|
HC POC MONO SCREENING MONOSPOT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC POC MONO SCREENING MONOSPOT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC POC PH BODY FLUID
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100760
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.87 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Aetna Commercial |
$21.82
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$21.20
|
| 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: Healthscope Commercial |
$23.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.25
|
| 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: PHP Commercial |
$21.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.59
|
| Rate for Payer: UHC Core |
$21.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.25
|
|
|
HC POC PH BODY FLUID
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100760
|
|
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 POC POTASSIUM
|
Facility
|
OP
|
$32.87
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.27
|
| Rate for Payer: BCBS Complete |
$6.08
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.02
|
| Rate for Payer: BCN Commercial |
$27.02
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.65
|
| Rate for Payer: Mclaren Medicaid |
$5.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.63
|
| Rate for Payer: Meridian Medicaid |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.94
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.65
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.94
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$8.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.88
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.93
|
| Rate for Payer: UHC Core |
$27.45
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicaid |
$5.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$5.79
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.65
|
|
|
HC POC POTASSIUM
|
Facility
|
IP
|
$32.87
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: BCBS Trust/PPO |
$27.15
|
| Rate for Payer: BCN Commercial |
$27.15
|
| Rate for Payer: Cash Price |
$26.30
|
| Rate for Payer: Cofinity Commercial |
$28.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.30
|
| Rate for Payer: Healthscope Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.94
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.65
|
| Rate for Payer: PHP Commercial |
$27.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.93
|
| Rate for Payer: UHC Core |
$27.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.65
|
|
|
HC POC PROTHROMBIN TIME
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500110
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.61
|
| Rate for Payer: BCBS Complete |
$9.24
|
| Rate for Payer: BCBS MAPPO |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$41.06
|
| Rate for Payer: BCN Medicare Advantage |
$12.48
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.48
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$8.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.11
|
| Rate for Payer: Meridian Medicaid |
$9.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Senior Care Partners |
$11.86
|
| Rate for Payer: PACE SWMI |
$12.48
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Medicare |
$12.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: UHC Exchange |
$12.48
|
| Rate for Payer: UHC Medicaid |
$8.80
|
| Rate for Payer: UHC Medicare Advantage |
$12.48
|
| Rate for Payer: UHCCP Medicaid |
$8.80
|
| Rate for Payer: VA VA |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC POC PROTHROMBIN TIME
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500110
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC POC SODIUM
|
Facility
|
IP
|
$33.53
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$30.18 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: BCBS Trust/PPO |
$27.69
|
| Rate for Payer: BCN Commercial |
$27.69
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.82
|
| Rate for Payer: Healthscope Commercial |
$30.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.50
|
| Rate for Payer: Nomi Health Commercial |
$27.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.15
|
| Rate for Payer: PHP Commercial |
$28.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.51
|
| Rate for Payer: UHC Core |
$28.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.15
|
|
|
HC POC SODIUM
|
Facility
|
OP
|
$33.53
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$30.18 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: Aetna Medicare |
$8.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.48
|
| Rate for Payer: BCBS Complete |
$6.21
|
| Rate for Payer: BCBS MAPPO |
$8.38
|
| Rate for Payer: BCBS Trust/PPO |
$27.57
|
| Rate for Payer: BCN Commercial |
$27.57
|
| Rate for Payer: BCN Medicare Advantage |
$8.38
|
| Rate for Payer: Cash Price |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.38
|
| Rate for Payer: Healthscope Commercial |
$30.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.15
|
| Rate for Payer: Mclaren Medicaid |
$5.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.80
|
| Rate for Payer: Meridian Medicaid |
$6.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.50
|
| Rate for Payer: Nomi Health Commercial |
$27.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.15
|
| Rate for Payer: PACE Senior Care Partners |
$7.96
|
| Rate for Payer: PACE SWMI |
$8.38
|
| Rate for Payer: PHP Commercial |
$28.50
|
| Rate for Payer: PHP Medicare Advantage |
$8.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.17
|
| Rate for Payer: Priority Health Medicare |
$8.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.51
|
| Rate for Payer: UHC Core |
$28.00
|
| Rate for Payer: UHC Exchange |
$8.38
|
| Rate for Payer: UHC Medicaid |
$5.91
|
| Rate for Payer: UHC Medicare Advantage |
$8.38
|
| Rate for Payer: UHCCP Medicaid |
$5.91
|
| Rate for Payer: VA VA |
$8.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.15
|
|
|
HC POC TOTAL CO2
|
Facility
|
IP
|
$18.54
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$16.69 |
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.32
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.90
|
|
|
HC POC TOTAL CO2
|
Facility
|
OP
|
$18.54
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$16.69 |
| Rate for Payer: Aetna Commercial |
$15.76
|
| Rate for Payer: Aetna Medicare |
