|
HC PROPOXYPHENE URINE CMPT
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC PROPOXYPHENE URINE CMPT
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.28
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.05
|
| Rate for Payer: BCN Commercial |
$27.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.64
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicaid |
$5.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
OP
|
$304.84
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.74 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$79.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.26
|
| Rate for Payer: BCBS Complete |
$56.43
|
| Rate for Payer: BCBS MAPPO |
$76.21
|
| Rate for Payer: BCBS Trust/PPO |
$250.61
|
| Rate for Payer: BCN Commercial |
$250.61
|
| Rate for Payer: BCN Medicare Advantage |
$76.21
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.21
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Mclaren Medicaid |
$53.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.02
|
| Rate for Payer: Meridian Medicaid |
$56.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PACE Senior Care Partners |
$72.40
|
| Rate for Payer: PACE SWMI |
$76.21
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: PHP Medicare Advantage |
$76.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Medicare |
$76.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.17
|
| Rate for Payer: Railroad Medicare Medicare |
$76.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: UHC Exchange |
$76.21
|
| Rate for Payer: UHC Medicaid |
$53.74
|
| Rate for Payer: UHC Medicare Advantage |
$76.21
|
| Rate for Payer: UHCCP Medicaid |
$53.74
|
| Rate for Payer: VA VA |
$76.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC PRO PREDICT 6 MP COMPONENT.
|
Facility
|
IP
|
$304.84
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100629
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$212.17 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: BCBS Trust/PPO |
$251.77
|
| Rate for Payer: BCN Commercial |
$251.77
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$249.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.26
|
| Rate for Payer: UHC Core |
$254.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
IP
|
$120.69
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: BCBS Trust/PPO |
$99.68
|
| Rate for Payer: BCN Commercial |
$99.68
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.21
|
| Rate for Payer: UHC Core |
$100.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PROSTHETIC TRNG INITIAL EACH 15 MIN
|
Facility
|
OP
|
$120.69
|
|
|
Service Code
|
CPT 97761
|
| Hospital Charge Code |
42000040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$108.62 |
| Rate for Payer: Aetna Commercial |
$102.59
|
| Rate for Payer: Aetna Medicare |
$31.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.72
|
| Rate for Payer: BCBS Complete |
$22.34
|
| Rate for Payer: BCBS MAPPO |
$30.17
|
| Rate for Payer: BCBS Trust/PPO |
$99.22
|
| Rate for Payer: BCN Commercial |
$99.22
|
| Rate for Payer: BCN Medicare Advantage |
$30.17
|
| Rate for Payer: Cash Price |
$96.55
|
| Rate for Payer: Cofinity Commercial |
$103.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.17
|
| Rate for Payer: Healthscope Commercial |
$108.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.52
|
| Rate for Payer: Mclaren Medicaid |
$21.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.68
|
| Rate for Payer: Meridian Medicaid |
$22.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.59
|
| Rate for Payer: Nomi Health Commercial |
$98.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.52
|
| Rate for Payer: PACE Senior Care Partners |
$28.66
|
| Rate for Payer: PACE SWMI |
$30.17
|
| Rate for Payer: PHP Commercial |
$102.59
|
| Rate for Payer: PHP Medicare Advantage |
$30.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.00
|
| Rate for Payer: Priority Health Medicare |
$30.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: Railroad Medicare Medicare |
$30.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.21
|
| Rate for Payer: UHC Core |
$100.78
|
| Rate for Payer: UHC Exchange |
$30.17
|
| Rate for Payer: UHC Medicaid |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$30.17
|
| Rate for Payer: UHCCP Medicaid |
$21.28
|
| Rate for Payer: VA VA |
$30.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.52
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: BCBS Trust/PPO |
$25.41
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.08
|
| Rate for Payer: UHC Core |
$25.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC PROTEINASE 3 AB (HC ANCA VASCULITIS PANEL CMPT)
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100173
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.62
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS MAPPO |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$25.30
|
| Rate for Payer: BCN Medicare Advantage |
$7.69
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.69
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Mclaren Medicaid |
$5.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.08
|
| Rate for Payer: Meridian Medicaid |
$5.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Senior Care Partners |
$7.31
|
| Rate for Payer: PACE SWMI |
$7.69
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.77
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.08
|
| Rate for Payer: UHC Core |
$25.69
|
| Rate for Payer: UHC Exchange |
$7.69
|
| Rate for Payer: UHC Medicaid |
$5.42
|
| Rate for Payer: UHC Medicare Advantage |
$7.69
|
| Rate for Payer: UHCCP Medicaid |
$5.42
|
| Rate for Payer: VA VA |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
IP
|
$64.73
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.05 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$53.46
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$53.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.96
|
| Rate for Payer: UHC Core |
$54.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.55
|
|
|
HC PROTEIN C ACTIVITY
|
Facility
|
OP
|
$64.73
|
|
|
Service Code
|
CPT 85303
|
| Hospital Charge Code |
30500038
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: Aetna Medicare |
$16.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.23
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS MAPPO |
$16.18
|
| Rate for Payer: BCBS Trust/PPO |
$53.21
|
| Rate for Payer: BCN Commercial |
$53.21
|
| Rate for Payer: BCN Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.18
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.55
|
| Rate for Payer: Mclaren Medicaid |
