Rate for Payer: VA VA |
$6.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
|
|
HC PHENOBARB LVL
|
Facility
|
IP
|
$102.58
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$92.32 |
| Rate for Payer: Aetna Commercial |
$87.19
|
| Rate for Payer: BCBS Trust/PPO |
$84.72
|
| Rate for Payer: BCN Commercial |
$84.72
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$88.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$92.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.19
|
| Rate for Payer: Nomi Health Commercial |
$84.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.94
|
| Rate for Payer: PHP Commercial |
$87.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.27
|
| Rate for Payer: UHC Core |
$85.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.94
|
|
|
HC PHENOBARB LVL
|
Facility
|
OP
|
$102.58
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.08 |
| Max. Negotiated Rate |
$92.32 |
| Rate for Payer: Aetna Commercial |
$87.19
|
| Rate for Payer: Aetna Medicare |
$26.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.06
|
| Rate for Payer: BCBS Complete |
$18.99
|
| Rate for Payer: BCBS MAPPO |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$84.33
|
| Rate for Payer: BCN Commercial |
$84.33
|
| Rate for Payer: BCN Medicare Advantage |
$25.64
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$88.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$92.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.94
|
| Rate for Payer: Mclaren Medicaid |
$18.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.93
|
| Rate for Payer: Meridian Medicaid |
$18.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.19
|
| Rate for Payer: Nomi Health Commercial |
$84.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.94
|
| Rate for Payer: PACE Senior Care Partners |
$24.36
|
| Rate for Payer: PACE SWMI |
$25.64
|
| Rate for Payer: PHP Commercial |
$87.19
|
| Rate for Payer: PHP Medicare Advantage |
$25.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.24
|
| Rate for Payer: Priority Health Medicare |
$25.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.40
|
| Rate for Payer: Railroad Medicare Medicare |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.27
|
| Rate for Payer: UHC Core |
$85.65
|
| Rate for Payer: UHC Exchange |
$25.64
|
| Rate for Payer: UHC Medicaid |
$18.08
|
| Rate for Payer: UHC Medicare Advantage |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$18.08
|
| Rate for Payer: VA VA |
$25.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.94
|
|
|
HC PH GASTRIC
|
Facility
|
IP
|
$25.17
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$20.79
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.88
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.15
|
| Rate for Payer: UHC Core |
$21.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC PH GASTRIC
|
Facility
|
OP
|
$25.17
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna Medicare |
$6.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.87
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS MAPPO |
$6.29
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$20.69
|
| Rate for Payer: BCN Medicare Advantage |
$6.29
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.29
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Mclaren Medicaid |
$4.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.61
|
| Rate for Payer: Meridian Medicaid |
$4.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.88
|
| Rate for Payer: PACE Senior Care Partners |
$5.98
|
| Rate for Payer: PACE SWMI |
$6.29
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: PHP Medicare Advantage |
$6.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.90
|
| Rate for Payer: Priority Health Medicare |
$6.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.52
|
| Rate for Payer: Railroad Medicare Medicare |
$6.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.15
|
| Rate for Payer: UHC Core |
$21.02
|
| Rate for Payer: UHC Exchange |
$6.29
|
| Rate for Payer: UHC Medicaid |
$4.44
|
| Rate for Payer: UHC Medicare Advantage |
$6.29
|
| Rate for Payer: UHCCP Medicaid |
$4.44
|
| Rate for Payer: VA VA |
$6.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
IP
|
$76.99
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.59 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$63.59
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.75
|
| Rate for Payer: UHC Core |
$64.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
OP
|
$76.99
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: Aetna Medicare |
$20.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.06
|
| Rate for Payer: BCBS Complete |
$14.25
|
| Rate for Payer: BCBS MAPPO |
$19.25
|
| Rate for Payer: BCBS Trust/PPO |
$63.29
|
| Rate for Payer: BCN Commercial |
$63.29
|
| Rate for Payer: BCN Medicare Advantage |
$19.25
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.25