$4.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.79
|
| Rate for Payer: BCBS Complete |
$3.43
|
| Rate for Payer: BCBS MAPPO |
$4.63
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$4.63
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cofinity Commercial |
$15.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.63
|
| Rate for Payer: Healthscope Commercial |
$16.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.90
|
| Rate for Payer: Mclaren Medicaid |
$3.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.87
|
| Rate for Payer: Meridian Medicaid |
$3.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.76
|
| Rate for Payer: Nomi Health Commercial |
$15.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.90
|
| Rate for Payer: PACE Senior Care Partners |
$4.40
|
| Rate for Payer: PACE SWMI |
$4.63
|
| Rate for Payer: PHP Commercial |
$15.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16.13
|
| Rate for Payer: Priority Health Medicare |
$4.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.90
|
| Rate for Payer: Railroad Medicare Medicare |
$4.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.32
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Exchange |
$4.63
|
| Rate for Payer: UHC Medicaid |
$3.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.63
|
| Rate for Payer: UHCCP Medicaid |
$3.27
|
| Rate for Payer: VA VA |
$4.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.90
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.76
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$5.41
|
| Rate for Payer: BCBS Trust/PPO |
$17.79
|
| Rate for Payer: BCN Commercial |
$17.79
|
| Rate for Payer: BCN Medicare Advantage |
$5.41
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.41
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.68
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PACE Senior Care Partners |
$5.14
|
| Rate for Payer: PACE SWMI |
$5.41
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$5.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.83
|
| Rate for Payer: Priority Health Medicare |
$5.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.04
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: UHC Exchange |
$5.41
|
| Rate for Payer: UHC Medicaid |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: UHCCP Medicaid |
$3.82
|
| Rate for Payer: VA VA |
$5.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$17.87
|
| Rate for Payer: BCN Commercial |
$17.87
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.04
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
OP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: Aetna Medicare |
$3.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.98
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$3.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.47
|
| Rate for Payer: BCN Commercial |
$10.47
|
| Rate for Payer: BCN Medicare Advantage |
$3.18
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Mclaren Medicaid |
$2.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.02
|
| Rate for Payer: PACE SWMI |
$3.18
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: PHP Medicare Advantage |
$3.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Medicare |
$3.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: UHC Exchange |
$3.18
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHC Medicare Advantage |
$3.18
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$3.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
IP
|
$12.73
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.51
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC POC UREA NITROGEN
|
Facility
|
IP
|
$16.09
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$14.48 |
| Rate for Payer: Aetna Commercial |
$13.68
|
| Rate for Payer: BCBS Trust/PPO |
$13.29
|
| Rate for Payer: BCN Commercial |
$13.29
|
| Rate for Payer: Cash Price |
$12.87
|
| Rate for Payer: Cofinity Commercial |
$13.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$14.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.68
|
| Rate for Payer: Nomi Health Commercial |
$13.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.07
|
| Rate for Payer: PHP Commercial |
$13.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.16
|
| Rate for Payer: UHC Core |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.07
|
|
|
HC POC UREA NITROGEN
|
Facility
|
OP
|
$16.09
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$14.48 |
| Rate for Payer: Aetna Commercial |
$13.68
|
| Rate for Payer: Aetna Medicare |
$4.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.03
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCBS Trust/PPO |
$13.23
|
| Rate for Payer: BCN Commercial |
$13.23
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$12.87
|
| Rate for Payer: Cofinity Commercial |
$13.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$14.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.07
|
| Rate for Payer: Mclaren Medicaid |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.68
|
| Rate for Payer: Nomi Health Commercial |
$13.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.07
|
| Rate for Payer: PACE Senior Care Partners |
$3.82
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Commercial |
$13.68
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.00
|
| Rate for Payer: Priority Health Medicare |
$4.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.20
|
| Rate for Payer: Railroad Medicare Medicare |
$4.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.16
|
| Rate for Payer: UHC Core |
$13.44
|
| Rate for Payer: UHC Exchange |
$4.02
|
| Rate for Payer: UHC Medicaid |
$2.84
|
| Rate for Payer: UHC Medicare Advantage |
$4.02
|
| Rate for Payer: UHCCP Medicaid |
$2.84
|
| Rate for Payer: VA VA |
$4.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.07
|
|
|
HC POC URINE PREG TEST
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.50
|
| Rate for Payer: BCBS MAPPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$24.42
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$24.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.43
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$5.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.80
|
| Rate for Payer: Meridian Medicaid |
$5.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Senior Care Partners |
$7.06
|
| Rate for Payer: PACE SWMI |
$7.43
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$7.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: UHC Exchange |
