|
HC POC LEAD
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100765
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.03
|
| Rate for Payer: BCBS Complete |
$9.19
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$36.90
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$8.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: Meridian Medicaid |
$9.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Exchange |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.22
|
| Rate for Payer: UHCCP Medicaid |
$8.76
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC POC MONO SCREENING MONOSPOT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC POC MONO SCREENING MONOSPOT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC POC PH BODY FLUID
|
Facility
|
IP
|
$25.17
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100760
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: BCBS Trust/PPO |
$20.55
|
| Rate for Payer: BCN Commercial |
$19.45
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.36
|
| Rate for Payer: Priority Health HMO/PPO |
$21.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.15
|
| Rate for Payer: UHC Core |
$21.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC POC PH BODY FLUID
|
Facility
|
OP
|
$25.17
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100760
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna Medicare |
$6.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.87
|
| Rate for Payer: BCBS Complete |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$6.29
|
| Rate for Payer: BCBS Trust/PPO |
$20.69
|
| Rate for Payer: BCN Commercial |
$19.57
|
| Rate for Payer: BCN Medicare Advantage |
$6.29
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.29
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Mclaren Medicaid |
$2.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.61
|
| Rate for Payer: Meridian Medicaid |
$2.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$20.64
|
| Rate for Payer: PACE Senior Care Partners |
$5.98
|
| Rate for Payer: PACE SWMI |
$6.29
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: PHP Medicare Advantage |
$6.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.36
|
| Rate for Payer: Priority Health HMO/PPO |
$21.90
|
| Rate for Payer: Priority Health Medicare |
$6.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.86
|
| Rate for Payer: Railroad Medicare Medicare |
$6.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.15
|
| Rate for Payer: UHC Core |
$21.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.29
|
| Rate for Payer: UHC Exchange |
$6.29
|
| Rate for Payer: UHC Medicare Advantage |
$6.29
|
| Rate for Payer: UHCCP Medicaid |
$2.59
|
| Rate for Payer: VA VA |
$6.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC POC POTASSIUM
|
Facility
|
IP
|
$32.23
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$29.01 |
| Rate for Payer: Aetna Commercial |
$27.40
|
| Rate for Payer: BCBS Trust/PPO |
$26.31
|
| Rate for Payer: BCN Commercial |
$24.91
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cofinity Commercial |
$27.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.78
|
| Rate for Payer: Healthscope Commercial |
$29.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.40
|
| Rate for Payer: Nomi Health Commercial |
$26.43
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.95
|
| Rate for Payer: Priority Health HMO/PPO |
$28.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.36
|
| Rate for Payer: UHC Core |
$26.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.17
|
|
|
HC POC POTASSIUM
|
Facility
|
OP
|
$32.23
|
|
|
Service Code
|
CPT 84132
|
| Hospital Charge Code |
30100501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$29.01 |
| Rate for Payer: Aetna Commercial |
$27.40
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.07
|
| Rate for Payer: BCBS Complete |
$3.61
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.50
|
| Rate for Payer: BCN Commercial |
$25.06
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cash Price |
$25.78
|
| Rate for Payer: Cofinity Commercial |
$27.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.17
|
| Rate for Payer: Mclaren Medicaid |
$3.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.46
|
| Rate for Payer: Meridian Medicaid |
$3.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.40
|
| Rate for Payer: Nomi Health Commercial |
$26.43
|
| Rate for Payer: PACE Senior Care Partners |
$7.65
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.40
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.95
|
| Rate for Payer: Priority Health HMO/PPO |
$28.04
|
| Rate for Payer: Priority Health Medicare |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.59
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.36
|
| Rate for Payer: UHC Core |
$26.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.06
|
| Rate for Payer: UHC Exchange |
$8.06
|
| Rate for Payer: UHC Medicare Advantage |
$8.06
|
| Rate for Payer: UHCCP Medicaid |
$3.44
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.17
|
|
|
HC POC PROTHROMBIN TIME
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500110
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$3.26
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$40.25
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: Meridian Medicaid |
$3.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Exchange |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.24
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC POC PROTHROMBIN TIME
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500110
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$39.97
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC POC SODIUM
|
Facility
|
IP
|
$32.87
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna Commercial |
$27.94
|
| Rate for Payer: BCBS Trust/PPO |
$26.83
|
| Rate for Payer: BCN Commercial |
$25.40
|
| 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: PHP Commercial |
$27.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.37
|
| Rate for Payer: Priority Health HMO/PPO |
$28.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.02
|
| 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 SODIUM
|
Facility
|
OP
|
$32.87
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.48 |
| 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 |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.02
|
| Rate for Payer: BCN Commercial |