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Mclaren Medicaid |
$13.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.21
|
| Rate for Payer: Meridian Medicaid |
$14.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: PACE Senior Care Partners |
$18.29
|
| Rate for Payer: PACE SWMI |
$19.25
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: PHP Medicare Advantage |
$19.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.98
|
| Rate for Payer: Priority Health Medicare |
$19.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: Railroad Medicare Medicare |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.75
|
| Rate for Payer: UHC Core |
$64.29
|
| Rate for Payer: UHC Exchange |
$19.25
|
| Rate for Payer: UHC Medicaid |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$19.25
|
| Rate for Payer: UHCCP Medicaid |
$13.57
|
| Rate for Payer: VA VA |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$22.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.98
|
| Rate for Payer: BCBS Complete |
$15.98
|
| Rate for Payer: BCBS MAPPO |
$21.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: BCN Medicare Advantage |
$21.59
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$15.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.67
|
| Rate for Payer: Meridian Medicaid |
$15.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Senior Care Partners |
$20.51
|
| Rate for Payer: PACE SWMI |
$21.59
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| Rate for Payer: Railroad Medicare Medicare |
$21.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: UHC Exchange |
$21.59
|
| Rate for Payer: UHC Medicaid |
$15.22
|
| Rate for Payer: UHC Medicare Advantage |
$21.59
|
| Rate for Payer: UHCCP Medicaid |
$15.22
|
| Rate for Payer: VA VA |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PHOSPHATIDYL GLYCEROL-PG
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100391
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.10 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$71.32
|
| Rate for Payer: BCN Commercial |
$71.32
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
IP
|
$56.24
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Aetna Commercial |
$47.80
|
| Rate for Payer: BCBS Trust/PPO |
$46.45
|
| Rate for Payer: BCN Commercial |
$46.45
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$48.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PHP Commercial |
$47.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.49
|
| Rate for Payer: UHC Core |
$46.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.18
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
OP
|
$56.24
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Aetna Commercial |
$47.80
|
| Rate for Payer: Aetna Medicare |
$14.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.57
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$14.06
|
| Rate for Payer: BCBS Trust/PPO |
$46.23
|
| Rate for Payer: BCN Commercial |
$46.23
|
| Rate for Payer: BCN Medicare Advantage |
$14.06
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$48.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.06
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.18
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.76
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PACE Senior Care Partners |
$13.36
|
| Rate for Payer: PACE SWMI |
$14.06
|
| Rate for Payer: PHP Commercial |
$47.80
|
| Rate for Payer: PHP Medicare Advantage |
$14.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.93
|
| Rate for Payer: Priority Health Medicare |
$14.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.14
|
| Rate for Payer: Railroad Medicare Medicare |
$14.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.49
|
| Rate for Payer: UHC Core |
$46.96
|
| Rate for Payer: UHC Exchange |
$14.06
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.18
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$14.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.21
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.36
|
| Rate for Payer: BCN Commercial |
$45.36
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Senior Care Partners |
$13.11
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Medicare |
$13.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: UHC Exchange |
$13.79
|
| Rate for Payer: UHC Medicaid |
$9.73
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$9.73
|
| Rate for Payer: VA VA |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: BCBS Trust/PPO |
$45.57
|
| Rate for Payer: BCN Commercial |
$45.57
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
OP
|
$287.77
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.73 |
| Max. Negotiated Rate |
$258.99 |
| Rate for Payer: Aetna Commercial |
$244.60
|
| Rate for Payer: Aetna Medicare |
$74.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.93
|
| Rate for Payer: BCBS Complete |
