|
HC VITAMIN B6 LEVEL
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$21.77
|
| Rate for Payer: BCBS MAPPO |
$14.02
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$14.02
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$20.74
|
| Rate for Payer: Meridian Medicaid |
$21.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PACE Senior Care Partners |
$13.32
|
| Rate for Payer: PACE SWMI |
$14.02
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.81
|
| Rate for Payer: Priority Health Medicare |
$14.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.02
|
| Rate for Payer: UHC Medicare Advantage |
$14.45
|
| Rate for Payer: VA VA |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.64 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.23
|
| Rate for Payer: BCN Commercial |
$50.23
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.30 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$16.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.31
|
| Rate for Payer: BCBS Complete |
$7.66
|
| Rate for Payer: BCBS MAPPO |
$16.25
|
| Rate for Payer: BCBS Trust/PPO |
$50.54
|
| Rate for Payer: BCN Commercial |
$50.54
|
| Rate for Payer: BCN Medicare Advantage |
$16.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.25
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$7.30
|
| Rate for Payer: Meridian Medicaid |
$7.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Senior Care Partners |
$15.44
|
| Rate for Payer: PACE SWMI |
$16.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$16.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
| Rate for Payer: UHC Core |
$54.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.25
|
| Rate for Payer: UHC Medicare Advantage |
$16.74
|
| Rate for Payer: VA VA |
$16.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$22.94
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$21.84
|
| Rate for Payer: Meridian Medicaid |
$22.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$29.83
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$71.37
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$28.41
|
| Rate for Payer: Meridian Medicaid |
$29.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$22.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.99 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$70.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$22.94
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$21.84
|
| Rate for Payer: Meridian Medicaid |
$22.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$10.99
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$10.46
|
| Rate for Payer: Meridian Medicaid |
$10.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$102.00
|
| Rate for Payer: Aetna Medicare |
$31.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.50
|
| Rate for Payer: BCBS Complete |
$10.63
|
| Rate for Payer: BCBS MAPPO |
$30.00
|
| Rate for Payer: BCBS Trust/PPO |
$93.30
|
| Rate for Payer: BCN Commercial |
$93.30
|
| Rate for Payer: BCN Medicare Advantage |
$30.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.00
|
| Rate for Payer: Healthscope Commercial |
$108.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.00
|
| Rate for Payer: Mclaren Medicaid |
$10.13
|
| Rate for Payer: Meridian Medicaid |
$10.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.00
|
| Rate for Payer: PACE Senior Care Partners |
$28.50
|
| Rate for Payer: PACE SWMI |
$30.00
|
| Rate for Payer: PHP Commercial |
$102.00
|
| Rate for Payer: PHP Medicare Advantage |
$30.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.40
|
| Rate for Payer: Priority Health Medicare |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.19
|
| Rate for Payer: Railroad Medicare Medicare |
$30.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.60
|
| Rate for Payer: UHC Core |
$100.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.00
|
| Rate for Payer: UHC Medicare Advantage |
$30.90
|
| Rate for Payer: VA VA |
$30.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.00
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.19 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Aetna Commercial |
$102.00
|
| Rate for Payer: BCBS Trust/PPO |
$92.74
|
| Rate for Payer: BCN Commercial |
$92.74
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.00
|
| Rate for Payer: Healthscope Commercial |
$108.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.00
|
| Rate for Payer: PHP Commercial |
$102.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.60
|
| Rate for Payer: UHC Core |
$100.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.00
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna Commercial |
$74.80
|
| Rate for Payer: Aetna Medicare |
$22.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.50
|
| Rate for Payer: BCBS Complete |
$12.01
|
| Rate for Payer: BCBS MAPPO |
$22.00
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$68.42
|
| Rate for Payer: BCN Medicare Advantage |
$22.00
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.00
|
| Rate for Payer: Healthscope Commercial |
$79.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.00
|
| Rate for Payer: Mclaren Medicaid |
$11.44
|
| Rate for Payer: Meridian Medicaid |
$12.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PACE Senior Care Partners |
$20.90
|
| Rate for Payer: PACE SWMI |
$22.00
|
| Rate for Payer: PHP Commercial |
$74.80
|
| Rate for Payer: PHP Medicare Advantage |
$22.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.56
|
| Rate for Payer: Priority Health Medicare |
$22.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: Railroad Medicare Medicare |
$22.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$73.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.00
|
| Rate for Payer: UHC Medicare Advantage |
$22.66
|
| Rate for Payer: VA VA |
$22.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.00
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.67 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna Commercial |
$74.80
|
| Rate for Payer: BCBS Trust/PPO |
$68.01
|
| Rate for Payer: BCN Commercial |
$68.01
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$79.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PHP Commercial |
$74.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$73.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.00
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.87 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$12.01
|
| Rate for Payer: BCBS MAPPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$36.54
|
| Rate for Payer: BCN Commercial |
$36.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.75
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.75
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Mclaren Medicaid |
$11.44
|
| Rate for Payer: Meridian Medicaid |
$12.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.16
|
| Rate for Payer: PACE SWMI |
$11.75
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Medicare |