$11.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.99
|
| Rate for Payer: Meridian Medicaid |
$11.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$53.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PACE Senior Care Partners |
$15.37
|
| Rate for Payer: PACE SWMI |
$16.18
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: PHP Medicare Advantage |
$16.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.32
|
| Rate for Payer: Priority Health Medicare |
$16.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.05
|
| Rate for Payer: Railroad Medicare Medicare |
$16.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.96
|
| Rate for Payer: UHC Core |
$54.05
|
| Rate for Payer: UHC Exchange |
$16.18
|
| Rate for Payer: UHC Medicaid |
$11.41
|
| Rate for Payer: UHC Medicare Advantage |
$16.18
|
| Rate for Payer: UHCCP Medicaid |
$11.41
|
| Rate for Payer: VA VA |
$16.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.55
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.88
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$47.04
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Mclaren Medicaid |
$10.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: Meridian Medicaid |
$10.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Senior Care Partners |
$13.59
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Medicare |
$14.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.83
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicaid |
$10.09
|
| Rate for Payer: UHC Medicare Advantage |
$14.30
|
| Rate for Payer: UHCCP Medicaid |
$10.09
|
| Rate for Payer: VA VA |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PROTEIN C ANTIGEN
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 85302
|
| Hospital Charge Code |
30500037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$47.26
|
| Rate for Payer: BCN Commercial |
$47.26
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC PROTEIN ELECTROPHORESIS SERUM
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84165
|
| Hospital Charge Code |
30100410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
IP
|
$107.78
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.01 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: BCBS Trust/PPO |
$89.02
|
| Rate for Payer: BCN Commercial |
$89.02
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Nomi Health Commercial |
$88.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.85
|
| Rate for Payer: UHC Core |
$90.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC PROTEIN ELECTROPHORESIS URINE
|
Facility
|
OP
|
$107.78
|
|
|
Service Code
|
CPT 84166
|
| Hospital Charge Code |
30100411
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna Medicare |
$28.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.68
|
| Rate for Payer: BCBS Complete |
$19.95
|
| Rate for Payer: BCBS MAPPO |
$26.95
|
| Rate for Payer: BCBS Trust/PPO |
$88.61
|
| Rate for Payer: BCN Commercial |
$88.61
|
| Rate for Payer: BCN Medicare Advantage |
$26.95
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.95
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: Mclaren Medicaid |
$19.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.29
|
| Rate for Payer: Meridian Medicaid |
$19.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Nomi Health Commercial |
$88.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PACE Senior Care Partners |
$25.60
|
| Rate for Payer: PACE SWMI |
$26.95
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: PHP Medicare Advantage |
$26.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.77
|
| Rate for Payer: Priority Health Medicare |
$27.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.01
|
| Rate for Payer: Railroad Medicare Medicare |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.85
|
| Rate for Payer: UHC Core |
$90.00
|
| Rate for Payer: UHC Exchange |
$26.95
|
| Rate for Payer: UHC Medicaid |
$19.00
|
| Rate for Payer: UHC Medicare Advantage |
$26.95
|
| Rate for Payer: UHCCP Medicaid |
$19.00
|
| Rate for Payer: VA VA |
$26.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$52.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Exchange |
$15.87
|
| Rate for Payer: UHC Medicaid |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC PROTEIN S ACTIVITY
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500039
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.59 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Medicare |
$22.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.63
|
| Rate for Payer: BCBS Complete |
$16.37
|
| Rate for Payer: BCBS MAPPO |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$72.70
|
| Rate for Payer: BCN Commercial |
$72.70
|
| Rate for Payer: BCN Medicare Advantage |
$22.11
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.11
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Mclaren Medicaid |
$15.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.21
|
| Rate for Payer: Meridian Medicaid |
$16.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PACE Senior Care Partners |
$21.00
|
| Rate for Payer: PACE SWMI |
$22.11
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$22.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.93
|
| Rate for Payer: Priority Health Medicare |
$22.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: Railroad Medicare Medicare |
$22.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.82
|
| Rate for Payer: UHC Core |
$73.84
|
| Rate for Payer: UHC Exchange |
$22.11
|
| Rate for Payer: UHC Medicaid |
$15.59
|
| Rate for Payer: UHC Medicare Advantage |
$22.11
|
| Rate for Payer: UHCCP Medicaid |
$15.59
|
| Rate for Payer: VA VA |
$22.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.55 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: BCBS Trust/PPO |
$73.03
|
| Rate for Payer: BCN Commercial |
$73.03
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.82
|
| Rate for Payer: UHC Core |
$73.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
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 PROTHROMBIN TIME
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
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 PROTIME WITH INR
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| 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: BCN Commercial |
$24.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| 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 PROTIME WITH INR
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| 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 PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
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
|
|