$7.43
|
| Rate for Payer: UHC Medicaid |
$5.24
|
| Rate for Payer: UHC Medicare Advantage |
$7.43
|
| Rate for Payer: UHCCP Medicaid |
$5.24
|
| Rate for Payer: VA VA |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC POC URINE PREG TEST
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC POC WET PREP
|
Facility
|
IP
|
$52.34
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.43 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$43.23
|
| Rate for Payer: BCN Commercial |
$43.23
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC POC WET PREP
|
Facility
|
OP
|
$52.34
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$47.11 |
| Rate for Payer: Aetna Commercial |
$44.49
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$9.69
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.03
|
| Rate for Payer: BCN Commercial |
$43.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$45.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$47.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.26
|
| Rate for Payer: Mclaren Medicaid |
$9.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$9.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.49
|
| Rate for Payer: Nomi Health Commercial |
$42.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.26
|
| Rate for Payer: PACE Senior Care Partners |
$12.43
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$44.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.54
|
| Rate for Payer: Priority Health Medicare |
$13.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.43
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.06
|
| Rate for Payer: UHC Core |
$43.70
|
| Rate for Payer: UHC Exchange |
$13.09
|
| Rate for Payer: UHC Medicaid |
$9.23
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$9.23
|
| Rate for Payer: VA VA |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.26
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
IP
|
$279.65
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$194.64 |
| Max. Negotiated Rate |
$251.69 |
| Rate for Payer: Aetna Commercial |
$237.70
|
| Rate for Payer: BCBS Trust/PPO |
$230.96
|
| Rate for Payer: BCN Commercial |
$230.96
|
| Rate for Payer: Cash Price |
$223.72
|
| Rate for Payer: Cofinity Commercial |
$240.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.72
|
| Rate for Payer: Healthscope Commercial |
$251.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.70
|
| Rate for Payer: Nomi Health Commercial |
$229.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.74
|
| Rate for Payer: PHP Commercial |
$237.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$243.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.09
|
| Rate for Payer: UHC Core |
$233.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.74
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
OP
|
$279.65
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.30 |
| Max. Negotiated Rate |
$251.69 |
| Rate for Payer: Aetna Commercial |
$237.70
|
| Rate for Payer: Aetna Medicare |
$72.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.39
|
| Rate for Payer: BCBS Complete |
$51.76
|
| Rate for Payer: BCBS MAPPO |
$69.91
|
| Rate for Payer: BCBS Trust/PPO |
$229.90
|
| Rate for Payer: BCN Commercial |
$229.90
|
| Rate for Payer: BCN Medicare Advantage |
$69.91
|
| Rate for Payer: Cash Price |
$223.72
|
| Rate for Payer: Cofinity Commercial |
$240.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$251.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.74
|
| Rate for Payer: Mclaren Medicaid |
$49.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.41
|
| Rate for Payer: Meridian Medicaid |
$51.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.70
|
| Rate for Payer: Nomi Health Commercial |
$229.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.74
|
| Rate for Payer: PACE Senior Care Partners |
$66.42
|
| Rate for Payer: PACE SWMI |
$69.91
|
| Rate for Payer: PHP Commercial |
$237.70
|
| Rate for Payer: PHP Medicare Advantage |
$69.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$243.30
|
| Rate for Payer: Priority Health Medicare |
$70.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.64
|
| Rate for Payer: Railroad Medicare Medicare |
$69.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.09
|
| Rate for Payer: UHC Core |
$233.51
|
| Rate for Payer: UHC Exchange |
$69.91
|
| Rate for Payer: UHC Medicaid |
$49.30
|
| Rate for Payer: UHC Medicare Advantage |
$69.91
|
| Rate for Payer: UHCCP Medicaid |
$49.30
|
| Rate for Payer: VA VA |
$69.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.74
|
|
|
HC POLIOVIRUS VACCINE, INACTIVATED (IPV) SUBQ/IM
|
Facility
|
OP
|
$44.36
|
|
|
Service Code
|
CPT 90713
|
| Hospital Charge Code |
63600082
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$39.92 |
| Rate for Payer: Aetna Commercial |
$37.71
|
| Rate for Payer: Aetna Medicare |
$11.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.86
|
| Rate for Payer: BCBS Complete |
$8.21
|
| Rate for Payer: BCBS MAPPO |
$11.09
|
| Rate for Payer: BCBS Trust/PPO |
$36.47
|
| Rate for Payer: BCN Commercial |
$36.47
|
| Rate for Payer: BCN Medicare Advantage |
$11.09
|
| Rate for Payer: Cash Price |
$35.49
|
| Rate for Payer: Cofinity Commercial |
$38.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.09
|
| Rate for Payer: Healthscope Commercial |
$39.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.27
|
| Rate for Payer: Mclaren Medicaid |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.64
|
| Rate for Payer: Meridian Medicaid |
$8.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.71
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.27
|
| Rate for Payer: PACE Senior Care Partners |
$10.54
|
| Rate for Payer: PACE SWMI |
$11.09
|
| Rate for Payer: PHP Commercial |
$37.71
|
| Rate for Payer: PHP Medicare Advantage |
$11.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.59
|
| Rate for Payer: Priority Health Medicare |
$11.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.87
|
| Rate for Payer: Railroad Medicare Medicare |
$11.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.04
|
| Rate for Payer: UHC Core |
$37.04
|
| Rate for Payer: UHC Exchange |
$11.09
|
| Rate for Payer: UHC Medicaid |
$7.82
|
| Rate for Payer: UHC Medicare Advantage |
$11.09
|
| Rate for Payer: UHCCP Medicaid |
$7.82
|
| Rate for Payer: VA VA |
$11.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.27
|
|