$25.56
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.30
|
| 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 |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.63
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.94
|
| Rate for Payer: Nomi Health Commercial |
$26.95
|
| 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 |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.37
|
| Rate for Payer: Priority Health HMO/PPO |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$8.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.02
|
| 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 Dual Complete DSNP |
$8.22
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$3.48
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.65
|
|
|
HC POC TOTAL CO2
|
Facility
|
OP
|
$18.18
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: Aetna Medicare |
$4.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.68
|
| Rate for Payer: BCBS Complete |
$3.70
|
| Rate for Payer: BCBS MAPPO |
$4.54
|
| Rate for Payer: BCBS Trust/PPO |
$14.95
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.63
|
| Rate for Payer: Mclaren Medicaid |
$3.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$3.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.45
|
| Rate for Payer: Nomi Health Commercial |
$14.91
|
| Rate for Payer: PACE Senior Care Partners |
$4.32
|
| Rate for Payer: PACE SWMI |
$4.54
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.82
|
| Rate for Payer: Priority Health HMO/PPO |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$4.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.18
|
| Rate for Payer: Railroad Medicare Medicare |
$4.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.54
|
| Rate for Payer: UHC Exchange |
$4.54
|
| Rate for Payer: UHC Medicare Advantage |
$4.54
|
| Rate for Payer: UHCCP Medicaid |
$3.53
|
| Rate for Payer: VA VA |
$4.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.63
|
|
|
HC POC TOTAL CO2
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100699
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$16.36 |
| Rate for Payer: Aetna Commercial |
$15.45
|
| Rate for Payer: BCBS Trust/PPO |
$14.84
|
| Rate for Payer: BCN Commercial |
$14.05
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$15.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$16.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.45
|
| Rate for Payer: Nomi Health Commercial |
$14.91
|
| Rate for Payer: PHP Commercial |
$15.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.82
|
| Rate for Payer: Priority Health HMO/PPO |
$15.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.00
|
| Rate for Payer: UHC Core |
$15.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.63
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$1.71
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.44
|
| Rate for Payer: BCN Commercial |
$16.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.91
|
| Rate for Payer: Mclaren Medicaid |
$1.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$1.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$17.40
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health HMO/PPO |
$18.46
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.22
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Exchange |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.30
|
| Rate for Payer: UHCCP Medicaid |
$1.63
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.91
|
|
|
HC POC UA DIPSTICK, AUTO
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700014
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$13.79 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$17.32
|
| Rate for Payer: BCN Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$17.40
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health HMO/PPO |
$18.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.91
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$3.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.90
|
| Rate for Payer: BCBS Complete |
$2.64
|
| Rate for Payer: BCBS MAPPO |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$10.26
|
| Rate for Payer: BCN Commercial |
$9.70
|
| Rate for Payer: BCN Medicare Advantage |
$3.12
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.12
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Mclaren Medicaid |
$2.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.28
|
| Rate for Payer: Meridian Medicaid |
$2.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: PACE Senior Care Partners |
$2.96
|
| Rate for Payer: PACE SWMI |
$3.12
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: PHP Medicare Advantage |
$3.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: Priority Health HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Medicare |
$3.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.12
|
| Rate for Payer: UHC Exchange |
$3.12
|
| Rate for Payer: UHC Medicare Advantage |
$3.12
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC POC UA DIPSTICK, MANUAL
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700013
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$10.19
|
| Rate for Payer: BCN Commercial |
$9.64
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: Priority Health HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC POC UREA NITROGEN
|
Facility
|
OP
|
$15.77
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$14.19 |
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: Aetna Medicare |
$4.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.93
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$3.94
|
| Rate for Payer: BCBS Trust/PPO |
$12.96
|
| Rate for Payer: BCN Commercial |
$12.26
|
| Rate for Payer: BCN Medicare Advantage |
$3.94
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.94
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.14
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: PACE Senior Care Partners |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.94
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.25
|
| Rate for Payer: Priority Health HMO/PPO |
$13.72
|
| Rate for Payer: Priority Health Medicare |
$3.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.88
|
| Rate for Payer: UHC Core |
$13.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.94
|
| Rate for Payer: UHC Exchange |
$3.94
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: UHCCP Medicaid |
$2.86
|