$11.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.10
|
| Rate for Payer: VA VA |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: BCBS Trust/PPO |
$36.32
|
| Rate for Payer: BCN Commercial |
$36.32
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC VMA URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: Aetna Medicare |
$12.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$12.01
|
| Rate for Payer: BCBS MAPPO |
$11.75
|
| Rate for Payer: BCBS Trust/PPO |
$36.54
|
| Rate for Payer: BCN Commercial |
$36.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.75
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.75
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Mclaren Medicaid |
$11.44
|
| Rate for Payer: Meridian Medicaid |
$12.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.16
|
| Rate for Payer: PACE SWMI |
$11.75
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Medicare |
$11.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.10
|
| Rate for Payer: VA VA |
$11.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.67 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Aetna Commercial |
$39.95
|
| Rate for Payer: BCBS Trust/PPO |
$36.32
|
| Rate for Payer: BCN Commercial |
$36.32
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$40.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.60
|
| Rate for Payer: Healthscope Commercial |
$42.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.95
|
| Rate for Payer: PHP Commercial |
$39.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.36
|
| Rate for Payer: UHC Core |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.25
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,014.75 |
| Max. Negotiated Rate |
$3,845.36 |
| Rate for Payer: Aetna Commercial |
$3,631.73
|
| Rate for Payer: Aetna Medicare |
$1,110.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,335.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,335.19
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,068.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,321.96
|
| Rate for Payer: BCN Commercial |
$3,321.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,068.16
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$3,674.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,418.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,068.16
|
| Rate for Payer: Healthscope Commercial |
$3,845.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,204.46
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,121.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,228.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,631.73
|
| Rate for Payer: PACE Senior Care Partners |
$1,014.75
|
| Rate for Payer: PACE SWMI |
$1,068.16
|
| Rate for Payer: PHP Commercial |
$3,631.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,068.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,717.18
|
| Rate for Payer: Priority Health Medicare |
$1,068.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,605.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,068.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,759.91
|
| Rate for Payer: UHC Core |
$3,567.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,068.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,100.20
|
| Rate for Payer: VA VA |
$1,068.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,204.46
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$4,272.62
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,605.87 |
| Max. Negotiated Rate |
$3,845.36 |
| Rate for Payer: Aetna Commercial |
$3,631.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.88
|
| Rate for Payer: BCN Commercial |
$3,301.88
|
| Rate for Payer: Cash Price |
$3,418.10
|
| Rate for Payer: Cofinity Commercial |
$3,674.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,418.10
|
| Rate for Payer: Healthscope Commercial |
$3,845.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,204.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,631.73
|
| Rate for Payer: PHP Commercial |
$3,631.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,990.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,717.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,605.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,759.91
|
| Rate for Payer: UHC Core |
$3,567.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,204.46
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,497.93 |
| Max. Negotiated Rate |
$2,210.42 |
| Rate for Payer: Aetna Commercial |
$2,087.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.01
|
| Rate for Payer: BCN Commercial |
$1,898.01
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$2,112.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,964.82
|
| Rate for Payer: Healthscope Commercial |
$2,210.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,842.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: PHP Commercial |
$2,087.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,497.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,161.30
|
| Rate for Payer: UHC Core |
$2,050.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,842.02
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,456.02
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$583.30 |
| Max. Negotiated Rate |
$2,210.42 |
| Rate for Payer: Aetna Commercial |
$2,087.62
|
| Rate for Payer: Aetna Medicare |
$638.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$767.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$767.51
|
| Rate for Payer: BCBS Complete |
$982.41
|
| Rate for Payer: BCBS MAPPO |
$614.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,909.56
|
| Rate for Payer: BCN Commercial |
$1,909.56
|
| Rate for Payer: BCN Medicare Advantage |
$614.00
|
| Rate for Payer: Cash Price |
$1,964.82
|
| Rate for Payer: Cofinity Commercial |
$2,112.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,964.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.00
|
| Rate for Payer: Healthscope Commercial |
$2,210.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,842.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$644.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,087.62
|
| Rate for Payer: PACE Senior Care Partners |
$583.30
|
| Rate for Payer: PACE SWMI |
$614.00
|
| Rate for Payer: PHP Commercial |
$2,087.62
|
| Rate for Payer: PHP Medicare Advantage |
$614.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,719.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,136.74
|
| Rate for Payer: Priority Health Medicare |
$614.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,497.93
|
| Rate for Payer: Railroad Medicare Medicare |
$614.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,161.30
|
| Rate for Payer: UHC Core |
$2,050.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.00
|
| Rate for Payer: UHC Medicare Advantage |
$632.43
|
| Rate for Payer: VA VA |
$614.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,842.02
|
|