$53.27
|
| Rate for Payer: BCBS MAPPO |
$71.94
|
| Rate for Payer: BCBS Trust/PPO |
$236.58
|
| Rate for Payer: BCN Commercial |
$236.58
|
| Rate for Payer: BCN Medicare Advantage |
$71.94
|
| Rate for Payer: Cash Price |
$230.22
|
| Rate for Payer: Cofinity Commercial |
$247.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.94
|
| Rate for Payer: Healthscope Commercial |
$258.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.83
|
| Rate for Payer: Mclaren Medicaid |
$50.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.54
|
| Rate for Payer: Meridian Medicaid |
$53.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.60
|
| Rate for Payer: Nomi Health Commercial |
$235.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.83
|
| Rate for Payer: PACE Senior Care Partners |
$68.35
|
| Rate for Payer: PACE SWMI |
$71.94
|
| Rate for Payer: PHP Commercial |
$244.60
|
| Rate for Payer: PHP Medicare Advantage |
$71.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$250.36
|
| Rate for Payer: Priority Health Medicare |
$72.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.29
|
| Rate for Payer: Railroad Medicare Medicare |
$71.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.24
|
| Rate for Payer: UHC Core |
$240.29
|
| Rate for Payer: UHC Exchange |
$71.94
|
| Rate for Payer: UHC Medicaid |
$50.73
|
| Rate for Payer: UHC Medicare Advantage |
$71.94
|
| Rate for Payer: UHCCP Medicaid |
$50.73
|
| Rate for Payer: VA VA |
$71.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.83
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
IP
|
$287.77
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$200.29 |
| Max. Negotiated Rate |
$258.99 |
| Rate for Payer: Aetna Commercial |
$244.60
|
| Rate for Payer: BCBS Trust/PPO |
$237.67
|
| Rate for Payer: BCN Commercial |
$237.67
|
| Rate for Payer: Cash Price |
$230.22
|
| Rate for Payer: Cofinity Commercial |
$247.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$230.22
|
| Rate for Payer: Healthscope Commercial |
$258.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.60
|
| Rate for Payer: Nomi Health Commercial |
$235.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.83
|
| Rate for Payer: PHP Commercial |
$244.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$250.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.24
|
| Rate for Payer: UHC Core |
$240.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.83
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
OP
|
$214.32
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$192.89 |
| Rate for Payer: Aetna Commercial |
$182.17
|
| Rate for Payer: Aetna Medicare |
$55.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.97
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$53.58
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: BCN Medicare Advantage |
$53.58
|
| Rate for Payer: Cash Price |
$171.46
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.58
|
| Rate for Payer: Healthscope Commercial |
$192.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.74
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.26
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.17
|
| Rate for Payer: Nomi Health Commercial |
$175.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.74
|
| Rate for Payer: PACE Senior Care Partners |
$50.90
|
| Rate for Payer: PACE SWMI |
$53.58
|
| Rate for Payer: PHP Commercial |
$182.17
|
| Rate for Payer: PHP Medicare Advantage |
$53.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.46
|
| Rate for Payer: Priority Health Medicare |
$54.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.17
|
| Rate for Payer: Railroad Medicare Medicare |
$53.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.60
|
| Rate for Payer: UHC Core |
$178.96
|
| Rate for Payer: UHC Exchange |
$53.58
|
| Rate for Payer: UHC Medicaid |
$37.78
|
| Rate for Payer: UHC Medicare Advantage |
$53.58
|
| Rate for Payer: UHCCP Medicaid |
$37.78
|
| Rate for Payer: VA VA |
$53.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.74
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
IP
|
$214.32
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$149.17 |
| Max. Negotiated Rate |
$192.89 |
| Rate for Payer: Aetna Commercial |
$182.17
|
| Rate for Payer: BCBS Trust/PPO |
$177.01
|
| Rate for Payer: BCN Commercial |
$177.01
|
| Rate for Payer: Cash Price |
$171.46
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.46
|
| Rate for Payer: Healthscope Commercial |
$192.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.17
|
| Rate for Payer: Nomi Health Commercial |
$175.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.74
|
| Rate for Payer: PHP Commercial |
$182.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.60
|
| Rate for Payer: UHC Core |
$178.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.74
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
IP
|
$214.32