| Rate for Payer: VA VA |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
|
|
HC POC UREA NITROGEN
|
Facility
|
IP
|
$15.77
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100698
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$14.19 |
| Rate for Payer: Aetna Commercial |
$13.40
|
| Rate for Payer: BCBS Trust/PPO |
$12.87
|
| Rate for Payer: BCN Commercial |
$12.19
|
| Rate for Payer: Cash Price |
$12.62
|
| Rate for Payer: Cofinity Commercial |
$13.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.62
|
| Rate for Payer: Healthscope Commercial |
$14.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.40
|
| Rate for Payer: Nomi Health Commercial |
$12.93
|
| Rate for Payer: PHP Commercial |
$13.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.25
|
| Rate for Payer: Priority Health HMO/PPO |
$13.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.88
|
| Rate for Payer: UHC Core |
$13.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.83
|
|
|
HC POC URINE PREG TEST
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$7.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.10
|
| Rate for Payer: BCBS Complete |
$6.54
|
| Rate for Payer: BCBS MAPPO |
$7.28
|
| Rate for Payer: BCBS Trust/PPO |
$23.95
|
| Rate for Payer: BCN Commercial |
$22.65
|
| Rate for Payer: BCN Medicare Advantage |
$7.28
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.28
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Mclaren Medicaid |
$6.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.65
|
| Rate for Payer: Meridian Medicaid |
$6.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PACE Senior Care Partners |
$6.92
|
| Rate for Payer: PACE SWMI |
$7.28
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO |
$25.34
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: Railroad Medicare Medicare |
$7.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.63
|
| Rate for Payer: UHC Core |
$24.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.28
|
| Rate for Payer: UHC Exchange |
$7.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.28
|
| Rate for Payer: UHCCP Medicaid |
$6.23
|
| Rate for Payer: VA VA |
$7.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC POC URINE PREG TEST
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.93 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: BCBS Trust/PPO |
$23.78
|
| Rate for Payer: BCN Commercial |
$22.51
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: Nomi Health Commercial |
$23.89
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health HMO/PPO |
$25.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.63
|
| Rate for Payer: UHC Core |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC POC WET PREP
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$13.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.03
|
| Rate for Payer: BCBS Complete |
$4.42
|
| Rate for Payer: BCBS MAPPO |
$12.83
|
| Rate for Payer: BCBS Trust/PPO |
$42.18
|
| Rate for Payer: BCN Commercial |
$39.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.83
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.83
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$4.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.47
|
| Rate for Payer: Meridian Medicaid |
$4.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PACE Senior Care Partners |
$12.19
|
| Rate for Payer: PACE SWMI |
$12.83
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Medicare |
$12.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: Railroad Medicare Medicare |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.83
|
| Rate for Payer: UHC Exchange |
$12.83
|
| Rate for Payer: UHC Medicare Advantage |
$12.83
|
| Rate for Payer: UHCCP Medicaid |
$4.21
|
| Rate for Payer: VA VA |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC POC WET PREP
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600342
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.35 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
IP
|
$274.17
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$178.21 |
| Max. Negotiated Rate |
$246.75 |
| Rate for Payer: Aetna Commercial |
$233.04
|
| Rate for Payer: BCBS Trust/PPO |
$223.80
|
| Rate for Payer: BCN Commercial |
$211.88
|
| Rate for Payer: Cash Price |
$219.34
|
| Rate for Payer: Cofinity Commercial |
$235.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.34
|
| Rate for Payer: Healthscope Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.04
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: PHP Commercial |
$233.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.21
|
| Rate for Payer: Priority Health HMO/PPO |
$238.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.27
|
| Rate for Payer: UHC Core |
$228.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.63
|
|
|
HC POLARCATH N.O. CARTRIDGE
|
Facility
|
OP
|
$274.17
|
|
| Hospital Charge Code |
27200148
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.12 |
| Max. Negotiated Rate |
$246.75 |
| Rate for Payer: Aetna Commercial |
$233.04
|
| Rate for Payer: Aetna Medicare |
$71.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.68
|
| Rate for Payer: BCBS Complete |
$109.67
|
| Rate for Payer: BCBS MAPPO |
$68.54
|
| Rate for Payer: BCBS Trust/PPO |
$225.40
|
| Rate for Payer: BCN Commercial |
$213.17
|
| Rate for Payer: BCN Medicare Advantage |
$68.54
|
| Rate for Payer: Cash Price |
$219.34
|
| Rate for Payer: Cofinity Commercial |
$235.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.54
|
| Rate for Payer: Healthscope Commercial |
$246.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.04
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: PACE Senior Care Partners |
$65.12
|
| Rate for Payer: PACE SWMI |
$68.54
|
| Rate for Payer: PHP Commercial |
$233.04
|
| Rate for Payer: PHP Medicare Advantage |
$68.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.21
|
| Rate for Payer: Priority Health HMO/PPO |
$238.53
|
| Rate for Payer: Priority Health Medicare |
$69.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.69
|
| Rate for Payer: Railroad Medicare Medicare |
$68.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.27
|
| Rate for Payer: UHC Core |
$228.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.54
|
| Rate for Payer: UHC Exchange |
$68.54
|
| Rate for Payer: UHC Medicare Advantage |
$68.54
|
| Rate for Payer: VA VA |
$68.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.63
|
|