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$149.17 |
| Max. Negotiated Rate |
$192.89 |
| Rate for Payer: Aetna Commercial |
$182.17
|
| Rate for Payer: BCBS Trust/PPO |
$177.01
|
| Rate for Payer: BCN Commercial |
$177.01
|
| Rate for Payer: Cash Price |
$171.46
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.46
|
| Rate for Payer: Healthscope Commercial |
$192.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.17
|
| Rate for Payer: Nomi Health Commercial |
$175.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.74
|
| Rate for Payer: PHP Commercial |
$182.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.60
|
| Rate for Payer: UHC Core |
$178.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.74
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
OP
|
$214.32
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$192.89 |
| Rate for Payer: Aetna Commercial |
$182.17
|
| Rate for Payer: Aetna Medicare |
$55.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.97
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$53.58
|
| Rate for Payer: BCBS Trust/PPO |
$176.19
|
| Rate for Payer: BCN Commercial |
$176.19
|
| Rate for Payer: BCN Medicare Advantage |
$53.58
|
| Rate for Payer: Cash Price |
$171.46
|
| Rate for Payer: Cofinity Commercial |
$184.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.58
|
| Rate for Payer: Healthscope Commercial |
$192.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.74
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.26
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.17
|
| Rate for Payer: Nomi Health Commercial |
$175.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.74
|
| Rate for Payer: PACE Senior Care Partners |
$50.90
|
| Rate for Payer: PACE SWMI |
$53.58
|
| Rate for Payer: PHP Commercial |
$182.17
|
| Rate for Payer: PHP Medicare Advantage |
$53.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$186.46
|
| Rate for Payer: Priority Health Medicare |
$54.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.17
|
| Rate for Payer: Railroad Medicare Medicare |
$53.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.60
|
| Rate for Payer: UHC Core |
$178.96
|
| Rate for Payer: UHC Exchange |
$53.58
|
| Rate for Payer: UHC Medicaid |
$37.78
|
| Rate for Payer: UHC Medicare Advantage |
$53.58
|
| Rate for Payer: UHCCP Medicaid |
$37.78
|
| Rate for Payer: VA VA |
$53.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.74
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| 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 |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: Aetna Medicare |
$14.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.88
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$13.50
|
| Rate for Payer: BCBS Trust/PPO |
$44.39
|
| Rate for Payer: BCN Commercial |
$44.39
|
| Rate for Payer: BCN Medicare Advantage |
$13.50
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$46.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.50
|
| Rate for Payer: Healthscope Commercial |
$48.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.50
|
| Rate for Payer: Mclaren Medicaid |
$9.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.18
|
| Rate for Payer: Meridian Medicaid |
$10.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.90
|
| Rate for Payer: Nomi Health Commercial |
$44.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.50
|
| Rate for Payer: PACE Senior Care Partners |
$12.82
|
| Rate for Payer: PACE SWMI |
$13.50
|
| Rate for Payer: PHP Commercial |
$45.90
|
| Rate for Payer: PHP Medicare Advantage |
$13.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.98
|
| Rate for Payer: Priority Health Medicare |
$13.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.58
|
| Rate for Payer: Railroad Medicare Medicare |
$13.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.52
|
| Rate for Payer: UHC Core |
$45.09
|
| Rate for Payer: UHC Exchange |
$13.50
|
| Rate for Payer: UHC Medicaid |
$9.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.50
|
| Rate for Payer: UHCCP Medicaid |
$9.52
|
| Rate for Payer: VA VA |
$13.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.50
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.58 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Aetna Commercial |
$45.90
|
| Rate for Payer: BCBS Trust/PPO |
$44.60
|
| Rate for Payer: BCN Commercial |
$44.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$46.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.20
|
| Rate for Payer: Healthscope Commercial |
$48.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.90
|
| Rate for Payer: Nomi Health Commercial |
$44.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.50
|
| Rate for Payer: PHP Commercial |
$45.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.52
|
| Rate for Payer: UHC Core |
$45.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.50
|
|
